Does Madison Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Madison Medical Center. In a medical emergency, call 911.

Where is Madison Medical Center?

611 W Main St, Fredericktown, MO 63645, in Madison County, Missouri.

What is the phone number of Madison Medical Center?

(573) 781-3341, as listed by Medicare (CMS).

What is the Medicare star rating of Madison Medical Center?

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

Madison Medical Center — Phone, Address & ER

Quick answers

Does Madison Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Madison Medical Center. In a medical emergency, call 911.
Where is Madison Medical Center?: 611 W Main St, Fredericktown, MO 63645, in Madison County, Missouri.
What is the phone number of Madison Medical Center?: (573) 781-3341, as listed by Medicare (CMS).
What is the Medicare star rating of Madison Medical Center?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[5][6]

Treatments^[5][7]

Physical therapy
Occupational therapy
Speech therapy
Cardiac rehab
Nuclear medicine
Cardiopulmonary services
Registered dietitian services
Laboratory
Respiratory therapy

Procedures^[5][7]

Nuclear medicine
Ultrasound
Mammography
CT scan
MRI
Radiology
Cardiac rehabilitation

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

Skilled Medicare/Swing Bed Program
Physician referral service

Emergency care (hospital website)^[4][5]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Patient portal	https://mycarecorner.net/

Doctors and clinicians (73)

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

Main specialties

And 49 more: the button below opens the full list.

Other emergency rooms nearby

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

Parkland Health Center17 mi · Farmington, MO · Acute Care Hospital
Iron County Medical Center19 mi · Pilot Knob, MO · Critical Access Hospital
Ste Genevieve County Memorial Hospital25 mi · Sainte Genevieve, MO · Critical Access Hospital
Mercy Hospital Perry27 mi · Perryville, MO · Critical Access Hospital
Parkland Health Center - Bonne Terre29 mi · Bonne Terre, MO · Rural Emergency Hospital

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

Other hospitals near Fredericktown

Southeast Missouri Mental Health Center17 mi · Farmington, MO · Psychiatric Hospital

Hospitals in Madison 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

Madison Medical Center0.0 mi · Fredericktown, MO · 5 of 5 stars
Claru Deville Nursing Center1.0 mi · Fredericktown, MO · 3 of 5 stars
St Francois Manor16 mi · Farmington, MO · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Legacy Hospice1.7 mi · Fredericktown, MO · 4 of 5 stars
Heart & Soul Hospice14 mi · Farmington, MO
Preferred Hospice of Missouri14 mi · Farmington, MO · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Americare Home Health Solutions14 mi · Farmington, MO · 2 of 5 stars
Elara Caring14 mi · Farmington, MO · 4.5 of 5 stars
Ste Genevieve Co Memorial Hospital Home Health Agency25 mi · Sainte Genevieve, MO · 3 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Maple Valley Dialysis14 mi · Farmington, MO · 2 of 5 stars
Farmington Dialysis Clinic14 mi · Farmington, MO · 3 of 5 stars

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.

Community health centers

Dayse Baker Learning Center14 mi · Farmington, MO · Community health center
Farmington R-VII Lincoln Intermediate16 mi · Farmington, MO · Community health center
Farmington R-VII Middle School16 mi · Farmington, MO · Community health center

Clinics and urgent care

Beyer Medical Group1.7 mi · Fredericktown, MO · Rural health clinic
Madison Medical Center1.7 mi · Fredericktown, MO · Rural health clinic
Apollo Healthcare, LLC14 mi · Farmington, MO · Rural health clinic

Pharmacies

Harps Food Stores, Inc1.7 mi · Fredericktown, MO · Community/retail pharmacy
Madison Memorial Hospital Stockhoff Memorial Nursing Home1.7 mi · Fredericktown, MO · Pharmacy
Parkland Pharmacy Development LLC1.7 mi · Fredericktown, MO · Community/retail pharmacy

Assisted living nearby

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

Ozark Manor1.7 mi · Fredericktown, MO
Wagner Residential Care, Inc1.7 mi · Fredericktown, MO
Heritage Hills Assisted Living Facility14 mi · Patton, MO
Anna Dodson Home LLC14 mi · Farmington, MO

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

What patients said (patient survey)

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

Rated the hospital 9 or 10 out of 10	61%National average: 72%
Would definitely recommend the hospital	57%National average: 71%
Nurses “always” communicated well	75%National average: 80%
Doctors “always” communicated well	76%National average: 80%
“Always” got help as soon as they wanted	61%National average: 64%
Staff “always” explained medicines before giving them	50%National average: 62%
Were given information about recovery at home	81%National average: 86%
Room and bathroom “always” clean	64%National average: 73%
Not reported to Medicare	Summary star rating (all survey topics); Overall rating of the hospital; Would recommend the hospital; Nurses communicated well; Doctors communicated well; Patients got help quickly from staff; Staff explained medicines; Information about recovery at home; Room and bathroom kept clean; Restfulness of Environment; Care Coordination; Symptoms After Stay
Completed surveys	85Response rate: 28%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 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: pneumonia patients	17.1%
Not reported to Medicare	Deaths within 30 days: heart attack patients; Deaths within 30 days: COPD patients; Deaths within 30 days: stroke patients; Deaths within 30 days: coronary bypass surgery (CABG); Serious complications (patient safety indicator PSI-90); Complications after hip or knee replacement
Too few cases to report	Deaths within 30 days: heart failure patients

Source: Complications and Deaths - Hospital — CMS, released October 20, 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)	15.7%
Readmitted within 30 days: pneumonia	17.3%
Not reported to Medicare	Readmitted within 30 days: heart attack; Readmitted within 30 days: COPD; Readmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement
Too few cases to report	Readmitted within 30 days: heart failure

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)	83 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%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: infections caught in the hospital. 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 Missouri Best hospitals in Missouri

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 65 common services exactly as Madison Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Show the prices of 65 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 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT - NEW PT - INTERMEDIATE	$240	$216	$142.08 – $173.53
New patient office visit (about 30–44 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $142.08 Anthem Blue Cross Blue Shield Missouri — Traditional: $171.36 UnitedHealthcare — Commercial: $160.08 UnitedHealthcare — Medicare Advantage: $173.53
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P (NEW) DETAIL HIST.	$240	$216	$142.08 – $173.53
New patient office visit (about 30–44 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $142.08 Anthem Blue Cross Blue Shield Missouri — Traditional: $171.36 UnitedHealthcare — Commercial: $160.08 UnitedHealthcare — Medicare Advantage: $173.53
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT NEW LEVEL 3	$240	$216	$142.08 – $173.53
New patient office visit (about 30–44 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $142.08 Anthem Blue Cross Blue Shield Missouri — Traditional: $171.36 UnitedHealthcare — Commercial: $160.08 UnitedHealthcare — Medicare Advantage: $173.53
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT - NEW PT - EXTENDED	$385	$346.50	$173.53 – $274.89
New patient office visit (about 45–59 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $227.92 Anthem Blue Cross Blue Shield Missouri — Traditional: $274.89 UnitedHealthcare — Commercial: $256.80 UnitedHealthcare — Medicare Advantage: $173.53
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P (NEW) COMPRE. HIST 45 MIN.	$385	$346.50	$173.53 – $274.89
New patient office visit (about 45–59 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $227.92 Anthem Blue Cross Blue Shield Missouri — Traditional: $274.89 UnitedHealthcare — Commercial: $256.80 UnitedHealthcare — Medicare Advantage: $173.53
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT NEW LEVEL 4	$385	$346.50	$173.53 – $274.89
New patient office visit (about 45–59 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $227.92 Anthem Blue Cross Blue Shield Missouri — Traditional: $274.89 UnitedHealthcare — Commercial: $256.80 UnitedHealthcare — Medicare Advantage: $173.53
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ER CODE BLUE	$937	$843.30	$337.32
New patient office visit (about 60–74 minutes): rates for 4 insurance plans UnitedHealthcare — Medicare Advantage: $337.32 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: 65.9% (a percentage in the contract, not a dollar amount) Anthem Blue Cross Blue Shield Missouri — Traditional: 71.4% (a percentage in the contract, not a dollar amount) UnitedHealthcare — Commercial: 66.7% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT - NEW PT - COMPREHENSIVE	$485	$436.50	$173.53 – $346.29
New patient office visit (about 60–74 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $287.12 Anthem Blue Cross Blue Shield Missouri — Traditional: $346.29 UnitedHealthcare — Commercial: $323.50 UnitedHealthcare — Medicare Advantage: $173.53
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P (NEW) COMPRE. HIST 60 MIN.	$485	$436.50	$173.53 – $346.29
New patient office visit (about 60–74 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $287.12 Anthem Blue Cross Blue Shield Missouri — Traditional: $346.29 UnitedHealthcare — Commercial: $323.50 UnitedHealthcare — Medicare Advantage: $173.53
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT - EST. PT - INTERMEDIATE	$160	$144	$94.72 – $173.53
Established patient office visit (about 20–29 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $94.72 Anthem Blue Cross Blue Shield Missouri — Traditional: $114.24 UnitedHealthcare — Commercial: $106.72 UnitedHealthcare — Medicare Advantage: $173.53
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT EST. PT.- INTER.	$160	$144	$94.72 – $173.53
Established patient office visit (about 20–29 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $94.72 Anthem Blue Cross Blue Shield Missouri — Traditional: $114.24 UnitedHealthcare — Commercial: $106.72 UnitedHealthcare — Medicare Advantage: $173.53
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT EST LEVEL 3	$160	$144	$94.72 – $173.53
Established patient office visit (about 20–29 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $94.72 Anthem Blue Cross Blue Shield Missouri — Traditional: $114.24 UnitedHealthcare — Commercial: $106.72 UnitedHealthcare — Medicare Advantage: $173.53
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT - EST. PT - EXTENDED	$250	$225	$148 – $178.50
Established patient office visit (about 30–39 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $148 Anthem Blue Cross Blue Shield Missouri — Traditional: $178.50 UnitedHealthcare — Commercial: $166.75 UnitedHealthcare — Medicare Advantage: $173.53
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT EST. PT.- EXTEND	$250	$225	$148 – $178.50
Established patient office visit (about 30–39 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $148 Anthem Blue Cross Blue Shield Missouri — Traditional: $178.50 UnitedHealthcare — Commercial: $166.75 UnitedHealthcare — Medicare Advantage: $173.53
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT EST LEVEL 4	$250	$225	$148 – $178.50
Established patient office visit (about 30–39 minutes): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $148 Anthem Blue Cross Blue Shield Missouri — Traditional: $178.50 UnitedHealthcare — Commercial: $166.75 UnitedHealthcare — Medicare Advantage: $173.53
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CONSULTATIONS - INITIAL - EXTENDED	$275	$247.50	$162.80 – $196.35
Office consultation with a specialist (moderate): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $162.80 Anthem Blue Cross Blue Shield Missouri — Traditional: $196.35 UnitedHealthcare — Commercial: $183.43 UnitedHealthcare — Medicare Advantage: $173.53
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONS.(NEW) 40 MIN.	$300	$270	$173.53 – $214.20
Office consultation with a specialist (moderate): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $177.60 Anthem Blue Cross Blue Shield Missouri — Traditional: $214.20 UnitedHealthcare — Commercial: $200.10 UnitedHealthcare — Medicare Advantage: $173.53
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULT LEVEL 3	$300	$270	$173.53 – $214.20
Office consultation with a specialist (moderate): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $177.60 Anthem Blue Cross Blue Shield Missouri — Traditional: $214.20 UnitedHealthcare — Commercial: $200.10 UnitedHealthcare — Medicare Advantage: $173.53
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CONSULTATIONS - INITIAL - COMPREHENSIVE	$375	$337.50	$173.53 – $267.75
Office consultation with a specialist (moderate to high): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $222 Anthem Blue Cross Blue Shield Missouri — Traditional: $267.75 UnitedHealthcare — Commercial: $250.12 UnitedHealthcare — Medicare Advantage: $173.53
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONS.(NEW) 60 MIN.	$410	$369	$173.53 – $292.74
Office consultation with a specialist (moderate to high): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $242.72 Anthem Blue Cross Blue Shield Missouri — Traditional: $292.74 UnitedHealthcare — Commercial: $273.47 UnitedHealthcare — Medicare Advantage: $173.53
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULT LEVEL 4	$400	$360	$173.53 – $285.60
Office consultation with a specialist (moderate to high): rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $236.80 Anthem Blue Cross Blue Shield Missouri — Traditional: $285.60 UnitedHealthcare — Commercial: $266.80 UnitedHealthcare — Medicare Advantage: $173.53
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCY SCREENING NEW PT AGE 18 - 39	$315	$283.50	$173.53 – $224.91
Preventive checkup, new patient, age 18–39: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $186.48 Anthem Blue Cross Blue Shield Missouri — Traditional: $224.91 UnitedHealthcare — Commercial: $210.10 UnitedHealthcare — Medicare Advantage: $173.53
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NP PHYSICAL AGE 18 - 39	$315	$283.50	$173.53 – $224.91
Preventive checkup, new patient, age 18–39: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $186.48 Anthem Blue Cross Blue Shield Missouri — Traditional: $224.91 UnitedHealthcare — Commercial: $210.10 UnitedHealthcare — Medicare Advantage: $173.53
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT NEW PT - 18-39 YRS OLD	$315	$283.50	$173.53 – $224.91
Preventive checkup, new patient, age 18–39: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $186.48 Anthem Blue Cross Blue Shield Missouri — Traditional: $224.91 UnitedHealthcare — Commercial: $210.10 UnitedHealthcare — Medicare Advantage: $173.53
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCY SCREENING NEW PT AGE 40 - 64	$375	$337.50	$173.53 – $267.75
Preventive checkup, new patient, age 40–64: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $222 Anthem Blue Cross Blue Shield Missouri — Traditional: $267.75 UnitedHealthcare — Commercial: $250.12 UnitedHealthcare — Medicare Advantage: $173.53
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NP PHYSICAL AGE 40-64	$375	$337.50	$173.53 – $267.75
Preventive checkup, new patient, age 40–64: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $222 Anthem Blue Cross Blue Shield Missouri — Traditional: $267.75 UnitedHealthcare — Commercial: $250.12 UnitedHealthcare — Medicare Advantage: $173.53
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE VISIT NEW PT - 40-64 YRS OLD	$375	$337.50	$173.53 – $267.75
Preventive checkup, new patient, age 40–64: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $222 Anthem Blue Cross Blue Shield Missouri — Traditional: $267.75 UnitedHealthcare — Commercial: $250.12 UnitedHealthcare — Medicare Advantage: $173.53
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: E/R VISIT-EXPANDED PROB. W/MOD.COMPLX	$141	$126.90	$83.47 – $557.78
Emergency room visit (moderate): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $246.07 Aetna — Medicare Advantage: $278.89 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $83.47 Anthem Blue Cross Blue Shield Missouri — Traditional: $100.67 Cigna — Commercial HMO & PPO: $278.89 Healthy Blue — CHP/Medicaid Managed Care: $221.46 Home State Health Plan — Medicaid Managed Care: $263.29 Home State Health Plan — Medicare Advantage: $278.89 Humana — Commercial: $557.78 Humana — Medicare Advantage: $278.89
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERG VISIT(MOD-COMPLEX)	$110	$99	$65.12 – $557.78
Emergency room visit (moderate): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $246.07 Aetna — Medicare Advantage: $278.89 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $65.12 Anthem Blue Cross Blue Shield Missouri — Traditional: $78.54 Cigna — Commercial HMO & PPO: $278.89 Healthy Blue — CHP/Medicaid Managed Care: $221.46 Home State Health Plan — Medicaid Managed Care: $263.29 Home State Health Plan — Medicare Advantage: $278.89 Humana — Commercial: $557.78 Humana — Medicare Advantage: $278.89
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERG. ROOM VISIT (INTER)	$141	$126.90	$83.47 – $557.78
Emergency room visit (moderate): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $246.07 Aetna — Medicare Advantage: $278.89 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $83.47 Anthem Blue Cross Blue Shield Missouri — Traditional: $100.67 Cigna — Commercial HMO & PPO: $278.89 Healthy Blue — CHP/Medicaid Managed Care: $221.46 Home State Health Plan — Medicaid Managed Care: $263.29 Home State Health Plan — Medicare Advantage: $278.89 Humana — Commercial: $557.78 Humana — Medicare Advantage: $278.89
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: E/R VISIT-DETAIL HIST. MOD COMPLEX	$212	$190.80	$125.50 – $852.60
Emergency room visit (moderately high): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $376.14 Aetna — Medicare Advantage: $426.30 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $125.50 Anthem Blue Cross Blue Shield Missouri — Traditional: $151.37 Cigna — Commercial HMO & PPO: $426.30 Healthy Blue — CHP/Medicaid Managed Care: $338.53 Home State Health Plan — Medicaid Managed Care: $402.47 Home State Health Plan — Medicare Advantage: $426.30 Humana — Commercial: $852.60 Humana — Medicare Advantage: $426.30
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERG. ROOM VISIT (EXTENDED)	$214	$192.60	$126.69 – $852.60
Emergency room visit (moderately high): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $376.14 Aetna — Medicare Advantage: $426.30 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $126.69 Anthem Blue Cross Blue Shield Missouri — Traditional: $152.80 Cigna — Commercial HMO & PPO: $426.30 Healthy Blue — CHP/Medicaid Managed Care: $338.53 Home State Health Plan — Medicaid Managed Care: $402.47 Home State Health Plan — Medicare Advantage: $426.30 Humana — Commercial: $852.60 Humana — Medicare Advantage: $426.30
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: ER PHYSICIAN/LEVEL 4	$863	$776.70	$100.99 – $302.05
Emergency room visit (moderately high): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $115.86 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $100.99 Cigna — Commercial HMO & PPO: $115.86 Healthy Blue — CHP/Medicaid Managed Care: $100.99 Home State Health Plan — Medicaid Managed Care: $111.09 Home State Health Plan — Medicare Advantage: $115.86 Optum — Medicare Advantage: $302.05 UnitedHealthcare — Medicaid Managed Care: $100.99
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: E/R VISIT-COMPRE HIST. HIGH COMPLEX	$307	$276.30	$173.53 – $1,216.86
Emergency room visit (high): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $536.84 Aetna — Medicare Advantage: $608.43 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $181.74 Anthem Blue Cross Blue Shield Missouri — Traditional: $219.20 Cigna — Commercial HMO & PPO: $608.43 Healthy Blue — CHP/Medicaid Managed Care: $483.16 Home State Health Plan — Medicaid Managed Care: $574.42 Home State Health Plan — Medicare Advantage: $608.43 Humana — Commercial: $1,216.86 Humana — Medicare Advantage: $608.43
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERG. ROOM VISIT (COMPRE)	$307	$276.30	$173.53 – $1,216.86
Emergency room visit (high): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $536.84 Aetna — Medicare Advantage: $608.43 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $181.74 Anthem Blue Cross Blue Shield Missouri — Traditional: $219.20 Cigna — Commercial HMO & PPO: $608.43 Healthy Blue — CHP/Medicaid Managed Care: $483.16 Home State Health Plan — Medicaid Managed Care: $574.42 Home State Health Plan — Medicare Advantage: $608.43 Humana — Commercial: $1,216.86 Humana — Medicare Advantage: $608.43
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: ER PHYSICIAN/LEVEL 5	$1,341	$1,206.90	$146.64 – $469.35
Emergency room visit (high): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $167.93 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $146.64 Cigna — Commercial HMO & PPO: $167.93 Healthy Blue — CHP/Medicaid Managed Care: $146.64 Home State Health Plan — Medicaid Managed Care: $161.30 Home State Health Plan — Medicare Advantage: $167.93 Optum — Medicare Advantage: $469.35 UnitedHealthcare — Medicaid Managed Care: $146.64

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BMP BASIC METABOLIC PROFILE	$301	$270.90	$7.61 – $214.91
Basic metabolic panel (blood test): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $7.61 Aetna — Medicare Advantage: $8.46 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $178.19 Anthem Blue Cross Blue Shield Missouri — Traditional: $214.91 Cigna — Commercial HMO & PPO: $8.46 Healthy Blue — CHP/Medicaid Managed Care: $7.61 Home State Health Plan — Medicaid Managed Care: $8.14 Home State Health Plan — Medicare Advantage: $8.46 Humana — Commercial: $16.92 Humana — Medicare Advantage: $8.46
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BMP BASIC METABOLIC PROFILE	$301	$270.90	Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CMP COMPREHENSIVE MET PROFILE	$381	$342.90	$9.50 – $272.03
Comprehensive metabolic panel (blood test): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $9.50 Aetna — Medicare Advantage: $10.56 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $225.55 Anthem Blue Cross Blue Shield Missouri — Traditional: $272.03 Cigna — Commercial HMO & PPO: $10.56 Healthy Blue — CHP/Medicaid Managed Care: $9.50 Home State Health Plan — Medicaid Managed Care: $10.16 Home State Health Plan — Medicare Advantage: $10.56 Humana — Commercial: $21.12 Humana — Medicare Advantage: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CMP-PICCOLO	$381	$342.90	$9.50 – $272.03
Comprehensive metabolic panel (blood test): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $9.50 Aetna — Medicare Advantage: $10.56 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $225.55 Anthem Blue Cross Blue Shield Missouri — Traditional: $272.03 Cigna — Commercial HMO & PPO: $10.56 Healthy Blue — CHP/Medicaid Managed Care: $9.50 Home State Health Plan — Medicaid Managed Care: $10.16 Home State Health Plan — Medicare Advantage: $10.56 Humana — Commercial: $21.12 Humana — Medicare Advantage: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CMP COMPREHENSIVE MET PROFILE	$381	$342.90	Not listed in the file
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRENATAL PANEL	$58	$52.20	$34.34 – $173.53
Obstetric blood test panel: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $43.03 Aetna — Medicare Advantage: $47.81 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $34.34 Anthem Blue Cross Blue Shield Missouri — Traditional: $41.41 Cigna — Commercial HMO & PPO: $47.81 Healthy Blue — CHP/Medicaid Managed Care: $38.73 Home State Health Plan — Medicaid Managed Care: $46.04 Home State Health Plan — Medicare Advantage: $47.81 Humana — Commercial: $95.62 Humana — Medicare Advantage: $47.81
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PRENATAL PANEL	$58	$52.20	Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PROF	$233	$209.70	$12.05 – $166.36
Cholesterol panel (lipid panel): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $12.05 Aetna — Medicare Advantage: $13.39 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $137.94 Anthem Blue Cross Blue Shield Missouri — Traditional: $166.36 Cigna — Commercial HMO & PPO: $13.39 Healthy Blue — CHP/Medicaid Managed Care: $12.05 Home State Health Plan — Medicaid Managed Care: $12.89 Home State Health Plan — Medicare Advantage: $13.39 Humana — Commercial: $26.78 Humana — Medicare Advantage: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PROF REFLEX DLDL	$233	$209.70	$12.05 – $166.36
Cholesterol panel (lipid panel): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $12.05 Aetna — Medicare Advantage: $13.39 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $137.94 Anthem Blue Cross Blue Shield Missouri — Traditional: $166.36 Cigna — Commercial HMO & PPO: $13.39 Healthy Blue — CHP/Medicaid Managed Care: $12.05 Home State Health Plan — Medicaid Managed Care: $12.89 Home State Health Plan — Medicare Advantage: $13.39 Humana — Commercial: $26.78 Humana — Medicare Advantage: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$49	$44.10	$10.85 – $173.53
Cholesterol panel (lipid panel): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $12.05 Aetna — Medicare Advantage: $13.39 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $29.01 Anthem Blue Cross Blue Shield Missouri — Traditional: $34.99 Cigna — Commercial HMO & PPO: $13.39 Healthy Blue — CHP/Medicaid Managed Care: $10.85 Home State Health Plan — Medicaid Managed Care: $12.89 Home State Health Plan — Medicare Advantage: $13.39 Humana — Commercial: $26.78 Humana — Medicare Advantage: $13.39
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL PANEL	$306	$275.40	$7.81 – $218.48
Kidney function panel: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $7.81 Aetna — Medicare Advantage: $8.68 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $181.15 Anthem Blue Cross Blue Shield Missouri — Traditional: $218.48 Cigna — Commercial HMO & PPO: $8.68 Healthy Blue — CHP/Medicaid Managed Care: $7.81 Home State Health Plan — Medicaid Managed Care: $8.36 Home State Health Plan — Medicare Advantage: $8.68 Humana — Commercial: $17.36 Humana — Medicare Advantage: $8.68
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL PANEL	$306	$275.40	Not listed in the file
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER PROFILE	$288	$259.20	$7.35 – $205.63
Liver function panel: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $7.35 Aetna — Medicare Advantage: $8.17 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $170.50 Anthem Blue Cross Blue Shield Missouri — Traditional: $205.63 Cigna — Commercial HMO & PPO: $8.17 Healthy Blue — CHP/Medicaid Managed Care: $7.35 Home State Health Plan — Medicaid Managed Care: $7.86 Home State Health Plan — Medicare Advantage: $8.17 Humana — Commercial: $16.34 Humana — Medicare Advantage: $8.17
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OUTREACH-HEPATIC PROFILE	$62	$55.80	$7.35 – $44.27
Liver function panel: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $7.35 Aetna — Medicare Advantage: $8.17 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $36.70 Anthem Blue Cross Blue Shield Missouri — Traditional: $44.27 Cigna — Commercial HMO & PPO: $8.17 Healthy Blue — CHP/Medicaid Managed Care: $7.35 Home State Health Plan — Medicaid Managed Care: $7.86 Home State Health Plan — Medicare Advantage: $8.17 Humana — Commercial: $16.34 Humana — Medicare Advantage: $8.17
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION PANEL	$47	$42.30	$6.62 – $173.53
Liver function panel: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $7.35 Aetna — Medicare Advantage: $8.17 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $27.82 Anthem Blue Cross Blue Shield Missouri — Traditional: $33.56 Cigna — Commercial HMO & PPO: $8.17 Healthy Blue — CHP/Medicaid Managed Care: $6.62 Home State Health Plan — Medicaid Managed Care: $7.86 Home State Health Plan — Medicare Advantage: $8.17 Humana — Commercial: $16.34 Humana — Medicare Advantage: $8.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: .UA COMP CHG ONLY	$77	$69.30	$2.85 – $54.98
Urine test (automated, with microscope): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $2.85 Aetna — Medicare Advantage: $3.17 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $45.58 Anthem Blue Cross Blue Shield Missouri — Traditional: $54.98 Cigna — Commercial HMO & PPO: $3.17 Healthy Blue — CHP/Medicaid Managed Care: $2.85 Home State Health Plan — Medicaid Managed Care: $3.05 Home State Health Plan — Medicare Advantage: $3.17 Humana — Commercial: $6.34 Humana — Medicare Advantage: $3.17
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: .UA COMP CHG ONLY	$77	$69.30	Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE DIP	$40	$36	$3.13 – $28.56
Urine test (manual, without microscope): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $3.13 Aetna — Medicare Advantage: $3.48 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $23.68 Anthem Blue Cross Blue Shield Missouri — Traditional: $28.56 Cigna — Commercial HMO & PPO: $3.48 Healthy Blue — CHP/Medicaid Managed Care: $3.13 Home State Health Plan — Medicaid Managed Care: $3.35 Home State Health Plan — Medicare Advantage: $3.48 Humana — Commercial: $6.96 Humana — Medicare Advantage: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FISCHER URINE DIP	$27	$24.30	$3.13 – $21
Urine test (manual, without microscope): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $3.13 Aetna — Medicare Advantage: $3.48 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $15.98 Anthem Blue Cross Blue Shield Missouri — Traditional: $19.28 Cigna — Commercial HMO & PPO: $3.48 Healthy Blue — CHP/Medicaid Managed Care: $3.13 Home State Health Plan — Medicaid Managed Care: $3.35 Home State Health Plan — Medicare Advantage: $3.48 Humana — Commercial: $6.96 Humana — Medicare Advantage: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS (DIP ONLY)	$27	$24.30	$3.13 – $21
Urine test (manual, without microscope): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $3.13 Aetna — Medicare Advantage: $3.48 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $15.98 Anthem Blue Cross Blue Shield Missouri — Traditional: $19.28 Cigna — Commercial HMO & PPO: $3.48 Healthy Blue — CHP/Medicaid Managed Care: $3.13 Home State Health Plan — Medicaid Managed Care: $3.35 Home State Health Plan — Medicare Advantage: $3.48 Humana — Commercial: $6.96 Humana — Medicare Advantage: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPECIFIC GRAVITY FLUID	$101	$90.90	$2.03 – $72.11
Urine test (automated, without microscope): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $2.03 Aetna — Medicare Advantage: $2.25 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $59.79 Anthem Blue Cross Blue Shield Missouri — Traditional: $72.11 Cigna — Commercial HMO & PPO: $2.25 Healthy Blue — CHP/Medicaid Managed Care: $2.03 Home State Health Plan — Medicaid Managed Care: $2.17 Home State Health Plan — Medicare Advantage: $2.25 Humana — Commercial: $4.50 Humana — Medicare Advantage: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE MICROSCOPIC EXAM	$127	$114.30	$2.03 – $90.68
Urine test (automated, without microscope): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $2.03 Aetna — Medicare Advantage: $2.25 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $75.18 Anthem Blue Cross Blue Shield Missouri — Traditional: $90.68 Cigna — Commercial HMO & PPO: $2.25 Healthy Blue — CHP/Medicaid Managed Care: $2.03 Home State Health Plan — Medicaid Managed Care: $2.17 Home State Health Plan — Medicare Advantage: $2.25 Humana — Commercial: $4.50 Humana — Medicare Advantage: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: .URINALYSIS	$78	$70.20	$2.03 – $55.69
Urine test (automated, without microscope): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $2.03 Aetna — Medicare Advantage: $2.25 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $46.18 Anthem Blue Cross Blue Shield Missouri — Traditional: $55.69 Cigna — Commercial HMO & PPO: $2.25 Healthy Blue — CHP/Medicaid Managed Care: $2.03 Home State Health Plan — Medicaid Managed Care: $2.17 Home State Health Plan — Medicare Advantage: $2.25 Humana — Commercial: $4.50 Humana — Medicare Advantage: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA SCREEN	$299	$269.10	$16.55 – $213.49
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $16.55 Aetna — Medicare Advantage: $18.39 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $177.01 Anthem Blue Cross Blue Shield Missouri — Traditional: $213.49 Cigna — Commercial HMO & PPO: $18.39 Healthy Blue — CHP/Medicaid Managed Care: $16.55 Home State Health Plan — Medicaid Managed Care: $17.71 Home State Health Plan — Medicare Advantage: $18.39 Humana — Commercial: $36.78 Humana — Medicare Advantage: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA SCREEN (LABCORP)	$299	$269.10	$16.55 – $213.49
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $16.55 Aetna — Medicare Advantage: $18.39 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $177.01 Anthem Blue Cross Blue Shield Missouri — Traditional: $213.49 Cigna — Commercial HMO & PPO: $18.39 Healthy Blue — CHP/Medicaid Managed Care: $16.55 Home State Health Plan — Medicaid Managed Care: $17.71 Home State Health Plan — Medicare Advantage: $18.39 Humana — Commercial: $36.78 Humana — Medicare Advantage: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA DIAGNOSTIC (LABCORP)	$299	$269.10	$16.55 – $213.49
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $16.55 Aetna — Medicare Advantage: $18.39 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $177.01 Anthem Blue Cross Blue Shield Missouri — Traditional: $213.49 Cigna — Commercial HMO & PPO: $18.39 Healthy Blue — CHP/Medicaid Managed Care: $16.55 Home State Health Plan — Medicaid Managed Care: $17.71 Home State Health Plan — Medicare Advantage: $18.39 Humana — Commercial: $36.78 Humana — Medicare Advantage: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTH	$195	$175.50	$15.12 – $139.23
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $15.12 Aetna — Medicare Advantage: $16.80 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $115.44 Anthem Blue Cross Blue Shield Missouri — Traditional: $139.23 Cigna — Commercial HMO & PPO: $16.80 Healthy Blue — CHP/Medicaid Managed Care: $15.12 Home State Health Plan — Medicaid Managed Care: $16.18 Home State Health Plan — Medicare Advantage: $16.80 Humana — Commercial: $33.60 Humana — Medicare Advantage: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH	$264	$237.60	$15.12 – $188.50
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $15.12 Aetna — Medicare Advantage: $16.80 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $156.29 Anthem Blue Cross Blue Shield Missouri — Traditional: $188.50 Cigna — Commercial HMO & PPO: $16.80 Healthy Blue — CHP/Medicaid Managed Care: $15.12 Home State Health Plan — Medicaid Managed Care: $16.18 Home State Health Plan — Medicare Advantage: $16.80 Humana — Commercial: $33.60 Humana — Medicare Advantage: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH REFLEX TT4	$264	$237.60	$15.12 – $188.50
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $15.12 Aetna — Medicare Advantage: $16.80 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $156.29 Anthem Blue Cross Blue Shield Missouri — Traditional: $188.50 Cigna — Commercial HMO & PPO: $16.80 Healthy Blue — CHP/Medicaid Managed Care: $15.12 Home State Health Plan — Medicaid Managed Care: $16.18 Home State Health Plan — Medicare Advantage: $16.80 Humana — Commercial: $33.60 Humana — Medicare Advantage: $16.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: .CBC AUTO DIFF CHG ONLY	$166	$149.40	$6.99 – $118.52
Complete blood count (CBC) with differential: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $6.99 Aetna — Medicare Advantage: $7.77 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $98.27 Anthem Blue Cross Blue Shield Missouri — Traditional: $118.52 Cigna — Commercial HMO & PPO: $7.77 Healthy Blue — CHP/Medicaid Managed Care: $6.99 Home State Health Plan — Medicaid Managed Care: $7.48 Home State Health Plan — Medicare Advantage: $7.77 Humana — Commercial: $15.54 Humana — Medicare Advantage: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W/ RFX PATH SLIDE REVIEW (LABCORP)	$10	$9	$3.60 – $21
Complete blood count (CBC) with differential: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $6.99 Aetna — Medicare Advantage: $7.77 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $5.92 Anthem Blue Cross Blue Shield Missouri — Traditional: $7.14 Cigna — Commercial HMO & PPO: $7.77 Healthy Blue — CHP/Medicaid Managed Care: $6.99 Home State Health Plan — Medicaid Managed Care: $7.48 Home State Health Plan — Medicare Advantage: $7.77 Humana — Commercial: $15.54 Humana — Medicare Advantage: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRECCLAMPSIA PANEL	$22	$19.80	$6.29 – $173.53
Complete blood count (CBC) with differential: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $6.99 Aetna — Medicare Advantage: $7.77 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $13.02 Anthem Blue Cross Blue Shield Missouri — Traditional: $15.71 Cigna — Commercial HMO & PPO: $7.77 Healthy Blue — CHP/Medicaid Managed Care: $6.29 Home State Health Plan — Medicaid Managed Care: $7.48 Home State Health Plan — Medicare Advantage: $7.77 Humana — Commercial: $15.54 Humana — Medicare Advantage: $7.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OUTREACH-CBC WO DIFF	$16	$14.40	$5.76 – $21
Complete blood count (CBC), automated: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $5.82 Aetna — Medicare Advantage: $6.47 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $9.47 Anthem Blue Cross Blue Shield Missouri — Traditional: $11.42 Cigna — Commercial HMO & PPO: $6.47 Healthy Blue — CHP/Medicaid Managed Care: $5.82 Home State Health Plan — Medicaid Managed Care: $6.23 Home State Health Plan — Medicare Advantage: $6.47 Humana — Commercial: $12.94 Humana — Medicare Advantage: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: .CBC CHG ONLY (NO AUTO DIFF)	$116	$104.40	$5.82 – $82.82
Complete blood count (CBC), automated: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $5.82 Aetna — Medicare Advantage: $6.47 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $68.67 Anthem Blue Cross Blue Shield Missouri — Traditional: $82.82 Cigna — Commercial HMO & PPO: $6.47 Healthy Blue — CHP/Medicaid Managed Care: $5.82 Home State Health Plan — Medicaid Managed Care: $6.23 Home State Health Plan — Medicare Advantage: $6.47 Humana — Commercial: $12.94 Humana — Medicare Advantage: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC PLT NO DIFFERENTIAL	$155	$139.50	$5.82 – $110.67
Complete blood count (CBC), automated: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $5.82 Aetna — Medicare Advantage: $6.47 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $91.76 Anthem Blue Cross Blue Shield Missouri — Traditional: $110.67 Cigna — Commercial HMO & PPO: $6.47 Healthy Blue — CHP/Medicaid Managed Care: $5.82 Home State Health Plan — Medicaid Managed Care: $6.23 Home State Health Plan — Medicare Advantage: $6.47 Humana — Commercial: $12.94 Humana — Medicare Advantage: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTIME/INR (LABCORP)	$127	$114.30	$3.86 – $90.68
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $3.86 Aetna — Medicare Advantage: $4.29 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $75.18 Anthem Blue Cross Blue Shield Missouri — Traditional: $90.68 Cigna — Commercial HMO & PPO: $4.29 Healthy Blue — CHP/Medicaid Managed Care: $3.86 Home State Health Plan — Medicaid Managed Care: $4.13 Home State Health Plan — Medicare Advantage: $4.29 Humana — Commercial: $8.58 Humana — Medicare Advantage: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OUTREACH-PROTHROMBIN TIME	$21	$18.90	$3.86 – $21
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $3.86 Aetna — Medicare Advantage: $4.29 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $12.43 Anthem Blue Cross Blue Shield Missouri — Traditional: $14.99 Cigna — Commercial HMO & PPO: $4.29 Healthy Blue — CHP/Medicaid Managed Care: $3.86 Home State Health Plan — Medicaid Managed Care: $4.13 Home State Health Plan — Medicare Advantage: $4.29 Humana — Commercial: $8.58 Humana — Medicare Advantage: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTIME / INR	$127	$114.30	$3.86 – $90.68
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $3.86 Aetna — Medicare Advantage: $4.29 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $75.18 Anthem Blue Cross Blue Shield Missouri — Traditional: $90.68 Cigna — Commercial HMO & PPO: $4.29 Healthy Blue — CHP/Medicaid Managed Care: $3.86 Home State Health Plan — Medicaid Managed Care: $4.13 Home State Health Plan — Medicare Advantage: $4.29 Humana — Commercial: $8.58 Humana — Medicare Advantage: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OUTREACH-PARTIAL THROMBOPLASTI	$39	$35.10	$5.41 – $27.85
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $5.41 Aetna — Medicare Advantage: $6.01 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $23.09 Anthem Blue Cross Blue Shield Missouri — Traditional: $27.85 Cigna — Commercial HMO & PPO: $6.01 Healthy Blue — CHP/Medicaid Managed Care: $5.41 Home State Health Plan — Medicaid Managed Care: $5.79 Home State Health Plan — Medicare Advantage: $6.01 Humana — Commercial: $12.02 Humana — Medicare Advantage: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: APTT	$126	$113.40	$5.41 – $89.96
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $5.41 Aetna — Medicare Advantage: $6.01 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $74.59 Anthem Blue Cross Blue Shield Missouri — Traditional: $89.96 Cigna — Commercial HMO & PPO: $6.01 Healthy Blue — CHP/Medicaid Managed Care: $5.41 Home State Health Plan — Medicaid Managed Care: $5.79 Home State Health Plan — Medicare Advantage: $6.01 Humana — Commercial: $12.02 Humana — Medicare Advantage: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRECCLAMPSIA PANEL	$22	$19.80	$4.87 – $173.53
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $5.41 Aetna — Medicare Advantage: $6.01 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $13.02 Anthem Blue Cross Blue Shield Missouri — Traditional: $15.71 Cigna — Commercial HMO & PPO: $6.01 Healthy Blue — CHP/Medicaid Managed Care: $4.87 Home State Health Plan — Medicaid Managed Care: $5.79 Home State Health Plan — Medicare Advantage: $6.01 Humana — Commercial: $12.02 Humana — Medicare Advantage: $6.01

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD WO CONTRAST	$2,518	$2,266.20	$94.24 – $1,797.85
CT scan of the head or brain, without contrast: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $94.24 Aetna — Medicare Advantage: $106.81 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $853 Anthem Blue Cross Blue Shield Missouri — Traditional: $1,797.85 Cigna — Commercial HMO & PPO: $106.81 Healthy Blue — CHP/Medicaid Managed Care: $94.24 Home State Health Plan — Medicaid Managed Care: $100.84 Home State Health Plan — Medicare Advantage: $106.81 Humana — Commercial: $213.62 Humana — Medicare Advantage: $106.81
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT HEAD WO CONTRAST	$2,518	$2,266.20	Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR BRAIN W WO CONTRAST	$4,375	$3,937.50	$314.49 – $3,123.75
MRI of the brain, before and after contrast: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $314.49 Aetna — Medicare Advantage: $356.43 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $1,555 Anthem Blue Cross Blue Shield Missouri — Traditional: $3,123.75 Cigna — Commercial HMO & PPO: $356.43 Healthy Blue — CHP/Medicaid Managed Care: $314.49 Home State Health Plan — Medicaid Managed Care: $336.50 Home State Health Plan — Medicare Advantage: $356.43 Humana — Commercial: $712.86 Humana — Medicare Advantage: $356.43
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR BRAIN W WO CONTRAST	$4,375	$3,937.50	Not listed in the file
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST XRAY 2V	$465	$418.50	$78.45 – $332.01
Chest X-ray, 2 views: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $78.45 Aetna — Medicare Advantage: $88.91 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $275.28 Anthem Blue Cross Blue Shield Missouri — Traditional: $332.01 Cigna — Commercial HMO & PPO: $88.91 Healthy Blue — CHP/Medicaid Managed Care: $78.45 Home State Health Plan — Medicaid Managed Care: $83.94 Home State Health Plan — Medicare Advantage: $88.91 Humana — Commercial: $177.82 Humana — Medicare Advantage: $88.91
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CHEST XRAY 2V	$465	$418.50	Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L SPINE OBLS XRAY	$625	$562.50	$94.24 – $446.25
X-ray of the lower spine, at least 4 views: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $94.24 Aetna — Medicare Advantage: $106.81 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $370 Anthem Blue Cross Blue Shield Missouri — Traditional: $446.25 Cigna — Commercial HMO & PPO: $106.81 Healthy Blue — CHP/Medicaid Managed Care: $94.24 Home State Health Plan — Medicaid Managed Care: $100.84 Home State Health Plan — Medicare Advantage: $106.81 Humana — Commercial: $213.62 Humana — Medicare Advantage: $106.81
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: L SPINE OBLS XRAY	$625	$562.50	Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR LUMBAR WO	$3,640	$3,276	$215.09 – $2,598.96
MRI of the lower back (lumbar spine), without contrast: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $215.09 Aetna — Medicare Advantage: $243.77 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $1,555 Anthem Blue Cross Blue Shield Missouri — Traditional: $2,598.96 Cigna — Commercial HMO & PPO: $243.77 Healthy Blue — CHP/Medicaid Managed Care: $215.09 Home State Health Plan — Medicaid Managed Care: $230.15 Home State Health Plan — Medicare Advantage: $243.77 Humana — Commercial: $487.54 Humana — Medicare Advantage: $243.77
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR LUMBAR WO	$3,640	$3,276	Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS WITH CONTRAST	$3,008	$2,707.20	$158.12 – $2,147.71
CT scan of the pelvis, with contrast: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $158.12 Aetna — Medicare Advantage: $179.20 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $853 Anthem Blue Cross Blue Shield Missouri — Traditional: $2,147.71 Cigna — Commercial HMO & PPO: $179.20 Healthy Blue — CHP/Medicaid Managed Care: $158.12 Home State Health Plan — Medicaid Managed Care: $169.19 Home State Health Plan — Medicare Advantage: $179.20 Humana — Commercial: $358.40 Humana — Medicare Advantage: $179.20
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS WITH CONTRAST	$3,008	$2,707.20	Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR RT LOWER JOINTW/O	$4,546	$4,091.40	$215.09 – $3,245.84
MRI of a leg joint (such as the knee), without contrast: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $215.09 Aetna — Medicare Advantage: $243.77 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $1,555 Anthem Blue Cross Blue Shield Missouri — Traditional: $3,245.84 Cigna — Commercial HMO & PPO: $243.77 Healthy Blue — CHP/Medicaid Managed Care: $215.09 Home State Health Plan — Medicaid Managed Care: $230.15 Home State Health Plan — Medicare Advantage: $243.77 Humana — Commercial: $487.54 Humana — Medicare Advantage: $243.77
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR LT LOWER JOINT WO	$4,546	$4,091.40	$215.09 – $3,245.84
MRI of a leg joint (such as the knee), without contrast: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $215.09 Aetna — Medicare Advantage: $243.77 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $1,555 Anthem Blue Cross Blue Shield Missouri — Traditional: $3,245.84 Cigna — Commercial HMO & PPO: $243.77 Healthy Blue — CHP/Medicaid Managed Care: $215.09 Home State Health Plan — Medicaid Managed Care: $230.15 Home State Health Plan — Medicare Advantage: $243.77 Humana — Commercial: $487.54 Humana — Medicare Advantage: $243.77
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR RT LOWER JOINTW/O	$4,546	$4,091.40	Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD PEL W CONT	$5,919	$5,327.10	$314.49 – $4,226.17
CT scan of the abdomen and pelvis, with contrast: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $314.49 Aetna — Medicare Advantage: $356.43 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $853 Anthem Blue Cross Blue Shield Missouri — Traditional: $4,226.17 Cigna — Commercial HMO & PPO: $356.43 Healthy Blue — CHP/Medicaid Managed Care: $314.49 Home State Health Plan — Medicaid Managed Care: $336.50 Home State Health Plan — Medicare Advantage: $356.43 Humana — Commercial: $712.86 Humana — Medicare Advantage: $356.43
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT ABD PEL W CONT	$5,919	$5,327.10	Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMEN COMPLETE	$1,197	$1,077.30	$94.24 – $854.66
Ultrasound of the abdomen, complete: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $94.24 Aetna — Medicare Advantage: $106.81 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $708.62 Anthem Blue Cross Blue Shield Missouri — Traditional: $854.66 Cigna — Commercial HMO & PPO: $106.81 Healthy Blue — CHP/Medicaid Managed Care: $94.24 Home State Health Plan — Medicaid Managed Care: $100.84 Home State Health Plan — Medicare Advantage: $106.81 Humana — Commercial: $213.62 Humana — Medicare Advantage: $106.81
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US ABDOMEN COMPLETE	$1,197	$1,077.30	Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US OB > 14 WEEKS	$1,020	$918	$94.24 – $728.28
Pregnancy ultrasound (after the first trimester): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $94.24 Aetna — Medicare Advantage: $106.81 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $603.84 Anthem Blue Cross Blue Shield Missouri — Traditional: $728.28 Cigna — Commercial HMO & PPO: $106.81 Healthy Blue — CHP/Medicaid Managed Care: $94.24 Home State Health Plan — Medicaid Managed Care: $100.84 Home State Health Plan — Medicare Advantage: $106.81 Humana — Commercial: $213.62 Humana — Medicare Advantage: $106.81
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND/COMPLETE OB	$358	$322.20	$84.82 – $255.61
Pregnancy ultrasound (after the first trimester): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $94.24 Aetna — Medicare Advantage: $106.81 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $211.94 Anthem Blue Cross Blue Shield Missouri — Traditional: $255.61 Cigna — Commercial HMO & PPO: $106.81 Healthy Blue — CHP/Medicaid Managed Care: $84.82 Home State Health Plan — Medicaid Managed Care: $100.84 Home State Health Plan — Medicare Advantage: $106.81 Humana — Commercial: $213.62 Humana — Medicare Advantage: $106.81
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US OB > 14 WEEKS	$1,020	$918	Not listed in the file
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PELVIC TRANS VAGINAL	$684	$615.60	$94.24 – $488.38
Transvaginal ultrasound: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $94.24 Aetna — Medicare Advantage: $106.81 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $404.93 Anthem Blue Cross Blue Shield Missouri — Traditional: $488.38 Cigna — Commercial HMO & PPO: $106.81 Healthy Blue — CHP/Medicaid Managed Care: $94.24 Home State Health Plan — Medicaid Managed Care: $100.84 Home State Health Plan — Medicare Advantage: $106.81 Humana — Commercial: $213.62 Humana — Medicare Advantage: $106.81
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GYN TRANS VAG. U S	$251	$225.90	$84.82 – $213.62
Transvaginal ultrasound: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $94.24 Aetna — Medicare Advantage: $106.81 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $148.59 Anthem Blue Cross Blue Shield Missouri — Traditional: $179.21 Cigna — Commercial HMO & PPO: $106.81 Healthy Blue — CHP/Medicaid Managed Care: $84.82 Home State Health Plan — Medicaid Managed Care: $100.84 Home State Health Plan — Medicare Advantage: $106.81 Humana — Commercial: $213.62 Humana — Medicare Advantage: $106.81
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US PELVIC TRANS VAGINAL	$684	$615.60	Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMOGRAM UNILATERAL LEFT	$326	$293.40	$107.41 – $232.76
Diagnostic mammogram, one breast: rates for 8 insurance plans Aetna — Better Health Medicaid/QHP: $107.41 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $192.99 Anthem Blue Cross Blue Shield Missouri — Traditional: $232.76 Healthy Blue — CHP/Medicaid Managed Care: $107.41 Home State Health Plan — Medicaid Managed Care: $114.93 UnitedHealthcare — Commercial: $111 UnitedHealthcare — Medicaid Managed Care: $107.41 UnitedHealthcare — Medicare Advantage: $117.36
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMOGRAM UNILATERAL RIGHT	$326	$293.40	$107.41 – $232.76
Diagnostic mammogram, one breast: rates for 8 insurance plans Aetna — Better Health Medicaid/QHP: $107.41 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $192.99 Anthem Blue Cross Blue Shield Missouri — Traditional: $232.76 Healthy Blue — CHP/Medicaid Managed Care: $107.41 Home State Health Plan — Medicaid Managed Care: $114.93 UnitedHealthcare — Commercial: $111 UnitedHealthcare — Medicaid Managed Care: $107.41 UnitedHealthcare — Medicare Advantage: $117.36
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMOGRAM UNILATERAL LEFT	$326	$293.40	Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMOGRAM BILAT DIAG	$521	$468.90	$111 – $371.99
Diagnostic mammogram, both breasts: rates for 8 insurance plans Aetna — Better Health Medicaid/QHP: $136.04 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $308.43 Anthem Blue Cross Blue Shield Missouri — Traditional: $371.99 Healthy Blue — CHP/Medicaid Managed Care: $136.04 Home State Health Plan — Medicaid Managed Care: $145.56 UnitedHealthcare — Commercial: $111 UnitedHealthcare — Medicaid Managed Care: $136.04 UnitedHealthcare — Medicare Advantage: $187.56
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMOGRAM BILAT DIAG	$521	$468.90	Not listed in the file
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMOGRAM SCREENING	$326	$293.40	$109.32 – $232.76
Screening mammogram, both breasts: rates for 7 insurance plans Aetna — Better Health Medicaid/QHP: $109.32 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $192.99 Anthem Blue Cross Blue Shield Missouri — Traditional: $232.76 Healthy Blue — CHP/Medicaid Managed Care: $109.32 Home State Health Plan — Medicaid Managed Care: $116.97 UnitedHealthcare — Commercial: $111 UnitedHealthcare — Medicaid Managed Care: $109.32
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMOGRAM SCREENING	$326	$293.40	Not listed in the file

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EKG WITH REPORT AND INTERPRETATION	$223	$200.70	$132.02 – $173.53
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $132.02 Anthem Blue Cross Blue Shield Missouri — Traditional: $159.22 UnitedHealthcare — Commercial: $148.74 UnitedHealthcare — Medicare Advantage: $173.53
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EKG WITH INTERPRETATION & REPORT	$223	$200.70	$132.02 – $173.53
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $132.02 Anthem Blue Cross Blue Shield Missouri — Traditional: $159.22 UnitedHealthcare — Commercial: $148.74 UnitedHealthcare — Medicare Advantage: $173.53
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EKG OFFICE	$90	$81	$53.28 – $173.53
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $53.28 Anthem Blue Cross Blue Shield Missouri — Traditional: $64.26 UnitedHealthcare — Commercial: $60.03 UnitedHealthcare — Medicare Advantage: $173.53

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EXERCISE 15 MIN ROM STRENGTH ENDUR	$147	$132.30	$25.56 – $136
Physical therapy: therapeutic exercise (each 15 minutes): rates for 8 insurance plans Aetna — Better Health Medicaid/QHP: $25.56 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $100 Anthem Blue Cross Blue Shield Missouri — Traditional: $136 Healthy Blue — CHP/Medicaid Managed Care: $25.56 Home State Health Plan — Medicaid Managed Care: $27.35 UnitedHealthcare — Commercial: $82 UnitedHealthcare — Medicaid Managed Care: $25.56 UnitedHealthcare — Medicare Advantage: $52.92
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OT THERAPEUTIC EXERCISE 15 MIN	$121	$108.90	$25.56 – $136
Physical therapy: therapeutic exercise (each 15 minutes): rates for 8 insurance plans Aetna — Better Health Medicaid/QHP: $25.56 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $100 Anthem Blue Cross Blue Shield Missouri — Traditional: $136 Healthy Blue — CHP/Medicaid Managed Care: $25.56 Home State Health Plan — Medicaid Managed Care: $27.35 UnitedHealthcare — Commercial: $82 UnitedHealthcare — Medicaid Managed Care: $25.56 UnitedHealthcare — Medicare Advantage: $43.56
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EXERCISE 15 MIN ROM STRENGTH ENDUR	$147	$132.30	Not listed in the file

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: EXCISION OF CYST BREAST	$899	$809.10	$314.65 – $433.53
Removal of breast growth (open surgery): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $383.57 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $394.12 Cigna — Commercial HMO & PPO: $383.57 Healthy Blue — CHP/Medicaid Managed Care: $394.12 Home State Health Plan — Medicaid Managed Care: $433.53 Home State Health Plan — Medicare Advantage: $383.57 Optum — Medicare Advantage: $314.65 UnitedHealthcare — Medicaid Managed Care: $394.12
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: EXC OF CYST,FIBRO OR BEN/MAL BREAST LESI	$1,365	$1,228.50	$383.57 – $477.75
Removal of breast growth (open surgery): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $383.57 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $394.12 Cigna — Commercial HMO & PPO: $383.57 Healthy Blue — CHP/Medicaid Managed Care: $394.12 Home State Health Plan — Medicaid Managed Care: $433.53 Home State Health Plan — Medicare Advantage: $383.57 Optum — Medicare Advantage: $477.75 UnitedHealthcare — Medicaid Managed Care: $394.12
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HIP NAILING PROSTH RT	$1,061	$954.90	$175 – $26,233.52
Total hip replacement: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $11,573.41 Aetna — Medicare Advantage: $13,116.76 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $628.11 Anthem Blue Cross Blue Shield Missouri — Traditional: $757.55 Cigna — Commercial HMO & PPO: $13,116.76 Healthy Blue — CHP/Medicaid Managed Care: $11,573.41 Home State Health Plan — Medicaid Managed Care: $12,383.55 Home State Health Plan — Medicare Advantage: $13,116.76 Humana — Commercial: $26,233.52 Humana — Medicare Advantage: $13,116.76
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HIP NAILING PROSTH LT	$1,061	$954.90	$175 – $26,233.52
Total hip replacement: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $11,573.41 Aetna — Medicare Advantage: $13,116.76 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $628.11 Anthem Blue Cross Blue Shield Missouri — Traditional: $757.55 Cigna — Commercial HMO & PPO: $13,116.76 Healthy Blue — CHP/Medicaid Managed Care: $11,573.41 Home State Health Plan — Medicaid Managed Care: $12,383.55 Home State Health Plan — Medicare Advantage: $13,116.76 Humana — Commercial: $26,233.52 Humana — Medicare Advantage: $13,116.76
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HIP NAILING PROSTH RT	$1,061	$954.90	Not listed in the file
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: ARTHROSCOPY W MENISCECTOMY	$4,470	$4,023	$409.55 – $1,564.50
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $481.35 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $409.55 Cigna — Commercial HMO & PPO: $481.35 Healthy Blue — CHP/Medicaid Managed Care: $409.55 Home State Health Plan — Medicaid Managed Care: $450.50 Home State Health Plan — Medicare Advantage: $481.35 Optum — Medicare Advantage: $1,564.50 UnitedHealthcare — Medicaid Managed Care: $409.55
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: TONSILLECTOMY & ADENOID < 12 YRS OLD	$1,400	$1,260	$226.54 – $490
Removal of tonsils and adenoids (under age 12): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $246.01 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $226.54 Cigna — Commercial HMO & PPO: $246.01 Healthy Blue — CHP/Medicaid Managed Care: $226.54 Home State Health Plan — Medicaid Managed Care: $249.19 Home State Health Plan — Medicare Advantage: $246.01 Optum — Medicare Advantage: $490 UnitedHealthcare — Medicaid Managed Care: $226.54
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD NO BIOPSY	$998	$898.20	$173.53 – $1,853.26
Upper GI endoscopy (diagnostic): 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $817.60 Aetna — Medicare Advantage: $926.63 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $590.82 Anthem Blue Cross Blue Shield Missouri — Traditional: $712.57 Cigna — Commercial HMO & PPO: $926.63 Healthy Blue — CHP/Medicaid Managed Care: $735.84 Home State Health Plan — Medicaid Managed Care: $874.83 Home State Health Plan — Medicare Advantage: $926.63 Humana — Commercial: $1,853.26 Humana — Medicare Advantage: $926.63
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: UPPER ENDOSCOPY	$685	$616.50	$105.60 – $254.10
Upper GI endoscopy (diagnostic): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $105.60 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $231 Cigna — Commercial HMO & PPO: $105.60 Healthy Blue — CHP/Medicaid Managed Care: $231 Home State Health Plan — Medicaid Managed Care: $254.10 Home State Health Plan — Medicare Advantage: $105.60 Optum — Medicare Advantage: $239.75 UnitedHealthcare — Medicaid Managed Care: $231
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD DIAG WITH BRUSHING AND WASHING	$1,100	$990	$105.60 – $385
Upper GI endoscopy (diagnostic): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $105.60 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $231 Cigna — Commercial HMO & PPO: $105.60 Healthy Blue — CHP/Medicaid Managed Care: $231 Home State Health Plan — Medicaid Managed Care: $254.10 Home State Health Plan — Medicare Advantage: $105.60 Optum — Medicare Advantage: $385 UnitedHealthcare — Medicaid Managed Care: $231
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD UPPER GASTRO ENDOSCOPY W/BIOPSY	$875	$787.50	$118.28 – $325.04
Upper GI endoscopy with biopsy: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $118.28 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $295.49 Cigna — Commercial HMO & PPO: $118.28 Healthy Blue — CHP/Medicaid Managed Care: $295.49 Home State Health Plan — Medicaid Managed Care: $325.04 Home State Health Plan — Medicare Advantage: $118.28 Optum — Medicare Advantage: $306.25 UnitedHealthcare — Medicaid Managed Care: $295.49
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD W/BIOPSY, SINGLE OR MULTIPLE	$1,050	$945	$118.28 – $367.50
Upper GI endoscopy with biopsy: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $118.28 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $295.49 Cigna — Commercial HMO & PPO: $118.28 Healthy Blue — CHP/Medicaid Managed Care: $295.49 Home State Health Plan — Medicaid Managed Care: $325.04 Home State Health Plan — Medicare Advantage: $118.28 Optum — Medicare Advantage: $367.50 UnitedHealthcare — Medicaid Managed Care: $295.49
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD WITH BIOPSY ADD ON CODE	$1,400	$1,260	$118.28 – $490
Upper GI endoscopy with biopsy: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $118.28 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $295.49 Cigna — Commercial HMO & PPO: $118.28 Healthy Blue — CHP/Medicaid Managed Care: $295.49 Home State Health Plan — Medicaid Managed Care: $325.04 Home State Health Plan — Medicare Advantage: $118.28 Optum — Medicare Advantage: $490 UnitedHealthcare — Medicaid Managed Care: $295.49
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY, FLEXIBLE	$1,260	$1,134	$158.13 – $441
Colonoscopy (diagnostic): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $158.13 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $290.56 Cigna — Commercial HMO & PPO: $158.13 Healthy Blue — CHP/Medicaid Managed Care: $290.56 Home State Health Plan — Medicaid Managed Care: $319.62 Home State Health Plan — Medicare Advantage: $158.13 Optum — Medicare Advantage: $441 UnitedHealthcare — Medicaid Managed Care: $290.56
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY DIAG BRUSHING & WASHING	$1,500	$1,350	$158.13 – $525
Colonoscopy (diagnostic): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $158.13 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $290.56 Cigna — Commercial HMO & PPO: $158.13 Healthy Blue — CHP/Medicaid Managed Care: $290.56 Home State Health Plan — Medicaid Managed Care: $319.62 Home State Health Plan — Medicare Advantage: $158.13 Optum — Medicare Advantage: $525 UnitedHealthcare — Medicaid Managed Care: $290.56
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)	Not listed in the file	Not listed in the file	$838.31 – $1,900.20
Colonoscopy (diagnostic): 10 of 12 insurance plan rates Aetna — Better Health Medicaid/QHP: $838.31 Aetna — Medicare Advantage: $950.10 Cigna — Commercial HMO & PPO: $950.10 Healthy Blue — CHP/Medicaid Managed Care: $838.31 Home State Health Plan — Medicaid Managed Care: $896.99 Home State Health Plan — Medicare Advantage: $950.10 Humana — Commercial: $1,900.20 Humana — Medicare Advantage: $950.10 UnitedHealthcare — Commercial: $1,462 UnitedHealthcare — Medicaid Managed Care: $838.31
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BIOPSY	$1,058	$952.20	$173.53 – $2,445.12
Colonoscopy with biopsy: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $1,078.71 Aetna — Medicare Advantage: $1,222.56 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $626.34 Anthem Blue Cross Blue Shield Missouri — Traditional: $755.41 Cigna — Commercial HMO & PPO: $1,222.56 Healthy Blue — CHP/Medicaid Managed Care: $970.84 Home State Health Plan — Medicaid Managed Care: $1,154.22 Home State Health Plan — Medicare Advantage: $1,222.56 Humana — Commercial: $2,445.12 Humana — Medicare Advantage: $1,222.56
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY, FLEXIBLE, WITH BIOPSY(S)	$1,260	$1,134	$170.74 – $441
Colonoscopy with biopsy: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $170.74 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $374.28 Cigna — Commercial HMO & PPO: $170.74 Healthy Blue — CHP/Medicaid Managed Care: $374.28 Home State Health Plan — Medicaid Managed Care: $411.71 Home State Health Plan — Medicare Advantage: $170.74 Optum — Medicare Advantage: $441 UnitedHealthcare — Medicaid Managed Care: $374.28
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY W BIOPSY ADD ON CODE	$1,800	$1,620	$170.74 – $630
Colonoscopy with biopsy: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $170.74 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $374.28 Cigna — Commercial HMO & PPO: $170.74 Healthy Blue — CHP/Medicaid Managed Care: $374.28 Home State Health Plan — Medicaid Managed Care: $411.71 Home State Health Plan — Medicare Advantage: $170.74 Optum — Medicare Advantage: $630 UnitedHealthcare — Medicaid Managed Care: $374.28
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY W/REM POLYPS BY HOT SNARE	$1,733	$1,559.70	$215.08 – $606.55
Colonoscopy with removal of polyps (snare): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $215.08 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $389.51 Cigna — Commercial HMO & PPO: $215.08 Healthy Blue — CHP/Medicaid Managed Care: $389.51 Home State Health Plan — Medicaid Managed Care: $428.46 Home State Health Plan — Medicare Advantage: $215.08 Optum — Medicare Advantage: $606.55 UnitedHealthcare — Medicaid Managed Care: $389.51
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY WITH REM POLYP BY SNARE	$2,150	$1,935	$215.08 – $752.50
Colonoscopy with removal of polyps (snare): rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $215.08 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $389.51 Cigna — Commercial HMO & PPO: $215.08 Healthy Blue — CHP/Medicaid Managed Care: $389.51 Home State Health Plan — Medicaid Managed Care: $428.46 Home State Health Plan — Medicare Advantage: $215.08 Optum — Medicare Advantage: $752.50 UnitedHealthcare — Medicaid Managed Care: $389.51
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	Not listed in the file	Not listed in the file	$1,078.71 – $2,445.12
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates Aetna — Better Health Medicaid/QHP: $1,078.71 Aetna — Medicare Advantage: $1,222.56 Cigna — Commercial HMO & PPO: $1,222.56 Healthy Blue — CHP/Medicaid Managed Care: $1,078.71 Home State Health Plan — Medicaid Managed Care: $1,154.22 Home State Health Plan — Medicare Advantage: $1,222.56 Humana — Commercial: $2,445.12 Humana — Medicare Advantage: $1,222.56 UnitedHealthcare — Commercial: $1,462 UnitedHealthcare — Medicaid Managed Care: $1,078.71
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: CHOLECYSTECOMY	$2,969	$2,672.10	$501.18 – $1,039.15
Gallbladder removal by laparoscope: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $601.79 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $501.18 Cigna — Commercial HMO & PPO: $601.79 Healthy Blue — CHP/Medicaid Managed Care: $501.18 Home State Health Plan — Medicaid Managed Care: $551.30 Home State Health Plan — Medicare Advantage: $601.79 Optum — Medicare Advantage: $1,039.15 UnitedHealthcare — Medicaid Managed Care: $501.18
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: LAPAROSCOPY CHOLECYSTECTOMY	$3,570	$3,213	$501.18 – $1,249.50
Gallbladder removal by laparoscope: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $601.79 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $501.18 Cigna — Commercial HMO & PPO: $601.79 Healthy Blue — CHP/Medicaid Managed Care: $501.18 Home State Health Plan — Medicaid Managed Care: $551.30 Home State Health Plan — Medicare Advantage: $601.79 Optum — Medicare Advantage: $1,249.50 UnitedHealthcare — Medicaid Managed Care: $501.18
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: REPAIR INIT ING HERNIA 5 YRS+ REDUCIBLE	$1,586	$1,427.40	$397.19 – $555.10
Groin (inguinal) hernia repair, age 5 or older: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $481.36 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $397.19 Cigna — Commercial HMO & PPO: $481.36 Healthy Blue — CHP/Medicaid Managed Care: $397.19 Home State Health Plan — Medicaid Managed Care: $436.91 Home State Health Plan — Medicare Advantage: $481.36 Optum — Medicare Advantage: $555.10 UnitedHealthcare — Medicaid Managed Care: $397.19
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: REPAIR INIT ING HERNIA >5 AGE REDUCIBLE	$1,995	$1,795.50	$397.19 – $698.25
Groin (inguinal) hernia repair, age 5 or older: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $481.36 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $397.19 Cigna — Commercial HMO & PPO: $481.36 Healthy Blue — CHP/Medicaid Managed Care: $397.19 Home State Health Plan — Medicaid Managed Care: $436.91 Home State Health Plan — Medicare Advantage: $481.36 Optum — Medicare Advantage: $698.25 UnitedHealthcare — Medicaid Managed Care: $397.19
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: BIOPSY, PROSTATE	$820	$738	$287
Prostate biopsy: rates for 1 insurance plan Optum — Medicare Advantage: $287
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy, prostate; needle or punch, single or multiple, any approach	Not listed in the file	Not listed in the file	Not listed in the file
Prostate biopsy: rates for 2 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: 59.2% (a percentage in the contract, not a dollar amount) Anthem Blue Cross Blue Shield Missouri — Traditional: 71.4% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: LESI WITH CT FLURO GUIDANCE	$1,200	$1,080	$85.62 – $420
Spinal injection, lower back (epidural), with imaging guidance: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $85.62 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $198.53 Cigna — Commercial HMO & PPO: $85.62 Healthy Blue — CHP/Medicaid Managed Care: $198.53 Home State Health Plan — Medicaid Managed Care: $218.38 Home State Health Plan — Medicare Advantage: $85.62 Optum — Medicare Advantage: $420 UnitedHealthcare — Medicaid Managed Care: $198.53
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: LESI WITH CT FLUORO GUIDANCE	$420	$378	$85.62 – $218.38
Spinal injection, lower back (epidural), with imaging guidance: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $85.62 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $198.53 Cigna — Commercial HMO & PPO: $85.62 Healthy Blue — CHP/Medicaid Managed Care: $198.53 Home State Health Plan — Medicaid Managed Care: $218.38 Home State Health Plan — Medicare Advantage: $85.62 Optum — Medicare Advantage: $147 UnitedHealthcare — Medicaid Managed Care: $198.53
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including ne	Not listed in the file	Not listed in the file	$636.32 – $1,442.34
Spinal injection, lower back (epidural), with imaging guidance: 10 of 12 insurance plan rates Aetna — Better Health Medicaid/QHP: $636.32 Aetna — Medicare Advantage: $721.17 Cigna — Commercial HMO & PPO: $721.17 Healthy Blue — CHP/Medicaid Managed Care: $636.32 Home State Health Plan — Medicaid Managed Care: $680.86 Home State Health Plan — Medicare Advantage: $721.17 Humana — Commercial: $1,442.34 Humana — Medicare Advantage: $721.17 UnitedHealthcare — Commercial: $947 UnitedHealthcare — Medicaid Managed Care: $636.32
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: INJECTION LUMBAR OR SACRAL, SECOND LEVEL	$1,300	$1,170	$94.96 – $455
Nerve root injection, lower back, with imaging guidance: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $94.96 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $189.23 Cigna — Commercial HMO & PPO: $94.96 Healthy Blue — CHP/Medicaid Managed Care: $189.23 Home State Health Plan — Medicaid Managed Care: $208.15 Home State Health Plan — Medicare Advantage: $94.96 Optum — Medicare Advantage: $455 UnitedHealthcare — Medicaid Managed Care: $189.23
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing	Not listed in the file	Not listed in the file	$797.31 – $1,807.26
Nerve root injection, lower back, with imaging guidance: 10 of 12 insurance plan rates Aetna — Better Health Medicaid/QHP: $797.31 Aetna — Medicare Advantage: $903.63 Cigna — Commercial HMO & PPO: $903.63 Healthy Blue — CHP/Medicaid Managed Care: $797.31 Home State Health Plan — Medicaid Managed Care: $853.12 Home State Health Plan — Medicare Advantage: $903.63 Humana — Commercial: $1,807.26 Humana — Medicare Advantage: $903.63 UnitedHealthcare — Commercial: $947 UnitedHealthcare — Medicaid Managed Care: $797.31
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEUROPLASTY AND OR TRANSPOSITION CTS MED	$2,450	$2,205	$173.53 – $3,990.04
Carpal tunnel release: 10 of 13 insurance plan rates Aetna — Better Health Medicaid/QHP: $1,760.28 Aetna — Medicare Advantage: $1,995.02 Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $1,450.40 Anthem Blue Cross Blue Shield Missouri — Traditional: $1,749.30 Cigna — Commercial HMO & PPO: $1,995.02 Healthy Blue — CHP/Medicaid Managed Care: $1,584.25 Home State Health Plan — Medicaid Managed Care: $1,883.50 Home State Health Plan — Medicare Advantage: $1,995.02 Humana — Commercial: $3,990.04 Humana — Medicare Advantage: $1,995.02
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: NEUROPLASTY MEDIAN NERVE AT CARPAL TUNNE	$2,600	$2,340	$335.75 – $910
Carpal tunnel release: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $390.85 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $335.75 Cigna — Commercial HMO & PPO: $390.85 Healthy Blue — CHP/Medicaid Managed Care: $335.75 Home State Health Plan — Medicaid Managed Care: $369.32 Home State Health Plan — Medicare Advantage: $390.85 Optum — Medicare Advantage: $910 UnitedHealthcare — Medicaid Managed Care: $335.75
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NEUROPLASTY AND OR TRANSPOSITION CTS MED	$2,450	$2,205	Not listed in the file

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VAGINAL DEL (POST CARE)	$2,315	$2,083.50	$173.53 – $1,652.91
Vaginal delivery, with care before and after: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $1,370.48 Anthem Blue Cross Blue Shield Missouri — Traditional: $1,652.91 UnitedHealthcare — Commercial: $1,544.11 UnitedHealthcare — Medicare Advantage: $173.53
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE OB W/VAG DEL	$2,207	$1,986.30	Not listed in the file
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Hospital (facility) fee In the file: VAGINAL DEL (POST CARE)	$2,315	$2,083.50	Not listed in the file
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: C-SECTION	$3,357	$3,021.30	$1,174.95 – $2,369.86
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans Aetna — Commercial/Medicare Advantage: $2,369.86 Anthem Blue Cross Blue Shield Missouri — Medicaid Managed Care: $1,987.76 Cigna — Commercial HMO & PPO: $2,369.86 Healthy Blue — CHP/Medicaid Managed Care: $1,987.76 Home State Health Plan — Medicaid Managed Care: $2,186.54 Home State Health Plan — Medicare Advantage: $2,369.86 Optum — Medicare Advantage: $1,174.95 UnitedHealthcare — Medicaid Managed Care: $1,987.76
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ANTE-POST C-SECTION	$3,357	$3,021.30	$173.53 – $2,396.90
Cesarean delivery (C-section), with care before and after: rates for 4 insurance plans Anthem Blue Cross Blue Shield Missouri — Blue Access/Blue Preferred and Pathway/Pathway X: $1,987.34 Anthem Blue Cross Blue Shield Missouri — Traditional: $2,396.90 UnitedHealthcare — Commercial: $2,239.12 UnitedHealthcare — Medicare Advantage: $173.53
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE OB WITH C/S	$2,592	$2,332.80	Not listed in the file
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE OB WITH VBAC	$2,381	$2,142.90	Not listed in the file

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$79,216.56 – $158,433.12
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 5 insurance plans Aetna — Medicare Advantage: $79,216.56 Cigna — Commercial HMO & PPO: $79,216.56 Home State Health Plan — Medicare Advantage: $79,216.56 Humana — Commercial: $158,433.12 Humana — Medicare Advantage: $79,216.56
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$16,939.66 – $33,879.32
Hip or knee replacement (major joint of the leg), without major complications: rates for 5 insurance plans Aetna — Medicare Advantage: $16,939.66 Cigna — Commercial HMO & PPO: $16,939.66 Home State Health Plan — Medicare Advantage: $16,939.66 Humana — Commercial: $33,879.32 Humana — Medicare Advantage: $16,939.66
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$20,976.09 – $41,952.18
Neck (cervical) spinal fusion, without complications: rates for 5 insurance plans Aetna — Medicare Advantage: $20,976.09 Cigna — Commercial HMO & PPO: $20,976.09 Home State Health Plan — Medicare Advantage: $20,976.09 Humana — Commercial: $41,952.18 Humana — Medicare Advantage: $20,976.09
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$11,530.34 – $23,060.68
Uterus and ovary surgery (not for cancer), without complications: rates for 5 insurance plans Aetna — Medicare Advantage: $11,530.34 Cigna — Commercial HMO & PPO: $11,530.34 Home State Health Plan — Medicare Advantage: $11,530.34 Humana — Commercial: $23,060.68 Humana — Medicare Advantage: $11,530.34

Source: Madison Medical Center’s standard charges file (pricetransparency.healthcare, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on October 13, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	611 W Main St, Fredericktown, MO 63645
County	Madison County
State	Missouri
Phone	(573) 781‑3341
Emergency services	Yes
Ownership	Voluntary non-profit - Other
Medicare overall rating	Not rated by CMS
CMS Certification Number	261302
Name in Medicare records	MADISON MEDICAL CENTER
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(573) 783‑3341^[4][5]
Official website	madisonmedicalcenter.net
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 2026-10-30.

Madison Medical Center — madisonmedicalcenter.net
Hospital - Madison Medical Center — madisonmedicalcenter.net
Outpatient Clinic – Madison Medical Center — madisonmedicalcenter.net
Contact – Madison Medical Center — madisonmedicalcenter.net
Rural Health Clinic – Madison Medical Center — madisonmedicalcenter.net
Physicians – Madison Medical Center — madisonmedicalcenter.net

Madison Medical Center

Summary

Profile from official sources

At a glance