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Acute Care Hospital

Madison Memorial Hospital

Rexburg, Idaho · Madison County · Emergency services listed

Madison Memorial Hospital is an acute care hospital at 450 East Main Street, Rexburg, ID 83440. Phone: (208) 359-6488. It has an emergency department.

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

Summary

Madison Memorial Hospital is an acute care hospital in Rexburg, Idaho. Medicare data lists emergency services. Its official website lists 27 services, specialties and programs. Medicare lists 194 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

A general hospital for short-term care: emergencies, surgery, illness and injury. Most patients stay a few days. More about hospital types

Call(208) 359‑6488 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
Not ratedNot rated by CMSMedicare rating
69Beds (hospital website)
194Doctors and clinicians
27Services listed

Quick answers

Does Madison Memorial Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Madison Memorial Hospital. In a medical emergency, call 911.
Where is Madison Memorial Hospital?
450 East Main Street, Rexburg, ID 83440, in Madison County, Idaho.
What is the phone number of Madison Memorial Hospital?
(208) 359-6488, as listed by Medicare (CMS).
What is the Medicare star rating of Madison Memorial Hospital?
CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.
Does Medicare reduce its payments to Madison Memorial Hospital for hospital-acquired conditions?
No. For fiscal year 2026, CMS lists no Medicare payment reduction for Madison Memorial Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.7806; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[6][7]

Treatments[7]

Procedures[7]

Programs and centers[8]

  • American Heart Association Authorized Training Center (CPR/BLS classes)

Emergency care (hospital website)[4]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

Patient portalMadisonhealth Patient Portal

Recognition[9][10]

  • Pathway to Excellence (ANCC)
  • DNV accreditation (NIHAO program), continuously accredited since 2009

Doctors and clinicians (194)

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

Main specialties

Doctors with a page on this site (194)

And 170 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Rexburg

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

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 3 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital4 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well3 of 5 stars
Patients got help quickly from staff3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean4 of 5 stars
Restfulness of Environment3 of 5 stars
Care Coordination3 of 5 stars
Symptoms After Stay3 of 5 stars
Rated the hospital 9 or 10 out of 1068%National average: 72%
Would definitely recommend the hospital67%National average: 71%
Nurses “always” communicated well76%National average: 80%
Doctors “always” communicated well79%National average: 80%
“Always” got help as soon as they wanted62%National average: 64%
Staff “always” explained medicines before giving them57%National average: 62%
Were given information about recovery at home85%National average: 86%
Room and bathroom “always” clean74%National average: 73%
Completed surveys275Response rate: 17%

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

Infections caught in the hospital

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

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

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

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 patients13.2%
Serious complications (patient safety indicator PSI-90)0.95No different from the national rate
Not reported to MedicareDeaths within 30 days: coronary bypass surgery (CABG)
Too few cases to reportDeaths within 30 days: heart attack patients; Deaths within 30 days: heart failure patients; Deaths within 30 days: COPD patients; Deaths within 30 days: stroke patients; Complications after hip or knee replacement

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)14.5%
Readmitted within 30 days: pneumonia17.4%
Not reported to MedicareReadmitted within 30 days: coronary bypass surgery
Too few cases to reportReadmitted within 30 days: heart attack; Readmitted within 30 days: heart failure; Readmitted within 30 days: COPD; Readmitted within 30 days: hip or knee replacement

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)141 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)71%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Madison Memorial Hospital, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026NoCMS lists no payment reduction for this hospital.
Total HAC Score-0.7806Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart failure1.0081More readmissions than expected
Pneumonia0.9942Fewer readmissions than expected
No result publishedHeart attack; COPD (chronic lung disease); Hip or knee replacement; Coronary bypass surgery (CABG) (not reported, or too few cases)

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio1.01Above the national median hospital (1.00): Medicare spent more

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

No result for this hospital: Hospital Value-Based Purchasing Program. This is normal when a hospital is paid under another Medicare system (for example critical access, children’s or psychiatric hospitals), is not in the program that year, or has too few cases.

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 IdahoBest hospitals in Idaho

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 60 common services exactly as Madison Memorial Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Show the prices of 60 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN $285 $213.75 $54.98 – $109.96
Established patient office visit (about 20–29 minutes): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $54.98
  • DMBA — Medicare Advantage: $54.98
  • MODA CONNEXUS/ SELECT — Commercial: $109.96
  • Molina Healthcare of Idaho — Medicare Advantage: $54.98
  • Partners Direct Health — Medicare Advantage: $93.47
  • Regence Blue Shield of Idaho — Medicare Advantage: $54.98
  • Select Health Idaho — Medicare Advantage: $55.53
  • Triwest Blue Shield — Commercial: $54.98
  • University Of UT Healthy Premier — Medicare Adv: $54.98
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES $274 $205.50 $54.98 – $109.96
Established patient office visit (about 20–29 minutes): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $54.98
  • DMBA — Medicare Advantage: $54.98
  • MODA CONNEXUS/ SELECT — Commercial: $109.96
  • Molina Healthcare of Idaho — Medicare Advantage: $54.98
  • Partners Direct Health — Medicare Advantage: $93.47
  • Regence Blue Shield of Idaho — Medicare Advantage: $54.98
  • Select Health Idaho — Medicare Advantage: $55.53
  • Triwest Blue Shield — Commercial: $54.98
  • University Of UT Healthy Premier — Medicare Adv: $54.98
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES $274 $205.50 $54.98 – $109.96
Established patient office visit (about 20–29 minutes): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $54.98
  • DMBA — Medicare Advantage: $54.98
  • MODA CONNEXUS/ SELECT — Commercial: $109.96
  • Molina Healthcare of Idaho — Medicare Advantage: $54.98
  • Partners Direct Health — Medicare Advantage: $93.47
  • Regence Blue Shield of Idaho — Medicare Advantage: $54.98
  • Select Health Idaho — Medicare Advantage: $55.53
  • Triwest Blue Shield — Commercial: $54.98
  • University Of UT Healthy Premier — Medicare Adv: $54.98
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN $225 $168.75 $80.78 – $161.56
Established patient office visit (about 30–39 minutes): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $80.78
  • DMBA — Medicare Advantage: $80.78
  • MODA CONNEXUS/ SELECT — Commercial: $161.56
  • Molina Healthcare of Idaho — Medicare Advantage: $80.78
  • Partners Direct Health — Medicare Advantage: $137.33
  • Regence Blue Shield of Idaho — Medicare Advantage: $80.78
  • Select Health Idaho — Medicare Advantage: $81.59
  • Triwest Blue Shield — Commercial: $80.78
  • University Of UT Healthy Premier — Medicare Adv: $80.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM $1,055 $791.25 $268.37 – $536.74
Emergency room visit (moderate): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $276.89
  • Altius Coventry Healthcare — Medicare Advantage: $268.37
  • Altius Coventry Healthcare — Workers Compensation: $276.89
  • DMBA — Medicare Advantage: $268.37
  • MODA CONNEXUS/ SELECT — Commercial: $536.74
  • Molina Healthcare of Idaho — Medicare Advantage: $268.37
  • Partners Direct Health — Medicare Advantage: $456.23
  • Regence Blue Shield of Idaho — Medicare Advantage: $268.37
  • Select Health Idaho — Medicare Advantage: $271.05
  • Triwest Blue Shield — Commercial: $268.37
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $977 $732.75 $268.37 – $536.74
Emergency room visit (moderate): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $276.89
  • Altius Coventry Healthcare — Medicare Advantage: $268.37
  • Altius Coventry Healthcare — Workers Compensation: $276.89
  • DMBA — Medicare Advantage: $268.37
  • MODA CONNEXUS/ SELECT — Commercial: $536.74
  • Molina Healthcare of Idaho — Medicare Advantage: $268.37
  • Partners Direct Health — Medicare Advantage: $456.23
  • Regence Blue Shield of Idaho — Medicare Advantage: $268.37
  • Select Health Idaho — Medicare Advantage: $271.05
  • Triwest Blue Shield — Commercial: $268.37
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $977 $732.75 $268.37 – $536.74
Emergency room visit (moderate): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $268.37
  • DMBA — Medicare Advantage: $268.37
  • MODA CONNEXUS/ SELECT — Commercial: $536.74
  • Molina Healthcare of Idaho — Medicare Advantage: $268.37
  • Partners Direct Health — Medicare Advantage: $456.23
  • Regence Blue Shield of Idaho — Medicare Advantage: $268.37
  • Select Health Idaho — Medicare Advantage: $271.05
  • Triwest Blue Shield — Commercial: $268.37
  • University Of UT Healthy Premier — Medicare Adv: $268.37
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM $1,661 $1,245.75 $410.21 – $820.42
Emergency room visit (moderately high): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $425.82
  • Altius Coventry Healthcare — Medicare Advantage: $410.21
  • Altius Coventry Healthcare — Workers Compensation: $425.82
  • DMBA — Medicare Advantage: $410.21
  • MODA CONNEXUS/ SELECT — Commercial: $820.42
  • Molina Healthcare of Idaho — Medicare Advantage: $410.21
  • Partners Direct Health — Medicare Advantage: $697.36
  • Regence Blue Shield of Idaho — Medicare Advantage: $410.21
  • Select Health Idaho — Medicare Advantage: $414.31
  • Triwest Blue Shield — Commercial: $410.21
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $1,538 $1,153.50 $410.21 – $820.42
Emergency room visit (moderately high): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $425.82
  • Altius Coventry Healthcare — Medicare Advantage: $410.21
  • Altius Coventry Healthcare — Workers Compensation: $425.82
  • DMBA — Medicare Advantage: $410.21
  • MODA CONNEXUS/ SELECT — Commercial: $820.42
  • Molina Healthcare of Idaho — Medicare Advantage: $410.21
  • Partners Direct Health — Medicare Advantage: $697.36
  • Regence Blue Shield of Idaho — Medicare Advantage: $410.21
  • Select Health Idaho — Medicare Advantage: $414.31
  • Triwest Blue Shield — Commercial: $410.21
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 24 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $1,538 $1,153.50 $410.21 – $820.42
Emergency room visit (moderately high): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $410.21
  • DMBA — Medicare Advantage: $410.21
  • MODA CONNEXUS/ SELECT — Commercial: $820.42
  • Molina Healthcare of Idaho — Medicare Advantage: $410.21
  • Partners Direct Health — Medicare Advantage: $697.36
  • Regence Blue Shield of Idaho — Medicare Advantage: $410.21
  • Select Health Idaho — Medicare Advantage: $414.31
  • Triwest Blue Shield — Commercial: $410.21
  • University Of UT Healthy Premier — Medicare Adv: $410.21
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM $2,384 $1,788 $585.47 – $1,170.94
Emergency room visit (high): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $613.10
  • Altius Coventry Healthcare — Medicare Advantage: $585.47
  • Altius Coventry Healthcare — Workers Compensation: $613.10
  • DMBA — Medicare Advantage: $585.47
  • MODA CONNEXUS/ SELECT — Commercial: $1,170.94
  • Molina Healthcare of Idaho — Medicare Advantage: $585.47
  • Partners Direct Health — Medicare Advantage: $995.30
  • Regence Blue Shield of Idaho — Medicare Advantage: $585.47
  • Select Health Idaho — Medicare Advantage: $591.32
  • Triwest Blue Shield — Commercial: $585.47
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $2,207 $1,655.25 $585.47 – $1,170.94
Emergency room visit (high): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $613.10
  • Altius Coventry Healthcare — Medicare Advantage: $585.47
  • Altius Coventry Healthcare — Workers Compensation: $613.10
  • DMBA — Medicare Advantage: $585.47
  • MODA CONNEXUS/ SELECT — Commercial: $1,170.94
  • Molina Healthcare of Idaho — Medicare Advantage: $585.47
  • Partners Direct Health — Medicare Advantage: $995.30
  • Regence Blue Shield of Idaho — Medicare Advantage: $585.47
  • Select Health Idaho — Medicare Advantage: $591.32
  • Triwest Blue Shield — Commercial: $585.47
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $2,207 $1,655.25 $585.47 – $1,170.94
Emergency room visit (high): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $585.47
  • DMBA — Medicare Advantage: $585.47
  • MODA CONNEXUS/ SELECT — Commercial: $1,170.94
  • Molina Healthcare of Idaho — Medicare Advantage: $585.47
  • Partners Direct Health — Medicare Advantage: $995.30
  • Regence Blue Shield of Idaho — Medicare Advantage: $585.47
  • Select Health Idaho — Medicare Advantage: $591.32
  • Triwest Blue Shield — Commercial: $585.47
  • University Of UT Healthy Premier — Medicare Adv: $585.47
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: METABOLIC PANEL TOTAL CA $55 $41.25 $8.46 – $16.92
Basic metabolic panel (blood test): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $8.46
  • DMBA — Medicare Advantage: $8.46
  • MODA CONNEXUS/ SELECT — Commercial: $16.92
  • Molina Healthcare of Idaho — Medicare Advantage: $8.46
  • Partners Direct Health — Medicare Advantage: $14.38
  • Regence Blue Shield of Idaho — Medicare Advantage: $8.46
  • Select Health Idaho — Medicare Advantage: $8.54
  • Triwest Blue Shield — Commercial: $8.46
  • University Of UT Healthy Premier — Medicare Adv: $8.46
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $57 $42.75 $8.46 – $16.92
Basic metabolic panel (blood test): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $8.46
  • DMBA — Medicare Advantage: $8.46
  • MODA CONNEXUS/ SELECT — Commercial: $16.92
  • Molina Healthcare of Idaho — Medicare Advantage: $8.46
  • Partners Direct Health — Medicare Advantage: $14.38
  • Regence Blue Shield of Idaho — Medicare Advantage: $8.46
  • Select Health Idaho — Medicare Advantage: $8.54
  • Triwest Blue Shield — Commercial: $8.46
  • University Of UT Healthy Premier — Medicare Adv: $8.46
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $53 $39.75 $8.46 – $16.92
Basic metabolic panel (blood test): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $8.46
  • DMBA — Medicare Advantage: $8.46
  • MODA CONNEXUS/ SELECT — Commercial: $16.92
  • Molina Healthcare of Idaho — Medicare Advantage: $8.46
  • Partners Direct Health — Medicare Advantage: $14.38
  • Regence Blue Shield of Idaho — Medicare Advantage: $8.46
  • Select Health Idaho — Medicare Advantage: $8.54
  • Triwest Blue Shield — Commercial: $8.46
  • University Of UT Healthy Premier — Medicare Adv: $8.46
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL $72 $54 $10.56 – $21.12
Comprehensive metabolic panel (blood test): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $10.56
  • DMBA — Medicare Advantage: $10.56
  • MODA CONNEXUS/ SELECT — Commercial: $21.12
  • Molina Healthcare of Idaho — Medicare Advantage: $10.56
  • Partners Direct Health — Medicare Advantage: $17.95
  • Regence Blue Shield of Idaho — Medicare Advantage: $10.56
  • Select Health Idaho — Medicare Advantage: $10.67
  • Triwest Blue Shield — Commercial: $10.56
  • University Of UT Healthy Premier — Medicare Adv: $10.56
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $144 $108 $10.56 – $21.12
Comprehensive metabolic panel (blood test): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $10.56
  • DMBA — Medicare Advantage: $10.56
  • MODA CONNEXUS/ SELECT — Commercial: $21.12
  • Molina Healthcare of Idaho — Medicare Advantage: $10.56
  • Partners Direct Health — Medicare Advantage: $17.95
  • Regence Blue Shield of Idaho — Medicare Advantage: $10.56
  • Select Health Idaho — Medicare Advantage: $10.67
  • Triwest Blue Shield — Commercial: $10.56
  • University Of UT Healthy Premier — Medicare Adv: $10.56
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91_QW In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $201 $150.75 $10.56 – $21.12
Comprehensive metabolic panel (blood test): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $10.56
  • DMBA — Medicare Advantage: $10.56
  • MODA CONNEXUS/ SELECT — Commercial: $21.12
  • Molina Healthcare of Idaho — Medicare Advantage: $10.56
  • Partners Direct Health — Medicare Advantage: $17.95
  • Regence Blue Shield of Idaho — Medicare Advantage: $10.56
  • Select Health Idaho — Medicare Advantage: $10.67
  • Triwest Blue Shield — Commercial: $10.56
  • University Of UT Healthy Premier — Medicare Adv: $10.56
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL $273 $204.75 $47.81 – $95.62
Obstetric blood test panel: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $47.81
  • DMBA — Medicare Advantage: $47.81
  • MODA CONNEXUS/ SELECT — Commercial: $95.62
  • Molina Healthcare of Idaho — Medicare Advantage: $47.81
  • Partners Direct Health — Medicare Advantage: $81.28
  • Regence Blue Shield of Idaho — Medicare Advantage: $47.81
  • Select Health Idaho — Medicare Advantage: $48.29
  • Triwest Blue Shield — Commercial: $47.81
  • University Of UT Healthy Premier — Medicare Adv: $47.81
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL $92 $69 $13.39 – $26.78
Cholesterol panel (lipid panel): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $13.39
  • DMBA — Medicare Advantage: $13.39
  • MODA CONNEXUS/ SELECT — Commercial: $26.78
  • Molina Healthcare of Idaho — Medicare Advantage: $13.39
  • Partners Direct Health — Medicare Advantage: $22.76
  • Regence Blue Shield of Idaho — Medicare Advantage: $13.39
  • Select Health Idaho — Medicare Advantage: $13.52
  • Triwest Blue Shield — Commercial: $13.39
  • University Of UT Healthy Premier — Medicare Adv: $13.39
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $85 $63.75 $13.39 – $26.78
Cholesterol panel (lipid panel): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $13.39
  • DMBA — Medicare Advantage: $13.39
  • MODA CONNEXUS/ SELECT — Commercial: $26.78
  • Molina Healthcare of Idaho — Medicare Advantage: $13.39
  • Partners Direct Health — Medicare Advantage: $22.76
  • Regence Blue Shield of Idaho — Medicare Advantage: $13.39
  • Select Health Idaho — Medicare Advantage: $13.52
  • Triwest Blue Shield — Commercial: $13.39
  • University Of UT Healthy Premier — Medicare Adv: $13.39
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $85 $63.75 $13.39 – $26.78
Cholesterol panel (lipid panel): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $13.39
  • DMBA — Medicare Advantage: $13.39
  • MODA CONNEXUS/ SELECT — Commercial: $26.78
  • Molina Healthcare of Idaho — Medicare Advantage: $13.39
  • Partners Direct Health — Medicare Advantage: $22.76
  • Regence Blue Shield of Idaho — Medicare Advantage: $13.39
  • Select Health Idaho — Medicare Advantage: $13.52
  • Triwest Blue Shield — Commercial: $13.39
  • University Of UT Healthy Premier — Medicare Adv: $13.39
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL $57 $42.75 $8.68 – $17.36
Kidney function panel: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $8.68
  • DMBA — Medicare Advantage: $8.68
  • MODA CONNEXUS/ SELECT — Commercial: $17.36
  • Molina Healthcare of Idaho — Medicare Advantage: $8.68
  • Partners Direct Health — Medicare Advantage: $14.76
  • Regence Blue Shield of Idaho — Medicare Advantage: $8.68
  • Select Health Idaho — Medicare Advantage: $8.77
  • Triwest Blue Shield — Commercial: $8.68
  • University Of UT Healthy Premier — Medicare Adv: $8.68
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: KIDNEY FUNCTION BLOOD TEST PANEL $55 $41.25 $8.68 – $17.36
Kidney function panel: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $8.68
  • DMBA — Medicare Advantage: $8.68
  • MODA CONNEXUS/ SELECT — Commercial: $17.36
  • Molina Healthcare of Idaho — Medicare Advantage: $8.68
  • Partners Direct Health — Medicare Advantage: $14.76
  • Regence Blue Shield of Idaho — Medicare Advantage: $8.68
  • Select Health Idaho — Medicare Advantage: $8.77
  • Triwest Blue Shield — Commercial: $8.68
  • University Of UT Healthy Premier — Medicare Adv: $8.68
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL $53 $39.75 $8.17 – $16.34
Liver function panel: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $8.17
  • DMBA — Medicare Advantage: $8.17
  • MODA CONNEXUS/ SELECT — Commercial: $16.34
  • Molina Healthcare of Idaho — Medicare Advantage: $8.17
  • Partners Direct Health — Medicare Advantage: $13.89
  • Regence Blue Shield of Idaho — Medicare Advantage: $8.17
  • Select Health Idaho — Medicare Advantage: $8.25
  • Triwest Blue Shield — Commercial: $8.17
  • University Of UT Healthy Premier — Medicare Adv: $8.17
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL $51 $38.25 $8.17 – $16.34
Liver function panel: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $8.17
  • DMBA — Medicare Advantage: $8.17
  • MODA CONNEXUS/ SELECT — Commercial: $16.34
  • Molina Healthcare of Idaho — Medicare Advantage: $8.17
  • Partners Direct Health — Medicare Advantage: $13.89
  • Regence Blue Shield of Idaho — Medicare Advantage: $8.17
  • Select Health Idaho — Medicare Advantage: $8.25
  • Triwest Blue Shield — Commercial: $8.17
  • University Of UT Healthy Premier — Medicare Adv: $8.17
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: LIVER FUNCTION BLOOD TEST PANEL $51 $38.25 $8.17 – $16.34
Liver function panel: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $8.17
  • DMBA — Medicare Advantage: $8.17
  • MODA CONNEXUS/ SELECT — Commercial: $16.34
  • Molina Healthcare of Idaho — Medicare Advantage: $8.17
  • Partners Direct Health — Medicare Advantage: $13.89
  • Regence Blue Shield of Idaho — Medicare Advantage: $8.17
  • Select Health Idaho — Medicare Advantage: $8.25
  • Triwest Blue Shield — Commercial: $8.17
  • University Of UT Healthy Premier — Medicare Adv: $8.17
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE $28 $21 $3.17 – $6.34
Urine test (automated, with microscope): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $3.17
  • DMBA — Medicare Advantage: $3.17
  • MODA CONNEXUS/ SELECT — Commercial: $6.34
  • Molina Healthcare of Idaho — Medicare Advantage: $3.17
  • Partners Direct Health — Medicare Advantage: $5.39
  • Regence Blue Shield of Idaho — Medicare Advantage: $3.17
  • Select Health Idaho — Medicare Advantage: $3.20
  • Triwest Blue Shield — Commercial: $3.17
  • University Of UT Healthy Premier — Medicare Adv: $3.17
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $52 $39 $3.17 – $6.34
Urine test (automated, with microscope): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $3.17
  • DMBA — Medicare Advantage: $3.17
  • MODA CONNEXUS/ SELECT — Commercial: $6.34
  • Molina Healthcare of Idaho — Medicare Advantage: $3.17
  • Partners Direct Health — Medicare Advantage: $5.39
  • Regence Blue Shield of Idaho — Medicare Advantage: $3.17
  • Select Health Idaho — Medicare Advantage: $3.20
  • Triwest Blue Shield — Commercial: $3.17
  • University Of UT Healthy Premier — Medicare Adv: $3.17
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XS In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $27 $20.25 $3.17 – $6.34
Urine test (automated, with microscope): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $3.17
  • DMBA — Medicare Advantage: $3.17
  • MODA CONNEXUS/ SELECT — Commercial: $6.34
  • Molina Healthcare of Idaho — Medicare Advantage: $3.17
  • Partners Direct Health — Medicare Advantage: $5.39
  • Regence Blue Shield of Idaho — Medicare Advantage: $3.17
  • Select Health Idaho — Medicare Advantage: $3.20
  • Triwest Blue Shield — Commercial: $3.17
  • University Of UT Healthy Premier — Medicare Adv: $3.17
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS; MANUAL TEST $26 $19.50 $3.48 – $6.96
Urine test (manual, without microscope): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $3.48
  • DMBA — Medicare Advantage: $3.48
  • MODA CONNEXUS/ SELECT — Commercial: $6.96
  • Molina Healthcare of Idaho — Medicare Advantage: $3.48
  • Partners Direct Health — Medicare Advantage: $5.92
  • Regence Blue Shield of Idaho — Medicare Advantage: $3.48
  • Select Health Idaho — Medicare Advantage: $3.51
  • Triwest Blue Shield — Commercial: $3.48
  • University Of UT Healthy Premier — Medicare Adv: $3.48
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE $18 $13.50 $3.48 – $6.96
Urine test (manual, without microscope): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $3.48
  • DMBA — Medicare Advantage: $3.48
  • MODA CONNEXUS/ SELECT — Commercial: $6.96
  • Molina Healthcare of Idaho — Medicare Advantage: $3.48
  • Partners Direct Health — Medicare Advantage: $5.92
  • Regence Blue Shield of Idaho — Medicare Advantage: $3.48
  • Select Health Idaho — Medicare Advantage: $3.51
  • Triwest Blue Shield — Commercial: $3.48
  • University Of UT Healthy Premier — Medicare Adv: $3.48
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: URINALYSIS; MANUAL TEST $25 $18.75 $3.48 – $6.96
Urine test (manual, without microscope): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $3.48
  • DMBA — Medicare Advantage: $3.48
  • MODA CONNEXUS/ SELECT — Commercial: $6.96
  • Molina Healthcare of Idaho — Medicare Advantage: $3.48
  • Partners Direct Health — Medicare Advantage: $5.92
  • Regence Blue Shield of Idaho — Medicare Advantage: $3.48
  • Select Health Idaho — Medicare Advantage: $3.51
  • Triwest Blue Shield — Commercial: $3.48
  • University Of UT Healthy Premier — Medicare Adv: $3.48
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL $105 $78.75 $18.39 – $36.78
PSA (prostate specific antigen) blood test: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $18.39
  • DMBA — Medicare Advantage: $18.39
  • MODA CONNEXUS/ SELECT — Commercial: $36.78
  • Molina Healthcare of Idaho — Medicare Advantage: $18.39
  • Partners Direct Health — Medicare Advantage: $31.26
  • Regence Blue Shield of Idaho — Medicare Advantage: $18.39
  • Select Health Idaho — Medicare Advantage: $18.57
  • Triwest Blue Shield — Commercial: $18.39
  • University Of UT Healthy Premier — Medicare Adv: $18.39
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL $101 $75.75 $18.39 – $36.78
PSA (prostate specific antigen) blood test: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $18.39
  • DMBA — Medicare Advantage: $18.39
  • MODA CONNEXUS/ SELECT — Commercial: $36.78
  • Molina Healthcare of Idaho — Medicare Advantage: $18.39
  • Partners Direct Health — Medicare Advantage: $31.26
  • Regence Blue Shield of Idaho — Medicare Advantage: $18.39
  • Select Health Idaho — Medicare Advantage: $18.57
  • Triwest Blue Shield — Commercial: $18.39
  • University Of UT Healthy Premier — Medicare Adv: $18.39
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ASSAY OF PSA TOTAL $59 $44.25 $18.39 – $36.78
PSA (prostate specific antigen) blood test: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $18.39
  • DMBA — Medicare Advantage: $18.39
  • MODA CONNEXUS/ SELECT — Commercial: $36.78
  • Molina Healthcare of Idaho — Medicare Advantage: $18.39
  • Partners Direct Health — Medicare Advantage: $31.26
  • Regence Blue Shield of Idaho — Medicare Advantage: $18.39
  • Select Health Idaho — Medicare Advantage: $18.57
  • Triwest Blue Shield — Commercial: $18.39
  • University Of UT Healthy Premier — Medicare Adv: $18.39
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE $116 $87 $16.80 – $33.60
Thyroid stimulating hormone (TSH) test: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $16.80
  • DMBA — Medicare Advantage: $16.80
  • MODA CONNEXUS/ SELECT — Commercial: $33.60
  • Molina Healthcare of Idaho — Medicare Advantage: $16.80
  • Partners Direct Health — Medicare Advantage: $28.56
  • Regence Blue Shield of Idaho — Medicare Advantage: $16.80
  • Select Health Idaho — Medicare Advantage: $16.97
  • Triwest Blue Shield — Commercial: $16.80
  • University Of UT Healthy Premier — Medicare Adv: $16.80
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $107 $80.25 $16.80 – $33.60
Thyroid stimulating hormone (TSH) test: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $16.80
  • DMBA — Medicare Advantage: $16.80
  • MODA CONNEXUS/ SELECT — Commercial: $33.60
  • Molina Healthcare of Idaho — Medicare Advantage: $16.80
  • Partners Direct Health — Medicare Advantage: $28.56
  • Regence Blue Shield of Idaho — Medicare Advantage: $16.80
  • Select Health Idaho — Medicare Advantage: $16.97
  • Triwest Blue Shield — Commercial: $16.80
  • University Of UT Healthy Premier — Medicare Adv: $16.80
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $107 $80.25 $16.80 – $33.60
Thyroid stimulating hormone (TSH) test: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $16.80
  • DMBA — Medicare Advantage: $16.80
  • MODA CONNEXUS/ SELECT — Commercial: $33.60
  • Molina Healthcare of Idaho — Medicare Advantage: $16.80
  • Partners Direct Health — Medicare Advantage: $28.56
  • Regence Blue Shield of Idaho — Medicare Advantage: $16.80
  • Select Health Idaho — Medicare Advantage: $16.97
  • Triwest Blue Shield — Commercial: $16.80
  • University Of UT Healthy Premier — Medicare Adv: $16.80
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC $70 $52.50 $7.77 – $15.54
Complete blood count (CBC) with differential: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $7.77
  • DMBA — Medicare Advantage: $7.77
  • MODA CONNEXUS/ SELECT — Commercial: $15.54
  • Molina Healthcare of Idaho — Medicare Advantage: $7.77
  • Partners Direct Health — Medicare Advantage: $13.21
  • Regence Blue Shield of Idaho — Medicare Advantage: $7.77
  • Select Health Idaho — Medicare Advantage: $7.85
  • Triwest Blue Shield — Commercial: $7.77
  • University Of UT Healthy Premier — Medicare Adv: $7.77
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $68 $51 $7.77 – $15.54
Complete blood count (CBC) with differential: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $7.77
  • DMBA — Medicare Advantage: $7.77
  • MODA CONNEXUS/ SELECT — Commercial: $15.54
  • Molina Healthcare of Idaho — Medicare Advantage: $7.77
  • Partners Direct Health — Medicare Advantage: $13.21
  • Regence Blue Shield of Idaho — Medicare Advantage: $7.77
  • Select Health Idaho — Medicare Advantage: $7.85
  • Triwest Blue Shield — Commercial: $7.77
  • University Of UT Healthy Premier — Medicare Adv: $7.77
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier KX In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $68 $51 $7.77 – $15.54
Complete blood count (CBC) with differential: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $7.77
  • DMBA — Medicare Advantage: $7.77
  • MODA CONNEXUS/ SELECT — Commercial: $15.54
  • Molina Healthcare of Idaho — Medicare Advantage: $7.77
  • Partners Direct Health — Medicare Advantage: $13.21
  • Regence Blue Shield of Idaho — Medicare Advantage: $7.77
  • Select Health Idaho — Medicare Advantage: $7.85
  • Triwest Blue Shield — Commercial: $7.77
  • University Of UT Healthy Premier — Medicare Adv: $7.77
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED $59 $44.25 $6.47 – $12.94
Complete blood count (CBC), automated: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $6.47
  • DMBA — Medicare Advantage: $6.47
  • MODA CONNEXUS/ SELECT — Commercial: $12.94
  • Molina Healthcare of Idaho — Medicare Advantage: $6.47
  • Partners Direct Health — Medicare Advantage: $11
  • Regence Blue Shield of Idaho — Medicare Advantage: $6.47
  • Select Health Idaho — Medicare Advantage: $6.53
  • Triwest Blue Shield — Commercial: $6.47
  • University Of UT Healthy Premier — Medicare Adv: $6.47
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $57 $42.75 $6.47 – $12.94
Complete blood count (CBC), automated: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $6.47
  • DMBA — Medicare Advantage: $6.47
  • MODA CONNEXUS/ SELECT — Commercial: $12.94
  • Molina Healthcare of Idaho — Medicare Advantage: $6.47
  • Partners Direct Health — Medicare Advantage: $11
  • Regence Blue Shield of Idaho — Medicare Advantage: $6.47
  • Select Health Idaho — Medicare Advantage: $6.53
  • Triwest Blue Shield — Commercial: $6.47
  • University Of UT Healthy Premier — Medicare Adv: $6.47
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $68 $51 $6.47 – $12.94
Complete blood count (CBC), automated: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $6.47
  • DMBA — Medicare Advantage: $6.47
  • MODA CONNEXUS/ SELECT — Commercial: $12.94
  • Molina Healthcare of Idaho — Medicare Advantage: $6.47
  • Partners Direct Health — Medicare Advantage: $11
  • Regence Blue Shield of Idaho — Medicare Advantage: $6.47
  • Select Health Idaho — Medicare Advantage: $6.53
  • Triwest Blue Shield — Commercial: $6.47
  • University Of UT Healthy Premier — Medicare Adv: $6.47
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $43.33 $32.50 $4.29 – $8.58
Blood clotting time test (prothrombin time, PT): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $4.29
  • DMBA — Medicare Advantage: $4.29
  • MODA CONNEXUS/ SELECT — Commercial: $8.58
  • Molina Healthcare of Idaho — Medicare Advantage: $4.29
  • Partners Direct Health — Medicare Advantage: $7.29
  • Regence Blue Shield of Idaho — Medicare Advantage: $4.29
  • Select Health Idaho — Medicare Advantage: $4.33
  • Triwest Blue Shield — Commercial: $4.29
  • University Of UT Healthy Premier — Medicare Adv: $4.29
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME $77.60 $58.20 $4.29 – $8.58
Blood clotting time test (prothrombin time, PT): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $4.29
  • DMBA — Medicare Advantage: $4.29
  • MODA CONNEXUS/ SELECT — Commercial: $8.58
  • Molina Healthcare of Idaho — Medicare Advantage: $4.29
  • Partners Direct Health — Medicare Advantage: $7.29
  • Regence Blue Shield of Idaho — Medicare Advantage: $4.29
  • Select Health Idaho — Medicare Advantage: $4.33
  • Triwest Blue Shield — Commercial: $4.29
  • University Of UT Healthy Premier — Medicare Adv: $4.29
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BLOOD TEST; CLOTTING TIME $11 $8.25 $4.29 – $8.58
Blood clotting time test (prothrombin time, PT): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $4.29
  • DMBA — Medicare Advantage: $4.29
  • MODA CONNEXUS/ SELECT — Commercial: $8.58
  • Molina Healthcare of Idaho — Medicare Advantage: $4.29
  • Partners Direct Health — Medicare Advantage: $7.29
  • Regence Blue Shield of Idaho — Medicare Advantage: $4.29
  • Select Health Idaho — Medicare Advantage: $4.33
  • Triwest Blue Shield — Commercial: $4.29
  • University Of UT Healthy Premier — Medicare Adv: $4.29
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL $54 $40.50 $6.01 – $12.02
Blood clotting test (partial thromboplastin time, PTT): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $6.01
  • DMBA — Medicare Advantage: $6.01
  • MODA CONNEXUS/ SELECT — Commercial: $12.02
  • Molina Healthcare of Idaho — Medicare Advantage: $6.01
  • Partners Direct Health — Medicare Advantage: $10.22
  • Regence Blue Shield of Idaho — Medicare Advantage: $6.01
  • Select Health Idaho — Medicare Advantage: $6.07
  • Triwest Blue Shield — Commercial: $6.01
  • University Of UT Healthy Premier — Medicare Adv: $6.01
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $66 $49.50 $6.01 – $12.02
Blood clotting test (partial thromboplastin time, PTT): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $6.01
  • DMBA — Medicare Advantage: $6.01
  • MODA CONNEXUS/ SELECT — Commercial: $12.02
  • Molina Healthcare of Idaho — Medicare Advantage: $6.01
  • Partners Direct Health — Medicare Advantage: $10.22
  • Regence Blue Shield of Idaho — Medicare Advantage: $6.01
  • Select Health Idaho — Medicare Advantage: $6.07
  • Triwest Blue Shield — Commercial: $6.01
  • University Of UT Healthy Premier — Medicare Adv: $6.01
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT HEAD/BRAIN W/O DYE $934 $700.50 $102.78 – $205.56
CT scan of the head or brain, without contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 76_TC In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $865 $648.75 $102.78 – $205.56
CT scan of the head or brain, without contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier MA_TC In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $865 $648.75 $102.78 – $205.56
CT scan of the head or brain, without contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE $2,906 $2,179.50 $342.98 – $685.96
MRI of the brain, before and after contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $357.13
  • Altius Coventry Healthcare — Medicare Advantage: $342.98
  • Altius Coventry Healthcare — Workers Compensation: $357.13
  • DMBA — Medicare Advantage: $342.98
  • MODA CONNEXUS/ SELECT — Commercial: $685.96
  • Molina Healthcare of Idaho — Medicare Advantage: $342.98
  • Partners Direct Health — Medicare Advantage: $583.07
  • Regence Blue Shield of Idaho — Medicare Advantage: $342.98
  • Select Health Idaho — Medicare Advantage: $346.41
  • Triwest Blue Shield — Commercial: $342.98
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST $2,792 $2,094 $342.98 – $685.96
MRI of the brain, before and after contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $357.13
  • Altius Coventry Healthcare — Medicare Advantage: $342.98
  • Altius Coventry Healthcare — Workers Compensation: $357.13
  • DMBA — Medicare Advantage: $342.98
  • MODA CONNEXUS/ SELECT — Commercial: $685.96
  • Molina Healthcare of Idaho — Medicare Advantage: $342.98
  • Partners Direct Health — Medicare Advantage: $583.07
  • Regence Blue Shield of Idaho — Medicare Advantage: $342.98
  • Select Health Idaho — Medicare Advantage: $346.41
  • Triwest Blue Shield — Commercial: $342.98
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI BRAIN STEM W/O & W/DYE $2,906 $2,179.50 $342.98 – $685.96
MRI of the brain, before and after contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $342.98
  • DMBA — Medicare Advantage: $342.98
  • MODA CONNEXUS/ SELECT — Commercial: $685.96
  • Molina Healthcare of Idaho — Medicare Advantage: $342.98
  • Partners Direct Health — Medicare Advantage: $583.07
  • Regence Blue Shield of Idaho — Medicare Advantage: $342.98
  • Select Health Idaho — Medicare Advantage: $346.41
  • Triwest Blue Shield — Commercial: $342.98
  • University Of UT Healthy Premier — Medicare Adv: $342.98
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY EXAM CHEST 2 VIEWS $262 $196.50 $85.56 – $171.12
Chest X-ray, 2 views: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $85.56
  • DMBA — Medicare Advantage: $85.56
  • MODA CONNEXUS/ SELECT — Commercial: $171.12
  • Molina Healthcare of Idaho — Medicare Advantage: $85.56
  • Partners Direct Health — Medicare Advantage: $145.45
  • Regence Blue Shield of Idaho — Medicare Advantage: $85.56
  • Select Health Idaho — Medicare Advantage: $86.42
  • Triwest Blue Shield — Commercial: $85.56
  • University Of UT Healthy Premier — Medicare Adv: $85.56
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 76_TC In the file: X-RAY OF CHEST; 2 VIEWS $243 $182.25 $85.56 – $171.12
Chest X-ray, 2 views: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $85.56
  • DMBA — Medicare Advantage: $85.56
  • MODA CONNEXUS/ SELECT — Commercial: $171.12
  • Molina Healthcare of Idaho — Medicare Advantage: $85.56
  • Partners Direct Health — Medicare Advantage: $145.45
  • Regence Blue Shield of Idaho — Medicare Advantage: $85.56
  • Select Health Idaho — Medicare Advantage: $86.42
  • Triwest Blue Shield — Commercial: $85.56
  • University Of UT Healthy Premier — Medicare Adv: $85.56
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC_XU In the file: X-RAY OF CHEST; 2 VIEWS $243 $182.25 $85.56 – $171.12
Chest X-ray, 2 views: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $85.56
  • DMBA — Medicare Advantage: $85.56
  • MODA CONNEXUS/ SELECT — Commercial: $171.12
  • Molina Healthcare of Idaho — Medicare Advantage: $85.56
  • Partners Direct Health — Medicare Advantage: $145.45
  • Regence Blue Shield of Idaho — Medicare Advantage: $85.56
  • Select Health Idaho — Medicare Advantage: $86.42
  • Triwest Blue Shield — Commercial: $85.56
  • University Of UT Healthy Premier — Medicare Adv: $85.56
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY EXAM L-2 SPINE 4/>VWS $271 $203.25 $102.78 – $205.56
X-ray of the lower spine, at least 4 views: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS $247 $185.25 $102.78 – $205.56
X-ray of the lower spine, at least 4 views: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI LUMBAR SPINE W/O DYE $1,570 $1,177.50 $234.57 – $469.14
MRI of the lower back (lumbar spine), without contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $234.57
  • DMBA — Medicare Advantage: $234.57
  • MODA CONNEXUS/ SELECT — Commercial: $469.14
  • Molina Healthcare of Idaho — Medicare Advantage: $234.57
  • Partners Direct Health — Medicare Advantage: $398.77
  • Regence Blue Shield of Idaho — Medicare Advantage: $234.57
  • Select Health Idaho — Medicare Advantage: $236.92
  • Triwest Blue Shield — Commercial: $234.57
  • University Of UT Healthy Premier — Medicare Adv: $234.57
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST $1,509 $1,131.75 $234.57 – $469.14
MRI of the lower back (lumbar spine), without contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $234.57
  • DMBA — Medicare Advantage: $234.57
  • MODA CONNEXUS/ SELECT — Commercial: $469.14
  • Molina Healthcare of Idaho — Medicare Advantage: $234.57
  • Partners Direct Health — Medicare Advantage: $398.77
  • Regence Blue Shield of Idaho — Medicare Advantage: $234.57
  • Select Health Idaho — Medicare Advantage: $236.92
  • Triwest Blue Shield — Commercial: $234.57
  • University Of UT Healthy Premier — Medicare Adv: $234.57
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT PELVIS W/DYE $1,638 $1,228.50 $172.44 – $344.88
CT scan of the pelvis, with contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $172.44
  • DMBA — Medicare Advantage: $172.44
  • MODA CONNEXUS/ SELECT — Commercial: $344.88
  • Molina Healthcare of Idaho — Medicare Advantage: $172.44
  • Partners Direct Health — Medicare Advantage: $293.15
  • Regence Blue Shield of Idaho — Medicare Advantage: $172.44
  • Select Health Idaho — Medicare Advantage: $174.16
  • Triwest Blue Shield — Commercial: $172.44
  • University Of UT Healthy Premier — Medicare Adv: $172.44
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT SCAN OF PELVIS WITH CONTRAST $1,574 $1,180.50 $172.44 – $344.88
CT scan of the pelvis, with contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $172.44
  • DMBA — Medicare Advantage: $172.44
  • MODA CONNEXUS/ SELECT — Commercial: $344.88
  • Molina Healthcare of Idaho — Medicare Advantage: $172.44
  • Partners Direct Health — Medicare Advantage: $293.15
  • Regence Blue Shield of Idaho — Medicare Advantage: $172.44
  • Select Health Idaho — Medicare Advantage: $174.16
  • Triwest Blue Shield — Commercial: $172.44
  • University Of UT Healthy Premier — Medicare Adv: $172.44
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT_TC In the file: MRI JNT OF LWR EXTRE W/O DYE $1,714 $1,285.50 $234.57 – $469.14
MRI of a leg joint (such as the knee), without contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $234.57
  • DMBA — Medicare Advantage: $234.57
  • MODA CONNEXUS/ SELECT — Commercial: $469.14
  • Molina Healthcare of Idaho — Medicare Advantage: $234.57
  • Partners Direct Health — Medicare Advantage: $398.77
  • Regence Blue Shield of Idaho — Medicare Advantage: $234.57
  • Select Health Idaho — Medicare Advantage: $236.92
  • Triwest Blue Shield — Commercial: $234.57
  • University Of UT Healthy Premier — Medicare Adv: $234.57
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_TC In the file: MRI JNT OF LWR EXTRE W/O DYE $2,572 $1,929 $517.55 – $1,035.10
MRI of a leg joint (such as the knee), without contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $517.55
  • DMBA — Medicare Advantage: $517.55
  • MODA CONNEXUS/ SELECT — Commercial: $1,035.10
  • Molina Healthcare of Idaho — Medicare Advantage: $517.55
  • Partners Direct Health — Medicare Advantage: $879.83
  • Regence Blue Shield of Idaho — Medicare Advantage: $517.55
  • Select Health Idaho — Medicare Advantage: $522.73
  • Triwest Blue Shield — Commercial: $517.55
  • University Of UT Healthy Premier — Medicare Adv: $517.55
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: MRI JNT OF LWR EXTRE W/O DYE $1,714 $1,285.50 $234.57 – $469.14
MRI of a leg joint (such as the knee), without contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $234.57
  • DMBA — Medicare Advantage: $234.57
  • MODA CONNEXUS/ SELECT — Commercial: $469.14
  • Molina Healthcare of Idaho — Medicare Advantage: $234.57
  • Partners Direct Health — Medicare Advantage: $398.77
  • Regence Blue Shield of Idaho — Medicare Advantage: $234.57
  • Select Health Idaho — Medicare Advantage: $236.92
  • Triwest Blue Shield — Commercial: $234.57
  • University Of UT Healthy Premier — Medicare Adv: $234.57
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT ABD & PELVIS W/CONTRAST $2,673 $2,004.75 $342.98 – $685.96
CT scan of the abdomen and pelvis, with contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $342.98
  • DMBA — Medicare Advantage: $342.98
  • MODA CONNEXUS/ SELECT — Commercial: $685.96
  • Molina Healthcare of Idaho — Medicare Advantage: $342.98
  • Partners Direct Health — Medicare Advantage: $583.07
  • Regence Blue Shield of Idaho — Medicare Advantage: $342.98
  • Select Health Idaho — Medicare Advantage: $346.41
  • Triwest Blue Shield — Commercial: $342.98
  • University Of UT Healthy Premier — Medicare Adv: $342.98
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier MA_TC In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $2,568 $1,926 $342.98 – $685.96
CT scan of the abdomen and pelvis, with contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $342.98
  • DMBA — Medicare Advantage: $342.98
  • MODA CONNEXUS/ SELECT — Commercial: $685.96
  • Molina Healthcare of Idaho — Medicare Advantage: $342.98
  • Partners Direct Health — Medicare Advantage: $583.07
  • Regence Blue Shield of Idaho — Medicare Advantage: $342.98
  • Select Health Idaho — Medicare Advantage: $346.41
  • Triwest Blue Shield — Commercial: $342.98
  • University Of UT Healthy Premier — Medicare Adv: $342.98
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ME_TC In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $2,568 $1,926 $342.98 – $685.96
CT scan of the abdomen and pelvis, with contrast: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $342.98
  • DMBA — Medicare Advantage: $342.98
  • MODA CONNEXUS/ SELECT — Commercial: $685.96
  • Molina Healthcare of Idaho — Medicare Advantage: $342.98
  • Partners Direct Health — Medicare Advantage: $583.07
  • Regence Blue Shield of Idaho — Medicare Advantage: $342.98
  • Select Health Idaho — Medicare Advantage: $346.41
  • Triwest Blue Shield — Commercial: $342.98
  • University Of UT Healthy Premier — Medicare Adv: $342.98
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: US EXAM ABDOM COMPLETE $320 $240 $102.78 – $205.56
Ultrasound of the abdomen, complete: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC_XU In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $308 $231 $102.78 – $205.56
Ultrasound of the abdomen, complete: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $308 $231 $102.78 – $205.56
Ultrasound of the abdomen, complete: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: OB US >= 14 WKS SNGL FETUS $532 $399 $102.78 – $205.56
Pregnancy ultrasound (after the first trimester): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS $421 $315.75 $102.78 – $205.56
Pregnancy ultrasound (after the first trimester): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: TRANSVAGINAL US NON-OB $338 $253.50 $102.78 – $205.56
Transvaginal ultrasound: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA $325 $243.75 $102.78 – $205.56
Transvaginal ultrasound: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $102.78
  • DMBA — Medicare Advantage: $102.78
  • MODA CONNEXUS/ SELECT — Commercial: $205.56
  • Molina Healthcare of Idaho — Medicare Advantage: $102.78
  • Partners Direct Health — Medicare Advantage: $174.73
  • Regence Blue Shield of Idaho — Medicare Advantage: $102.78
  • Select Health Idaho — Medicare Advantage: $103.81
  • Triwest Blue Shield — Commercial: $102.78
  • University Of UT Healthy Premier — Medicare Adv: $102.78
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) $4,067 $3,050.25 $844.23 – $1,688.46
Sleep study (overnight, in a sleep lab): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $1,017.39
  • Altius Coventry Healthcare — Medicare Advantage: $844.23
  • Altius Coventry Healthcare — Workers Compensation: $1,017.39
  • DMBA — Medicare Advantage: $844.23
  • MODA CONNEXUS/ SELECT — Commercial: $1,688.46
  • Molina Healthcare of Idaho — Medicare Advantage: $844.23
  • Partners Direct Health — Medicare Advantage: $1,435.19
  • Regence Blue Shield of Idaho — Medicare Advantage: $844.23
  • Select Health Idaho — Medicare Advantage: $852.67
  • Triwest Blue Shield — Commercial: $844.23
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: POLYSOM 6/> YRS 4/> PARAM $4,233 $3,174.75 $844.23 – $1,688.46
Sleep study (overnight, in a sleep lab): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $844.23
  • DMBA — Medicare Advantage: $844.23
  • MODA CONNEXUS/ SELECT — Commercial: $1,688.46
  • Molina Healthcare of Idaho — Medicare Advantage: $844.23
  • Partners Direct Health — Medicare Advantage: $1,435.19
  • Regence Blue Shield of Idaho — Medicare Advantage: $844.23
  • Select Health Idaho — Medicare Advantage: $852.67
  • Triwest Blue Shield — Commercial: $844.23
  • University Of UT Healthy Premier — Medicare Adv: $844.23
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) $4,067 $3,050.25 $844.23 – $1,688.46
Sleep study (overnight, in a sleep lab): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $844.23
  • DMBA — Medicare Advantage: $844.23
  • MODA CONNEXUS/ SELECT — Commercial: $1,688.46
  • Molina Healthcare of Idaho — Medicare Advantage: $844.23
  • Partners Direct Health — Medicare Advantage: $1,435.19
  • Regence Blue Shield of Idaho — Medicare Advantage: $844.23
  • Select Health Idaho — Medicare Advantage: $852.67
  • Triwest Blue Shield — Commercial: $844.23
  • University Of UT Healthy Premier — Medicare Adv: $844.23
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THERAPEUTIC EXERCISES $83 $62.25 $27.79 – $55.58
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $27.79
  • DMBA — Medicare Advantage: $27.79
  • MODA CONNEXUS/ SELECT — Commercial: $55.58
  • Molina Healthcare of Idaho — Medicare Advantage: $27.79
  • Partners Direct Health — Medicare Advantage: $47.24
  • Regence Blue Shield of Idaho — Medicare Advantage: $27.79
  • Select Health Idaho — Medicare Advantage: $28.07
  • Triwest Blue Shield — Commercial: $27.79
  • University Of UT Healthy Premier — Medicare Adv: $27.79
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THERAPEUTIC EXERCISES $83 $62.25 $27.79 – $55.58
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $27.79
  • DMBA — Medicare Advantage: $27.79
  • MODA CONNEXUS/ SELECT — Commercial: $55.58
  • Molina Healthcare of Idaho — Medicare Advantage: $27.79
  • Partners Direct Health — Medicare Advantage: $47.24
  • Regence Blue Shield of Idaho — Medicare Advantage: $27.79
  • Select Health Idaho — Medicare Advantage: $28.07
  • Triwest Blue Shield — Commercial: $27.79
  • University Of UT Healthy Premier — Medicare Adv: $27.79
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO_CO In the file: THERAPEUTIC EXERCISES $83 $62.25 $27.79 – $55.58
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $27.79
  • DMBA — Medicare Advantage: $27.79
  • MODA CONNEXUS/ SELECT — Commercial: $55.58
  • Molina Healthcare of Idaho — Medicare Advantage: $27.79
  • Partners Direct Health — Medicare Advantage: $47.24
  • Regence Blue Shield of Idaho — Medicare Advantage: $27.79
  • Select Health Idaho — Medicare Advantage: $28.07
  • Triwest Blue Shield — Commercial: $27.79
  • University Of UT Healthy Premier — Medicare Adv: $27.79
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES $200 $150 $94 – $188
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $94
  • DMBA — Medicare Advantage: $94
  • MODA CONNEXUS/ SELECT — Commercial: $188
  • Molina Healthcare of Idaho — Medicare Advantage: $94
  • Partners Direct Health — Medicare Advantage: $159.80
  • Regence Blue Shield of Idaho — Medicare Advantage: $94
  • Select Health Idaho — Medicare Advantage: $94.94
  • Triwest Blue Shield — Commercial: $94
  • University Of UT Healthy Premier — Medicare Adv: $94
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL LOW COMPLEX 20 MIN $208 $156 $94 – $188
Physical therapy evaluation (low complexity): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $94
  • DMBA — Medicare Advantage: $94
  • MODA CONNEXUS/ SELECT — Commercial: $188
  • Molina Healthcare of Idaho — Medicare Advantage: $94
  • Partners Direct Health — Medicare Advantage: $159.80
  • Regence Blue Shield of Idaho — Medicare Advantage: $94
  • Select Health Idaho — Medicare Advantage: $94.94
  • Triwest Blue Shield — Commercial: $94
  • University Of UT Healthy Premier — Medicare Adv: $94
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_XU In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES $200 $150 $94 – $188
Physical therapy evaluation (low complexity): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $94
  • DMBA — Medicare Advantage: $94
  • MODA CONNEXUS/ SELECT — Commercial: $188
  • Molina Healthcare of Idaho — Medicare Advantage: $94
  • Partners Direct Health — Medicare Advantage: $159.80
  • Regence Blue Shield of Idaho — Medicare Advantage: $94
  • Select Health Idaho — Medicare Advantage: $94.94
  • Triwest Blue Shield — Commercial: $94
  • University Of UT Healthy Premier — Medicare Adv: $94
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEX 30 MIN $223 $167.25 $94 – $188
Physical therapy evaluation (moderate complexity): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $94
  • DMBA — Medicare Advantage: $94
  • MODA CONNEXUS/ SELECT — Commercial: $188
  • Molina Healthcare of Idaho — Medicare Advantage: $94
  • Partners Direct Health — Medicare Advantage: $159.80
  • Regence Blue Shield of Idaho — Medicare Advantage: $94
  • Select Health Idaho — Medicare Advantage: $94.94
  • Triwest Blue Shield — Commercial: $94
  • University Of UT Healthy Premier — Medicare Adv: $94
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES $215 $161.25 $94 – $188
Physical therapy evaluation (moderate complexity): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $94
  • DMBA — Medicare Advantage: $94
  • MODA CONNEXUS/ SELECT — Commercial: $188
  • Molina Healthcare of Idaho — Medicare Advantage: $94
  • Partners Direct Health — Medicare Advantage: $159.80
  • Regence Blue Shield of Idaho — Medicare Advantage: $94
  • Select Health Idaho — Medicare Advantage: $94.94
  • Triwest Blue Shield — Commercial: $94
  • University Of UT Healthy Premier — Medicare Adv: $94
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEX 45 MIN $239 $179.25 $94 – $188
Physical therapy evaluation (high complexity): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $94
  • DMBA — Medicare Advantage: $94
  • MODA CONNEXUS/ SELECT — Commercial: $188
  • Molina Healthcare of Idaho — Medicare Advantage: $94
  • Partners Direct Health — Medicare Advantage: $159.80
  • Regence Blue Shield of Idaho — Medicare Advantage: $94
  • Select Health Idaho — Medicare Advantage: $94.94
  • Triwest Blue Shield — Commercial: $94
  • University Of UT Healthy Premier — Medicare Adv: $94
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES $230 $172.50 $94 – $188
Physical therapy evaluation (high complexity): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $94
  • DMBA — Medicare Advantage: $94
  • MODA CONNEXUS/ SELECT — Commercial: $188
  • Molina Healthcare of Idaho — Medicare Advantage: $94
  • Partners Direct Health — Medicare Advantage: $159.80
  • Regence Blue Shield of Idaho — Medicare Advantage: $94
  • Select Health Idaho — Medicare Advantage: $94.94
  • Triwest Blue Shield — Commercial: $94
  • University Of UT Healthy Premier — Medicare Adv: $94
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION $7,387 $5,540.25 $3,829.28 – $7,698.56
Removal of breast growth (open surgery): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $3,829.28
  • Altius Coventry Healthcare — Medicare Advantage: $3,849.28
  • Altius Coventry Healthcare — Workers Compensation: $3,829.28
  • DMBA — Medicare Advantage: $3,849.28
  • MODA CONNEXUS/ SELECT — Commercial: $7,698.56
  • Molina Healthcare of Idaho — Medicare Advantage: $3,849.28
  • Partners Direct Health — Medicare Advantage: $6,543.78
  • Regence Blue Shield of Idaho — Medicare Advantage: $3,849.28
  • Select Health Idaho — Medicare Advantage: $3,887.77
  • Triwest Blue Shield — Commercial: $3,849.28
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $7,097 $5,322.75 $3,849.28 – $7,698.56
Removal of breast growth (open surgery): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $3,849.28
  • DMBA — Medicare Advantage: $3,849.28
  • MODA CONNEXUS/ SELECT — Commercial: $7,698.56
  • Molina Healthcare of Idaho — Medicare Advantage: $3,849.28
  • Partners Direct Health — Medicare Advantage: $6,543.78
  • Regence Blue Shield of Idaho — Medicare Advantage: $3,849.28
  • Select Health Idaho — Medicare Advantage: $3,887.77
  • Triwest Blue Shield — Commercial: $3,849.28
  • University Of UT Healthy Premier — Medicare Adv: $3,849.28
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $5,097 $3,822.75 $3,849.28 – $7,698.56
Removal of breast growth (open surgery): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $3,849.28
  • DMBA — Medicare Advantage: $3,849.28
  • MODA CONNEXUS/ SELECT — Commercial: $7,698.56
  • Molina Healthcare of Idaho — Medicare Advantage: $3,849.28
  • Partners Direct Health — Medicare Advantage: $6,543.78
  • Regence Blue Shield of Idaho — Medicare Advantage: $3,849.28
  • Select Health Idaho — Medicare Advantage: $3,887.77
  • Triwest Blue Shield — Commercial: $3,849.28
  • University Of UT Healthy Premier — Medicare Adv: $3,849.28
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY $24,847 $18,635.25 $12,621.76 – $25,243.52
Total hip replacement: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $12,866.82
  • Altius Coventry Healthcare — Medicare Advantage: $12,621.76
  • Altius Coventry Healthcare — Workers Compensation: $12,866.82
  • DMBA — Medicare Advantage: $12,621.76
  • MODA CONNEXUS/ SELECT — Commercial: $25,243.52
  • Molina Healthcare of Idaho — Medicare Advantage: $12,621.76
  • Partners Direct Health — Medicare Advantage: $21,456.99
  • Regence Blue Shield of Idaho — Medicare Advantage: $12,621.76
  • Select Health Idaho — Medicare Advantage: $12,747.98
  • Triwest Blue Shield — Commercial: $12,621.76
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $23,869 $17,901.75 $12,621.76 – $25,243.52
Total hip replacement: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $12,621.76
  • DMBA — Medicare Advantage: $12,621.76
  • MODA CONNEXUS/ SELECT — Commercial: $25,243.52
  • Molina Healthcare of Idaho — Medicare Advantage: $12,621.76
  • Partners Direct Health — Medicare Advantage: $21,456.99
  • Regence Blue Shield of Idaho — Medicare Advantage: $12,621.76
  • Select Health Idaho — Medicare Advantage: $12,747.98
  • Triwest Blue Shield — Commercial: $12,621.76
  • University Of UT Healthy Premier — Medicare Adv: $12,621.76
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $23,869 $17,901.75 $12,621.76 – $25,243.52
Total hip replacement: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $12,621.76
  • DMBA — Medicare Advantage: $12,621.76
  • MODA CONNEXUS/ SELECT — Commercial: $25,243.52
  • Molina Healthcare of Idaho — Medicare Advantage: $12,621.76
  • Partners Direct Health — Medicare Advantage: $21,456.99
  • Regence Blue Shield of Idaho — Medicare Advantage: $12,621.76
  • Select Health Idaho — Medicare Advantage: $12,747.98
  • Triwest Blue Shield — Commercial: $12,621.76
  • University Of UT Healthy Premier — Medicare Adv: $12,621.76
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY $18,945 $14,208.75 $12,621.76 – $25,243.52
Total knee replacement: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $12,866.82
  • Altius Coventry Healthcare — Medicare Advantage: $12,621.76
  • Altius Coventry Healthcare — Workers Compensation: $12,866.82
  • DMBA — Medicare Advantage: $12,621.76
  • MODA CONNEXUS/ SELECT — Commercial: $25,243.52
  • Molina Healthcare of Idaho — Medicare Advantage: $12,621.76
  • Partners Direct Health — Medicare Advantage: $21,456.99
  • Regence Blue Shield of Idaho — Medicare Advantage: $12,621.76
  • Select Health Idaho — Medicare Advantage: $12,747.98
  • Triwest Blue Shield — Commercial: $12,621.76
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE $18,199 $13,649.25 $12,621.76 – $25,243.52
Total knee replacement: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $12,621.76
  • DMBA — Medicare Advantage: $12,621.76
  • MODA CONNEXUS/ SELECT — Commercial: $25,243.52
  • Molina Healthcare of Idaho — Medicare Advantage: $12,621.76
  • Partners Direct Health — Medicare Advantage: $21,456.99
  • Regence Blue Shield of Idaho — Medicare Advantage: $12,621.76
  • Select Health Idaho — Medicare Advantage: $12,747.98
  • Triwest Blue Shield — Commercial: $12,621.76
  • University Of UT Healthy Premier — Medicare Adv: $12,621.76
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE $18,199 $13,649.25 $12,621.76 – $25,243.52
Total knee replacement: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $12,621.76
  • DMBA — Medicare Advantage: $12,621.76
  • MODA CONNEXUS/ SELECT — Commercial: $25,243.52
  • Molina Healthcare of Idaho — Medicare Advantage: $12,621.76
  • Partners Direct Health — Medicare Advantage: $21,456.99
  • Regence Blue Shield of Idaho — Medicare Advantage: $12,621.76
  • Select Health Idaho — Medicare Advantage: $12,747.98
  • Triwest Blue Shield — Commercial: $12,621.76
  • University Of UT Healthy Premier — Medicare Adv: $12,621.76
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION $8,672 $6,504 $134.99 – $269.98
Shoulder arthroscopy: shaving of shoulder bone: 10 of 21 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $134.99
  • DMBA — Medicare Advantage: $134.99
  • MODA CONNEXUS/ SELECT — Commercial: $269.98
  • Molina Healthcare of Idaho — Medicare Advantage: $134.99
  • Partners Direct Health — Medicare Advantage: $229.48
  • Regence Blue Shield of Idaho — Medicare Advantage: $134.99
  • Select Health Idaho — Medicare Advantage: $136.34
  • Triwest Blue Shield — Commercial: $134.99
  • University Of UT Healthy Premier — Medicare Adv: $134.99
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE $8,331 $6,248.25 $134.99 – $269.98
Shoulder arthroscopy: shaving of shoulder bone: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $134.99
  • DMBA — Medicare Advantage: $134.99
  • MODA CONNEXUS/ SELECT — Commercial: $269.98
  • Molina Healthcare of Idaho — Medicare Advantage: $134.99
  • Partners Direct Health — Medicare Advantage: $229.48
  • Regence Blue Shield of Idaho — Medicare Advantage: $134.99
  • Select Health Idaho — Medicare Advantage: $136.34
  • Triwest Blue Shield — Commercial: $134.99
  • University Of UT Healthy Premier — Medicare Adv: $134.99
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE $5,906 $4,429.50 $134.99 – $269.98
Shoulder arthroscopy: shaving of shoulder bone: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $134.99
  • DMBA — Medicare Advantage: $134.99
  • MODA CONNEXUS/ SELECT — Commercial: $269.98
  • Molina Healthcare of Idaho — Medicare Advantage: $134.99
  • Partners Direct Health — Medicare Advantage: $229.48
  • Regence Blue Shield of Idaho — Medicare Advantage: $134.99
  • Select Health Idaho — Medicare Advantage: $136.34
  • Triwest Blue Shield — Commercial: $134.99
  • University Of UT Healthy Premier — Medicare Adv: $134.99
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KNEE ARTHROSCOPY/SURGERY $5,553 $4,164.75 $3,216.72 – $6,433.44
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $3,244.61
  • Altius Coventry Healthcare — Medicare Advantage: $3,216.72
  • Altius Coventry Healthcare — Workers Compensation: $3,244.61
  • DMBA — Medicare Advantage: $3,216.72
  • MODA CONNEXUS/ SELECT — Commercial: $6,433.44
  • Molina Healthcare of Idaho — Medicare Advantage: $3,216.72
  • Partners Direct Health — Medicare Advantage: $5,468.42
  • Regence Blue Shield of Idaho — Medicare Advantage: $3,216.72
  • Select Health Idaho — Medicare Advantage: $3,248.89
  • Triwest Blue Shield — Commercial: $3,216.72
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $4,111 $3,083.25 $3,216.72 – $6,433.44
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $3,216.72
  • DMBA — Medicare Advantage: $3,216.72
  • MODA CONNEXUS/ SELECT — Commercial: $6,433.44
  • Molina Healthcare of Idaho — Medicare Advantage: $3,216.72
  • Partners Direct Health — Medicare Advantage: $5,468.42
  • Regence Blue Shield of Idaho — Medicare Advantage: $3,216.72
  • Select Health Idaho — Medicare Advantage: $3,248.89
  • Triwest Blue Shield — Commercial: $3,216.72
  • University Of UT Healthy Premier — Medicare Adv: $3,216.72
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $4,111 $3,083.25 $3,216.72 – $6,433.44
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $3,216.72
  • DMBA — Medicare Advantage: $3,216.72
  • MODA CONNEXUS/ SELECT — Commercial: $6,433.44
  • Molina Healthcare of Idaho — Medicare Advantage: $3,216.72
  • Partners Direct Health — Medicare Advantage: $5,468.42
  • Regence Blue Shield of Idaho — Medicare Advantage: $3,216.72
  • Select Health Idaho — Medicare Advantage: $3,248.89
  • Triwest Blue Shield — Commercial: $3,216.72
  • University Of UT Healthy Premier — Medicare Adv: $3,216.72
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS $11,392 $8,544 $5,819.80 – $11,639.60
Removal of tonsils and adenoids (under age 12): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $5,915.66
  • Altius Coventry Healthcare — Medicare Advantage: $5,819.80
  • Altius Coventry Healthcare — Workers Compensation: $5,915.66
  • DMBA — Medicare Advantage: $5,819.80
  • MODA CONNEXUS/ SELECT — Commercial: $11,639.60
  • Molina Healthcare of Idaho — Medicare Advantage: $5,819.80
  • Partners Direct Health — Medicare Advantage: $9,893.66
  • Regence Blue Shield of Idaho — Medicare Advantage: $5,819.80
  • Select Health Idaho — Medicare Advantage: $5,878
  • Triwest Blue Shield — Commercial: $5,819.80
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) $10,944 $8,208 $5,819.80 – $11,639.60
Removal of tonsils and adenoids (under age 12): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $5,915.66
  • Altius Coventry Healthcare — Medicare Advantage: $5,819.80
  • Altius Coventry Healthcare — Workers Compensation: $5,915.66
  • DMBA — Medicare Advantage: $5,819.80
  • MODA CONNEXUS/ SELECT — Commercial: $11,639.60
  • Molina Healthcare of Idaho — Medicare Advantage: $5,819.80
  • Partners Direct Health — Medicare Advantage: $9,893.66
  • Regence Blue Shield of Idaho — Medicare Advantage: $5,819.80
  • Select Health Idaho — Medicare Advantage: $5,878
  • Triwest Blue Shield — Commercial: $5,819.80
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH $1,863 $1,397.25 $891.66 – $1,783.32
Upper GI endoscopy (diagnostic): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $937.56
  • Altius Coventry Healthcare — Medicare Advantage: $891.66
  • Altius Coventry Healthcare — Workers Compensation: $937.56
  • DMBA — Medicare Advantage: $891.66
  • MODA CONNEXUS/ SELECT — Commercial: $1,783.32
  • Molina Healthcare of Idaho — Medicare Advantage: $891.66
  • Partners Direct Health — Medicare Advantage: $1,515.82
  • Regence Blue Shield of Idaho — Medicare Advantage: $891.66
  • Select Health Idaho — Medicare Advantage: $900.58
  • Triwest Blue Shield — Commercial: $891.66
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,790 $1,342.50 $891.66 – $1,783.32
Upper GI endoscopy (diagnostic): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $937.56
  • Altius Coventry Healthcare — Medicare Advantage: $891.66
  • Altius Coventry Healthcare — Workers Compensation: $937.56
  • DMBA — Medicare Advantage: $891.66
  • MODA CONNEXUS/ SELECT — Commercial: $1,783.32
  • Molina Healthcare of Idaho — Medicare Advantage: $891.66
  • Partners Direct Health — Medicare Advantage: $1,515.82
  • Regence Blue Shield of Idaho — Medicare Advantage: $891.66
  • Select Health Idaho — Medicare Advantage: $900.58
  • Triwest Blue Shield — Commercial: $891.66
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE $1,863 $1,397.25 $891.66 – $1,783.32
Upper GI endoscopy with biopsy: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $937.56
  • Altius Coventry Healthcare — Medicare Advantage: $891.66
  • Altius Coventry Healthcare — Workers Compensation: $937.56
  • DMBA — Medicare Advantage: $891.66
  • MODA CONNEXUS/ SELECT — Commercial: $1,783.32
  • Molina Healthcare of Idaho — Medicare Advantage: $891.66
  • Partners Direct Health — Medicare Advantage: $1,515.82
  • Regence Blue Shield of Idaho — Medicare Advantage: $891.66
  • Select Health Idaho — Medicare Advantage: $900.58
  • Triwest Blue Shield — Commercial: $891.66
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,790 $1,342.50 $891.66 – $1,783.32
Upper GI endoscopy with biopsy: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $937.56
  • Altius Coventry Healthcare — Medicare Advantage: $891.66
  • Altius Coventry Healthcare — Workers Compensation: $937.56
  • DMBA — Medicare Advantage: $891.66
  • MODA CONNEXUS/ SELECT — Commercial: $1,783.32
  • Molina Healthcare of Idaho — Medicare Advantage: $891.66
  • Partners Direct Health — Medicare Advantage: $1,515.82
  • Regence Blue Shield of Idaho — Medicare Advantage: $891.66
  • Select Health Idaho — Medicare Advantage: $900.58
  • Triwest Blue Shield — Commercial: $891.66
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XS In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,790 $1,342.50 $891.66 – $1,783.32
Upper GI endoscopy with biopsy: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $891.66
  • DMBA — Medicare Advantage: $891.66
  • MODA CONNEXUS/ SELECT — Commercial: $1,783.32
  • Molina Healthcare of Idaho — Medicare Advantage: $891.66
  • Partners Direct Health — Medicare Advantage: $1,515.82
  • Regence Blue Shield of Idaho — Medicare Advantage: $891.66
  • Select Health Idaho — Medicare Advantage: $900.58
  • Triwest Blue Shield — Commercial: $891.66
  • University Of UT Healthy Premier — Medicare Adv: $891.66
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY $1,870 $1,402.50 $911.71 – $1,828.50
Colonoscopy (diagnostic): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $911.71
  • Altius Coventry Healthcare — Medicare Advantage: $914.25
  • Altius Coventry Healthcare — Workers Compensation: $911.71
  • DMBA — Medicare Advantage: $914.25
  • MODA CONNEXUS/ SELECT — Commercial: $1,828.50
  • Molina Healthcare of Idaho — Medicare Advantage: $914.25
  • Partners Direct Health — Medicare Advantage: $1,554.22
  • Regence Blue Shield of Idaho — Medicare Advantage: $914.25
  • Select Health Idaho — Medicare Advantage: $923.39
  • Triwest Blue Shield — Commercial: $914.25
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $1,225 $918.75 $911.71 – $1,828.50
Colonoscopy (diagnostic): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $911.71
  • Altius Coventry Healthcare — Medicare Advantage: $914.25
  • Altius Coventry Healthcare — Workers Compensation: $911.71
  • DMBA — Medicare Advantage: $914.25
  • MODA CONNEXUS/ SELECT — Commercial: $1,828.50
  • Molina Healthcare of Idaho — Medicare Advantage: $914.25
  • Partners Direct Health — Medicare Advantage: $1,554.22
  • Regence Blue Shield of Idaho — Medicare Advantage: $914.25
  • Select Health Idaho — Medicare Advantage: $923.39
  • Triwest Blue Shield — Commercial: $914.25
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33 In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $1,797 $1,347.75 $914.25 – $1,828.50
Colonoscopy (diagnostic): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $914.25
  • DMBA — Medicare Advantage: $914.25
  • MODA CONNEXUS/ SELECT — Commercial: $1,828.50
  • Molina Healthcare of Idaho — Medicare Advantage: $914.25
  • Partners Direct Health — Medicare Advantage: $1,554.22
  • Regence Blue Shield of Idaho — Medicare Advantage: $914.25
  • Select Health Idaho — Medicare Advantage: $923.39
  • Triwest Blue Shield — Commercial: $914.25
  • University Of UT Healthy Premier — Medicare Adv: $914.25
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY $2,435 $1,826.25 $1,176.43 – $2,352.86
Colonoscopy with biopsy: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $1,179.08
  • Altius Coventry Healthcare — Medicare Advantage: $1,176.43
  • Altius Coventry Healthcare — Workers Compensation: $1,179.08
  • DMBA — Medicare Advantage: $1,176.43
  • MODA CONNEXUS/ SELECT — Commercial: $2,352.86
  • Molina Healthcare of Idaho — Medicare Advantage: $1,176.43
  • Partners Direct Health — Medicare Advantage: $1,999.93
  • Regence Blue Shield of Idaho — Medicare Advantage: $1,176.43
  • Select Health Idaho — Medicare Advantage: $1,188.19
  • Triwest Blue Shield — Commercial: $1,176.43
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $1,594 $1,195.50 $1,176.43 – $2,352.86
Colonoscopy with biopsy: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $1,179.08
  • Altius Coventry Healthcare — Medicare Advantage: $1,176.43
  • Altius Coventry Healthcare — Workers Compensation: $1,179.08
  • DMBA — Medicare Advantage: $1,176.43
  • MODA CONNEXUS/ SELECT — Commercial: $2,352.86
  • Molina Healthcare of Idaho — Medicare Advantage: $1,176.43
  • Partners Direct Health — Medicare Advantage: $1,999.93
  • Regence Blue Shield of Idaho — Medicare Advantage: $1,176.43
  • Select Health Idaho — Medicare Advantage: $1,188.19
  • Triwest Blue Shield — Commercial: $1,176.43
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33 In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $2,340 $1,755 $1,176.43 – $2,352.86
Colonoscopy with biopsy: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $1,176.43
  • DMBA — Medicare Advantage: $1,176.43
  • MODA CONNEXUS/ SELECT — Commercial: $2,352.86
  • Molina Healthcare of Idaho — Medicare Advantage: $1,176.43
  • Partners Direct Health — Medicare Advantage: $1,999.93
  • Regence Blue Shield of Idaho — Medicare Advantage: $1,176.43
  • Select Health Idaho — Medicare Advantage: $1,188.19
  • Triwest Blue Shield — Commercial: $1,176.43
  • University Of UT Healthy Premier — Medicare Adv: $1,176.43
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL $2,435 $1,826.25 $1,176.43 – $2,352.86
Colonoscopy with removal of polyps (snare): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $1,179.08
  • Altius Coventry Healthcare — Medicare Advantage: $1,176.43
  • Altius Coventry Healthcare — Workers Compensation: $1,179.08
  • DMBA — Medicare Advantage: $1,176.43
  • MODA CONNEXUS/ SELECT — Commercial: $2,352.86
  • Molina Healthcare of Idaho — Medicare Advantage: $1,176.43
  • Partners Direct Health — Medicare Advantage: $1,999.93
  • Regence Blue Shield of Idaho — Medicare Advantage: $1,176.43
  • Select Health Idaho — Medicare Advantage: $1,188.19
  • Triwest Blue Shield — Commercial: $1,176.43
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $1,594 $1,195.50 $1,176.43 – $2,352.86
Colonoscopy with removal of polyps (snare): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $1,179.08
  • Altius Coventry Healthcare — Medicare Advantage: $1,176.43
  • Altius Coventry Healthcare — Workers Compensation: $1,179.08
  • DMBA — Medicare Advantage: $1,176.43
  • MODA CONNEXUS/ SELECT — Commercial: $2,352.86
  • Molina Healthcare of Idaho — Medicare Advantage: $1,176.43
  • Partners Direct Health — Medicare Advantage: $1,999.93
  • Regence Blue Shield of Idaho — Medicare Advantage: $1,176.43
  • Select Health Idaho — Medicare Advantage: $1,188.19
  • Triwest Blue Shield — Commercial: $1,176.43
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33 In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $1,594 $1,195.50 $1,176.43 – $2,352.86
Colonoscopy with removal of polyps (snare): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $1,176.43
  • DMBA — Medicare Advantage: $1,176.43
  • MODA CONNEXUS/ SELECT — Commercial: $2,352.86
  • Molina Healthcare of Idaho — Medicare Advantage: $1,176.43
  • Partners Direct Health — Medicare Advantage: $1,999.93
  • Regence Blue Shield of Idaho — Medicare Advantage: $1,176.43
  • Select Health Idaho — Medicare Advantage: $1,188.19
  • Triwest Blue Shield — Commercial: $1,176.43
  • University Of UT Healthy Premier — Medicare Adv: $1,176.43
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLON CA SCRN NOT HI RSK IND $1,328 $996 $911.71 – $1,828.50
Screening colonoscopy (not high risk): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $911.71
  • Altius Coventry Healthcare — Medicare Advantage: $914.25
  • Altius Coventry Healthcare — Workers Compensation: $911.71
  • DMBA — Medicare Advantage: $914.25
  • MODA CONNEXUS/ SELECT — Commercial: $1,828.50
  • Molina Healthcare of Idaho — Medicare Advantage: $914.25
  • Partners Direct Health — Medicare Advantage: $1,554.22
  • Regence Blue Shield of Idaho — Medicare Advantage: $914.25
  • Select Health Idaho — Medicare Advantage: $923.39
  • Triwest Blue Shield — Commercial: $914.25
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $1,723 $1,292.25 $911.71 – $1,828.50
Screening colonoscopy (not high risk): 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $911.71
  • Altius Coventry Healthcare — Medicare Advantage: $914.25
  • Altius Coventry Healthcare — Workers Compensation: $911.71
  • DMBA — Medicare Advantage: $914.25
  • MODA CONNEXUS/ SELECT — Commercial: $1,828.50
  • Molina Healthcare of Idaho — Medicare Advantage: $914.25
  • Partners Direct Health — Medicare Advantage: $1,554.22
  • Regence Blue Shield of Idaho — Medicare Advantage: $914.25
  • Select Health Idaho — Medicare Advantage: $923.39
  • Triwest Blue Shield — Commercial: $914.25
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY $11,201 $8,400.75 $5,834.36 – $11,886.76
Gallbladder removal by laparoscope: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $5,834.36
  • Altius Coventry Healthcare — Medicare Advantage: $5,943.38
  • Altius Coventry Healthcare — Workers Compensation: $5,834.36
  • DMBA — Medicare Advantage: $5,943.38
  • MODA CONNEXUS/ SELECT — Commercial: $11,886.76
  • Molina Healthcare of Idaho — Medicare Advantage: $5,943.38
  • Partners Direct Health — Medicare Advantage: $10,103.75
  • Regence Blue Shield of Idaho — Medicare Advantage: $5,943.38
  • Select Health Idaho — Medicare Advantage: $6,002.81
  • Triwest Blue Shield — Commercial: $5,943.38
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE $10,760 $8,070 $5,834.36 – $11,886.76
Gallbladder removal by laparoscope: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $5,834.36
  • Altius Coventry Healthcare — Medicare Advantage: $5,943.38
  • Altius Coventry Healthcare — Workers Compensation: $5,834.36
  • DMBA — Medicare Advantage: $5,943.38
  • MODA CONNEXUS/ SELECT — Commercial: $11,886.76
  • Molina Healthcare of Idaho — Medicare Advantage: $5,943.38
  • Partners Direct Health — Medicare Advantage: $10,103.75
  • Regence Blue Shield of Idaho — Medicare Advantage: $5,943.38
  • Select Health Idaho — Medicare Advantage: $6,002.81
  • Triwest Blue Shield — Commercial: $5,943.38
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR $6,542 $4,906.50 $3,519.91 – $7,039.82
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $3,529.06
  • Altius Coventry Healthcare — Medicare Advantage: $3,519.91
  • Altius Coventry Healthcare — Workers Compensation: $3,529.06
  • DMBA — Medicare Advantage: $3,519.91
  • MODA CONNEXUS/ SELECT — Commercial: $7,039.82
  • Molina Healthcare of Idaho — Medicare Advantage: $3,519.91
  • Partners Direct Health — Medicare Advantage: $5,983.85
  • Regence Blue Shield of Idaho — Medicare Advantage: $3,519.91
  • Select Health Idaho — Medicare Advantage: $3,555.11
  • Triwest Blue Shield — Commercial: $3,519.91
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $4,281 $3,210.75 $3,519.91 – $7,039.82
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $3,529.06
  • Altius Coventry Healthcare — Medicare Advantage: $3,519.91
  • Altius Coventry Healthcare — Workers Compensation: $3,529.06
  • DMBA — Medicare Advantage: $3,519.91
  • MODA CONNEXUS/ SELECT — Commercial: $7,039.82
  • Molina Healthcare of Idaho — Medicare Advantage: $3,519.91
  • Partners Direct Health — Medicare Advantage: $5,983.85
  • Regence Blue Shield of Idaho — Medicare Advantage: $3,519.91
  • Select Health Idaho — Medicare Advantage: $3,555.11
  • Triwest Blue Shield — Commercial: $3,519.91
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $4,281 $3,210.75 $5,968.32 – $11,936.64
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $5,968.32
  • DMBA — Medicare Advantage: $5,968.32
  • MODA CONNEXUS/ SELECT — Commercial: $11,936.64
  • Molina Healthcare of Idaho — Medicare Advantage: $5,968.32
  • Partners Direct Health — Medicare Advantage: $10,146.14
  • Regence Blue Shield of Idaho — Medicare Advantage: $5,968.32
  • Select Health Idaho — Medicare Advantage: $6,028
  • Triwest Blue Shield — Commercial: $5,968.32
  • University Of UT Healthy Premier — Medicare Adv: $5,968.32
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE GLAND $2,999 $2,249.25 $2,048.51
Prostate biopsy: 10 of 14 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $2,048.51
  • Altius Coventry Healthcare — Workers Compensation: $2,048.51
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross of Idaho POS — Managed MedicareTrueBlue: 70% (a percentage in the contract, not a dollar amount)
  • Blue Cross of Idaho PPO — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 70.56% (a percentage in the contract, not a dollar amount)
  • Desert Mutual Benefit Administrators — Commercial: 88.5% (a percentage in the contract, not a dollar amount)
  • Expion Healthcare — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • First Choice — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • IPN Pacific Source Health Plan — Commercial: 69.2% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY $6,088 $4,566 $3,179.53 – $6,364.86
Hysteroscopy with biopsy of the uterus lining: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $3,179.53
  • Altius Coventry Healthcare — Medicare Advantage: $3,182.43
  • Altius Coventry Healthcare — Workers Compensation: $3,179.53
  • DMBA — Medicare Advantage: $3,182.43
  • MODA CONNEXUS/ SELECT — Commercial: $6,364.86
  • Molina Healthcare of Idaho — Medicare Advantage: $3,182.43
  • Partners Direct Health — Medicare Advantage: $5,410.13
  • Regence Blue Shield of Idaho — Medicare Advantage: $3,182.43
  • Select Health Idaho — Medicare Advantage: $3,214.25
  • Triwest Blue Shield — Commercial: $3,182.43
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE $5,849 $4,386.75 $3,179.53 – $6,364.86
Hysteroscopy with biopsy of the uterus lining: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $3,179.53
  • Altius Coventry Healthcare — Medicare Advantage: $3,182.43
  • Altius Coventry Healthcare — Workers Compensation: $3,179.53
  • DMBA — Medicare Advantage: $3,182.43
  • MODA CONNEXUS/ SELECT — Commercial: $6,364.86
  • Molina Healthcare of Idaho — Medicare Advantage: $3,182.43
  • Partners Direct Health — Medicare Advantage: $5,410.13
  • Regence Blue Shield of Idaho — Medicare Advantage: $3,182.43
  • Select Health Idaho — Medicare Advantage: $3,214.25
  • Triwest Blue Shield — Commercial: $3,182.43
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC $1,534 $1,150.50 $692.52 – $1,387.90
Spinal injection, lower back (epidural), with imaging guidance: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $692.52
  • Altius Coventry Healthcare — Medicare Advantage: $693.95
  • Altius Coventry Healthcare — Workers Compensation: $692.52
  • DMBA — Medicare Advantage: $693.95
  • MODA CONNEXUS/ SELECT — Commercial: $1,387.90
  • Molina Healthcare of Idaho — Medicare Advantage: $693.95
  • Partners Direct Health — Medicare Advantage: $1,179.72
  • Regence Blue Shield of Idaho — Medicare Advantage: $693.95
  • Select Health Idaho — Medicare Advantage: $700.89
  • Triwest Blue Shield — Commercial: $693.95
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: NJX INTERLAMINAR LMBR/SAC $1,469 $1,101.75 $693.95 – $1,387.90
Spinal injection, lower back (epidural), with imaging guidance: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $693.95
  • DMBA — Medicare Advantage: $693.95
  • MODA CONNEXUS/ SELECT — Commercial: $1,387.90
  • Molina Healthcare of Idaho — Medicare Advantage: $693.95
  • Partners Direct Health — Medicare Advantage: $1,179.72
  • Regence Blue Shield of Idaho — Medicare Advantage: $693.95
  • Select Health Idaho — Medicare Advantage: $700.89
  • Triwest Blue Shield — Commercial: $693.95
  • University Of UT Healthy Premier — Medicare Adv: $693.95
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE $1,412 $1,059 $693.95 – $1,387.90
Spinal injection, lower back (epidural), with imaging guidance: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $693.95
  • DMBA — Medicare Advantage: $693.95
  • MODA CONNEXUS/ SELECT — Commercial: $1,387.90
  • Molina Healthcare of Idaho — Medicare Advantage: $693.95
  • Partners Direct Health — Medicare Advantage: $1,179.72
  • Regence Blue Shield of Idaho — Medicare Advantage: $693.95
  • Select Health Idaho — Medicare Advantage: $700.89
  • Triwest Blue Shield — Commercial: $693.95
  • University Of UT Healthy Premier — Medicare Adv: $693.95
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1 $1,907 $1,430.25 $869.53 – $1,739.06
Nerve root injection, lower back, with imaging guidance: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $890.29
  • Altius Coventry Healthcare — Medicare Advantage: $869.53
  • Altius Coventry Healthcare — Workers Compensation: $890.29
  • DMBA — Medicare Advantage: $869.53
  • MODA CONNEXUS/ SELECT — Commercial: $1,739.06
  • Molina Healthcare of Idaho — Medicare Advantage: $869.53
  • Partners Direct Health — Medicare Advantage: $1,478.20
  • Regence Blue Shield of Idaho — Medicare Advantage: $869.53
  • Select Health Idaho — Medicare Advantage: $878.23
  • Triwest Blue Shield — Commercial: $869.53
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: NJX AA&/STRD TFRM EPI L/S 1 $1,988 $1,491 $869.53 – $1,739.06
Nerve root injection, lower back, with imaging guidance: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $869.53
  • DMBA — Medicare Advantage: $869.53
  • MODA CONNEXUS/ SELECT — Commercial: $1,739.06
  • Molina Healthcare of Idaho — Medicare Advantage: $869.53
  • Partners Direct Health — Medicare Advantage: $1,478.20
  • Regence Blue Shield of Idaho — Medicare Advantage: $869.53
  • Select Health Idaho — Medicare Advantage: $878.23
  • Triwest Blue Shield — Commercial: $869.53
  • University Of UT Healthy Premier — Medicare Adv: $869.53
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY $4,153 $3,114.75 $1,919.73 – $3,839.46
Carpal tunnel release: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $1,952.77
  • Altius Coventry Healthcare — Medicare Advantage: $1,919.73
  • Altius Coventry Healthcare — Workers Compensation: $1,952.77
  • DMBA — Medicare Advantage: $1,919.73
  • MODA CONNEXUS/ SELECT — Commercial: $3,839.46
  • Molina Healthcare of Idaho — Medicare Advantage: $1,919.73
  • Partners Direct Health — Medicare Advantage: $3,263.54
  • Regence Blue Shield of Idaho — Medicare Advantage: $1,919.73
  • Select Health Idaho — Medicare Advantage: $1,938.93
  • Triwest Blue Shield — Commercial: $1,919.73
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: CARPAL TUNNEL SURGERY $6,230 $4,672.50 $1,919.73 – $3,839.46
Carpal tunnel release: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $1,919.73
  • DMBA — Medicare Advantage: $1,919.73
  • MODA CONNEXUS/ SELECT — Commercial: $3,839.46
  • Molina Healthcare of Idaho — Medicare Advantage: $1,919.73
  • Partners Direct Health — Medicare Advantage: $3,263.54
  • Regence Blue Shield of Idaho — Medicare Advantage: $1,919.73
  • Select Health Idaho — Medicare Advantage: $1,938.93
  • Triwest Blue Shield — Commercial: $1,919.73
  • University Of UT Healthy Premier — Medicare Adv: $1,919.73
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $3,990 $2,992.50 $1,919.73 – $3,839.46
Carpal tunnel release: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $1,919.73
  • DMBA — Medicare Advantage: $1,919.73
  • MODA CONNEXUS/ SELECT — Commercial: $3,839.46
  • Molina Healthcare of Idaho — Medicare Advantage: $1,919.73
  • Partners Direct Health — Medicare Advantage: $3,263.54
  • Regence Blue Shield of Idaho — Medicare Advantage: $1,919.73
  • Select Health Idaho — Medicare Advantage: $1,938.93
  • Triwest Blue Shield — Commercial: $1,919.73
  • University Of UT Healthy Premier — Medicare Adv: $1,919.73
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP $4,301 $3,225.75 $2,268.83 – $4,537.66
Cataract removal with lens implant: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: $2,280.73
  • Altius Coventry Healthcare — Medicare Advantage: $2,268.83
  • Altius Coventry Healthcare — Workers Compensation: $2,280.73
  • DMBA — Medicare Advantage: $2,268.83
  • MODA CONNEXUS/ SELECT — Commercial: $4,537.66
  • Molina Healthcare of Idaho — Medicare Advantage: $2,268.83
  • Partners Direct Health — Medicare Advantage: $3,857.01
  • Regence Blue Shield of Idaho — Medicare Advantage: $2,268.83
  • Select Health Idaho — Medicare Advantage: $2,291.52
  • Triwest Blue Shield — Commercial: $2,268.83
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: XCAPSL CTRC RMVL W/O ECP $4,301 $3,225.75 $2,268.83 – $4,537.66
Cataract removal with lens implant: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $2,268.83
  • DMBA — Medicare Advantage: $2,268.83
  • MODA CONNEXUS/ SELECT — Commercial: $4,537.66
  • Molina Healthcare of Idaho — Medicare Advantage: $2,268.83
  • Partners Direct Health — Medicare Advantage: $3,857.01
  • Regence Blue Shield of Idaho — Medicare Advantage: $2,268.83
  • Select Health Idaho — Medicare Advantage: $2,291.52
  • Triwest Blue Shield — Commercial: $2,268.83
  • University Of UT Healthy Premier — Medicare Adv: $2,268.83
  • Aetna — Commercial: 95% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OBSTETRICAL CARE $1,880 $1,410 Not listed in the file
Vaginal delivery, with care before and after: 10 of 13 insurance plan rates
  • Altius Coventry Healthcare — Auto Liability: 98% (a percentage in the contract, not a dollar amount)
  • Blue Cross of Idaho POS — Managed MedicareTrueBlue: 80% (a percentage in the contract, not a dollar amount)
  • Blue Cross of Idaho PPO — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 70.56% (a percentage in the contract, not a dollar amount)
  • Desert Mutual Benefit Administrators — Commercial: 87% (a percentage in the contract, not a dollar amount)
  • Expion Healthcare — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • First Choice — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • IPN Pacific Source Health Plan — Commercial: 69.2% (a percentage in the contract, not a dollar amount)
  • MODA CONNEXUS/ SELECT — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Mountain Health Co Op — Commercial: 90% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance 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 $82,233.67 – $159,536.74
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $83,911.91
  • Altius Coventry Healthcare — Workers Compensation: $82,233.67
  • Blue Cross of Idaho POS — Managed MedicareTrueBlue: $159,536.74
  • Desert Mutual Benefit Administrators — Commercial: $116,778.31
  • DMBA — Medicare Advantage: $83,911.91
  • MODA CONNEXUS/ SELECT — Commercial: $159,243.15
  • Molina Healthcare of Idaho — Medicare Advantage: $83,911.91
  • Partners Direct Health — Medicare Advantage: $134,259.06
  • Regence Blue Shield of Idaho — Medicare Advantage: $83,911.91
  • Select Health Idaho — Medicare Advantage: $84,751.03
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 COMORBITY Not listed in the file Not listed in the file $17,371.24 – $30,207.23
Hip or knee replacement (major joint of the leg), without major complications: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $17,725.76
  • Altius Coventry Healthcare — Workers Compensation: $17,371.24
  • Blue Cross of Idaho POS — Managed MedicareTrueBlue: $30,207.23
  • Desert Mutual Benefit Administrators — Commercial: $22,814.55
  • DMBA — Medicare Advantage: $17,725.76
  • MODA CONNEXUS/ SELECT — Commercial: $25,000
  • Molina Healthcare of Idaho — Medicare Advantage: $17,725.76
  • Partners Direct Health — Medicare Advantage: $28,361.22
  • Regence Blue Shield of Idaho — Medicare Advantage: $17,725.76
  • Select Health Idaho — Medicare Advantage: $17,903.02
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 $21,602.96 – $40,350.44
Neck (cervical) spinal fusion, without complications: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $22,043.84
  • Altius Coventry Healthcare — Workers Compensation: $21,602.96
  • Blue Cross of Idaho POS — Managed MedicareTrueBlue: $40,350.44
  • Desert Mutual Benefit Administrators — Commercial: $28,645.54
  • DMBA — Medicare Advantage: $22,043.84
  • MODA CONNEXUS/ SELECT — Commercial: $39,062.10
  • Molina Healthcare of Idaho — Medicare Advantage: $22,043.84
  • Partners Direct Health — Medicare Advantage: $35,270.14
  • Regence Blue Shield of Idaho — Medicare Advantage: $22,043.84
  • Select Health Idaho — Medicare Advantage: $22,264.28
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 $11,687.69 – $19,778.55
Uterus and ovary surgery (not for cancer), without complications: 10 of 23 insurance plan rates
  • Altius Coventry Healthcare — Medicare Advantage: $11,926.21
  • Altius Coventry Healthcare — Workers Compensation: $11,687.69
  • Blue Cross of Idaho POS — Managed MedicareTrueBlue: $17,998.84
  • Desert Mutual Benefit Administrators — Commercial: $14,504.27
  • DMBA — Medicare Advantage: $11,926.21
  • MODA CONNEXUS/ SELECT — Commercial: $19,778.55
  • Molina Healthcare of Idaho — Medicare Advantage: $11,926.21
  • Partners Direct Health — Medicare Advantage: $19,081.94
  • Regence Blue Shield of Idaho — Medicare Advantage: $11,926.21
  • Select Health Idaho — Medicare Advantage: $12,045.47

Source: Madison Memorial Hospital’s standard charges file (apim.services.craneware.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 26, 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 typeAcute Care Hospital
Address450 East Main Street, Rexburg, ID 83440
CountyMadison County
StateIdaho
Phone(208) 359‑6488
Emergency servicesYes
OwnershipGovernment - Local
Medicare overall ratingNot rated by CMS
CMS Certification Number130025
Name in Medicare recordsMADISON MEMORIAL HOSPITAL
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(208) 359‑6900[4][5]
Official websitemadisonhealth.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Locations - Madisonhealth — madisonhealth.org
  2. Madisonhealth — madisonhealth.org
  3. Rexburg’s Madison Memorial Hospital – Madisonhealth — madisonhealth.org
  4. Emergency Room 24/7 | Rexburg | Madisonhealth — madisonhealth.org
  5. Madisonhealth | Family Doctors that Inspires Healthy Living — madisonhealth.org
  6. Awards and Recognition - Madisonhealth — madisonhealth.org
  7. Accreditation - Madisonhealth — madisonhealth.org