Does Margaret Mary Community Hospital Inc have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Margaret Mary Community Hospital Inc. In a medical emergency, call 911.

Where is Margaret Mary Community Hospital Inc?

321 Mitchell Ave, Batesville, IN 47006, in Ripley County, Indiana.

What is the phone number of Margaret Mary Community Hospital Inc?

(812) 934-6624, as listed by Medicare (CMS).

What is the Medicare star rating of Margaret Mary Community Hospital Inc?

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.

Margaret Mary Community Hospital Inc

Quick answers

Does Margaret Mary Community Hospital Inc have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Margaret Mary Community Hospital Inc. In a medical emergency, call 911.
Where is Margaret Mary Community Hospital Inc?: 321 Mitchell Ave, Batesville, IN 47006, in Ripley County, Indiana.
What is the phone number of Margaret Mary Community Hospital Inc?: (812) 934-6624, as listed by Medicare (CMS).
What is the Medicare star rating of Margaret Mary Community Hospital Inc?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[5][6]

Emergency medicine
Heart & vascular
Maternity
Surgery
Sleep medicine
Diabetes care
Nutrition services
Laboratory
X-ray / imaging
Inpatient care

Programs and centers^[5]

The Christ Hospital Chest Pain Network (accredited member)
University of Cincinnati Stroke Team telemedicine partnership
EMS hub (medical director and supervising hospital for local EMS)

Emergency care (hospital website)^[5][6]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Acute Stroke Ready Hospital

Visiting and practical information

Patient portal	Patient Portal

Recognition^[4][5]

Critical access hospital
Acute Stroke Ready Hospital (American Heart Association / Joint Commission)

Doctors and clinicians (210)

210 doctors and other clinicians list Margaret Mary Community Hospital Inc 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 (210)

Ahmad Anjak, MDNephrology
Alan D. Glassman, MDCardiovascular Disease (Cardiology)
Allison M. Halcomb, NPNurse Practitioner
Alyssa Teepen, NPNurse Practitioner
Amy M. Jelinek, DPMPodiatry
Andrea Bashor, PANurse Practitioner
Andrew A. Angus, MDGeneral Surgery
Andrew E. Noll, MDCardiac Electrophysiology
Angelia Lovins, NPNurse Practitioner
Ankit K. Bhatia, MDAdvanced Heart Failure and Transplant Cardiology
Ann M. Nixdorf, PAPhysician Assistant
Arthur Craig, MDInternal Medicine
Arthur L. Hughes, MDNeurology
Ashley Campbell, NPNurse Practitioner
Ashley N. Partin, NPNurse Practitioner
Atul Chandoke, MDAnesthesiology
Barbara Steel, MDPathology
Blake R. Nestok, MDPathology
Brian J. Albers, MDGeneral Surgery
Brian Mannion, MDHematology/Oncology
Bryan A. Schatmeyer, MDNeurosurgery
Bryan W. Rabe, CNACertified Registered Nurse Anesthetist (CRNA)
Carl C. Flink, MDDiagnostic Radiology
Cary M. Guse, MDOrthopedic Surgery

And 186 more: the button below opens the full list.

Other emergency rooms nearby

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

Decatur County Memorial Hospital14 mi · Greensburg, IN · Critical Access Hospital
St Elizabeth Dearborn Hospital23 mi · Lawrenceburg, IN · Acute Care Hospital
Rush Memorial Hospital25 mi · Rushville, IN · Critical Access Hospital
McCullough-Hyde Memorial Hospital29 mi · Oxford, OH · Acute Care Hospital
Ascension St Vincent Jennings30 mi · North Vernon, IN · Critical Access Hospital

Other hospitals nearby

Incompass Healthcare23 mi · Lawrenceburg, IN · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

The Waters of Batesville0.5 mi · Batesville, IN · 1 of 5 stars
St Andrews Health Campus1.5 mi · Batesville, IN · 4 of 5 stars
Ripley Crossing11 mi · Milan, IN · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Margaret Mary Health Hospice1.5 mi · Batesville, IN · 5 of 5 stars
Loving Hearts Hospice and Palliative Care LLC22 mi · Lawrenceburg, IN

All hospice providers in the state →

Home health agencies

Remedy Home Healthcare, LLC15 mi · Brookville, IN
Caring First Home Health LLC19 mi · W Harrison, IN
Personal Touch Home Care of Indiana Inc22 mi · Lawrenceburg, IN · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

FMC - Tree City Dialysis14 mi · Greensburg, IN · 2 of 5 stars
DaVita Lawrenceburg Dialysis Center22 mi · Greendale, IN · 3 of 5 stars
FMC - Connersville22 mi · Connersville, IN · 1 of 5 stars

All dialysis facilities in the state →

Community care nearby

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

Community health centers

Crossroad Health Center Harrison23 mi · Harrison, OH · Community health center
Meridian Health Services Corp23 mi · Connersville, IN · Community health center
Grogan Family Medicine - Centerstone Health Services24 mi · Connersville, IN · Community health center

Clinics and urgent care

Accudoc Inc PC1.5 mi · Batesville, IN · Urgent care center
Margaret Mary Medical Arts Center1.5 mi · Batesville, IN · Rural health clinic
Margaret Mary Physician Center1.5 mi · Batesville, IN · Rural health clinic

Pharmacies

Hook-Superx LLC1.5 mi · Batesville, IN · Pharmacy
Kroger Limited Partnership I1.5 mi · Batesville, IN · Community/retail pharmacy

Assisted living nearby

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

Assisted Living at Romweber Flats1.5 mi · Batesville, IN
Chateau of Batesville1.5 mi · Batesville, IN
Crown Pointe of Greensburg14 mi · Greensburg, IN

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 Margaret Mary Community Hospital Inc 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)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	4 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	5 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	74%National average: 72%
Would definitely recommend the hospital	69%National average: 71%
Nurses “always” communicated well	80%National average: 80%
Doctors “always” communicated well	85%National average: 80%
Staff “always” explained medicines before giving them	59%National average: 62%
Were given information about recovery at home	91%National average: 86%
Room and bathroom “always” clean	82%National average: 74%
Area around the room “always” quiet at night	54%National average: 60%
Completed surveys	143Response rate: 17%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	2.909Worse than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	11.8%
Deaths within 30 days: pneumonia patients	17.3%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	22%
Readmitted within 30 days: pneumonia	17.3%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	132 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	78%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Indiana Best hospitals in Indiana

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 74 common services exactly as Margaret Mary Community Hospital Inc 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 →

$ 2 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Office/Outpatient Visit New Pt. Level 3 (99203)	$282	$236.88	$110.53 – $127.11
New patient office visit (about 30–44 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $127.11 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $110.53 Consumer Life — Commercial: $143.69 Coventry — Commercial: $154.74
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Office/Outpatient Visit New Pt. Level 4 (99204)	$327.08	$274.75	$167.22 – $192.30
New patient office visit (about 45–59 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $192.30 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $167.22 Consumer Life — Commercial: $217.39 Coventry — Commercial: $234.11
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Office/Outpatient Visit New Pt. Level 5 (99205)	$537.52	$451.52	$222.76 – $256.17
New patient office visit (about 60–74 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $256.17 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $222.76 Consumer Life — Commercial: $289.59 Coventry — Commercial: $311.86
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Office/Outpatient Visit Established Pt. Level 3 (99213)	$212.95	$178.88	$13.60 – $90.09
Established patient office visit (about 20–29 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $13.60 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $90.09 Consumer Life — Commercial: $117.12 Coventry — Commercial: $126.13
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Office/Outpatient Visit Established Pt. Level 4 (99214)	$301.80	$253.51	$128.33 – $147.58
Established patient office visit (about 30–39 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $147.58 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $128.33 Consumer Life — Commercial: $166.83 Coventry — Commercial: $179.66
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 99243 Office Consult New or Est. L3 Pt 40 min	$574.21	$482.34	Not listed in the file
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Office Consult New or Est. 40 Min (99244)	$853.99	$717.35	Not listed in the file
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 99385 Preventive Eval Initial New Pt. 18-39 year age	$180.96	$152.01	Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 99386 PREVENTIVE CHECKUP, NEW, 40-64 YRS	$210.08	$176.47	Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 99386 Preventive Eval Initial New Pt. 40-64 year age	$210.08	$176.47	Not listed in the file
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY RM - LEVEL 3	$760.72	$639	$75.80 – $169.63
Emergency room visit (moderate): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $169.63 Anthem — Medicaid: $75.80 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $169.63 Care Improvement Plus — Medicare Advantage: $169.63 Humana Healthnet — Tricare: $161.15 Managed Health Services — Medicaid: $75.80 United Healthcare — Medicaid: $75.80 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY PHYSICIAN LEVEL 3	$523	$439.32	$65.36 – $75.16
Emergency room visit (moderate): rates for 4 insurance plans Aetna — Medicare Advantage: $75.16 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $65.36 Consumer Life — Commercial: $84.97 Coventry — Commercial: $91.50
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ER visit for E/M of pt level 3 (99283)	$523	$439.32	$65.36 – $75.16
Emergency room visit (moderate): rates for 4 insurance plans Aetna — Medicare Advantage: $75.16 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $65.36 Consumer Life — Commercial: $84.97 Coventry — Commercial: $91.50
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY RM - LEVEL 4	$1,159.49	$973.97	$75.80 – $258.55
Emergency room visit (moderately high): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $258.55 Anthem — Medicaid: $75.80 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $258.55 Care Improvement Plus — Medicare Advantage: $258.55 Humana Healthnet — Tricare: $245.62 Managed Health Services — Medicaid: $75.80 United Healthcare — Medicaid: $75.80 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY PHYSICIAN LEVEL 4	$650.20	$546.17	$111.13 – $127.80
Emergency room visit (moderately high): rates for 4 insurance plans Aetna — Medicare Advantage: $127.80 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $111.13 Consumer Life — Commercial: $144.47 Coventry — Commercial: $155.58
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ER visit for E/M of pt level 4 (99284)	$650.20	$546.17	$111.13 – $127.80
Emergency room visit (moderately high): rates for 4 insurance plans Aetna — Medicare Advantage: $127.80 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $111.13 Consumer Life — Commercial: $144.47 Coventry — Commercial: $155.58
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY RM - LEVEL 5	$1,639.63	$1,377.29	$75.80 – $365.62
Emergency room visit (high): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $365.62 Anthem — Medicaid: $75.80 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $365.62 Care Improvement Plus — Medicare Advantage: $365.62 Humana Healthnet — Tricare: $347.34 Managed Health Services — Medicaid: $75.80 United Healthcare — Medicaid: $75.80 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY PHYSICIAN LEVEL 5	$1,114.29	$936	$161.52 – $185.75
Emergency room visit (high): rates for 4 insurance plans Aetna — Medicare Advantage: $185.75 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $161.52 Consumer Life — Commercial: $209.98 Coventry — Commercial: $226.13
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ER visit for E/M of pt level 5 (99285)	$1,114.29	$936	$161.52 – $185.75
Emergency room visit (high): rates for 4 insurance plans Aetna — Medicare Advantage: $185.75 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $161.52 Consumer Life — Commercial: $209.98 Coventry — Commercial: $226.13

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$189.67	$159.32	$8.46 – $44.09
Basic metabolic panel (blood test): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $44.09 Anthem — Medicaid: $8.46 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $44.09 Care Improvement Plus — Medicare Advantage: $44.09 Humana Healthnet — Tricare: $41.88 Managed Health Services — Medicaid: $8.46 United Healthcare — Medicaid: $8.46 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: METABOLIC PANEL, BASIC	$166.70	$140.03	$38.01 – $40.01
Basic metabolic panel (blood test): rates for 8 insurance plans Aetna — Medicare Advantage: $40.01 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $40.01 Care Improvement Plus — Medicare Advantage: $40.01 Humana Healthnet — Tricare: $38.01 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount) Encore — PPO: 77.1% (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: COMP METABOLIC PANEL	$210.84	$177.11	$10.56 – $49.01
Comprehensive metabolic panel (blood test): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $49.01 Anthem — Medicaid: $10.56 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $49.01 Care Improvement Plus — Medicare Advantage: $49.01 Humana Healthnet — Tricare: $46.56 Managed Health Services — Medicaid: $10.56 United Healthcare — Medicaid: $10.56 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: CMP	$195.50	$164.22	$44.57 – $46.92
Comprehensive metabolic panel (blood test): rates for 8 insurance plans Aetna — Medicare Advantage: $46.92 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $46.92 Care Improvement Plus — Medicare Advantage: $46.92 Humana Healthnet — Tricare: $44.57 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount) Encore — PPO: 77.1% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: CMP POCT	$210.84	$177.11	$10.56 – $49.01
Comprehensive metabolic panel (blood test): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $49.01 Anthem — Medicaid: $10.56 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $49.01 Care Improvement Plus — Medicare Advantage: $49.01 Humana Healthnet — Tricare: $46.56 Managed Health Services — Medicaid: $10.56 United Healthcare — Medicaid: $10.56 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: OBSTETRICS PANEL	$419.20	$352.13	$47.81 – $97.44
Obstetric blood test panel: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $97.44 Anthem — Medicaid: $47.81 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $97.44 Care Improvement Plus — Medicare Advantage: $97.44 Humana Healthnet — Tricare: $92.57 Managed Health Services — Medicaid: $47.81 United Healthcare — Medicaid: $47.81 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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	$157.70	$132.47	$47.36 – $49.85
Cholesterol panel (lipid panel): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $49.85 Anthem — Medicaid: $13.39 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $49.85 Care Improvement Plus — Medicare Advantage: $49.85 Humana Healthnet — Tricare: $47.36 Managed Health Services — Medicaid: $13.39 United Healthcare — Medicaid: $13.39 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 Profile POC	$157.70	$132.47	$47.36 – $49.85
Cholesterol panel (lipid panel): rates for 8 insurance plans Aetna — Medicare Advantage: $49.85 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $49.85 Care Improvement Plus — Medicare Advantage: $49.85 Humana Healthnet — Tricare: $47.36 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount) Encore — PPO: 77.1% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$204.13	$171.47	$8.68 – $47.45
Kidney function panel: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $47.45 Anthem — Medicaid: $8.68 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $47.45 Care Improvement Plus — Medicare Advantage: $47.45 Humana Healthnet — Tricare: $45.08 Managed Health Services — Medicaid: $8.68 United Healthcare — Medicaid: $8.68 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 FUNCT PANEL	$192.77	$161.93	$8.17 – $44.81
Liver function panel: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $44.81 Anthem — Medicaid: $8.17 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $44.81 Care Improvement Plus — Medicare Advantage: $44.81 Humana Healthnet — Tricare: $42.57 Managed Health Services — Medicaid: $8.17 United Healthcare — Medicaid: $8.17 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: LFT LIVER FUNCTION TEST	$138.90	$116.68	$31.67 – $33.34
Liver function panel: rates for 8 insurance plans Aetna — Medicare Advantage: $33.34 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $33.34 Care Improvement Plus — Medicare Advantage: $33.34 Humana Healthnet — Tricare: $31.67 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount) Encore — PPO: 77.1% (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: UA WITH MICROSCOPIC	$93.54	$78.57	$3.17 – $21.74
Urine test (automated, with microscope): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $21.74 Anthem — Medicaid: $3.17 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $21.74 Care Improvement Plus — Medicare Advantage: $21.74 Humana Healthnet — Tricare: $20.66 Managed Health Services — Medicaid: $3.17 United Healthcare — Medicaid: $3.17 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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, AUTOMATED W/MICROSCOPY	$93.54	$78.57	$3.17 – $21.74
Urine test (automated, with microscope): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $21.74 Anthem — Medicaid: $3.17 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $21.74 Care Improvement Plus — Medicare Advantage: $21.74 Humana Healthnet — Tricare: $20.66 Managed Health Services — Medicaid: $3.17 United Healthcare — Medicaid: $3.17 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: Urine Microscopy POC	$11.60	$9.74	$2.64 – $2.78
Urine test (automated, with microscope): rates for 8 insurance plans Aetna — Medicare Advantage: $2.78 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $2.78 Care Improvement Plus — Medicare Advantage: $2.78 Humana Healthnet — Tricare: $2.64 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount) Encore — PPO: 77.1% (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: Urine Dipstick POC	$21.13	$17.75	$3.48 – $4.80
Urine test (manual, without microscope): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $4.80 Anthem — Medicaid: $3.48 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $4.80 Care Improvement Plus — Medicare Advantage: $4.80 Humana Healthnet — Tricare: $4.56 Managed Health Services — Medicaid: $3.48 United Healthcare — Medicaid: $3.48 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Protein Urine	$65.56	$55.07	$2.25 – $15.24
Urine test (automated, without microscope): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $15.24 Anthem — Medicaid: $2.25 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $15.24 Care Improvement Plus — Medicare Advantage: $15.24 Humana Healthnet — Tricare: $14.48 Managed Health Services — Medicaid: $2.25 United Healthcare — Medicaid: $2.25 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine pH	$65.56	$55.07	$2.25 – $15.24
Urine test (automated, without microscope): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $15.24 Anthem — Medicaid: $2.25 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $15.24 Care Improvement Plus — Medicare Advantage: $15.24 Humana Healthnet — Tricare: $14.48 Managed Health Services — Medicaid: $2.25 United Healthcare — Medicaid: $2.25 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS	$80.23	$67.39	$2.25 – $15.24
Urine test (automated, without microscope): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $15.24 Anthem — Medicaid: $2.25 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $15.24 Care Improvement Plus — Medicare Advantage: $15.24 Humana Healthnet — Tricare: $14.48 Managed Health Services — Medicaid: $2.25 United Healthcare — Medicaid: $2.25 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: Prostate-Specific Ag, Serum LC	$118.94	$99.91	$18.39 – $46.54
PSA (prostate specific antigen) blood test: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $46.54 Anthem — Medicaid: $18.39 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $46.54 Care Improvement Plus — Medicare Advantage: $46.54 Humana Healthnet — Tricare: $44.21 Managed Health Services — Medicaid: $18.39 United Healthcare — Medicaid: $18.39 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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	$118.94	$99.91	$18.39 – $46.54
PSA (prostate specific antigen) blood test: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $46.54 Anthem — Medicaid: $18.39 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $46.54 Care Improvement Plus — Medicare Advantage: $46.54 Humana Healthnet — Tricare: $44.21 Managed Health Services — Medicaid: $18.39 United Healthcare — Medicaid: $18.39 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 Total + % Free LC	$118.94	$99.91	$18.39 – $46.54
PSA (prostate specific antigen) blood test: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $46.54 Anthem — Medicaid: $18.39 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $46.54 Care Improvement Plus — Medicare Advantage: $46.54 Humana Healthnet — Tricare: $44.21 Managed Health Services — Medicaid: $18.39 United Healthcare — Medicaid: $18.39 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: TSH	$26.70	$22.43	$6.09 – $6.41
Thyroid stimulating hormone (TSH) test: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $6.41 Anthem — Medicaid: $16.80 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $6.41 Care Improvement Plus — Medicare Advantage: $6.41 Humana Healthnet — Tricare: $6.09 Managed Health Services — Medicaid: $16.80 United Healthcare — Medicaid: $16.80 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: Thyroid Cascade Profile LC	$313.26	$263.14	$16.80 – $72.82
Thyroid stimulating hormone (TSH) test: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $72.82 Anthem — Medicaid: $16.80 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $72.82 Care Improvement Plus — Medicare Advantage: $72.82 Humana Healthnet — Tricare: $69.18 Managed Health Services — Medicaid: $16.80 United Healthcare — Medicaid: $16.80 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: TSH LC	$313.26	$263.14	$16.80 – $72.82
Thyroid stimulating hormone (TSH) test: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $72.82 Anthem — Medicaid: $16.80 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $72.82 Care Improvement Plus — Medicare Advantage: $72.82 Humana Healthnet — Tricare: $69.18 Managed Health Services — Medicaid: $16.80 United Healthcare — Medicaid: $16.80 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: CBC	$104.90	$88.12	$7.77 – $24.38
Complete blood count (CBC) with differential: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $24.38 Anthem — Medicaid: $7.77 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $24.38 Care Improvement Plus — Medicare Advantage: $24.38 Humana Healthnet — Tricare: $23.16 Managed Health Services — Medicaid: $7.77 United Healthcare — Medicaid: $7.77 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: CBC AUTO/AUTO	$104.90	$88.12	$7.77 – $24.38
Complete blood count (CBC) with differential: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $24.38 Anthem — Medicaid: $7.77 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $24.38 Care Improvement Plus — Medicare Advantage: $24.38 Humana Healthnet — Tricare: $23.16 Managed Health Services — Medicaid: $7.77 United Healthcare — Medicaid: $7.77 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: BLD CNT, COMPL CBC W/AUTO DIFF WBC	$91.50	$76.86	$20.86 – $21.96
Complete blood count (CBC) with differential: rates for 8 insurance plans Aetna — Medicare Advantage: $21.96 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $21.96 Care Improvement Plus — Medicare Advantage: $21.96 Humana Healthnet — Tricare: $20.86 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount) Encore — PPO: 77.1% (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: HEMOGRAM	$130.92	$109.97	$6.47 – $30.43
Complete blood count (CBC), automated: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $30.43 Anthem — Medicaid: $6.47 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $30.43 Care Improvement Plus — Medicare Advantage: $30.43 Humana Healthnet — Tricare: $28.91 Managed Health Services — Medicaid: $6.47 United Healthcare — Medicaid: $6.47 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: HEMOGRAM 800642	$130.92	$109.97	$6.47 – $30.43
Complete blood count (CBC), automated: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $30.43 Anthem — Medicaid: $6.47 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $30.43 Care Improvement Plus — Medicare Advantage: $30.43 Humana Healthnet — Tricare: $28.91 Managed Health Services — Medicaid: $6.47 United Healthcare — Medicaid: $6.47 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 (PT)	$93.54	$78.57	$4.29 – $21.74
Blood clotting time test (prothrombin time, PT): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $21.74 Anthem — Medicaid: $4.29 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $21.74 Care Improvement Plus — Medicare Advantage: $21.74 Humana Healthnet — Tricare: $20.66 Managed Health Services — Medicaid: $4.29 United Healthcare — Medicaid: $4.29 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: 85610 Prothrombin time CHARGE	$88.30	$74.17	$21.04 – $22.15
Blood clotting time test (prothrombin time, PT): rates for 8 insurance plans Aetna — Medicare Advantage: $22.15 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $22.15 Care Improvement Plus — Medicare Advantage: $22.15 Humana Healthnet — Tricare: $21.04 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount) Encore — PPO: 77.1% (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: 85610 PT/INR POC	$88.30	$74.17	$21.04 – $22.15
Blood clotting time test (prothrombin time, PT): rates for 8 insurance plans Aetna — Medicare Advantage: $22.15 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $22.15 Care Improvement Plus — Medicare Advantage: $22.15 Humana Healthnet — Tricare: $21.04 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount) Encore — PPO: 77.1% (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: PTT	$130.92	$109.97	$6.01 – $30.43
Blood clotting test (partial thromboplastin time, PTT): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $30.43 Anthem — Medicaid: $6.01 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $30.43 Care Improvement Plus — Medicare Advantage: $30.43 Humana Healthnet — Tricare: $28.91 Managed Health Services — Medicaid: $6.01 United Healthcare — Medicaid: $6.01 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Head or Brain w/o Contrast	$1,899.39	$1,595.49	$56.64 – $441.50
CT scan of the head or brain, without contrast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $441.50 Anthem — Medicaid: $56.64 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $441.50 Care Improvement Plus — Medicare Advantage: $441.50 Humana Healthnet — Tricare: $419.43 Managed Health Services — Medicaid: $56.64 United Healthcare — Medicaid: $56.64 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 w/ + w/o Contrast	$5,059.20	$4,249.73	$193.88 – $1,184.59
MRI of the brain, before and after contrast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $1,184.59 Anthem — Medicaid: $193.88 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $1,184.59 Care Improvement Plus — Medicare Advantage: $1,184.59 Humana Healthnet — Tricare: $1,125.36 Managed Health Services — Medicaid: $193.88 United Healthcare — Medicaid: $193.88 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: XR Chest Special Views	$200.72	$168.60	$42.82 – $62.12
Chest X-ray, 2 views: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $45.07 Anthem — Medicaid: $62.12 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $45.07 Care Improvement Plus — Medicare Advantage: $45.07 Humana Healthnet — Tricare: $42.82 Managed Health Services — Medicaid: $62.12 United Healthcare — Medicaid: $62.12 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: XR Chest 2 Views	$297.45	$249.86	$62.12 – $66.79
Chest X-ray, 2 views: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $66.79 Anthem — Medicaid: $62.12 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $66.79 Care Improvement Plus — Medicare Advantage: $66.79 Humana Healthnet — Tricare: $63.45 Managed Health Services — Medicaid: $62.12 United Healthcare — Medicaid: $62.12 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: XR Spine Lumbosacral Minimum 4 Views	$339.45	$285.14	$23.45 – $76.22
X-ray of the lower spine, at least 4 views: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $76.22 Anthem — Medicaid: $23.45 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $76.22 Care Improvement Plus — Medicare Advantage: $76.22 Humana Healthnet — Tricare: $72.41 Managed Health Services — Medicaid: $23.45 United Healthcare — Medicaid: $23.45 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: MRI Spine Lumbar w/o Contrast	$3,238.44	$2,720.29	$117.33 – $752.76
MRI of the lower back (lumbar spine), without contrast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $752.76 Anthem — Medicaid: $117.33 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $752.76 Care Improvement Plus — Medicare Advantage: $752.76 Humana Healthnet — Tricare: $715.12 Managed Health Services — Medicaid: $117.33 United Healthcare — Medicaid: $117.33 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: CT Pelvis w/ Contrast	$2,012.76	$1,690.72	$123.28 – $467.86
CT scan of the pelvis, with contrast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $467.86 Anthem — Medicaid: $123.28 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $467.86 Care Improvement Plus — Medicare Advantage: $467.86 Humana Healthnet — Tricare: $444.46 Managed Health Services — Medicaid: $123.28 United Healthcare — Medicaid: $123.28 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: MRI LE Joint w/o Contrast Bilateral	$7,393.22	$6,210.30	$129.47 – $1,731.10
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $1,731.10 Anthem — Medicaid: $129.47 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $1,731.10 Care Improvement Plus — Medicare Advantage: $1,731.10 Humana Healthnet — Tricare: $1,644.54 Managed Health Services — Medicaid: $129.47 United Healthcare — Medicaid: $129.47 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: MRI LE Joint w/o Contrast Left	$7,393.22	$6,210.30	$129.47 – $1,731.10
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $1,731.10 Anthem — Medicaid: $129.47 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $1,731.10 Care Improvement Plus — Medicare Advantage: $1,731.10 Humana Healthnet — Tricare: $1,644.54 Managed Health Services — Medicaid: $129.47 United Healthcare — Medicaid: $129.47 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: MRI LE Joint w/o Contrast Right	$7,393.22	$6,210.30	$129.47 – $1,731.10
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $1,731.10 Anthem — Medicaid: $129.47 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $1,731.10 Care Improvement Plus — Medicare Advantage: $1,731.10 Humana Healthnet — Tricare: $1,644.54 Managed Health Services — Medicaid: $129.47 United Healthcare — Medicaid: $129.47 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: CT Abdomen and Pelvis w/ Contrast	$3,376.17	$2,835.98	$162.17 – $784.78
CT scan of the abdomen and pelvis, with contrast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $784.78 Anthem — Medicaid: $162.17 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $784.78 Care Improvement Plus — Medicare Advantage: $784.78 Humana Healthnet — Tricare: $745.54 Managed Health Services — Medicaid: $162.17 United Healthcare — Medicaid: $162.17 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: CT Abdomen/Pelvis w/ Contrast	$3,376.17	$2,835.98	$162.17 – $784.78
CT scan of the abdomen and pelvis, with contrast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $784.78 Anthem — Medicaid: $162.17 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $784.78 Care Improvement Plus — Medicare Advantage: $784.78 Humana Healthnet — Tricare: $745.54 Managed Health Services — Medicaid: $162.17 United Healthcare — Medicaid: $162.17 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: US Abdomen Complete	$1,305.71	$1,096.80	$70.27 – $294.94
Ultrasound of the abdomen, complete: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $294.94 Anthem — Medicaid: $70.27 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $294.94 Care Improvement Plus — Medicare Advantage: $294.94 Humana Healthnet — Tricare: $280.19 Managed Health Services — Medicaid: $70.27 United Healthcare — Medicaid: $70.27 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 In the file: US OB More Than 14 Weeks 1st Gest	$783.28	$657.96	$67.54 – $176.93
Pregnancy ultrasound (after the first trimester): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $176.93 Anthem — Medicaid: $67.54 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $176.93 Care Improvement Plus — Medicare Advantage: $176.93 Humana Healthnet — Tricare: $168.08 Managed Health Services — Medicaid: $67.54 United Healthcare — Medicaid: $67.54 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MMCH US Transvaginal	$725.64	$609.54	$64.08 – $168.67
Transvaginal ultrasound: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $168.67 Anthem — Medicaid: $64.08 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $168.67 Care Improvement Plus — Medicare Advantage: $168.67 Humana Healthnet — Tricare: $160.24 Managed Health Services — Medicaid: $64.08 United Healthcare — Medicaid: $64.08 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MMCH US Transvaginal Non-OB	$793.68	$666.69	$64.08 – $184.49
Transvaginal ultrasound: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $184.49 Anthem — Medicaid: $64.08 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $184.49 Care Improvement Plus — Medicare Advantage: $184.49 Humana Healthnet — Tricare: $175.26 Managed Health Services — Medicaid: $64.08 United Healthcare — Medicaid: $64.08 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Transvaginal Non-OB	$793.68	$666.69	$64.08 – $184.49
Transvaginal ultrasound: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $184.49 Anthem — Medicaid: $64.08 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $184.49 Care Improvement Plus — Medicare Advantage: $184.49 Humana Healthnet — Tricare: $175.26 Managed Health Services — Medicaid: $64.08 United Healthcare — Medicaid: $64.08 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MA Diag Lt w/ Cad	$610.93	$513.18	$65.56 – $137.18
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $137.18 Anthem — Medicaid: $65.56 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $137.18 Care Improvement Plus — Medicare Advantage: $137.18 Humana Healthnet — Tricare: $130.32 Managed Health Services — Medicaid: $65.56 United Healthcare — Medicaid: $65.56 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: MA Diag Rt w/ Cad	$610.93	$513.18	$65.56 – $137.18
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $137.18 Anthem — Medicaid: $65.56 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $137.18 Care Improvement Plus — Medicare Advantage: $137.18 Humana Healthnet — Tricare: $130.32 Managed Health Services — Medicaid: $65.56 United Healthcare — Medicaid: $65.56 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MA Mammogram Diagnostic Left w/Tomo	$610.93	$513.18	$65.56 – $137.18
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $137.18 Anthem — Medicaid: $65.56 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $137.18 Care Improvement Plus — Medicare Advantage: $137.18 Humana Healthnet — Tricare: $130.32 Managed Health Services — Medicaid: $65.56 United Healthcare — Medicaid: $65.56 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Diag Bil w/ Cad	$763.87	$641.65	$83.89 – $171.53
Diagnostic mammogram, both breasts: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $171.53 Anthem — Medicaid: $83.89 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $171.53 Care Improvement Plus — Medicare Advantage: $171.53 Humana Healthnet — Tricare: $162.95 Managed Health Services — Medicaid: $83.89 United Healthcare — Medicaid: $83.89 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA Routine Screen Bil w/ Cad	$456.91	$383.80	$69.28 – $102.60
Screening mammogram, both breasts: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $102.60 Anthem — Medicaid: $69.28 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $102.60 Care Improvement Plus — Medicare Advantage: $102.60 Humana Healthnet — Tricare: $97.47 Managed Health Services — Medicaid: $69.28 United Healthcare — Medicaid: $69.28 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: MA Routine Screen Lt w/ Cad	$456.91	$383.80	$69.28 – $102.60
Screening mammogram, both breasts: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $102.60 Anthem — Medicaid: $69.28 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $102.60 Care Improvement Plus — Medicare Advantage: $102.60 Humana Healthnet — Tricare: $97.47 Managed Health Services — Medicaid: $69.28 United Healthcare — Medicaid: $69.28 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: MA Routine Screen Rt w/ Cad	$456.91	$383.80	$69.28 – $102.60
Screening mammogram, both breasts: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $102.60 Anthem — Medicaid: $69.28 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $102.60 Care Improvement Plus — Medicare Advantage: $102.60 Humana Healthnet — Tricare: $97.47 Managed Health Services — Medicaid: $69.28 United Healthcare — Medicaid: $69.28 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EKG PEDIATRIC W/INTERP	$334.64	$281.10	$34.97 – $75.14
Electrocardiogram (ECG/EKG) with reading: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $75.14 Anthem — Medicaid: $34.97 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $75.14 Care Improvement Plus — Medicare Advantage: $75.14 Humana Healthnet — Tricare: $71.39 Managed Health Services — Medicaid: $34.97 United Healthcare — Medicaid: $34.97 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ELECTROCARDIOGRAM, COMPLETE (ECG)	$282.30	$237.13	$14.36 – $16.51
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans Aetna — Medicare Advantage: $16.51 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $14.36 Consumer Life — Commercial: $18.67 Coventry — Commercial: $20.10
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EKG PEDIATRIC W/INTERP	$125.10	$105.08	$14.36 – $16.51
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans Aetna — Medicare Advantage: $16.51 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $14.36 Consumer Life — Commercial: $18.67 Coventry — Commercial: $20.10
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPHY	$4,209.40	$3,535.90	$200.10 – $1,113.77
Sleep study (overnight, in a sleep lab): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $1,113.77 Anthem — Medicaid: $200.10 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $1,113.77 Care Improvement Plus — Medicare Advantage: $1,113.77 Humana Healthnet — Tricare: $1,058.08 Managed Health Services — Medicaid: $200.10 United Healthcare — Medicaid: $200.10 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSG MD INTERP FEE	$856.70	$719.63	$115.18 – $132.46
Sleep study (overnight, in a sleep lab): rates for 4 insurance plans Aetna — Medicare Advantage: $132.46 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $115.18 Consumer Life — Commercial: $149.73 Coventry — Commercial: $161.25

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Therapeutic exercises (97110)	$89.22	$74.94	$27.89 – $32.70
Physical therapy: therapeutic exercise (each 15 minutes): rates for 4 insurance plans Aetna — Medicare Advantage: $32.70 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $27.89 Consumer Life — Commercial: $36.26 Coventry — Commercial: $39.05
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: OT THERAPEUTIC EXERCISE 15 MIN	$147.35	$123.77	$31.94 – $47.81
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $33.62 Anthem — Medicaid: $47.81 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $33.62 Care Improvement Plus — Medicare Advantage: $33.62 Humana Healthnet — Tricare: $31.94 Managed Health Services — Medicaid: $47.81 United Healthcare — Medicaid: $47.81 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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: PHYS THER EXERCISE 0-15 MIN.	$147.99	$124.31	$31.94 – $47.81
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $33.62 Anthem — Medicaid: $47.81 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $33.62 Care Improvement Plus — Medicare Advantage: $33.62 Humana Healthnet — Tricare: $31.94 Managed Health Services — Medicaid: $47.81 United Healthcare — Medicaid: $47.81 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 COMPLEXITY	$246.33	$206.92	$47.81 – $55.97
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $55.97 Anthem — Medicaid: $47.81 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $55.97 Care Improvement Plus — Medicare Advantage: $55.97 Humana Healthnet — Tricare: $53.17 Managed Health Services — Medicaid: $47.81 United Healthcare — Medicaid: $47.81 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 COMPLEXITY	$246.33	$206.92	$47.81 – $55.97
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $55.97 Anthem — Medicaid: $47.81 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $55.97 Care Improvement Plus — Medicare Advantage: $55.97 Humana Healthnet — Tricare: $53.17 Managed Health Services — Medicaid: $47.81 United Healthcare — Medicaid: $47.81 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — 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 COMPLEXITY	$246.33	$206.92	$47.81 – $55.97
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $55.97 Anthem — Medicaid: $47.81 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $55.97 Care Improvement Plus — Medicare Advantage: $55.97 Humana Healthnet — Tricare: $53.17 Managed Health Services — Medicaid: $47.81 United Healthcare — Medicaid: $47.81 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 90832 PSYCHOTHERAPY, 30 MIN W/PATIENT	$157.04	$131.91	$84.16 – $96.78
Psychotherapy, 30 minutes: rates for 4 insurance plans Aetna — Medicare Advantage: $96.78 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $84.16 Consumer Life — Commercial: $109.41 Coventry — Commercial: $117.82
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY, 45 MIN W/PATIENT	$213.40	$179.26	$111.53 – $128.26
Psychotherapy, 45 minutes: rates for 4 insurance plans Aetna — Medicare Advantage: $128.26 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $111.53 Consumer Life — Commercial: $144.99 Coventry — Commercial: $156.14
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 90837 Psychotherapy, 60 minutes with patient	$401.51	$337.27	$163.74 – $188.30
Psychotherapy, 60 minutes: rates for 4 insurance plans Aetna — Medicare Advantage: $188.30 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $163.74 Consumer Life — Commercial: $212.86 Coventry — Commercial: $229.24
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 90837PSYCHOTHERAPY PATIENT 60 min	$566.56	$475.91	$163.74 – $188.30
Psychotherapy, 60 minutes: rates for 4 insurance plans Aetna — Medicare Advantage: $188.30 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $163.74 Consumer Life — Commercial: $212.86 Coventry — Commercial: $229.24
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY, W/O PATIENT,50MIN	$251.68	$211.41	$12.50 – $104.39
Family psychotherapy, without the patient: rates for 4 insurance plans Aetna — Medicare Advantage: $12.50 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $104.39 Consumer Life — Commercial: $135.71 Coventry — Commercial: $146.15
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY,W/PT PRESENT, 50MIN	$336.24	$282.44	$108.24 – $124.48
Family psychotherapy, with the patient: rates for 4 insurance plans Aetna — Medicare Advantage: $124.48 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $108.24 Consumer Life — Commercial: $140.71 Coventry — Commercial: $151.54
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 90853 IOPH GROUP THRPY 90 MIN	$80.53	$67.65	$29.66 – $34.11
Group psychotherapy: rates for 4 insurance plans Aetna — Medicare Advantage: $34.11 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $29.66 Consumer Life — Commercial: $38.56 Coventry — Commercial: $41.52

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Exc. of cyst fibroadenomabenign or malignant tumorbreast tissnippleareolarM/F 1+lesion 19120	$1,196.20	$1,004.81	$62.63 – $524.03
Removal of breast growth (open surgery): rates for 4 insurance plans Aetna — Medicare Advantage: $62.63 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $524.03 Consumer Life — Commercial: $681.24 Coventry — Commercial: $733.64
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Charge for Total Hip Arthroplasty 27130	$3,830.16	$3,217.33	$1,063.97 – $1,223.57
Total hip replacement: rates for 4 insurance plans Aetna — Medicare Advantage: $1,223.57 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $1,063.97 Consumer Life — Commercial: $1,383.16 Coventry — Commercial: $1,489.56
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Charge for Total knee arthroplasty 27447	$3,828.15	$3,215.65	$1,062.40 – $1,221.76
Total knee replacement: rates for 4 insurance plans Aetna — Medicare Advantage: $1,221.76 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $1,062.40 Consumer Life — Commercial: $1,381.12 Coventry — Commercial: $1,487.36
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Arthroscopy Shoulder Surgical Decompression Of Subacromial Space With Partial Acromioplasty With 29826	$496.17	$416.78	$135.46 – $155.78
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans Aetna — Medicare Advantage: $155.78 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $135.46 Consumer Life — Commercial: $176.10 Coventry — Commercial: $189.64
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Knee arthroscopy/surgery w/meniscectomy med OR lat 29881	$1,529.19	$1,284.52	$474.45 – $545.62
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 4 insurance plans Aetna — Medicare Advantage: $545.62 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $474.45 Consumer Life — Commercial: $616.78 Coventry — Commercial: $664.23
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: TONSILLECTOMY ADENOIDECTOMY UNDER 12	$693.24	$582.32	$243.15 – $279.62
Removal of tonsils and adenoids (under age 12): rates for 4 insurance plans Aetna — Medicare Advantage: $279.62 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $243.15 Consumer Life — Commercial: $316.10 Coventry — Commercial: $340.41
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 42820 TONSILLECTOMY ADENOIDECTOMY UNDER 12	$869.50	$730.38	$243.15 – $279.62
Removal of tonsils and adenoids (under age 12): rates for 4 insurance plans Aetna — Medicare Advantage: $279.62 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $243.15 Consumer Life — Commercial: $316.10 Coventry — Commercial: $340.41
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: UPPER GI ENDOSCOPY, DIAGNOSTIC	$745.67	$626.36	$300.85 – $345.98
Upper GI endoscopy (diagnostic): rates for 4 insurance plans Aetna — Medicare Advantage: $345.98 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $300.85 Consumer Life — Commercial: $391.11 Coventry — Commercial: $421.19
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PHY EGD DIAGNOSTIC	$910.10	$764.48	$300.85 – $345.98
Upper GI endoscopy (diagnostic): rates for 4 insurance plans Aetna — Medicare Advantage: $345.98 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $300.85 Consumer Life — Commercial: $391.11 Coventry — Commercial: $421.19
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: UPPER GI ENDOSCOPY, W/BIOPSY	$882.50	$741.30	$389.98 – $448.48
Upper GI endoscopy with biopsy: rates for 4 insurance plans Aetna — Medicare Advantage: $448.48 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $389.98 Consumer Life — Commercial: $506.97 Coventry — Commercial: $545.97
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PHY EGD BX SNGLE OR MULTIPLE	$1,081.80	$908.71	$389.98 – $448.48
Upper GI endoscopy with biopsy: rates for 4 insurance plans Aetna — Medicare Advantage: $448.48 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $389.98 Consumer Life — Commercial: $506.97 Coventry — Commercial: $545.97
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PHY DX COLONOSCOPY FLEXIBLE	$1,356	$1,139.04	$22.79 – $176.34
Colonoscopy (diagnostic): rates for 4 insurance plans Aetna — Medicare Advantage: $22.79 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $176.34 Consumer Life — Commercial: $229.24 Coventry — Commercial: $246.88
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY/BIOPSY	$1,138.79	$956.58	$447.52 – $514.65
Colonoscopy with biopsy: rates for 4 insurance plans Aetna — Medicare Advantage: $514.65 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $447.52 Consumer Life — Commercial: $581.78 Coventry — Commercial: $626.53
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PHY COLONOSCOPY AND BIOPSY(S)	$1,491.70	$1,253.03	$447.52 – $514.65
Colonoscopy with biopsy: rates for 4 insurance plans Aetna — Medicare Advantage: $514.65 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $447.52 Consumer Life — Commercial: $581.78 Coventry — Commercial: $626.53
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY/REMOVE LESION W/SNARE	$1,282.31	$1,077.14	$467.18 – $537.26
Colonoscopy with removal of polyps (snare): rates for 4 insurance plans Aetna — Medicare Advantage: $537.26 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $467.18 Consumer Life — Commercial: $607.33 Coventry — Commercial: $654.05
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PHY COLONOSCOPY LES REM SNARE	$1,939.80	$1,629.43	$467.18 – $537.26
Colonoscopy with removal of polyps (snare): rates for 4 insurance plans Aetna — Medicare Advantage: $537.26 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $467.18 Consumer Life — Commercial: $607.33 Coventry — Commercial: $654.05
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: G0121 SCRN COLONOSCOPY PT NOT HIGH RISK	$1,197.70	$1,006.07	$22.79 – $176.34
Screening colonoscopy (not high risk): rates for 4 insurance plans Aetna — Medicare Advantage: $22.79 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $176.34 Consumer Life — Commercial: $229.24 Coventry — Commercial: $246.88
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLON CA SCRN	$954.71	$801.96	$22.79 – $176.34
Screening colonoscopy (not high risk): rates for 4 insurance plans Aetna — Medicare Advantage: $22.79 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $176.34 Consumer Life — Commercial: $229.24 Coventry — Commercial: $246.88
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LAPAROSCOPY, CHOLECYSTECTOMY	$1,538.15	$1,292.05	$571.22 – $656.90
Gallbladder removal by laparoscope: rates for 4 insurance plans Aetna — Medicare Advantage: $656.90 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $571.22 Consumer Life — Commercial: $742.59 Coventry — Commercial: $799.71
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 47562 Laparoscopy, Surgical; Cholecystectomy Pro	$1,929.50	$1,620.78	$571.22 – $656.90
Gallbladder removal by laparoscope: rates for 4 insurance plans Aetna — Medicare Advantage: $656.90 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $571.22 Consumer Life — Commercial: $742.59 Coventry — Commercial: $799.71
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: REPAIR INGNL HERNIA, 5+ YRS, REDUC	$1,218.87	$1,023.85	$459.50 – $528.42
Groin (inguinal) hernia repair, age 5 or older: rates for 4 insurance plans Aetna — Medicare Advantage: $528.42 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $459.50 Consumer Life — Commercial: $597.35 Coventry — Commercial: $643.30
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: 49505 Repair initial inguinal hernia, age 5 years or over; r	$1,528.90	$1,284.28	$459.50 – $528.42
Groin (inguinal) hernia repair, age 5 or older: rates for 4 insurance plans Aetna — Medicare Advantage: $528.42 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $459.50 Consumer Life — Commercial: $597.35 Coventry — Commercial: $643.30
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Hysteroscopy surgical w/ sampling (biopsy) of endometrium and/or polypectomy w/ w/o D C 58558	$1,247.99	$1,048.31	$1,177.45 – $1,354.70
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans Aetna — Medicare Advantage: $1,354.70 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $1,177.45 Consumer Life — Commercial: $1,530.69 Coventry — Commercial: $1,648.43
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Inj foramen epidural l/s 64483	$647.76	$544.12	$247.54 – $284.67
Nerve root injection, lower back, with imaging guidance: rates for 4 insurance plans Aetna — Medicare Advantage: $284.67 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $247.54 Consumer Life — Commercial: $321.80 Coventry — Commercial: $346.56
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Carpal tunnel surgery 64721	$1,222.17	$1,026.62	$444.65 – $511.35
Carpal tunnel release: rates for 4 insurance plans Aetna — Medicare Advantage: $511.35 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $444.65 Consumer Life — Commercial: $578.04 Coventry — Commercial: $622.51
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Posterior Capsulotomy Charge 66821	$1,485.90	$1,248.16	$338.79 – $443.28
Laser treatment of clouding after cataract surgery: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $356.62 Anthem — Medicaid: $443.28 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $356.62 Care Improvement Plus — Medicare Advantage: $356.62 Humana Healthnet — Tricare: $338.79 Managed Health Services — Medicaid: $443.28 United Healthcare — Medicaid: $443.28 Anthem — PPO HMO EXCHANGE: 66.32% (a percentage in the contract, not a dollar amount) Consumer Life — Commercial: 98% (a percentage in the contract, not a dollar amount) Coventry — Commercial: 95% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Routine OB Care Antepartum/Vaginal Delivery/Postpartum 59400	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$1,987.62 – $2,285.76
Vaginal delivery, with care before and after: rates for 4 insurance plans Aetna — Medicare Advantage: $2,285.76 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $1,987.62 Consumer Life — Commercial: $2,583.91 Coventry — Commercial: $2,782.67
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Routine obstetric care including antepartum care cesarean delivery and postpartum care 59510	$6,000.38	$5,040.32	$2,201.70 – $2,531.95
Cesarean delivery (C-section), with care before and after: rates for 4 insurance plans Aetna — Medicare Advantage: $2,531.95 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $2,201.70 Consumer Life — Commercial: $2,862.21 Coventry — Commercial: $3,082.38
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Routine OB Care Antepartum/Vaginal Delivery After Cesarean/Postpartum Charge 59610	$5,677.63	$4,769.21	$2,071.72 – $2,382.48
Vaginal delivery after a previous C-section, with care before and after: rates for 4 insurance plans Aetna — Medicare Advantage: $2,382.48 Anthem — Medicare Advantage PPO Medicare Advantage HMO: $2,071.72 Consumer Life — Commercial: $2,693.24 Coventry — Commercial: $2,900.41

Source: Margaret Mary Community Hospital Inc’s standard charges file (mmhealth.org, CSV, CMS template 2.0.0; it can be a very large file), last updated by the hospital on April 8, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

Found through the price transparency link on the hospital’s website (mmhealth.org), because the hospital has no cms-hpt.txt file; both are required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Critical Access Hospital
Address	321 Mitchell Ave, Batesville, IN 47006
County	Ripley County
State	Indiana
Phone	(812) 934‑6624
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	151329
Name in Medicare records	MARGARET MARY COMMUNITY HOSPITAL INC
Profile level	Medicare data + hospital website
Name on the hospital’s website	Margaret Mary Health
Official website	mmhealth.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

About MMH - Margaret Mary Health — mmhealth.org
Emergency Services - Margaret Mary Health — mmhealth.org
Margaret Mary Health Main Campus - Margaret Mary Health — mmhealth.org