Does Mariners Hospital have an emergency room?

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

Where is Mariners Hospital?

91500 Overseas Highway, Tavernier, FL 33070, in Monroe County, Florida.

What is the phone number of Mariners Hospital?

(305) 434-3000, as listed by Medicare (CMS).

What is the Medicare star rating of Mariners Hospital?

5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Mariners Hospital — Tavernier, FL

Quick answers

Does Mariners Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Mariners Hospital. In a medical emergency, call 911.
Where is Mariners Hospital?: 91500 Overseas Highway, Tavernier, FL 33070, in Monroe County, Florida.
What is the phone number of Mariners Hospital?: (305) 434-3000, as listed by Medicare (CMS).
What is the Medicare star rating of Mariners Hospital?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Gastroenterology
Hyperbaric Medicine
Infectious Disease
Internal Medicine
Physical Medicine and Rehabilitation
Sleep Medicine
Urology Services
Cancer Care
Heart and Vascular Care
Orthopedic Care
Brain and Spine Care
Primary Care Sports Medicine
Breast Surgery
Oculoplastic Surgery
Orthognathic Surgery

Conditions treated^[4]

Diving-related injuries
UTI

Treatments^[4]

Radiation therapies
Outpatient infusion therapy for cancer
Hyperbaric chamber therapy
Physical therapy
Occupational therapy
Speech therapy
Cardiac rehabilitation
Pulmonary rehabilitation
Outpatient diabetes care
Hyperbaric oxygen therapy
Outpatient cancer infusion therapy
Non-surgical treatments
Tetanus shots
Flu shots

Procedures^[4]

Endoscopy
Breast surgery
Cancer surgery
Oculoplastic surgery
Orthognathic surgery
Breast biopsy
MRI
CT scan
PET/CT scan
Ultrasound
3D mammography
Bone density (DEXA) scan
Nuclear medicine studies
Core biopsy
Digital X-ray
Electrocardiogram
Fluoroscopy studies
Galactogram

Programs and centers^[4]

Cardiac rehabilitation
Pulmonary rehabilitation
Heart failure services
Outpatient diabetes care
Cardiovascular disease prevention services
Cancer patient support services

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Visiting	Visiting hours 7 a.m. to 9 p.m.; after 9 p.m. enter through the Emergency Department^[4]
Parking	Reserved patient parking, valet service, and EV charging stations on campus^[4]
Patient portal	https://baptisthealth.net/patient-resources/mybaptisthealth-patient-portal

Recognition^[4]

Pathway to Excellence (ANCC), 2012

Doctors and clinicians (404)

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

Main specialties

Doctors with a page on this site (404)

Abbe F. Rosenbaum, MDCardiovascular Disease (Cardiology)
Abraham Wolfenzon, MDCardiovascular Disease (Cardiology)
Adam R. Geronemus, MDInterventional Radiology
Adedapo Iluyomade, MDCardiovascular Disease (Cardiology)
Adeel Kaiser, MDRadiation Oncology
Adrian CristianPhysical Medicine and Rehabilitation
Adriana Gonzalez, NPNurse Practitioner
Ahmed H. Eldefrawy, MDUrology
Ailec E. EstradaNurse Practitioner
Aimee M. Aguiar, MDDiagnostic Radiology
Akshay Goyal, MDPain Management
Alberto Convers, MDDiagnostic Radiology
Alejandro Sarria Arbocco, MDCardiovascular Disease (Cardiology)
Alex Powell, MDDiagnostic Radiology
Alexander Toirac, MDCardiovascular Disease (Cardiology)
Alexander Van Der Ven, MDOrthopedic Surgery
Alexis J. Blanco, PAPhysician Assistant
Alexis Lorente, NPNurse Practitioner
Alvaro Gomez, MDInterventional Cardiology
Alvaro I. Martinez Jr., MDCardiovascular Disease (Cardiology)
Alyssa Ionno, MDDiagnostic Radiology
Amanda E. Cruz Cruz, MDInternal Medicine
Ana C. Sandoval LeonHematology/Oncology
Andrea M. Vitello, MDCardiovascular Disease (Cardiology)

And 380 more: the button below opens the full list.

Other emergency rooms nearby

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

Homestead Hospital33 mi · Homestead, FL · Acute Care Hospital
Fishermen's Community Hospital41 mi · Marathon, FL · Critical Access Hospital
West Kendall Baptist Hospital47 mi · Miami, FL · Acute Care Hospital
Baptist Hospital of Miami49 mi · Miami, FL · Acute Care Hospital
South Miami Hospital50 mi · Miami, FL · Acute Care Hospital

Other hospitals nearby

Encompass Health Rehabilitation Hospital of Miami41 mi · Miami, FL · Inpatient Rehabilitation 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

Oasis at the Keys Nursing and Rehab2.5 mi · Tavernier, FL · 2 of 5 stars

All nursing homes 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

Tavernier Health Center0.2 mi · Tavernier, FL · Community health center
Key Largo Health Center7.8 mi · Key Largo, FL · Community health center

Clinics and urgent care

Agape Health Medical Group LLC0.6 mi · Tavernier, FL · Urgent care center
Bruce L Boros MD PA17 mi · Key Largo, FL · Urgent care center

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	91%National average: 72%
Would definitely recommend the hospital	88%National average: 71%
Nurses “always” communicated well	90%National average: 80%
Doctors “always” communicated well	88%National average: 80%
Staff “always” explained medicines before giving them	73%National average: 62%
Were given information about recovery at home	93%National average: 86%
Room and bathroom “always” clean	77%National average: 74%
Area around the room “always” quiet at night	69%National average: 60%
Completed surveys	68Response rate: 28%

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	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

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

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	11.4%
Deaths within 30 days: COPD patients	7.2%
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	Not reported to Medicare

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	17.1%
Readmitted within 30 days: COPD	20.2%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	118 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Too few cases to report

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 Florida Best hospitals in Florida

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 52 common services exactly as Mariners Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: OFFICE O/P NEW LOW 30 MIN	$842	$547.30	$145.67 – $842
New patient office visit (about 30–44 minutes): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $673.60 AETNA — AETNA HMO: $673.60 AETNA — AETNA HMO EXCHANGE: $597.82 AETNA — AETNA MEDICARE: $193.66 AETNA — AETNA PPO: $673.60 AETNA — AETNA TIER 2: $673.60 AFFORDABLE — AFFORDABLE PPO: $757.80 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $631.50 AVMED — AVMED ENTRUST: $579.30 AVMED — AVMED HMO: $698.86
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: OFFICE O/P NEW MOD 45 MIN	$1,149	$746.85	$198.78 – $1,149
New patient office visit (about 45–59 minutes): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $919.20 AETNA — AETNA HMO: $919.20 AETNA — AETNA HMO EXCHANGE: $815.79 AETNA — AETNA MEDICARE: $264.27 AETNA — AETNA PPO: $919.20 AETNA — AETNA TIER 2: $919.20 AFFORDABLE — AFFORDABLE PPO: $1,034.10 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $861.75 AVMED — AVMED ENTRUST: $790.51 AVMED — AVMED HMO: $953.67
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: OFFICE O/P NEW HI 60 MIN	$1,186	$770.90	$205.18 – $1,186
New patient office visit (about 60–74 minutes): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $948.80 AETNA — AETNA HMO: $948.80 AETNA — AETNA HMO EXCHANGE: $842.06 AETNA — AETNA MEDICARE: $272.78 AETNA — AETNA PPO: $948.80 AETNA — AETNA TIER 2: $948.80 AFFORDABLE — AFFORDABLE PPO: $1,067.40 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $889.50 AVMED — AVMED ENTRUST: $815.97 AVMED — AVMED HMO: $984.38
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Est pat visit lvl III wnd	$841	$546.65	$145.49 – $841
Established patient office visit (about 20–29 minutes): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $672.80 AETNA — AETNA HMO: $672.80 AETNA — AETNA HMO EXCHANGE: $597.11 AETNA — AETNA MEDICARE: $193.43 AETNA — AETNA PPO: $672.80 AETNA — AETNA TIER 2: $672.80 AFFORDABLE — AFFORDABLE PPO: $756.90 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $630.75 AVMED — AVMED ENTRUST: $578.61 AVMED — AVMED HMO: $698.03
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · modifier 25 In the file: Est pat visit lvl III wnd	$841	$546.65	$145.49 – $841
Established patient office visit (about 20–29 minutes): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $672.80 AETNA — AETNA HMO: $672.80 AETNA — AETNA HMO EXCHANGE: $597.11 AETNA — AETNA MEDICARE: $193.43 AETNA — AETNA PPO: $672.80 AETNA — AETNA TIER 2: $672.80 AFFORDABLE — AFFORDABLE PPO: $756.90 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $630.75 AVMED — AVMED ENTRUST: $578.61 AVMED — AVMED HMO: $698.03
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Est pat visit lvl IV wnd	$1,169	$759.85	$202.24 – $1,169
Established patient office visit (about 30–39 minutes): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $935.20 AETNA — AETNA HMO: $935.20 AETNA — AETNA HMO EXCHANGE: $829.99 AETNA — AETNA MEDICARE: $268.87 AETNA — AETNA PPO: $935.20 AETNA — AETNA TIER 2: $935.20 AFFORDABLE — AFFORDABLE PPO: $1,052.10 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $876.75 AVMED — AVMED ENTRUST: $804.27 AVMED — AVMED HMO: $970.27
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · modifier 25 In the file: Est pat visit lvl IV wnd	$1,169	$759.85	$202.24 – $1,169
Established patient office visit (about 30–39 minutes): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $935.20 AETNA — AETNA HMO: $935.20 AETNA — AETNA HMO EXCHANGE: $829.99 AETNA — AETNA MEDICARE: $268.87 AETNA — AETNA PPO: $935.20 AETNA — AETNA TIER 2: $935.20 AFFORDABLE — AFFORDABLE PPO: $1,052.10 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $876.75 AVMED — AVMED ENTRUST: $804.27 AVMED — AVMED HMO: $970.27
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: ER level 3	$1,814	$1,179.10	$313.82 – $1,814
Emergency room visit (moderate): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $1,451.20 AETNA — AETNA HMO: $1,451.20 AETNA — AETNA HMO EXCHANGE: $1,287.94 AETNA — AETNA MEDICARE: $417.22 AETNA — AETNA PPO: $1,451.20 AETNA — AETNA TIER 2: $1,451.20 AFFORDABLE — AFFORDABLE PPO: $1,632.60 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,360.50 AVMED — AVMED ENTRUST: $1,248.03 AVMED — AVMED HMO: $1,505.62
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier 76 In the file: ER level 3	$1,814	$1,179.10	$313.82 – $1,814
Emergency room visit (moderate): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $1,451.20 AETNA — AETNA HMO: $1,451.20 AETNA — AETNA HMO EXCHANGE: $1,287.94 AETNA — AETNA MEDICARE: $417.22 AETNA — AETNA PPO: $1,451.20 AETNA — AETNA TIER 2: $1,451.20 AFFORDABLE — AFFORDABLE PPO: $1,632.60 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,360.50 AVMED — AVMED ENTRUST: $1,248.03 AVMED — AVMED HMO: $1,505.62
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier 27 In the file: ER level 3	$1,814	$1,179.10	$313.82 – $1,814
Emergency room visit (moderate): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $1,451.20 AETNA — AETNA HMO: $1,451.20 AETNA — AETNA HMO EXCHANGE: $1,287.94 AETNA — AETNA MEDICARE: $417.22 AETNA — AETNA PPO: $1,451.20 AETNA — AETNA TIER 2: $1,451.20 AFFORDABLE — AFFORDABLE PPO: $1,632.60 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,360.50 AVMED — AVMED ENTRUST: $1,248.03 AVMED — AVMED HMO: $1,505.62
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: ER level 4	$2,444	$1,588.60	$422.81 – $2,444
Emergency room visit (moderately high): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $1,955.20 AETNA — AETNA HMO: $1,955.20 AETNA — AETNA HMO EXCHANGE: $1,735.24 AETNA — AETNA MEDICARE: $562.12 AETNA — AETNA PPO: $1,955.20 AETNA — AETNA TIER 2: $1,955.20 AFFORDABLE — AFFORDABLE PPO: $2,199.60 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,833 AVMED — AVMED ENTRUST: $1,681.47 AVMED — AVMED HMO: $2,028.52
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · modifier ER In the file: ER level 4	$2,444	$1,588.60	$422.81 – $2,444
Emergency room visit (moderately high): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $1,955.20 AETNA — AETNA HMO: $1,955.20 AETNA — AETNA HMO EXCHANGE: $1,735.24 AETNA — AETNA MEDICARE: $562.12 AETNA — AETNA PPO: $1,955.20 AETNA — AETNA TIER 2: $1,955.20 AFFORDABLE — AFFORDABLE PPO: $2,199.60 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,833 AVMED — AVMED ENTRUST: $1,681.47 AVMED — AVMED HMO: $2,028.52
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · modifier 27 In the file: ER level 4	$2,444	$1,588.60	$422.81 – $2,444
Emergency room visit (moderately high): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $1,955.20 AETNA — AETNA HMO: $1,955.20 AETNA — AETNA HMO EXCHANGE: $1,735.24 AETNA — AETNA MEDICARE: $562.12 AETNA — AETNA PPO: $1,955.20 AETNA — AETNA TIER 2: $1,955.20 AFFORDABLE — AFFORDABLE PPO: $2,199.60 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $1,833 AVMED — AVMED ENTRUST: $1,681.47 AVMED — AVMED HMO: $2,028.52
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: ER level 5	$2,912	$1,892.80	$503.78 – $2,912
Emergency room visit (high): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $2,329.60 AETNA — AETNA HMO: $2,329.60 AETNA — AETNA HMO EXCHANGE: $2,067.52 AETNA — AETNA MEDICARE: $669.76 AETNA — AETNA PPO: $2,329.60 AETNA — AETNA TIER 2: $2,329.60 AFFORDABLE — AFFORDABLE PPO: $2,620.80 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,184 AVMED — AVMED ENTRUST: $2,003.46 AVMED — AVMED HMO: $2,416.96
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · modifier ER In the file: ER level 5	$2,912	$1,892.80	$503.78 – $2,912
Emergency room visit (high): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $2,329.60 AETNA — AETNA HMO: $2,329.60 AETNA — AETNA HMO EXCHANGE: $2,067.52 AETNA — AETNA MEDICARE: $669.76 AETNA — AETNA PPO: $2,329.60 AETNA — AETNA TIER 2: $2,329.60 AFFORDABLE — AFFORDABLE PPO: $2,620.80 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,184 AVMED — AVMED ENTRUST: $2,003.46 AVMED — AVMED HMO: $2,416.96
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · modifier 25 In the file: ER level 5	$2,912	$1,892.80	$503.78 – $2,912
Emergency room visit (high): 10 of 47 insurance plan rates AETNA — AETNA CATASTROPHIC: $2,329.60 AETNA — AETNA HMO: $2,329.60 AETNA — AETNA HMO EXCHANGE: $2,067.52 AETNA — AETNA MEDICARE: $669.76 AETNA — AETNA PPO: $2,329.60 AETNA — AETNA TIER 2: $2,329.60 AFFORDABLE — AFFORDABLE PPO: $2,620.80 AMERIHEALTH — AMERIHTH CARITAS NXT EX: $2,184 AVMED — AVMED ENTRUST: $2,003.46 AVMED — AVMED HMO: $2,416.96

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Basic metabolic panel (BMP)	$675	$438.75	$4.59 – $675
Basic metabolic panel (blood test): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $540 AETNA — AETNA HMO: $540 AETNA — AETNA HMO EXCHANGE: $479.25 AETNA — AETNA MEDICARE: $155.25 AETNA — AETNA PPO: $540 AETNA — AETNA TIER 2: $540 AFFORDABLE — AFFORDABLE PPO: $607.50 AMERIGROUP — AMERIGROUP: $4.59
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier PN In the file: Basic metabolic panel (BMP)	$675	$438.75	$4.59 – $675
Basic metabolic panel (blood test): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $540 AETNA — AETNA HMO: $540 AETNA — AETNA HMO EXCHANGE: $479.25 AETNA — AETNA MEDICARE: $155.25 AETNA — AETNA PPO: $540 AETNA — AETNA TIER 2: $540 AFFORDABLE — AFFORDABLE PPO: $607.50 AMERIGROUP — AMERIGROUP: $4.59
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier Q1 In the file: Basic metabolic panel (BMP)	$675	$438.75	$4.59 – $675
Basic metabolic panel (blood test): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $540 AETNA — AETNA HMO: $540 AETNA — AETNA HMO EXCHANGE: $479.25 AETNA — AETNA MEDICARE: $155.25 AETNA — AETNA PPO: $540 AETNA — AETNA TIER 2: $540 AFFORDABLE — AFFORDABLE PPO: $607.50 AMERIGROUP — AMERIGROUP: $4.59
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Comprehensive metabolic panel	$1,178	$765.70	$4.59 – $1,178
Comprehensive metabolic panel (blood test): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $942.40 AETNA — AETNA HMO: $942.40 AETNA — AETNA HMO EXCHANGE: $836.38 AETNA — AETNA MEDICARE: $270.94 AETNA — AETNA PPO: $942.40 AETNA — AETNA TIER 2: $942.40 AFFORDABLE — AFFORDABLE PPO: $1,060.20 AMERIGROUP — AMERIGROUP: $4.59
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier AY In the file: Comprehensive metabolic panel	$1,178	$765.70	$4.59 – $1,178
Comprehensive metabolic panel (blood test): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $942.40 AETNA — AETNA HMO: $942.40 AETNA — AETNA HMO EXCHANGE: $836.38 AETNA — AETNA MEDICARE: $270.94 AETNA — AETNA PPO: $942.40 AETNA — AETNA TIER 2: $942.40 AFFORDABLE — AFFORDABLE PPO: $1,060.20 AMERIGROUP — AMERIGROUP: $4.59
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier ER In the file: Comprehensive metabolic panel	$1,178	$765.70	$4.59 – $1,178
Comprehensive metabolic panel (blood test): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $942.40 AETNA — AETNA HMO: $942.40 AETNA — AETNA HMO EXCHANGE: $836.38 AETNA — AETNA MEDICARE: $270.94 AETNA — AETNA PPO: $942.40 AETNA — AETNA TIER 2: $942.40 AFFORDABLE — AFFORDABLE PPO: $1,060.20 AMERIGROUP — AMERIGROUP: $4.59
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: NMR-lipid panel	$59	$38.35	$4.59 – $59
Cholesterol panel (lipid panel): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $47.20 AETNA — AETNA HMO: $47.20 AETNA — AETNA HMO EXCHANGE: $41.89 AETNA — AETNA MEDICARE: $13.57 AETNA — AETNA PPO: $47.20 AETNA — AETNA TIER 2: $47.20 AFFORDABLE — AFFORDABLE PPO: $53.10 AMERIGROUP — AMERIGROUP: $4.59
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: Lipid panel	$252	$163.80	$4.59 – $252
Cholesterol panel (lipid panel): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $201.60 AETNA — AETNA HMO: $201.60 AETNA — AETNA HMO EXCHANGE: $178.92 AETNA — AETNA MEDICARE: $57.96 AETNA — AETNA PPO: $201.60 AETNA — AETNA TIER 2: $201.60 AFFORDABLE — AFFORDABLE PPO: $226.80 AMERIGROUP — AMERIGROUP: $4.59
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · modifier PN In the file: NMR-lipid panel	$59	$38.35	$4.59 – $59
Cholesterol panel (lipid panel): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $47.20 AETNA — AETNA HMO: $47.20 AETNA — AETNA HMO EXCHANGE: $41.89 AETNA — AETNA MEDICARE: $13.57 AETNA — AETNA PPO: $47.20 AETNA — AETNA TIER 2: $47.20 AFFORDABLE — AFFORDABLE PPO: $53.10 AMERIGROUP — AMERIGROUP: $4.59
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: Renal function panel	$841	$546.65	$4.59 – $841
Kidney function panel: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $672.80 AETNA — AETNA HMO: $672.80 AETNA — AETNA HMO EXCHANGE: $597.11 AETNA — AETNA MEDICARE: $193.43 AETNA — AETNA PPO: $672.80 AETNA — AETNA TIER 2: $672.80 AFFORDABLE — AFFORDABLE PPO: $756.90 AMERIGROUP — AMERIGROUP: $4.59
Kidney function panel CPT 80069 · Inpatient or outpatient · modifier AY In the file: Renal function panel	$841	$546.65	$4.59 – $841
Kidney function panel: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $672.80 AETNA — AETNA HMO: $672.80 AETNA — AETNA HMO EXCHANGE: $597.11 AETNA — AETNA MEDICARE: $193.43 AETNA — AETNA PPO: $672.80 AETNA — AETNA TIER 2: $672.80 AFFORDABLE — AFFORDABLE PPO: $756.90 AMERIGROUP — AMERIGROUP: $4.59
Kidney function panel CPT 80069 · Inpatient or outpatient · modifier ER In the file: Renal function panel	$841	$546.65	$4.59 – $841
Kidney function panel: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $672.80 AETNA — AETNA HMO: $672.80 AETNA — AETNA HMO EXCHANGE: $597.11 AETNA — AETNA MEDICARE: $193.43 AETNA — AETNA PPO: $672.80 AETNA — AETNA TIER 2: $672.80 AFFORDABLE — AFFORDABLE PPO: $756.90 AMERIGROUP — AMERIGROUP: $4.59
Liver function panel CPT 80076 · Inpatient or outpatient In the file: Hepatic function panel	$590	$383.50	$4.59 – $590
Liver function panel: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $472 AETNA — AETNA HMO: $472 AETNA — AETNA HMO EXCHANGE: $418.90 AETNA — AETNA MEDICARE: $135.70 AETNA — AETNA PPO: $472 AETNA — AETNA TIER 2: $472 AFFORDABLE — AFFORDABLE PPO: $531 AMERIGROUP — AMERIGROUP: $4.59
Liver function panel CPT 80076 · Inpatient or outpatient · modifier 59 In the file: Hepatic function panel	$590	$383.50	$4.59 – $590
Liver function panel: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $472 AETNA — AETNA HMO: $472 AETNA — AETNA HMO EXCHANGE: $418.90 AETNA — AETNA MEDICARE: $135.70 AETNA — AETNA PPO: $472 AETNA — AETNA TIER 2: $472 AFFORDABLE — AFFORDABLE PPO: $531 AMERIGROUP — AMERIGROUP: $4.59
Liver function panel CPT 80076 · Inpatient or outpatient · modifier ER In the file: Hepatic function panel	$590	$383.50	$4.59 – $590
Liver function panel: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $4.96 AETNA — AETNA BETTER HEALTH MEDICAID: $4.96 AETNA — AETNA CATASTROPHIC: $472 AETNA — AETNA HMO: $472 AETNA — AETNA HMO EXCHANGE: $418.90 AETNA — AETNA MEDICARE: $135.70 AETNA — AETNA PPO: $472 AETNA — AETNA TIER 2: $472 AFFORDABLE — AFFORDABLE PPO: $531 AMERIGROUP — AMERIGROUP: $4.59
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URO UA Complete	$251	$163.15	$1.49 – $251
Urine test (automated, with microscope): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61 AETNA — AETNA BETTER HEALTH MEDICAID: $1.61 AETNA — AETNA CATASTROPHIC: $200.80 AETNA — AETNA HMO: $200.80 AETNA — AETNA HMO EXCHANGE: $178.21 AETNA — AETNA MEDICARE: $57.73 AETNA — AETNA PPO: $200.80 AETNA — AETNA TIER 2: $200.80 AFFORDABLE — AFFORDABLE PPO: $225.90 AMERIGROUP — AMERIGROUP: $1.49
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: Urinalysis (with micro)	$251	$163.15	$1.49 – $251
Urine test (automated, with microscope): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61 AETNA — AETNA BETTER HEALTH MEDICAID: $1.61 AETNA — AETNA CATASTROPHIC: $200.80 AETNA — AETNA HMO: $200.80 AETNA — AETNA HMO EXCHANGE: $178.21 AETNA — AETNA MEDICARE: $57.73 AETNA — AETNA PPO: $200.80 AETNA — AETNA TIER 2: $200.80 AFFORDABLE — AFFORDABLE PPO: $225.90 AMERIGROUP — AMERIGROUP: $1.49
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · modifier Q1 In the file: Urinalysis (with micro)	$251	$163.15	$1.49 – $251
Urine test (automated, with microscope): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61 AETNA — AETNA BETTER HEALTH MEDICAID: $1.61 AETNA — AETNA CATASTROPHIC: $200.80 AETNA — AETNA HMO: $200.80 AETNA — AETNA HMO EXCHANGE: $178.21 AETNA — AETNA MEDICARE: $57.73 AETNA — AETNA PPO: $200.80 AETNA — AETNA TIER 2: $200.80 AFFORDABLE — AFFORDABLE PPO: $225.90 AMERIGROUP — AMERIGROUP: $1.49
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: URINALYSIS AUTO W/O SCOPE	$88	$57.20	$1.49 – $88
Urine test (automated, without microscope): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61 AETNA — AETNA BETTER HEALTH MEDICAID: $1.61 AETNA — AETNA CATASTROPHIC: $70.40 AETNA — AETNA HMO: $70.40 AETNA — AETNA HMO EXCHANGE: $62.48 AETNA — AETNA MEDICARE: $20.24 AETNA — AETNA PPO: $70.40 AETNA — AETNA TIER 2: $70.40 AFFORDABLE — AFFORDABLE PPO: $79.20 AMERIGROUP — AMERIGROUP: $1.49
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: Specific gravity-urine	$136	$88.40	$1.49 – $136
Urine test (automated, without microscope): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61 AETNA — AETNA BETTER HEALTH MEDICAID: $1.61 AETNA — AETNA CATASTROPHIC: $108.80 AETNA — AETNA HMO: $108.80 AETNA — AETNA HMO EXCHANGE: $96.56 AETNA — AETNA MEDICARE: $31.28 AETNA — AETNA PPO: $108.80 AETNA — AETNA TIER 2: $108.80 AFFORDABLE — AFFORDABLE PPO: $122.40 AMERIGROUP — AMERIGROUP: $1.49
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier 59 In the file: Specific gravity-urine	$136	$88.40	$1.49 – $136
Urine test (automated, without microscope): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $1.61 AETNA — AETNA BETTER HEALTH MEDICAID: $1.61 AETNA — AETNA CATASTROPHIC: $108.80 AETNA — AETNA HMO: $108.80 AETNA — AETNA HMO EXCHANGE: $96.56 AETNA — AETNA MEDICARE: $31.28 AETNA — AETNA PPO: $108.80 AETNA — AETNA TIER 2: $108.80 AFFORDABLE — AFFORDABLE PPO: $122.40 AMERIGROUP — AMERIGROUP: $1.49
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA Free & Total	$482	$313.30	$6.12 – $482
PSA (prostate specific antigen) blood test: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $6.61 AETNA — AETNA BETTER HEALTH MEDICAID: $6.61 AETNA — AETNA CATASTROPHIC: $385.60 AETNA — AETNA HMO: $385.60 AETNA — AETNA HMO EXCHANGE: $342.22 AETNA — AETNA MEDICARE: $110.86 AETNA — AETNA PPO: $385.60 AETNA — AETNA TIER 2: $385.60 AFFORDABLE — AFFORDABLE PPO: $433.80 AMERIGROUP — AMERIGROUP: $6.12
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: ARU Prostate Specific Ag	$37	$24.05	$6.12 – $37
PSA (prostate specific antigen) blood test: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $6.61 AETNA — AETNA BETTER HEALTH MEDICAID: $6.61 AETNA — AETNA CATASTROPHIC: $29.60 AETNA — AETNA HMO: $29.60 AETNA — AETNA HMO EXCHANGE: $26.27 AETNA — AETNA MEDICARE: $8.51 AETNA — AETNA PPO: $29.60 AETNA — AETNA TIER 2: $29.60 AFFORDABLE — AFFORDABLE PPO: $33.30 AMERIGROUP — AMERIGROUP: $6.12
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA total	$324	$210.60	$6.12 – $324
PSA (prostate specific antigen) blood test: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $6.61 AETNA — AETNA BETTER HEALTH MEDICAID: $6.61 AETNA — AETNA CATASTROPHIC: $259.20 AETNA — AETNA HMO: $259.20 AETNA — AETNA HMO EXCHANGE: $230.04 AETNA — AETNA MEDICARE: $74.52 AETNA — AETNA PPO: $259.20 AETNA — AETNA TIER 2: $259.20 AFFORDABLE — AFFORDABLE PPO: $291.60 AMERIGROUP — AMERIGROUP: $6.12
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: ARU TSH 3rd Generation	$32	$20.80	$5.54 – $32
Thyroid stimulating hormone (TSH) test: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $7.26 AETNA — AETNA BETTER HEALTH MEDICAID: $7.26 AETNA — AETNA CATASTROPHIC: $25.60 AETNA — AETNA HMO: $25.60 AETNA — AETNA HMO EXCHANGE: $22.72 AETNA — AETNA MEDICARE: $7.36 AETNA — AETNA PPO: $25.60 AETNA — AETNA TIER 2: $25.60 AFFORDABLE — AFFORDABLE PPO: $28.80 AMERIGROUP — AMERIGROUP: $6.72
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: ASSAY THYROID STIM HORMONE	$255	$165.75	$6.72 – $255
Thyroid stimulating hormone (TSH) test: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $7.26 AETNA — AETNA BETTER HEALTH MEDICAID: $7.26 AETNA — AETNA CATASTROPHIC: $204 AETNA — AETNA HMO: $204 AETNA — AETNA HMO EXCHANGE: $181.05 AETNA — AETNA MEDICARE: $58.65 AETNA — AETNA PPO: $204 AETNA — AETNA TIER 2: $204 AFFORDABLE — AFFORDABLE PPO: $229.50 AMERIGROUP — AMERIGROUP: $6.72
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier 59 In the file: ARU TSH 3rd Generation	$32	$20.80	$5.54 – $32
Thyroid stimulating hormone (TSH) test: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $7.26 AETNA — AETNA BETTER HEALTH MEDICAID: $7.26 AETNA — AETNA CATASTROPHIC: $25.60 AETNA — AETNA HMO: $25.60 AETNA — AETNA HMO EXCHANGE: $22.72 AETNA — AETNA MEDICARE: $7.36 AETNA — AETNA PPO: $25.60 AETNA — AETNA TIER 2: $25.60 AFFORDABLE — AFFORDABLE PPO: $28.80 AMERIGROUP — AMERIGROUP: $6.72
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: COMPLETE CBC W/AUTO DIFF WBC	$389	$252.85	$3.02 – $389
Complete blood count (CBC) with differential: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27 AETNA — AETNA BETTER HEALTH MEDICAID: $3.27 AETNA — AETNA CATASTROPHIC: $311.20 AETNA — AETNA HMO: $311.20 AETNA — AETNA HMO EXCHANGE: $276.19 AETNA — AETNA MEDICARE: $89.47 AETNA — AETNA PPO: $311.20 AETNA — AETNA TIER 2: $311.20 AFFORDABLE — AFFORDABLE PPO: $350.10 AMERIGROUP — AMERIGROUP: $3.02
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier AY In the file: COMPLETE CBC W/AUTO DIFF WBC	$389	$252.85	$3.02 – $389
Complete blood count (CBC) with differential: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27 AETNA — AETNA BETTER HEALTH MEDICAID: $3.27 AETNA — AETNA CATASTROPHIC: $311.20 AETNA — AETNA HMO: $311.20 AETNA — AETNA HMO EXCHANGE: $276.19 AETNA — AETNA MEDICARE: $89.47 AETNA — AETNA PPO: $311.20 AETNA — AETNA TIER 2: $311.20 AFFORDABLE — AFFORDABLE PPO: $350.10 AMERIGROUP — AMERIGROUP: $3.02
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier 59 In the file: COMPLETE CBC W/AUTO DIFF WBC	$389	$252.85	$3.02 – $389
Complete blood count (CBC) with differential: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27 AETNA — AETNA BETTER HEALTH MEDICAID: $3.27 AETNA — AETNA CATASTROPHIC: $311.20 AETNA — AETNA HMO: $311.20 AETNA — AETNA HMO EXCHANGE: $276.19 AETNA — AETNA MEDICARE: $89.47 AETNA — AETNA PPO: $311.20 AETNA — AETNA TIER 2: $311.20 AFFORDABLE — AFFORDABLE PPO: $350.10 AMERIGROUP — AMERIGROUP: $3.02
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: COMPLETE CBC AUTOMATED	$247	$160.55	$3.02 – $247
Complete blood count (CBC), automated: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27 AETNA — AETNA BETTER HEALTH MEDICAID: $3.27 AETNA — AETNA CATASTROPHIC: $197.60 AETNA — AETNA HMO: $197.60 AETNA — AETNA HMO EXCHANGE: $175.37 AETNA — AETNA MEDICARE: $56.81 AETNA — AETNA PPO: $197.60 AETNA — AETNA TIER 2: $197.60 AFFORDABLE — AFFORDABLE PPO: $222.30 AMERIGROUP — AMERIGROUP: $3.02
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier PN In the file: COMPLETE CBC AUTOMATED	$247	$160.55	$3.02 – $247
Complete blood count (CBC), automated: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27 AETNA — AETNA BETTER HEALTH MEDICAID: $3.27 AETNA — AETNA CATASTROPHIC: $197.60 AETNA — AETNA HMO: $197.60 AETNA — AETNA HMO EXCHANGE: $175.37 AETNA — AETNA MEDICARE: $56.81 AETNA — AETNA PPO: $197.60 AETNA — AETNA TIER 2: $197.60 AFFORDABLE — AFFORDABLE PPO: $222.30 AMERIGROUP — AMERIGROUP: $3.02
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier 59 In the file: COMPLETE CBC AUTOMATED	$247	$160.55	$3.02 – $247
Complete blood count (CBC), automated: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $3.27 AETNA — AETNA BETTER HEALTH MEDICAID: $3.27 AETNA — AETNA CATASTROPHIC: $197.60 AETNA — AETNA HMO: $197.60 AETNA — AETNA HMO EXCHANGE: $175.37 AETNA — AETNA MEDICARE: $56.81 AETNA — AETNA PPO: $197.60 AETNA — AETNA TIER 2: $197.60 AFFORDABLE — AFFORDABLE PPO: $222.30 AMERIGROUP — AMERIGROUP: $3.02
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: POCT pt prothrombin time	$83	$53.95	$2.24 – $83
Blood clotting time test (prothrombin time, PT): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42 AETNA — AETNA BETTER HEALTH MEDICAID: $2.42 AETNA — AETNA CATASTROPHIC: $66.40 AETNA — AETNA HMO: $66.40 AETNA — AETNA HMO EXCHANGE: $58.93 AETNA — AETNA MEDICARE: $19.09 AETNA — AETNA PPO: $66.40 AETNA — AETNA TIER 2: $66.40 AFFORDABLE — AFFORDABLE PPO: $74.70 AMERIGROUP — AMERIGROUP: $2.24
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PT-charge	$191	$124.15	$2.24 – $191
Blood clotting time test (prothrombin time, PT): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42 AETNA — AETNA BETTER HEALTH MEDICAID: $2.42 AETNA — AETNA CATASTROPHIC: $152.80 AETNA — AETNA HMO: $152.80 AETNA — AETNA HMO EXCHANGE: $135.61 AETNA — AETNA MEDICARE: $43.93 AETNA — AETNA PPO: $152.80 AETNA — AETNA TIER 2: $152.80 AFFORDABLE — AFFORDABLE PPO: $171.90 AMERIGROUP — AMERIGROUP: $2.24
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PT-INR (prothrombin time)	$201	$130.65	$2.24 – $201
Blood clotting time test (prothrombin time, PT): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42 AETNA — AETNA BETTER HEALTH MEDICAID: $2.42 AETNA — AETNA CATASTROPHIC: $160.80 AETNA — AETNA HMO: $160.80 AETNA — AETNA HMO EXCHANGE: $142.71 AETNA — AETNA MEDICARE: $46.23 AETNA — AETNA PPO: $160.80 AETNA — AETNA TIER 2: $160.80 AFFORDABLE — AFFORDABLE PPO: $180.90 AMERIGROUP — AMERIGROUP: $2.24
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: ARU PTT-LA Ratio	$25	$16.25	$2.24 – $25
Blood clotting test (partial thromboplastin time, PTT): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42 AETNA — AETNA BETTER HEALTH MEDICAID: $2.42 AETNA — AETNA CATASTROPHIC: $20 AETNA — AETNA HMO: $20 AETNA — AETNA HMO EXCHANGE: $17.75 AETNA — AETNA MEDICARE: $5.75 AETNA — AETNA PPO: $20 AETNA — AETNA TIER 2: $20 AFFORDABLE — AFFORDABLE PPO: $22.50 AMERIGROUP — AMERIGROUP: $2.24
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT (partial thromb time)	$244	$158.60	$2.24 – $244
Blood clotting test (partial thromboplastin time, PTT): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42 AETNA — AETNA BETTER HEALTH MEDICAID: $2.42 AETNA — AETNA CATASTROPHIC: $195.20 AETNA — AETNA HMO: $195.20 AETNA — AETNA HMO EXCHANGE: $173.24 AETNA — AETNA MEDICARE: $56.12 AETNA — AETNA PPO: $195.20 AETNA — AETNA TIER 2: $195.20 AFFORDABLE — AFFORDABLE PPO: $219.60 AMERIGROUP — AMERIGROUP: $2.24
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HCA mixing studies-PTT	$54	$35.10	$2.24 – $54
Blood clotting test (partial thromboplastin time, PTT): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $2.42 AETNA — AETNA BETTER HEALTH MEDICAID: $2.42 AETNA — AETNA CATASTROPHIC: $43.20 AETNA — AETNA HMO: $43.20 AETNA — AETNA HMO EXCHANGE: $38.34 AETNA — AETNA MEDICARE: $12.42 AETNA — AETNA PPO: $43.20 AETNA — AETNA TIER 2: $43.20 AFFORDABLE — AFFORDABLE PPO: $48.60 AMERIGROUP — AMERIGROUP: $2.24

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT HEAD/BRAIN W/O DYE	$4,699	$3,054.35	$197.10 – $4,699
CT scan of the head or brain, without contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86 AETNA — AETNA BETTER HEALTH MEDICAID: $212.86 AETNA — AETNA CATASTROPHIC: $3,759.20 AETNA — AETNA HMO: $3,759.20 AETNA — AETNA HMO EXCHANGE: $3,336.29 AETNA — AETNA MEDICARE: $1,080.77 AETNA — AETNA PPO: $3,759.20 AETNA — AETNA TIER 2: $3,759.20 AFFORDABLE — AFFORDABLE PPO: $4,229.10 AMERIGROUP — AMERIGROUP: $197.10
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier 59 In the file: CT HEAD/BRAIN W/O DYE	$4,699	$3,054.35	$197.10 – $4,699
CT scan of the head or brain, without contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86 AETNA — AETNA BETTER HEALTH MEDICAID: $212.86 AETNA — AETNA CATASTROPHIC: $3,759.20 AETNA — AETNA HMO: $3,759.20 AETNA — AETNA HMO EXCHANGE: $3,336.29 AETNA — AETNA MEDICARE: $1,080.77 AETNA — AETNA PPO: $3,759.20 AETNA — AETNA TIER 2: $3,759.20 AFFORDABLE — AFFORDABLE PPO: $4,229.10 AMERIGROUP — AMERIGROUP: $197.10
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier Q1 In the file: CT HEAD/BRAIN W/O DYE	$4,699	$3,054.35	$197.10 – $4,699
CT scan of the head or brain, without contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86 AETNA — AETNA BETTER HEALTH MEDICAID: $212.86 AETNA — AETNA CATASTROPHIC: $3,759.20 AETNA — AETNA HMO: $3,759.20 AETNA — AETNA HMO EXCHANGE: $3,336.29 AETNA — AETNA MEDICARE: $1,080.77 AETNA — AETNA PPO: $3,759.20 AETNA — AETNA TIER 2: $3,759.20 AFFORDABLE — AFFORDABLE PPO: $4,229.10 AMERIGROUP — AMERIGROUP: $197.10
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Mri brain stem w/o & w/dye	$7,569	$4,919.85	$247.73 – $7,569
MRI of the brain, before and after contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $267.55 AETNA — AETNA BETTER HEALTH MEDICAID: $267.55 AETNA — AETNA CATASTROPHIC: $6,055.20 AETNA — AETNA HMO: $6,055.20 AETNA — AETNA HMO EXCHANGE: $5,373.99 AETNA — AETNA MEDICARE: $1,740.87 AETNA — AETNA PPO: $6,055.20 AETNA — AETNA TIER 2: $6,055.20 AFFORDABLE — AFFORDABLE PPO: $6,812.10 AMERIGROUP — AMERIGROUP: $247.73
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier KX In the file: Mri brain stem w/o & w/dye	$7,569	$4,919.85	$247.73 – $7,569
MRI of the brain, before and after contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $267.55 AETNA — AETNA BETTER HEALTH MEDICAID: $267.55 AETNA — AETNA CATASTROPHIC: $6,055.20 AETNA — AETNA HMO: $6,055.20 AETNA — AETNA HMO EXCHANGE: $5,373.99 AETNA — AETNA MEDICARE: $1,740.87 AETNA — AETNA PPO: $6,055.20 AETNA — AETNA TIER 2: $6,055.20 AFFORDABLE — AFFORDABLE PPO: $6,812.10 AMERIGROUP — AMERIGROUP: $247.73
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier Q1 In the file: Mri brain stem w/o & w/dye	$7,569	$4,919.85	$247.73 – $7,569
MRI of the brain, before and after contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $267.55 AETNA — AETNA BETTER HEALTH MEDICAID: $267.55 AETNA — AETNA CATASTROPHIC: $6,055.20 AETNA — AETNA HMO: $6,055.20 AETNA — AETNA HMO EXCHANGE: $5,373.99 AETNA — AETNA MEDICARE: $1,740.87 AETNA — AETNA PPO: $6,055.20 AETNA — AETNA TIER 2: $6,055.20 AFFORDABLE — AFFORDABLE PPO: $6,812.10 AMERIGROUP — AMERIGROUP: $247.73
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: Chest XR 2 views	$765	$497.25	$34.17 – $765
Chest X-ray, 2 views: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $36.90 AETNA — AETNA BETTER HEALTH MEDICAID: $36.90 AETNA — AETNA CATASTROPHIC: $612 AETNA — AETNA HMO: $612 AETNA — AETNA HMO EXCHANGE: $543.15 AETNA — AETNA MEDICARE: $175.95 AETNA — AETNA PPO: $612 AETNA — AETNA TIER 2: $612 AFFORDABLE — AFFORDABLE PPO: $688.50 AMERIGROUP — AMERIGROUP: $34.17
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier Q1 In the file: Chest XR 2 views	$765	$497.25	$34.17 – $765
Chest X-ray, 2 views: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $36.90 AETNA — AETNA BETTER HEALTH MEDICAID: $36.90 AETNA — AETNA CATASTROPHIC: $612 AETNA — AETNA HMO: $612 AETNA — AETNA HMO EXCHANGE: $543.15 AETNA — AETNA MEDICARE: $175.95 AETNA — AETNA PPO: $612 AETNA — AETNA TIER 2: $612 AFFORDABLE — AFFORDABLE PPO: $688.50 AMERIGROUP — AMERIGROUP: $34.17
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier ER In the file: Chest XR 2 views	$765	$497.25	$34.17 – $765
Chest X-ray, 2 views: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $36.90 AETNA — AETNA BETTER HEALTH MEDICAID: $36.90 AETNA — AETNA CATASTROPHIC: $612 AETNA — AETNA HMO: $612 AETNA — AETNA HMO EXCHANGE: $543.15 AETNA — AETNA MEDICARE: $175.95 AETNA — AETNA PPO: $612 AETNA — AETNA TIER 2: $612 AFFORDABLE — AFFORDABLE PPO: $688.50 AMERIGROUP — AMERIGROUP: $34.17
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: Lumbar spine mini 4 view xr	$1,723	$1,119.95	$34.17 – $1,723
X-ray of the lower spine, at least 4 views: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $36.90 AETNA — AETNA BETTER HEALTH MEDICAID: $36.90 AETNA — AETNA CATASTROPHIC: $1,378.40 AETNA — AETNA HMO: $1,378.40 AETNA — AETNA HMO EXCHANGE: $1,223.33 AETNA — AETNA MEDICARE: $396.29 AETNA — AETNA PPO: $1,378.40 AETNA — AETNA TIER 2: $1,378.40 AFFORDABLE — AFFORDABLE PPO: $1,550.70 AMERIGROUP — AMERIGROUP: $34.17
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR SPINE W/O DYE	$5,808	$3,775.20	$147.32 – $5,808
MRI of the lower back (lumbar spine), without contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $159.10 AETNA — AETNA BETTER HEALTH MEDICAID: $159.10 AETNA — AETNA CATASTROPHIC: $4,646.40 AETNA — AETNA HMO: $4,646.40 AETNA — AETNA HMO EXCHANGE: $4,123.68 AETNA — AETNA MEDICARE: $1,335.84 AETNA — AETNA PPO: $4,646.40 AETNA — AETNA TIER 2: $4,646.40 AFFORDABLE — AFFORDABLE PPO: $5,227.20 AMERIGROUP — AMERIGROUP: $147.32
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier KX In the file: MRI LUMBAR SPINE W/O DYE	$5,808	$3,775.20	$147.32 – $5,808
MRI of the lower back (lumbar spine), without contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $159.10 AETNA — AETNA BETTER HEALTH MEDICAID: $159.10 AETNA — AETNA CATASTROPHIC: $4,646.40 AETNA — AETNA HMO: $4,646.40 AETNA — AETNA HMO EXCHANGE: $4,123.68 AETNA — AETNA MEDICARE: $1,335.84 AETNA — AETNA PPO: $4,646.40 AETNA — AETNA TIER 2: $4,646.40 AFFORDABLE — AFFORDABLE PPO: $5,227.20 AMERIGROUP — AMERIGROUP: $147.32
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier 52 In the file: MRI LUMBAR SPINE W/O DYE	$5,808	$3,775.20	$73.66 – $5,808
MRI of the lower back (lumbar spine), without contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $79.55 AETNA — AETNA BETTER HEALTH MEDICAID: $79.55 AETNA — AETNA CATASTROPHIC: $4,646.40 AETNA — AETNA HMO: $4,646.40 AETNA — AETNA HMO EXCHANGE: $4,123.68 AETNA — AETNA MEDICARE: $1,335.84 AETNA — AETNA PPO: $4,646.40 AETNA — AETNA TIER 2: $4,646.40 AFFORDABLE — AFFORDABLE PPO: $5,227.20 AMERIGROUP — AMERIGROUP: $73.66
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W/DYE	$5,201	$3,380.65	$197.10 – $5,201
CT scan of the pelvis, with contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86 AETNA — AETNA BETTER HEALTH MEDICAID: $212.86 AETNA — AETNA CATASTROPHIC: $4,160.80 AETNA — AETNA HMO: $4,160.80 AETNA — AETNA HMO EXCHANGE: $3,692.71 AETNA — AETNA MEDICARE: $1,196.23 AETNA — AETNA PPO: $4,160.80 AETNA — AETNA TIER 2: $4,160.80 AFFORDABLE — AFFORDABLE PPO: $4,680.90 AMERIGROUP — AMERIGROUP: $197.10
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · modifier ER In the file: CT PELVIS W/DYE	$5,201	$3,380.65	$197.10 – $5,201
CT scan of the pelvis, with contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86 AETNA — AETNA BETTER HEALTH MEDICAID: $212.86 AETNA — AETNA CATASTROPHIC: $4,160.80 AETNA — AETNA HMO: $4,160.80 AETNA — AETNA HMO EXCHANGE: $3,692.71 AETNA — AETNA MEDICARE: $1,196.23 AETNA — AETNA PPO: $4,160.80 AETNA — AETNA TIER 2: $4,160.80 AFFORDABLE — AFFORDABLE PPO: $4,680.90 AMERIGROUP — AMERIGROUP: $197.10
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI JNT OF LWR EXTRE W/O DYE	$5,526	$3,591.90	$147.32 – $5,526
MRI of a leg joint (such as the knee), without contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $159.10 AETNA — AETNA BETTER HEALTH MEDICAID: $159.10 AETNA — AETNA CATASTROPHIC: $4,420.80 AETNA — AETNA HMO: $4,420.80 AETNA — AETNA HMO EXCHANGE: $3,923.46 AETNA — AETNA MEDICARE: $1,270.98 AETNA — AETNA PPO: $4,420.80 AETNA — AETNA TIER 2: $4,420.80 AFFORDABLE — AFFORDABLE PPO: $4,973.40 AMERIGROUP — AMERIGROUP: $147.32
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier KX In the file: MRI JNT OF LWR EXTRE W/O DYE	$5,526	$3,591.90	$147.32 – $5,526
MRI of a leg joint (such as the knee), without contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $159.10 AETNA — AETNA BETTER HEALTH MEDICAID: $159.10 AETNA — AETNA CATASTROPHIC: $4,420.80 AETNA — AETNA HMO: $4,420.80 AETNA — AETNA HMO EXCHANGE: $3,923.46 AETNA — AETNA MEDICARE: $1,270.98 AETNA — AETNA PPO: $4,420.80 AETNA — AETNA TIER 2: $4,420.80 AFFORDABLE — AFFORDABLE PPO: $4,973.40 AMERIGROUP — AMERIGROUP: $147.32
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Abd pelvis CT scans w con	$9,176	$5,964.40	$197.10 – $9,176
CT scan of the abdomen and pelvis, with contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86 AETNA — AETNA BETTER HEALTH MEDICAID: $212.86 AETNA — AETNA CATASTROPHIC: $7,340.80 AETNA — AETNA HMO: $7,340.80 AETNA — AETNA HMO EXCHANGE: $6,514.96 AETNA — AETNA MEDICARE: $2,110.48 AETNA — AETNA PPO: $7,340.80 AETNA — AETNA TIER 2: $7,340.80 AFFORDABLE — AFFORDABLE PPO: $8,258.40 AMERIGROUP — AMERIGROUP: $197.10
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier Q1 In the file: Abd pelvis CT scans w con	$9,176	$5,964.40	$197.10 – $9,176
CT scan of the abdomen and pelvis, with contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86 AETNA — AETNA BETTER HEALTH MEDICAID: $212.86 AETNA — AETNA CATASTROPHIC: $7,340.80 AETNA — AETNA HMO: $7,340.80 AETNA — AETNA HMO EXCHANGE: $6,514.96 AETNA — AETNA MEDICARE: $2,110.48 AETNA — AETNA PPO: $7,340.80 AETNA — AETNA TIER 2: $7,340.80 AFFORDABLE — AFFORDABLE PPO: $8,258.40 AMERIGROUP — AMERIGROUP: $197.10
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier AY In the file: Abd pelvis CT scans w con	$9,176	$5,964.40	$197.10 – $9,176
CT scan of the abdomen and pelvis, with contrast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $212.86 AETNA — AETNA BETTER HEALTH MEDICAID: $212.86 AETNA — AETNA CATASTROPHIC: $7,340.80 AETNA — AETNA HMO: $7,340.80 AETNA — AETNA HMO EXCHANGE: $6,514.96 AETNA — AETNA MEDICARE: $2,110.48 AETNA — AETNA PPO: $7,340.80 AETNA — AETNA TIER 2: $7,340.80 AFFORDABLE — AFFORDABLE PPO: $8,258.40 AMERIGROUP — AMERIGROUP: $197.10
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: Abdominal complete US	$2,276	$1,479.40	$101.50 – $2,276
Ultrasound of the abdomen, complete: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $109.62 AETNA — AETNA BETTER HEALTH MEDICAID: $109.62 AETNA — AETNA CATASTROPHIC: $1,820.80 AETNA — AETNA HMO: $1,820.80 AETNA — AETNA HMO EXCHANGE: $1,615.96 AETNA — AETNA MEDICARE: $523.48 AETNA — AETNA PPO: $1,820.80 AETNA — AETNA TIER 2: $1,820.80 AFFORDABLE — AFFORDABLE PPO: $2,048.40 AMERIGROUP — AMERIGROUP: $101.50
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier 59 In the file: Abdominal complete US	$2,276	$1,479.40	$101.50 – $2,276
Ultrasound of the abdomen, complete: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $109.62 AETNA — AETNA BETTER HEALTH MEDICAID: $109.62 AETNA — AETNA CATASTROPHIC: $1,820.80 AETNA — AETNA HMO: $1,820.80 AETNA — AETNA HMO EXCHANGE: $1,615.96 AETNA — AETNA MEDICARE: $523.48 AETNA — AETNA PPO: $1,820.80 AETNA — AETNA TIER 2: $1,820.80 AFFORDABLE — AFFORDABLE PPO: $2,048.40 AMERIGROUP — AMERIGROUP: $101.50
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier ER In the file: Abdominal complete US	$2,276	$1,479.40	$101.50 – $2,276
Ultrasound of the abdomen, complete: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $109.62 AETNA — AETNA BETTER HEALTH MEDICAID: $109.62 AETNA — AETNA CATASTROPHIC: $1,820.80 AETNA — AETNA HMO: $1,820.80 AETNA — AETNA HMO EXCHANGE: $1,615.96 AETNA — AETNA MEDICARE: $523.48 AETNA — AETNA PPO: $1,820.80 AETNA — AETNA TIER 2: $1,820.80 AFFORDABLE — AFFORDABLE PPO: $2,048.40 AMERIGROUP — AMERIGROUP: $101.50
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: OB 2nd 3rd tri complete US	$1,259	$818.35	$61.43 – $1,259
Pregnancy ultrasound (after the first trimester): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $66.34 AETNA — AETNA BETTER HEALTH MEDICAID: $66.34 AETNA — AETNA CATASTROPHIC: $1,007.20 AETNA — AETNA HMO: $1,007.20 AETNA — AETNA HMO EXCHANGE: $893.89 AETNA — AETNA MEDICARE: $289.57 AETNA — AETNA PPO: $1,007.20 AETNA — AETNA TIER 2: $1,007.20 AFFORDABLE — AFFORDABLE PPO: $1,133.10 AMERIGROUP — AMERIGROUP: $61.43
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Transvaginal US	$1,354	$880.10	$66.99 – $1,354
Transvaginal ultrasound: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $72.35 AETNA — AETNA BETTER HEALTH MEDICAID: $72.35 AETNA — AETNA CATASTROPHIC: $1,083.20 AETNA — AETNA HMO: $1,083.20 AETNA — AETNA HMO EXCHANGE: $961.34 AETNA — AETNA MEDICARE: $311.42 AETNA — AETNA PPO: $1,083.20 AETNA — AETNA TIER 2: $1,083.20 AFFORDABLE — AFFORDABLE PPO: $1,218.60 AMERIGROUP — AMERIGROUP: $66.99
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier ER In the file: Transvaginal US	$1,354	$880.10	$66.99 – $1,354
Transvaginal ultrasound: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $72.35 AETNA — AETNA BETTER HEALTH MEDICAID: $72.35 AETNA — AETNA CATASTROPHIC: $1,083.20 AETNA — AETNA HMO: $1,083.20 AETNA — AETNA HMO EXCHANGE: $961.34 AETNA — AETNA MEDICARE: $311.42 AETNA — AETNA PPO: $1,083.20 AETNA — AETNA TIER 2: $1,083.20 AFFORDABLE — AFFORDABLE PPO: $1,218.60 AMERIGROUP — AMERIGROUP: $66.99
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: DX MAMMO INCL CAD UNI	$665	$432.25	$28.79 – $665
Diagnostic mammogram, one breast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $31.09 AETNA — AETNA BETTER HEALTH MEDICAID: $31.09 AETNA — AETNA CATASTROPHIC: $532 AETNA — AETNA HMO: $532 AETNA — AETNA HMO EXCHANGE: $472.15 AETNA — AETNA MEDICARE: $152.95 AETNA — AETNA PPO: $532 AETNA — AETNA TIER 2: $532 AFFORDABLE — AFFORDABLE PPO: $598.50 AMERIGROUP — AMERIGROUP: $28.79
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier 52 In the file: DX MAMMO INCL CAD UNI	$665	$432.25	$14.40 – $665
Diagnostic mammogram, one breast: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $15.55 AETNA — AETNA BETTER HEALTH MEDICAID: $15.55 AETNA — AETNA CATASTROPHIC: $532 AETNA — AETNA HMO: $532 AETNA — AETNA HMO EXCHANGE: $472.15 AETNA — AETNA MEDICARE: $152.95 AETNA — AETNA PPO: $532 AETNA — AETNA TIER 2: $532 AFFORDABLE — AFFORDABLE PPO: $598.50 AMERIGROUP — AMERIGROUP: $14.40
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: DX MAMMO INCL CAD BI	$862	$560.30	$28.79 – $862
Diagnostic mammogram, both breasts: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $31.09 AETNA — AETNA BETTER HEALTH MEDICAID: $31.09 AETNA — AETNA CATASTROPHIC: $689.60 AETNA — AETNA HMO: $689.60 AETNA — AETNA HMO EXCHANGE: $612.02 AETNA — AETNA MEDICARE: $198.26 AETNA — AETNA PPO: $689.60 AETNA — AETNA TIER 2: $689.60 AFFORDABLE — AFFORDABLE PPO: $775.80 AMERIGROUP — AMERIGROUP: $28.79
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier 52 In the file: DX MAMMO INCL CAD BI	$862	$560.30	$14.40 – $862
Diagnostic mammogram, both breasts: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $15.55 AETNA — AETNA BETTER HEALTH MEDICAID: $15.55 AETNA — AETNA CATASTROPHIC: $689.60 AETNA — AETNA HMO: $689.60 AETNA — AETNA HMO EXCHANGE: $612.02 AETNA — AETNA MEDICARE: $198.26 AETNA — AETNA PPO: $689.60 AETNA — AETNA TIER 2: $689.60 AFFORDABLE — AFFORDABLE PPO: $775.80 AMERIGROUP — AMERIGROUP: $14.40
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier GA In the file: DX MAMMO INCL CAD BI	$862	$560.30	$28.79 – $862
Diagnostic mammogram, both breasts: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $31.09 AETNA — AETNA BETTER HEALTH MEDICAID: $31.09 AETNA — AETNA CATASTROPHIC: $689.60 AETNA — AETNA HMO: $689.60 AETNA — AETNA HMO EXCHANGE: $612.02 AETNA — AETNA MEDICARE: $198.26 AETNA — AETNA PPO: $689.60 AETNA — AETNA TIER 2: $689.60 AFFORDABLE — AFFORDABLE PPO: $775.80 AMERIGROUP — AMERIGROUP: $28.79
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: SCR MAMMO BI INCL CAD	$731	$475.15	$28.79 – $731
Screening mammogram, both breasts: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $31.09 AETNA — AETNA BETTER HEALTH MEDICAID: $31.09 AETNA — AETNA CATASTROPHIC: $584.80 AETNA — AETNA HMO: $584.80 AETNA — AETNA HMO EXCHANGE: $519.01 AETNA — AETNA MEDICARE: $168.13 AETNA — AETNA PPO: $584.80 AETNA — AETNA TIER 2: $584.80 AFFORDABLE — AFFORDABLE PPO: $657.90 AMERIGROUP — AMERIGROUP: $28.79
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier 52 In the file: SCR MAMMO BI INCL CAD	$731	$475.15	$14.40 – $731
Screening mammogram, both breasts: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $15.55 AETNA — AETNA BETTER HEALTH MEDICAID: $15.55 AETNA — AETNA CATASTROPHIC: $584.80 AETNA — AETNA HMO: $584.80 AETNA — AETNA HMO EXCHANGE: $519.01 AETNA — AETNA MEDICARE: $168.13 AETNA — AETNA PPO: $584.80 AETNA — AETNA TIER 2: $584.80 AFFORDABLE — AFFORDABLE PPO: $657.90 AMERIGROUP — AMERIGROUP: $14.40
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier GA In the file: SCR MAMMO BI INCL CAD	$731	$475.15	$28.79 – $731
Screening mammogram, both breasts: 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $31.09 AETNA — AETNA BETTER HEALTH MEDICAID: $31.09 AETNA — AETNA CATASTROPHIC: $584.80 AETNA — AETNA HMO: $584.80 AETNA — AETNA HMO EXCHANGE: $519.01 AETNA — AETNA MEDICARE: $168.13 AETNA — AETNA PPO: $584.80 AETNA — AETNA TIER 2: $584.80 AFFORDABLE — AFFORDABLE PPO: $657.90 AMERIGROUP — AMERIGROUP: $28.79

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: Polysom 6/> yrs 4/> param	$6,505	$4,228.25	$471.38 – $6,505
Sleep study (overnight, in a sleep lab): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $509.09 AETNA — AETNA BETTER HEALTH MEDICAID: $509.09 AETNA — AETNA CATASTROPHIC: $5,204 AETNA — AETNA HMO: $5,204 AETNA — AETNA HMO EXCHANGE: $4,618.55 AETNA — AETNA MEDICARE: $1,496.15 AETNA — AETNA PPO: $5,204 AETNA — AETNA TIER 2: $5,204 AFFORDABLE — AFFORDABLE PPO: $5,854.50 AMERIGROUP — AMERIGROUP: $471.38
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · modifier TC In the file: Polysom 6/> yrs 4/> param	$6,505	$4,228.25	$471.38 – $6,505
Sleep study (overnight, in a sleep lab): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $509.09 AETNA — AETNA BETTER HEALTH MEDICAID: $509.09 AETNA — AETNA CATASTROPHIC: $5,204 AETNA — AETNA HMO: $5,204 AETNA — AETNA HMO EXCHANGE: $4,618.55 AETNA — AETNA MEDICARE: $1,496.15 AETNA — AETNA PPO: $5,204 AETNA — AETNA TIER 2: $5,204 AFFORDABLE — AFFORDABLE PPO: $5,854.50 AMERIGROUP — AMERIGROUP: $471.38

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: THERAPEUTIC EXERCISES	$248	$161.20	$21.73 – $248
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $23.47 AETNA — AETNA BETTER HEALTH MEDICAID: $23.47 AETNA — AETNA CATASTROPHIC: $198.40 AETNA — AETNA HMO: $198.40 AETNA — AETNA HMO EXCHANGE: $176.08 AETNA — AETNA MEDICARE: $57.04 AETNA — AETNA PPO: $198.40 AETNA — AETNA TIER 2: $198.40 AFFORDABLE — AFFORDABLE PPO: $223.20 AMERIGROUP — AMERIGROUP: $21.73
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier KX In the file: THERAPEUTIC EXERCISES	$248	$161.20	$21.73 – $248
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $23.47 AETNA — AETNA BETTER HEALTH MEDICAID: $23.47 AETNA — AETNA CATASTROPHIC: $198.40 AETNA — AETNA HMO: $198.40 AETNA — AETNA HMO EXCHANGE: $176.08 AETNA — AETNA MEDICARE: $57.04 AETNA — AETNA PPO: $198.40 AETNA — AETNA TIER 2: $198.40 AFFORDABLE — AFFORDABLE PPO: $223.20 AMERIGROUP — AMERIGROUP: $21.73
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier 97 In the file: THERAPEUTIC EXERCISES	$248	$161.20	$21.73 – $248
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $23.47 AETNA — AETNA BETTER HEALTH MEDICAID: $23.47 AETNA — AETNA CATASTROPHIC: $198.40 AETNA — AETNA HMO: $198.40 AETNA — AETNA HMO EXCHANGE: $176.08 AETNA — AETNA MEDICARE: $57.04 AETNA — AETNA PPO: $198.40 AETNA — AETNA TIER 2: $198.40 AFFORDABLE — AFFORDABLE PPO: $223.20 AMERIGROUP — AMERIGROUP: $21.73
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: PT eval low complex	$402	$261.30	$69.55 – $402
Physical therapy evaluation (low complexity): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67 AETNA — AETNA BETTER HEALTH MEDICAID: $154.67 AETNA — AETNA CATASTROPHIC: $321.60 AETNA — AETNA HMO: $321.60 AETNA — AETNA HMO EXCHANGE: $285.42 AETNA — AETNA MEDICARE: $92.46 AETNA — AETNA PPO: $321.60 AETNA — AETNA TIER 2: $321.60 AFFORDABLE — AFFORDABLE PPO: $361.80 AMERIGROUP — AMERIGROUP: $143.21
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier 59 In the file: PT eval low complex	$402	$261.30	$69.55 – $402
Physical therapy evaluation (low complexity): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67 AETNA — AETNA BETTER HEALTH MEDICAID: $154.67 AETNA — AETNA CATASTROPHIC: $321.60 AETNA — AETNA HMO: $321.60 AETNA — AETNA HMO EXCHANGE: $285.42 AETNA — AETNA MEDICARE: $92.46 AETNA — AETNA PPO: $321.60 AETNA — AETNA TIER 2: $321.60 AFFORDABLE — AFFORDABLE PPO: $361.80 AMERIGROUP — AMERIGROUP: $143.21
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier KX In the file: PT eval low complex	$402	$261.30	$69.55 – $402
Physical therapy evaluation (low complexity): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67 AETNA — AETNA BETTER HEALTH MEDICAID: $154.67 AETNA — AETNA CATASTROPHIC: $321.60 AETNA — AETNA HMO: $321.60 AETNA — AETNA HMO EXCHANGE: $285.42 AETNA — AETNA MEDICARE: $92.46 AETNA — AETNA PPO: $321.60 AETNA — AETNA TIER 2: $321.60 AFFORDABLE — AFFORDABLE PPO: $361.80 AMERIGROUP — AMERIGROUP: $143.21
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: PT eval mod complex	$602	$391.30	$104.15 – $602
Physical therapy evaluation (moderate complexity): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67 AETNA — AETNA BETTER HEALTH MEDICAID: $154.67 AETNA — AETNA CATASTROPHIC: $481.60 AETNA — AETNA HMO: $481.60 AETNA — AETNA HMO EXCHANGE: $427.42 AETNA — AETNA MEDICARE: $138.46 AETNA — AETNA PPO: $481.60 AETNA — AETNA TIER 2: $481.60 AFFORDABLE — AFFORDABLE PPO: $541.80 AMERIGROUP — AMERIGROUP: $143.21
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier CQ In the file: PT eval mod complex	$602	$391.30	$104.15 – $602
Physical therapy evaluation (moderate complexity): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67 AETNA — AETNA BETTER HEALTH MEDICAID: $154.67 AETNA — AETNA CATASTROPHIC: $481.60 AETNA — AETNA HMO: $481.60 AETNA — AETNA HMO EXCHANGE: $427.42 AETNA — AETNA MEDICARE: $138.46 AETNA — AETNA PPO: $481.60 AETNA — AETNA TIER 2: $481.60 AFFORDABLE — AFFORDABLE PPO: $541.80 AMERIGROUP — AMERIGROUP: $143.21
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier KX In the file: PT eval mod complex	$602	$391.30	$104.15 – $602
Physical therapy evaluation (moderate complexity): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67 AETNA — AETNA BETTER HEALTH MEDICAID: $154.67 AETNA — AETNA CATASTROPHIC: $481.60 AETNA — AETNA HMO: $481.60 AETNA — AETNA HMO EXCHANGE: $427.42 AETNA — AETNA MEDICARE: $138.46 AETNA — AETNA PPO: $481.60 AETNA — AETNA TIER 2: $481.60 AFFORDABLE — AFFORDABLE PPO: $541.80 AMERIGROUP — AMERIGROUP: $143.21
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: PT eval high complex	$903	$586.95	$143.21 – $903
Physical therapy evaluation (high complexity): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67 AETNA — AETNA BETTER HEALTH MEDICAID: $154.67 AETNA — AETNA CATASTROPHIC: $722.40 AETNA — AETNA HMO: $722.40 AETNA — AETNA HMO EXCHANGE: $641.13 AETNA — AETNA MEDICARE: $207.69 AETNA — AETNA PPO: $722.40 AETNA — AETNA TIER 2: $722.40 AFFORDABLE — AFFORDABLE PPO: $812.70 AMERIGROUP — AMERIGROUP: $143.21
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier GP In the file: PT eval high complex	$903	$586.95	$143.21 – $903
Physical therapy evaluation (high complexity): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67 AETNA — AETNA BETTER HEALTH MEDICAID: $154.67 AETNA — AETNA CATASTROPHIC: $722.40 AETNA — AETNA HMO: $722.40 AETNA — AETNA HMO EXCHANGE: $641.13 AETNA — AETNA MEDICARE: $207.69 AETNA — AETNA PPO: $722.40 AETNA — AETNA TIER 2: $722.40 AFFORDABLE — AFFORDABLE PPO: $812.70 AMERIGROUP — AMERIGROUP: $143.21
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier 97 In the file: PT eval high complex	$903	$586.95	$143.21 – $903
Physical therapy evaluation (high complexity): 10 of 57 insurance plan rates AETNA — AETNA BETTER HEALTH HEALTHY KIDS: $154.67 AETNA — AETNA BETTER HEALTH MEDICAID: $154.67 AETNA — AETNA CATASTROPHIC: $722.40 AETNA — AETNA HMO: $722.40 AETNA — AETNA HMO EXCHANGE: $641.13 AETNA — AETNA MEDICARE: $207.69 AETNA — AETNA PPO: $722.40 AETNA — AETNA TIER 2: $722.40 AFFORDABLE — AFFORDABLE PPO: $812.70 AMERIGROUP — AMERIGROUP: $143.21

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$5,795.63 – $37,992
Total knee replacement: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier 59 In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$5,795.63 – $37,992
Total knee replacement: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier 50 In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$6,572.62 – $37,992
Total knee replacement: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$1,334.27 – $8,489.82
Shoulder arthroscopy: shaving of shoulder bone: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$1,334.27 – $16,239.32
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 59 In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$1,334.27 – $16,239.32
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$611.20 – $3,532.92
Upper GI endoscopy (diagnostic): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 74 In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$611.20 – $3,532.92
Upper GI endoscopy (diagnostic): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$617.47 – $3,586.97
Upper GI endoscopy with biopsy: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 59 In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$617.47 – $4,514.50
Upper GI endoscopy with biopsy: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 33 In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$617.47 – $3,586.97
Upper GI endoscopy with biopsy: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$549.64 – $3,177.13
Colonoscopy (diagnostic): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 33 In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$613.58 – $8,764.67
Colonoscopy (diagnostic): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 53 In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$549.64 – $3,177.13
Colonoscopy (diagnostic): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$613.58 – $3,985.55
Colonoscopy with biopsy: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier PT In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$613.58 – $3,985.55
Colonoscopy with biopsy: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier 74 In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$613.58 – $3,985.55
Colonoscopy with biopsy: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$613.58 – $3,780.11
Colonoscopy with removal of polyps (snare): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 59 In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$613.58 – $3,780.11
Colonoscopy with removal of polyps (snare): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier PT In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$613.58 – $3,780.11
Colonoscopy with removal of polyps (snare): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLON CA SCRN NOT HI RSK IND	Not listed in the file	Not listed in the file	$576.28 – $3,331.08
Screening colonoscopy (not high risk): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier 74 In the file: COLON CA SCRN NOT HI RSK IND	Not listed in the file	Not listed in the file	$576.28 – $3,331.08
Screening colonoscopy (not high risk): 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$2,234.72 – $21,555.81
Gallbladder removal by laparoscope: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 59 In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$2,234.72 – $21,555.81
Gallbladder removal by laparoscope: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 22 In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$2,234.72 – $21,555.81
Gallbladder removal by laparoscope: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$2,250.18 – $15,285.23
Groin (inguinal) hernia repair, age 5 or older: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 50 In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$2,644.34 – $15,285.23
Groin (inguinal) hernia repair, age 5 or older: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$836.71 – $12,052.68
Carpal tunnel release: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 50 In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$1,255.06 – $12,052.68
Carpal tunnel release: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 59 In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$836.71 – $12,052.68
Carpal tunnel release: 10 of 41 insurance plan rates AETNA — AETNA CATASTROPHIC: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA HMO EXCHANGE: 71% (a percentage in the contract, not a dollar amount) AETNA — AETNA MEDICARE: 23% (a percentage in the contract, not a dollar amount) AETNA — AETNA PPO: 80% (a percentage in the contract, not a dollar amount) AETNA — AETNA TIER 2: 80% (a percentage in the contract, not a dollar amount) AFFORDABLE — AFFORDABLE PPO: 90% (a percentage in the contract, not a dollar amount) AMERIHEALTH — AMERIHTH CARITAS NXT EX: 75% (a percentage in the contract, not a dollar amount) AVMED — AVMED ENTRUST: 68.8% (a percentage in the contract, not a dollar amount) AVMED — AVMED HMO: 83% (a percentage in the contract, not a dollar amount)

Source: Mariners Hospital’s standard charges file (baptisthealth.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 30, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	91500 Overseas Highway, Tavernier, FL 33070
County	Monroe County
State	Florida
Phone	(305) 434‑3000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	5 of 5 stars
CMS Certification Number	101313
Name in Medicare records	MARINERS HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	Baptist Health Mariners Hospital
Official website	baptisthealth.net
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 2026-10-30.

Mariners Hospital - Baptist Health — baptisthealth.net