Does Matagorda Regional Medical Center have an emergency room?

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

Where is Matagorda Regional Medical Center?

104 7th Street, Bay City, TX 77414, in Matagorda County, Texas.

What is the phone number of Matagorda Regional Medical Center?

(979) 245-6383, as listed by Medicare (CMS).

What is the Medicare star rating of Matagorda Regional Medical Center?

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

Matagorda Regional Medical Center

Quick answers

Does Matagorda Regional Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Matagorda Regional Medical Center. In a medical emergency, call 911.
Where is Matagorda Regional Medical Center?: 104 7th Street, Bay City, TX 77414, in Matagorda County, Texas.
What is the phone number of Matagorda Regional Medical Center?: (979) 245-6383, as listed by Medicare (CMS).
What is the Medicare star rating of Matagorda Regional Medical Center?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[4][6][7][8][10][15][18]}

Cardiac care
Cardio-pulmonary
Critical care
Emergency department
Hospitalist program
Laboratory services
Medical-surgical unit
Outpatient rehabilitation
Radiology and imaging
Surgical services
Women's Center
Wound Healing Center
Cardiology
Pathology
General surgery
Otolaryngology (ENT)
Orthopedic surgery
Vascular surgery
Podiatric surgery
Gynecological surgery
Obstetrics
Gynecology
Neurology
Pulmonology

Conditions treated^{[6][7][11][13][18]}

Treatments^{[4][8][11][13][18]}

IV therapy
CT scan
MRI
Nuclear medicine
Ultrasound
X-ray
Bone density
3D mammography
Digital mammography
Echocardiogram
Stress test
Electrocardiogram (EKG)
Holter monitoring
Pulmonary function testing
Sleep studies
Laboratory services
Blood bank and transfusion
Respiratory therapy
Physical therapy
Occupational therapy
Speech therapy

Procedures^{[4][7][13][15]}

Diagnostic testing
Sleep studies
Cataract surgery
Balloon sinuplasty
Colonoscopy
Upper GI endoscopy
Flexible sigmoidoscopy
Endoscopic ultrasound
Hysteroscopy
Dilation and curettage (D&C)
Pelvic laparoscopy
Cervical cryosurgery
Cesarean section
Total knee or hip replacement
Rotator cuff repair

Programs and centers^{[4][6][10][13][14][15][18]}

Community health programs
Health & Wellness
WIC Clinic
Emergency Department
Heart Team (chest pain and STEMI response)
Stroke rapid response team
Critical care and intensive care unit
Women's Center (labor, delivery, recovery)
Hospitalist program
Outpatient rehabilitation
Sleep study program

Emergency care (hospital website)^[4][6]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV

Visiting and practical information

Visiting	Visiting hours set by unit: Med/Surg 6am-9pm weekdays, 8am-9pm weekends; ICU 8am-6pm and 8-9pm; no children in ICU or Women's Center^[12]
Interpreters and languages	Spanish patient rights document available on request; Spanish medical records forms offered^[16][17]
Patient portal	Patient Portal

Recognition^{[4][6][9][16]}

Joint Commission accreditation
ANCC Pathway to Excellence designated organization
Joint Commission accredited facility
Level IV Trauma Center designation

Doctors and clinicians (157)

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

Main specialties

Doctors with a page on this site (157)

Aaron T. Krenek, CNACertified Registered Nurse Anesthetist (CRNA)
Alan N. Byrd, MDFamily Practice
Alessandra L. Falk, MDOrthopedic Surgery
Amanda T. Ferraro, NPNurse Practitioner
Amish M. Dave, MDDiagnostic Radiology
Amish S. Dave, MDCardiac Electrophysiology
Amy L. Keffer, MDInternal Medicine
Anam A. Shaikh, DORheumatology
Andrew J. Johnsrud, MDHematology/Oncology
Aricia M. Byrd, MDEmergency Medicine
Ashley K. BookPhysician Assistant
Ashley Koudela, PAPhysician Assistant
Ashvin K. Dewan, MDSports Medicine
Aymen Aldujaili, MDNephrology
Barbara K. Hayes, NPNurse Practitioner
Barry J. Liberoni, MDInternal Medicine
Belma H. Cruz, NPNurse Practitioner
Bhuvaneswari Krishnan, MDPathology
Blair W. Krell, MDNeurology
Brooke Dorotik, MDFamily Practice
Bruce A. Barker, DOFamily Practice
Bruce A. Ramsey, PAPhysician Assistant
Bushra I. Cheema, MDHematology/Oncology
Carlyle Langhorn, MDEmergency Medicine

And 133 more: the button below opens the full list.

Other emergency rooms nearby

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

Palacios Community Medical Center18 mi · Palacios, TX · Critical Access Hospital
Sweeny Community Hospital21 mi · Sweeny, TX · Critical Access Hospital
CHI St. Luke's Health Brazosport32 mi · Lake Jackson, TX · Acute Care Hospital
El Campo Memorial Hospital34 mi · El Campo, TX · Acute Care Hospital
UTMB Health Angleton Danbury Campus Hospital40 mi · Angleton, TX · Acute Care Hospital

Other hospitals nearby

Jackson Healthcare Center43 mi · Edna, TX · Critical Access 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

Matagorda Nursing & Rehabilitation Center8.7 mi · Bay City, TX · 2 of 5 stars
Paradigm at Bay City11 mi · Bay City, TX · 4 of 5 stars
Avir at Bay City11 mi · Bay City, TX · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Angels Care Hospice5.8 mi · Bay City, TX · 5 of 5 stars

All hospice providers in the state →

Home health agencies

Angels Care Home Health5.8 mi · Bay City, TX
Gold Standard Home Health LLC5.8 mi · Bay City, TX
Shining Nightingale Health Care5.8 mi · Bay City, TX

All home health agencies in the state →

Dialysis facilities

Bay City Regional Dialysis Center5.8 mi · Bay City, TX · 3 of 5 stars
Sweeny Dialysis Care, LLP20 mi · Sweeny, TX · 4 of 5 stars

All dialysis facilities in the state →

Community care nearby

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

Community health centers

MEHOP Primary and Behavioral Health11 mi · Bay City, TX · Community health center
MEHOP Women and Children Center12 mi · Bay City, TX · Community health center
MEHOP Administration and Outreach12 mi · Bay City, TX · Community health center

Clinics and urgent care

Matagorda Medical Group5.8 mi · Bay City, TX · Rural health clinic
Mid Coast Medical Clinic-Palacios19 mi · Palacios, TX · Rural health clinic

Pharmacies

El Campo Memorial Hospital5.8 mi · Bay City, TX · Pharmacy
H-E-B, LP5.8 mi · Bay City, TX · Community/retail pharmacy
Matagorda Episcopal Health Outreach Program Corporation5.8 mi · Bay City, TX · Community/retail pharmacy

Assisted living nearby

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

Avir at Bay City Villas5.8 mi · Bay City, TX

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	5 of 5 stars
Quiet at night	5 of 5 stars
Rated the hospital 9 or 10 out of 10	75%National average: 72%
Would definitely recommend the hospital	67%National average: 71%
Nurses “always” communicated well	83%National average: 80%
Doctors “always” communicated well	81%National average: 80%
Staff “always” explained medicines before giving them	66%National average: 62%
Were given information about recovery at home	81%National average: 86%
Room and bathroom “always” clean	84%National average: 74%
Area around the room “always” quiet at night	73%National average: 60%
Completed surveys	145Response rate: 11%

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	0No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	9%
Deaths within 30 days: pneumonia patients	13.2%
Deaths within 30 days: COPD patients	7.9%
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)	0.94No different from the national rate
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	14.5%
Readmitted within 30 days: heart failure	20.5%
Readmitted within 30 days: pneumonia	15.9%
Readmitted within 30 days: COPD	19.1%
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)	114 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	72%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Texas Best hospitals in Texas

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 69 common services exactly as Matagorda Regional Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: BASIC OFFICE VISIT	$122	$61	$68.32 – $254.15
Established patient office visit (about 30–39 minutes): 10 of 23 insurance plan rates Aetna — PPO: $76.49 BCBS — Blue Advantage: $228.65 BCBS — Blue Essentials: $210.33 BCBS — PPO: $254.15 BCBS — Traditional: $254.15 Cigna — Commercial: $91.50 Comm Care — Medicaid: $68.32 Coventry First Health — PPO: $85.40 Galaxy Health — PPO: $85.40 Health Smart — Preferred: $109.80
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: OB LEVEL 3	$506	$253	$283.36 – $1,085
Emergency room visit (moderate): 10 of 23 insurance plan rates Aetna — PPO: $366.34 BCBS — Blue Advantage: $609 BCBS — Blue Essentials: $976 BCBS — PPO: $1,085 BCBS — Traditional: $1,085 Cigna — Commercial: $354.20 Comm Care — Medicaid: $283.36 Coventry First Health — PPO: $354.20 Galaxy Health — PPO: $354.20 Health Smart — Preferred: $455.40
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: ER LEVEL 3	$508	$254	$284.48 – $1,085
Emergency room visit (moderate): 10 of 23 insurance plan rates Aetna — PPO: $367.79 BCBS — Blue Advantage: $609 BCBS — Blue Essentials: $976 BCBS — PPO: $1,085 BCBS — Traditional: $1,085 Cigna — Commercial: $355.60 Comm Care — Medicaid: $284.48 Coventry First Health — PPO: $355.60 Galaxy Health — PPO: $355.60 Health Smart — Preferred: $457.20
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: OB LEVEL 4	$810	$405	$453.60 – $2,860
Emergency room visit (moderately high): 10 of 23 insurance plan rates Aetna — PPO: $586.44 BCBS — Blue Advantage: $1,520 BCBS — Blue Essentials: $2,560 BCBS — PPO: $2,860 BCBS — Traditional: $2,860 Cigna — Commercial: $567 Comm Care — Medicaid: $453.60 Coventry First Health — PPO: $567 Galaxy Health — PPO: $567 Health Smart — Preferred: $729
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: ER LEVEL 4	$810	$405	$453.60 – $2,860
Emergency room visit (moderately high): 10 of 23 insurance plan rates Aetna — PPO: $586.44 BCBS — Blue Advantage: $1,520 BCBS — Blue Essentials: $2,560 BCBS — PPO: $2,860 BCBS — Traditional: $2,860 Cigna — Commercial: $567 Comm Care — Medicaid: $453.60 Coventry First Health — PPO: $567 Galaxy Health — PPO: $567 Health Smart — Preferred: $729
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: OB LEVEL 5	$1,213	$606.50	$679.28 – $3,480
Emergency room visit (high): 10 of 23 insurance plan rates Aetna — PPO: $878.21 BCBS — Blue Advantage: $3,000 BCBS — Blue Essentials: $3,160 BCBS — PPO: $3,480 BCBS — Traditional: $3,480 Cigna — Commercial: $849.10 Comm Care — Medicaid: $679.28 Coventry First Health — PPO: $849.10 Galaxy Health — PPO: $849.10 Health Smart — Preferred: $1,091.70
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: ER LEVEL 5	$1,211	$605.50	$678.16 – $3,480
Emergency room visit (high): 10 of 23 insurance plan rates Aetna — PPO: $876.76 BCBS — Blue Advantage: $3,000 BCBS — Blue Essentials: $3,160 BCBS — PPO: $3,480 BCBS — Traditional: $3,480 Cigna — Commercial: $847.70 Comm Care — Medicaid: $678.16 Coventry First Health — PPO: $847.70 Galaxy Health — PPO: $847.70 Health Smart — Preferred: $1,089.90

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	$75	Not listed in the file	$8.46 – $74.96
Basic metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $8.46 Aetna — PPO: $47.02 Alliance — Worker Comp: $11.84 AM Better — EPO/HMO: $10.15 BCBS — Blue Advantage: $48.13 BCBS — Blue Essentials: $25.47 BCBS — PPO: $74.96 BCBS — Traditional: $74.96 Cigna — Commercial: $56.25 Comm Care — Medicaid: $42
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMPREHENSIVE METABOLIC PANEL	$94	Not listed in the file	$10.56 – $93.63
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $10.56 Aetna — PPO: $58.94 Alliance — Worker Comp: $14.78 AM Better — EPO/HMO: $12.67 BCBS — Blue Advantage: $60.11 BCBS — Blue Essentials: $31.82 BCBS — PPO: $93.63 BCBS — Traditional: $93.63 Cigna — Commercial: $70.50 Comm Care — Medicaid: $52.64
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PANEL	$119	Not listed in the file	$13.39 – $118.69
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $13.39 Aetna — PPO: $74.61 Alliance — Worker Comp: $18.75 AM Better — EPO/HMO: $16.07 BCBS — Blue Advantage: $76.20 BCBS — Blue Essentials: $40.33 BCBS — PPO: $118.69 BCBS — Traditional: $118.69 Cigna — Commercial: $89.25 Comm Care — Medicaid: $66.64
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: RENA FUNCTION PANEL	$77	Not listed in the file	$8.68 – $76.97
Kidney function panel: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $8.68 Aetna — PPO: $48.28 Alliance — Worker Comp: $12.15 AM Better — EPO/HMO: $10.42 BCBS — Blue Advantage: $49.42 BCBS — Blue Essentials: $26.16 BCBS — PPO: $76.97 BCBS — Traditional: $76.97 Cigna — Commercial: $57.75 Comm Care — Medicaid: $43.12
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HEPATIC FUNCTION PANEL	$73	Not listed in the file	$8.17 – $72.45
Liver function panel: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $8.17 Aetna — PPO: $45.77 Alliance — Worker Comp: $11.44 AM Better — EPO/HMO: $9.80 BCBS — Blue Advantage: $46.51 BCBS — Blue Essentials: $24.62 BCBS — PPO: $72.45 BCBS — Traditional: $72.45 Cigna — Commercial: $54.75 Comm Care — Medicaid: $40.88
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URINALYSIS W/MICRO	$29	Not listed in the file	$3.17 – $28.15
Urine test (automated, with microscope): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $3.17 Aetna — PPO: $18.18 Alliance — Worker Comp: $4.44 AM Better — EPO/HMO: $3.80 BCBS — Blue Advantage: $18.07 BCBS — Blue Essentials: $9.56 BCBS — PPO: $28.15 BCBS — Traditional: $28.15 Cigna — Commercial: $21.75 Comm Care — Medicaid: $16.24
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: MACROSCOPIC UA W/O MICRO	$20	Not listed in the file	$2.25 – $19.89
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $2.25 Aetna — PPO: $12.54 Alliance — Worker Comp: $3.15 AM Better — EPO/HMO: $2.70 BCBS — Blue Advantage: $12.77 BCBS — Blue Essentials: $6.76 BCBS — PPO: $19.89 BCBS — Traditional: $19.89 Cigna — Commercial: $15 Comm Care — Medicaid: $11.20
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: GLUCOSE, URINE	$20	Not listed in the file	$2.25 – $19.89
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $2.25 Aetna — PPO: $12.54 Alliance — Worker Comp: $3.15 AM Better — EPO/HMO: $2.70 BCBS — Blue Advantage: $12.77 BCBS — Blue Essentials: $6.76 BCBS — PPO: $19.89 BCBS — Traditional: $19.89 Cigna — Commercial: $15 Comm Care — Medicaid: $11.20
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: URINE KETONES(AUTO NO MICRO)	$20	Not listed in the file	$2.25 – $19.89
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $2.25 Aetna — PPO: $12.54 Alliance — Worker Comp: $3.15 AM Better — EPO/HMO: $2.70 BCBS — Blue Advantage: $12.77 BCBS — Blue Essentials: $6.76 BCBS — PPO: $19.89 BCBS — Traditional: $19.89 Cigna — Commercial: $15 Comm Care — Medicaid: $11.20
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA DIAGNOSTIC	$164	Not listed in the file	$18.39 – $163.06
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $18.39 Aetna — PPO: $102.83 Alliance — Worker Comp: $25.75 AM Better — EPO/HMO: $22.07 BCBS — Blue Advantage: $104.69 BCBS — Blue Essentials: $55.41 BCBS — PPO: $163.06 BCBS — Traditional: $163.06 Cigna — Commercial: $123 Comm Care — Medicaid: $91.84
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA, ULTRASENSITIVE	$164	Not listed in the file	$18.39 – $163.06
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $18.39 Aetna — PPO: $102.83 Alliance — Worker Comp: $25.75 AM Better — EPO/HMO: $22.07 BCBS — Blue Advantage: $104.69 BCBS — Blue Essentials: $55.41 BCBS — PPO: $163.06 BCBS — Traditional: $163.06 Cigna — Commercial: $123 Comm Care — Medicaid: $91.84
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: TSH	$149	Not listed in the file	$16.80 – $148.99
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $16.80 Aetna — PPO: $93.42 Alliance — Worker Comp: $23.52 AM Better — EPO/HMO: $20.16 BCBS — Blue Advantage: $95.66 BCBS — Blue Essentials: $50.63 BCBS — PPO: $148.99 BCBS — Traditional: $148.99 Cigna — Commercial: $111.75 Comm Care — Medicaid: $83.44
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: TSH (ULTRASENSITIVE)	$149	Not listed in the file	$16.80 – $148.99
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $16.80 Aetna — PPO: $93.42 Alliance — Worker Comp: $23.52 AM Better — EPO/HMO: $20.16 BCBS — Blue Advantage: $95.66 BCBS — Blue Essentials: $50.63 BCBS — PPO: $148.99 BCBS — Traditional: $148.99 Cigna — Commercial: $111.75 Comm Care — Medicaid: $83.44
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC W/DIFF	$69	Not listed in the file	$7.77 – $68.86
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $7.77 Aetna — PPO: $43.26 Alliance — Worker Comp: $10.88 AM Better — EPO/HMO: $9.32 BCBS — Blue Advantage: $44.21 BCBS — Blue Essentials: $23.40 BCBS — PPO: $68.86 BCBS — Traditional: $68.86 Cigna — Commercial: $51.75 Comm Care — Medicaid: $38.64
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier 91 In the file: CBC, SUBSEQUENT	$69	Not listed in the file	$7.77 – $68.86
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $7.77 Aetna — PPO: $43.26 Alliance — Worker Comp: $10.88 AM Better — EPO/HMO: $9.32 BCBS — Blue Advantage: $44.21 BCBS — Blue Essentials: $23.40 BCBS — PPO: $68.86 BCBS — Traditional: $68.86 Cigna — Commercial: $51.75 Comm Care — Medicaid: $38.64
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: CBC, NO DIF	$58	Not listed in the file	$6.47 – $57.30
Complete blood count (CBC), automated: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $6.47 Aetna — PPO: $36.37 Alliance — Worker Comp: $9.06 AM Better — EPO/HMO: $7.76 BCBS — Blue Advantage: $36.79 BCBS — Blue Essentials: $19.47 BCBS — PPO: $57.30 BCBS — Traditional: $57.30 Cigna — Commercial: $43.50 Comm Care — Medicaid: $32.48
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HEMOGRAM	$58	Not listed in the file	$6.47 – $57.30
Complete blood count (CBC), automated: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $6.47 Aetna — PPO: $36.37 Alliance — Worker Comp: $9.06 AM Better — EPO/HMO: $7.76 BCBS — Blue Advantage: $36.79 BCBS — Blue Essentials: $19.47 BCBS — PPO: $57.30 BCBS — Traditional: $57.30 Cigna — Commercial: $43.50 Comm Care — Medicaid: $32.48
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PT, PROTHROMBIN TIME	$35	Not listed in the file	$4.29 – $34.82
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $4.29 Aetna — PPO: $21.95 Alliance — Worker Comp: $6.01 AM Better — EPO/HMO: $5.15 BCBS — Blue Advantage: $22.36 BCBS — Blue Essentials: $11.83 BCBS — PPO: $34.82 BCBS — Traditional: $34.82 Cigna — Commercial: $26.25 Comm Care — Medicaid: $19.60
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PROTHROMBIN TIME(INR)	$35	Not listed in the file	$4.29 – $34.82
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $4.29 Aetna — PPO: $21.95 Alliance — Worker Comp: $6.01 AM Better — EPO/HMO: $5.15 BCBS — Blue Advantage: $22.36 BCBS — Blue Essentials: $11.83 BCBS — PPO: $34.82 BCBS — Traditional: $34.82 Cigna — Commercial: $26.25 Comm Care — Medicaid: $19.60
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT,PARTIAL THROMBO. TIME	$54	Not listed in the file	$6.01 – $53.28
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $6.01 Aetna — PPO: $33.86 Alliance — Worker Comp: $8.41 AM Better — EPO/HMO: $7.21 BCBS — Blue Advantage: $34.21 BCBS — Blue Essentials: $18.10 BCBS — PPO: $53.28 BCBS — Traditional: $53.28 Cigna — Commercial: $40.50 Comm Care — Medicaid: $30.24
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: APTT	$54	Not listed in the file	$6.01 – $53.28
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $6.01 Aetna — PPO: $33.86 Alliance — Worker Comp: $8.41 AM Better — EPO/HMO: $7.21 BCBS — Blue Advantage: $34.21 BCBS — Blue Essentials: $18.10 BCBS — PPO: $53.28 BCBS — Traditional: $53.28 Cigna — Commercial: $40.50 Comm Care — Medicaid: $30.24
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PARTIAL THROMBOPLASTIN TIME	$54	Not listed in the file	$6.01 – $53.28
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna — Medicare Advantage: $6.01 Aetna — PPO: $33.86 Alliance — Worker Comp: $8.41 AM Better — EPO/HMO: $7.21 BCBS — Blue Advantage: $34.21 BCBS — Blue Essentials: $18.10 BCBS — PPO: $53.28 BCBS — Traditional: $53.28 Cigna — Commercial: $40.50 Comm Care — Medicaid: $30.24

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 W/O CONTRAST	$1,530	$765	$105.47 – $959.31
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $105.47 Aetna — PPO: $959.31 Alliance — Worker Comp: $147.65 AM Better — EPO/HMO: $126.56 BCBS — Blue Advantage: $535.67 BCBS — Blue Essentials: $423.50 BCBS — PPO: $596.34 BCBS — Traditional: $596.34 Cigna — Commercial: $600 Comm Care — Medicaid: $856.80
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI PITUITARY GLAND W & W/O	$2,763	$1,381.50	$354.19 – $2,377.69
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $354.19 Aetna — PPO: $1,732.40 Alliance — Worker Comp: $495.87 AM Better — EPO/HMO: $425.03 BCBS — Blue Advantage: $2,135.81 BCBS — Blue Essentials: $1,688.57 BCBS — PPO: $2,377.69 BCBS — Traditional: $2,377.69 Cigna — Commercial: $700 Comm Care — Medicaid: $1,547.28
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN W & WO CONTRAST	$2,763	$1,381.50	$354.19 – $2,377.69
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $354.19 Aetna — PPO: $1,732.40 Alliance — Worker Comp: $495.87 AM Better — EPO/HMO: $425.03 BCBS — Blue Advantage: $2,135.81 BCBS — Blue Essentials: $1,688.57 BCBS — PPO: $2,377.69 BCBS — Traditional: $2,377.69 Cigna — Commercial: $700 Comm Care — Medicaid: $1,547.28
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI IAC W&WO CONTRAST	$2,763	$1,381.50	$354.19 – $2,377.69
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $354.19 Aetna — PPO: $1,732.40 Alliance — Worker Comp: $495.87 AM Better — EPO/HMO: $425.03 BCBS — Blue Advantage: $2,135.81 BCBS — Blue Essentials: $1,688.57 BCBS — PPO: $2,377.69 BCBS — Traditional: $2,377.69 Cigna — Commercial: $700 Comm Care — Medicaid: $1,547.28
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: CHEST 2 VIEWS	$369	$184.50	$87.33 – $276.75
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $87.33 Aetna — PPO: $231.36 Alliance — Worker Comp: $122.26 AM Better — EPO/HMO: $104.79 BCBS — Blue Advantage: $239.16 BCBS — Blue Essentials: $132.94 BCBS — PPO: $265.87 BCBS — Traditional: $265.87 Cigna — Commercial: $276.75 Comm Care — Medicaid: $206.64
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: TB CHEST-2 VIEW	$88	$44	$49.28 – $265.87
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $87.33 Aetna — PPO: $55.18 Alliance — Worker Comp: $122.26 AM Better — EPO/HMO: $104.79 BCBS — Blue Advantage: $239.16 BCBS — Blue Essentials: $132.94 BCBS — PPO: $265.87 BCBS — Traditional: $265.87 Cigna — Commercial: $66 Comm Care — Medicaid: $49.28
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: CHEST 2 VIEWS,INITIAL	$369	$184.50	$87.33 – $276.75
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $87.33 Aetna — PPO: $231.36 Alliance — Worker Comp: $122.26 AM Better — EPO/HMO: $104.79 BCBS — Blue Advantage: $239.16 BCBS — Blue Essentials: $132.94 BCBS — PPO: $265.87 BCBS — Traditional: $265.87 Cigna — Commercial: $276.75 Comm Care — Medicaid: $206.64
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: SPINE;L-S;COMPLETE, W/OBLIQUE	$644	$322	$105.47 – $489.89
X-ray of the lower spine, at least 4 views: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $105.47 Aetna — PPO: $403.79 Alliance — Worker Comp: $147.65 AM Better — EPO/HMO: $126.56 BCBS — Blue Advantage: $440.67 BCBS — Blue Essentials: $244.94 BCBS — PPO: $489.89 BCBS — Traditional: $489.89 Cigna — Commercial: $483 Comm Care — Medicaid: $360.64
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier PN In the file: SPINE;L-S;COMPLETE, W/OBLIQUE	$644	$322	$105.47 – $489.89
X-ray of the lower spine, at least 4 views: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $105.47 Aetna — PPO: $403.79 Alliance — Worker Comp: $147.65 AM Better — EPO/HMO: $126.56 BCBS — Blue Advantage: $440.67 BCBS — Blue Essentials: $244.94 BCBS — PPO: $489.89 BCBS — Traditional: $489.89 Cigna — Commercial: $483 Comm Care — Medicaid: $360.64
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR SPINE WO CONTRAST	$1,927	$963.50	$239.73 – $1,210.34
MRI of the lower back (lumbar spine), without contrast: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $239.73 Aetna — PPO: $1,208.23 Alliance — Worker Comp: $335.63 AM Better — EPO/HMO: $287.68 BCBS — Blue Advantage: $1,087.21 BCBS — Blue Essentials: $859.55 BCBS — PPO: $1,210.34 BCBS — Traditional: $1,210.34 Cigna — Commercial: $700 Comm Care — Medicaid: $1,079.12
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W/ CONTRAST	$1,711	$855.50	$176.56 – $1,316.78
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $176.56 Aetna — PPO: $1,072.80 Alliance — Worker Comp: $247.18 AM Better — EPO/HMO: $211.87 BCBS — Blue Advantage: $1,182.82 BCBS — Blue Essentials: $935.14 BCBS — PPO: $1,316.78 BCBS — Traditional: $1,316.78 Cigna — Commercial: $600 Comm Care — Medicaid: $958.16
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier RT In the file: MRI ANKLE RT WO CONTRAST	$1,707	$853.50	$239.73 – $1,210.34
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $239.73 Aetna — PPO: $1,070.29 Alliance — Worker Comp: $335.63 AM Better — EPO/HMO: $287.68 BCBS — Blue Advantage: $1,087.21 BCBS — Blue Essentials: $859.55 BCBS — PPO: $1,210.34 BCBS — Traditional: $1,210.34 Cigna — Commercial: $700 Comm Care — Medicaid: $955.92
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier LT In the file: MRI ANKLE LT WO CONTRAST	$1,707	$853.50	$239.73 – $1,210.34
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $239.73 Aetna — PPO: $1,070.29 Alliance — Worker Comp: $335.63 AM Better — EPO/HMO: $287.68 BCBS — Blue Advantage: $1,087.21 BCBS — Blue Essentials: $859.55 BCBS — PPO: $1,210.34 BCBS — Traditional: $1,210.34 Cigna — Commercial: $700 Comm Care — Medicaid: $955.92
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier RT In the file: MRI HIP RT WO CONTRAST	$1,707	$853.50	$239.73 – $1,210.34
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $239.73 Aetna — PPO: $1,070.29 Alliance — Worker Comp: $335.63 AM Better — EPO/HMO: $287.68 BCBS — Blue Advantage: $1,087.21 BCBS — Blue Essentials: $859.55 BCBS — PPO: $1,210.34 BCBS — Traditional: $1,210.34 Cigna — Commercial: $700 Comm Care — Medicaid: $955.92
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD & PELVIS W	$1,831	$915.50	$354.19 – $1,316.78
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $354.19 Aetna — PPO: $1,148.04 Alliance — Worker Comp: $495.87 AM Better — EPO/HMO: $425.03 BCBS — Blue Advantage: $1,182.82 BCBS — Blue Essentials: $935.14 BCBS — PPO: $1,316.78 BCBS — Traditional: $1,316.78 Cigna — Commercial: $600 Comm Care — Medicaid: $1,025.36
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: ABDOMINAL ULTRASOUND	$1,023	$511.50	$105.47 – $767.25
Ultrasound of the abdomen, complete: 10 of 33 insurance plan rates Aetna — Medicare Advantage: $105.47 Aetna — PPO: $641.42 Alliance — Worker Comp: $147.65 AM Better — EPO/HMO: $126.56 BCBS — Blue Advantage: $440.67 BCBS — Blue Essentials: $244.94 BCBS — PPO: $489.89 BCBS — Traditional: $489.89 Cigna — Commercial: $767.25 Comm Care — Medicaid: $572.88
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: OB >14 WEEK 1ST FETUS	$771	$385.50	$201.22 – $578.25
Pregnancy ultrasound (after the first trimester): 10 of 23 insurance plan rates Aetna — PPO: $483.42 BCBS — Blue Advantage: $362.02 BCBS — Blue Essentials: $201.22 BCBS — PPO: $402.45 BCBS — Traditional: $402.45 Cigna — Commercial: $578.25 Comm Care — Medicaid: $431.76 Coventry First Health — PPO: $539.70 Galaxy Health — PPO: $539.70 Health Smart — Preferred: $693.90
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: VAGINAL NON OB	$847	$423.50	$191.23 – $635.25
Transvaginal ultrasound: 10 of 23 insurance plan rates Aetna — PPO: $531.07 BCBS — Blue Advantage: $344.04 BCBS — Blue Essentials: $191.23 BCBS — PPO: $382.46 BCBS — Traditional: $382.46 Cigna — Commercial: $635.25 Comm Care — Medicaid: $474.32 Coventry First Health — PPO: $592.90 Galaxy Health — PPO: $592.90 Health Smart — Preferred: $762.30
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier RT In the file: MAMMO DIAGNOSTIC RIGHT	$509	$254.50	$205.05 – $410.11
Diagnostic mammogram, one breast: 10 of 23 insurance plan rates Aetna — PPO: $319.14 BCBS — Blue Advantage: $368.91 BCBS — Blue Essentials: $205.05 BCBS — PPO: $410.11 BCBS — Traditional: $410.11 Cigna — Commercial: $381.75 Comm Care — Medicaid: $285.04 Coventry First Health — PPO: $356.30 Galaxy Health — PPO: $356.30 Health Smart — Preferred: $458.10
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier RT In the file: MAMMO DIAGNOSTIC RIGHT W/TOMO	$402	$201	$205.05 – $410.11
Diagnostic mammogram, one breast: 10 of 23 insurance plan rates Aetna — PPO: $252.05 BCBS — Blue Advantage: $368.91 BCBS — Blue Essentials: $205.05 BCBS — PPO: $410.11 BCBS — Traditional: $410.11 Cigna — Commercial: $301.50 Comm Care — Medicaid: $225.12 Coventry First Health — PPO: $281.40 Galaxy Health — PPO: $281.40 Health Smart — Preferred: $361.80
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier LT In the file: MAMMO DIAGNOSTIC LEFT	$509	$254.50	$205.05 – $410.11
Diagnostic mammogram, one breast: 10 of 23 insurance plan rates Aetna — PPO: $319.14 BCBS — Blue Advantage: $368.91 BCBS — Blue Essentials: $205.05 BCBS — PPO: $410.11 BCBS — Traditional: $410.11 Cigna — Commercial: $381.75 Comm Care — Medicaid: $285.04 Coventry First Health — PPO: $356.30 Galaxy Health — PPO: $356.30 Health Smart — Preferred: $458.10
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: MAMMO BILATERAL DIAGNOSTIC	$594	$297	$261.89 – $523.79
Diagnostic mammogram, both breasts: 10 of 23 insurance plan rates Aetna — PPO: $372.44 BCBS — Blue Advantage: $471.16 BCBS — Blue Essentials: $261.89 BCBS — PPO: $523.79 BCBS — Traditional: $523.79 Cigna — Commercial: $445.50 Comm Care — Medicaid: $332.64 Coventry First Health — PPO: $415.80 Galaxy Health — PPO: $415.80 Health Smart — Preferred: $534.60
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: MAMMO BIL DX W/TOMO	$594	$297	$261.89 – $523.79
Diagnostic mammogram, both breasts: 10 of 23 insurance plan rates Aetna — PPO: $372.44 BCBS — Blue Advantage: $471.16 BCBS — Blue Essentials: $261.89 BCBS — PPO: $523.79 BCBS — Traditional: $523.79 Cigna — Commercial: $445.50 Comm Care — Medicaid: $332.64 Coventry First Health — PPO: $415.80 Galaxy Health — PPO: $415.80 Health Smart — Preferred: $534.60
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MAMMO BILATERAL SCREENING	$99	$49.50	$55.44 – $433.18
Screening mammogram, both breasts: 10 of 23 insurance plan rates Aetna — PPO: $62.07 BCBS — Blue Advantage: $389.66 BCBS — Blue Essentials: $216.59 BCBS — PPO: $433.18 BCBS — Traditional: $433.18 Cigna — Commercial: $74.25 Comm Care — Medicaid: $55.44 Coventry First Health — PPO: $69.30 Galaxy Health — PPO: $69.30 Health Smart — Preferred: $89.10
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: MAMMO BIL SCR W/TOMO	$566	$283	$216.59 – $433.18
Screening mammogram, both breasts: 10 of 23 insurance plan rates Aetna — PPO: $354.88 BCBS — Blue Advantage: $389.66 BCBS — Blue Essentials: $216.59 BCBS — PPO: $433.18 BCBS — Traditional: $433.18 Cigna — Commercial: $424.50 Comm Care — Medicaid: $316.96 Coventry First Health — PPO: $396.20 Galaxy Health — PPO: $396.20 Health Smart — Preferred: $509.40
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier 52\|LT In the file: MAMMO SCREEN LEFT	$99	$49.50	$55.44 – $433.18
Screening mammogram, both breasts: 10 of 23 insurance plan rates Aetna — PPO: $62.07 BCBS — Blue Advantage: $389.66 BCBS — Blue Essentials: $216.59 BCBS — PPO: $433.18 BCBS — Traditional: $433.18 Cigna — Commercial: $74.25 Comm Care — Medicaid: $55.44 Coventry First Health — PPO: $69.30 Galaxy Health — PPO: $69.30 Health Smart — Preferred: $89.10

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: L hrt cath w/njx l ventriculography img s&i	Not listed in the file	Not listed in the file	$2,194.61 – $2,757.33
Left heart catheterization (diagnostic): rates for 4 insurance plans BCBS — Blue Advantage: $2,391.56 BCBS — Blue Essentials: $2,194.61 BCBS — PPO: $2,757.33 BCBS — Traditional: $2,757.33
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Left hrt cath w/ventrclgrphy	Not listed in the file	Not listed in the file	$1,555
Left heart catheterization (diagnostic): rates for 2 insurance plans Aetna — PPO: $1,555 UHC — PPO: $1,536
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Comprehensive ep evaluation	Not listed in the file	Not listed in the file	$1,555
Heart rhythm study (electrophysiology evaluation): rates for 2 insurance plans Aetna — PPO: $1,555 UHC — PPO: $1,773
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Ephys evl trnsptl tx atrial fib isolat pulm vein	Not listed in the file	Not listed in the file	$14,442.58 – $18,145.81
Heart rhythm study with ablation for atrial fibrillation: rates for 4 insurance plans BCBS — Blue Advantage: $15,738.71 BCBS — Blue Essentials: $14,442.58 BCBS — PPO: $18,145.81 BCBS — Traditional: $18,145.81
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Compre ep eval abltj atr fib	Not listed in the file	Not listed in the file	$1,555
Heart rhythm study with ablation for atrial fibrillation: rates for 2 insurance plans Aetna — PPO: $1,555 UHC — PPO: $5,306
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: POLYSOMNOGRAPHY;4+PARAM 1ST NT	$2,428	$1,214	$1,353.92 – $1,821
Sleep study (overnight, in a sleep lab): 10 of 23 insurance plan rates Aetna — PPO: $1,522.36 BCBS — Blue Advantage: $1,471.88 BCBS — Blue Essentials: $1,353.92 BCBS — PPO: $1,635.99 BCBS — Traditional: $1,635.99 Cigna — Commercial: $1,821 Comm Care — Medicaid: $1,359.68 Coventry First Health — PPO: $1,699.60 Galaxy Health — PPO: $1,699.60 Health Smart — Preferred: $2,185.20

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GP In the file: THERAPEUTIC EXERCISE BY PT	$149	$74.50	$82.42 – $111.75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates Aetna — PPO: $93.42 BCBS — Blue Advantage: $89.60 BCBS — Blue Essentials: $82.42 BCBS — PPO: $99.59 BCBS — Traditional: $99.59 Cigna — Commercial: $111.75 Comm Care — Medicaid: $83.44 Coventry First Health — PPO: $104.30 Galaxy Health — PPO: $104.30 Health Smart — Preferred: $134.10
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GP\|CQ In the file: THERAPEUTIC EXERCISE BY PTA	$149	$74.50	$82.42 – $111.75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates Aetna — PPO: $93.42 BCBS — Blue Advantage: $89.60 BCBS — Blue Essentials: $82.42 BCBS — PPO: $99.59 BCBS — Traditional: $99.59 Cigna — Commercial: $111.75 Comm Care — Medicaid: $83.44 Coventry First Health — PPO: $104.30 Galaxy Health — PPO: $104.30 Health Smart — Preferred: $134.10
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GO In the file: THERAPEUTIC EX BY OT 15'	$143	$71.50	$80.08 – $107.25
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates Aetna — PPO: $89.66 BCBS — Blue Advantage: $89.60 BCBS — Blue Essentials: $82.42 BCBS — PPO: $99.59 BCBS — Traditional: $99.59 Cigna — Commercial: $107.25 Comm Care — Medicaid: $80.08 Coventry First Health — PPO: $100.10 Galaxy Health — PPO: $100.10 Health Smart — Preferred: $128.70
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier GP In the file: LOW COMPLEXITY EVALUATION(PT)	$193	$96.50	$108.08 – $272.49
Physical therapy evaluation (low complexity): 10 of 23 insurance plan rates Aetna — PPO: $121.01 BCBS — Blue Advantage: $245.16 BCBS — Blue Essentials: $225.51 BCBS — PPO: $272.49 BCBS — Traditional: $272.49 Cigna — Commercial: $144.75 Comm Care — Medicaid: $108.08 Coventry First Health — PPO: $135.10 Galaxy Health — PPO: $135.10 Health Smart — Preferred: $173.70
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier GP In the file: MOD COMPLEXITY EVALUATION(PT)	$243	$121.50	$136.08 – $272.49
Physical therapy evaluation (moderate complexity): 10 of 23 insurance plan rates Aetna — PPO: $152.36 BCBS — Blue Advantage: $245.16 BCBS — Blue Essentials: $225.51 BCBS — PPO: $272.49 BCBS — Traditional: $272.49 Cigna — Commercial: $182.25 Comm Care — Medicaid: $136.08 Coventry First Health — PPO: $170.10 Galaxy Health — PPO: $170.10 Health Smart — Preferred: $218.70
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier GP In the file: HIGH COMPLEXITY EVALUATION(PT)	$293	$146.50	$164.08 – $272.49
Physical therapy evaluation (high complexity): 10 of 23 insurance plan rates Aetna — PPO: $183.71 BCBS — Blue Advantage: $245.16 BCBS — Blue Essentials: $225.51 BCBS — PPO: $272.49 BCBS — Traditional: $272.49 Cigna — Commercial: $219.75 Comm Care — Medicaid: $164.08 Coventry First Health — PPO: $205.10 Galaxy Health — PPO: $205.10 Health Smart — Preferred: $263.70

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Exc cyst/aberrant breast tissue open 1/> lesion	Not listed in the file	Not listed in the file	$2,127.72 – $2,673.28
Removal of breast growth (open surgery): rates for 4 insurance plans BCBS — Blue Advantage: $2,318.66 BCBS — Blue Essentials: $2,127.72 BCBS — PPO: $2,673.28 BCBS — Traditional: $2,673.28
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$809 – $982.93
Removal of breast growth (open surgery): rates for 3 insurance plans Aetna — PPO: $809 UHC — PPO: $1,044 UHC Comm Care — Medicaid: $982.93
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Arthrp acetblr/prox fem prostc agrft/algrft	Not listed in the file	Not listed in the file	$1,096.21 – $1,377.29
Total hip replacement: rates for 4 insurance plans BCBS — Blue Advantage: $1,194.59 BCBS — Blue Essentials: $1,096.21 BCBS — PPO: $1,377.29 BCBS — Traditional: $1,377.29
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$1,308
Total hip replacement: rates for 2 insurance plans Aetna — PPO: $1,308 UHC — PPO: $3,634
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Arthrp kne condyle&platu medial&lat compartments	Not listed in the file	Not listed in the file	$7,895.88 – $9,920.46
Total knee replacement: rates for 4 insurance plans BCBS — Blue Advantage: $8,604.48 BCBS — Blue Essentials: $7,895.88 BCBS — PPO: $9,920.46 BCBS — Traditional: $9,920.46
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	$1,308
Total knee replacement: rates for 2 insurance plans Aetna — PPO: $1,308 UHC — PPO: $3,634
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	$809
Shoulder arthroscopy: shaving of shoulder bone: rates for 2 insurance plans Aetna — PPO: $809 UHC — PPO: $132
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthrs kne surg w/meniscectomy med/lat w/shvg	Not listed in the file	Not listed in the file	$2,063.28 – $2,592.33
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 4 insurance plans BCBS — Blue Advantage: $2,248.45 BCBS — Blue Essentials: $2,063.28 BCBS — PPO: $2,592.33 BCBS — Traditional: $2,592.33
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$993 – $1,110.04
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 3 insurance plans Aetna — PPO: $993 UHC — PPO: $1,394 UHC Comm Care — Medicaid: $1,110.04
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Tonsillectomy & adenoidectomy <age 12	Not listed in the file	Not listed in the file	$3,384.26 – $4,252.01
Removal of tonsils and adenoids (under age 12): rates for 4 insurance plans BCBS — Blue Advantage: $3,687.97 BCBS — Blue Essentials: $3,384.26 BCBS — PPO: $4,252.01 BCBS — Traditional: $4,252.01
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$809 – $1,993.30
Removal of tonsils and adenoids (under age 12): rates for 3 insurance plans Aetna — PPO: $809 UHC — PPO: $1,044 UHC Comm Care — Medicaid: $1,993.30
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy transoral diagnostic	Not listed in the file	Not listed in the file	$579.92 – $728.62
Upper GI endoscopy (diagnostic): rates for 4 insurance plans BCBS — Blue Advantage: $631.97 BCBS — Blue Essentials: $579.92 BCBS — PPO: $728.62 BCBS — Traditional: $728.62
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	$341.65 – $536
Upper GI endoscopy (diagnostic): rates for 3 insurance plans Aetna — PPO: $536 UHC — PPO: $627 UHC Comm Care — Medicaid: $341.65
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd transoral biopsy single/multiple	Not listed in the file	Not listed in the file	$579.92 – $728.62
Upper GI endoscopy with biopsy: rates for 4 insurance plans BCBS — Blue Advantage: $631.97 BCBS — Blue Essentials: $579.92 BCBS — PPO: $728.62 BCBS — Traditional: $728.62
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	$341.65 – $712
Upper GI endoscopy with biopsy: rates for 3 insurance plans Aetna — PPO: $712 UHC — PPO: $627 UHC Comm Care — Medicaid: $341.65
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy flx dx w/collj spec when pfrmd	Not listed in the file	Not listed in the file	$553.78 – $695.78
Colonoscopy (diagnostic): rates for 4 insurance plans BCBS — Blue Advantage: $603.48 BCBS — Blue Essentials: $553.78 BCBS — PPO: $695.78 BCBS — Traditional: $695.78
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Diagnostic colonoscopy	Not listed in the file	Not listed in the file	$335.07 – $712
Colonoscopy (diagnostic): rates for 3 insurance plans Aetna — PPO: $712 UHC — PPO: $627 UHC Comm Care — Medicaid: $335.07
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy w/biopsy single/multiple	Not listed in the file	Not listed in the file	$730.38 – $917.66
Colonoscopy with biopsy: rates for 4 insurance plans BCBS — Blue Advantage: $795.93 BCBS — Blue Essentials: $730.38 BCBS — PPO: $917.66 BCBS — Traditional: $917.66
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	$437.85 – $712
Colonoscopy with biopsy: rates for 3 insurance plans Aetna — PPO: $712 UHC — PPO: $627 UHC Comm Care — Medicaid: $437.85
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colsc flx w/rmvl of tumor polyp lesion snare tq	Not listed in the file	Not listed in the file	$730.38 – $917.66
Colonoscopy with removal of polyps (snare): rates for 4 insurance plans BCBS — Blue Advantage: $795.93 BCBS — Blue Essentials: $730.38 BCBS — PPO: $917.66 BCBS — Traditional: $917.66
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	$437.85 – $712
Colonoscopy with removal of polyps (snare): rates for 3 insurance plans Aetna — PPO: $712 UHC — PPO: $627 UHC Comm Care — Medicaid: $437.85
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colsc flx w/ndsc us xm rctm et al lmtd&adj strux	Not listed in the file	Not listed in the file	$730.38 – $917.66
Ultrasound of the lower bowel by endoscope: rates for 4 insurance plans BCBS — Blue Advantage: $795.93 BCBS — Blue Essentials: $730.38 BCBS — PPO: $917.66 BCBS — Traditional: $917.66
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colonoscopy w/endoscope us	Not listed in the file	Not listed in the file	$437.85 – $712
Ultrasound of the lower bowel by endoscope: rates for 3 insurance plans Aetna — PPO: $712 UHC — PPO: $627 UHC Comm Care — Medicaid: $437.85
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	$553.78 – $695.78
Screening colonoscopy (not high risk): rates for 7 insurance plans Aetna — PPO: $712 BCBS — Blue Advantage: $603.48 BCBS — Blue Essentials: $553.78 BCBS — PPO: $695.78 BCBS — Traditional: $695.78 UHC — PPO: $462 UHC Comm Care — Medicaid: $335.07
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy surg cholecystectomy	Not listed in the file	Not listed in the file	$3,501.17 – $4,398.91
Gallbladder removal by laparoscope: rates for 4 insurance plans BCBS — Blue Advantage: $3,815.38 BCBS — Blue Essentials: $3,501.17 BCBS — PPO: $4,398.91 BCBS — Traditional: $4,398.91
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	$1,127 – $1,926.63
Gallbladder removal by laparoscope: rates for 3 insurance plans Aetna — PPO: $1,127 UHC — PPO: $1,773 UHC Comm Care — Medicaid: $1,926.63
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Rpr 1st ingun hrna age 5 yrs/> reducible	Not listed in the file	Not listed in the file	$2,270.70 – $2,852.94
Groin (inguinal) hernia repair, age 5 or older: rates for 4 insurance plans BCBS — Blue Advantage: $2,474.49 BCBS — Blue Essentials: $2,270.70 BCBS — PPO: $2,852.94 BCBS — Traditional: $2,852.94
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	$993 – $1,174.57
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans Aetna — PPO: $993 UHC — PPO: $1,394 UHC Comm Care — Medicaid: $1,174.57
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Prostate needle biopsy any approach	Not listed in the file	Not listed in the file	$1,322.63 – $1,661.77
Prostate biopsy: rates for 4 insurance plans BCBS — Blue Advantage: $1,441.33 BCBS — Blue Essentials: $1,322.63 BCBS — PPO: $1,661.77 BCBS — Traditional: $1,661.77
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy of prostate	Not listed in the file	Not listed in the file	$665.86 – $712
Prostate biopsy: rates for 3 insurance plans Aetna — PPO: $712 UHC — PPO: $627 UHC Comm Care — Medicaid: $665.86
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laps prostect retropubic rad w/nrv sparing robot	Not listed in the file	Not listed in the file	$5,924.43 – $7,443.51
Prostate removal by laparoscope (radical prostatectomy): rates for 4 insurance plans BCBS — Blue Advantage: $6,456.11 BCBS — Blue Essentials: $5,924.43 BCBS — PPO: $7,443.51 BCBS — Traditional: $7,443.51
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laps surg prst8ect rpbic rad	Not listed in the file	Not listed in the file	$1,127
Prostate removal by laparoscope (radical prostatectomy): rates for 2 insurance plans Aetna — PPO: $1,127 UHC — PPO: $3,634
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy bx endometrium&/polypc w/wo d&c	Not listed in the file	Not listed in the file	$1,772.76 – $2,227.31
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans BCBS — Blue Advantage: $1,931.85 BCBS — Blue Essentials: $1,772.76 BCBS — PPO: $2,227.31 BCBS — Traditional: $2,227.31
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$809 – $1,084.79
Hysteroscopy with biopsy of the uterus lining: rates for 3 insurance plans Aetna — PPO: $809 UHC — PPO: $1,044 UHC Comm Care — Medicaid: $1,084.79
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn	Not listed in the file	Not listed in the file	$423.84 – $532.51
Spinal injection, lower back (epidural), with imaging guidance: rates for 4 insurance plans BCBS — Blue Advantage: $461.87 BCBS — Blue Essentials: $423.84 BCBS — PPO: $532.51 BCBS — Traditional: $532.51
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Njx interlaminar lmbr/sac	Not listed in the file	Not listed in the file	$268.12 – $536
Spinal injection, lower back (epidural), with imaging guidance: rates for 3 insurance plans Aetna — PPO: $536 UHC — PPO: $462 UHC Comm Care — Medicaid: $268.12
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Njx anes&/strd w/img tfrml edrl lmbr/sac 1 lvl	Not listed in the file	Not listed in the file	$524.30 – $658.74
Nerve root injection, lower back, with imaging guidance: rates for 4 insurance plans BCBS — Blue Advantage: $571.35 BCBS — Blue Essentials: $524.30 BCBS — PPO: $658.74 BCBS — Traditional: $658.74
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Njx aa&/strd tfrm epi l/s 1	Not listed in the file	Not listed in the file	$347.59 – $536
Nerve root injection, lower back, with imaging guidance: rates for 3 insurance plans Aetna — PPO: $536 UHC — PPO: $462 UHC Comm Care — Medicaid: $347.59
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty &/transpos median nrv carpal tunne	Not listed in the file	Not listed in the file	$1,256.19 – $1,578.29
Carpal tunnel release: rates for 4 insurance plans BCBS — Blue Advantage: $1,368.93 BCBS — Blue Essentials: $1,256.19 BCBS — PPO: $1,578.29 BCBS — Traditional: $1,578.29
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	$673.14 – $712
Carpal tunnel release: rates for 3 insurance plans Aetna — PPO: $712 UHC — PPO: $1,044 UHC Comm Care — Medicaid: $673.14
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Post-cataract laser surgery	Not listed in the file	Not listed in the file	$380.62 – $478.22
Laser treatment of clouding after cataract surgery: rates for 4 insurance plans BCBS — Blue Advantage: $414.78 BCBS — Blue Essentials: $380.62 BCBS — PPO: $478.22 BCBS — Traditional: $478.22
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$212.50 – $712
Laser treatment of clouding after cataract surgery: rates for 3 insurance plans Aetna — PPO: $712 UHC — PPO: $462 UHC Comm Care — Medicaid: $212.50
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Cataract removal insertion of lens	Not listed in the file	Not listed in the file	$1,498.45 – $1,882.67
Cataract removal with lens implant: rates for 4 insurance plans BCBS — Blue Advantage: $1,632.93 BCBS — Blue Essentials: $1,498.45 BCBS — PPO: $1,882.67 BCBS — Traditional: $1,882.67
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Xcapsl ctrc rmvl w/o ecp	Not listed in the file	Not listed in the file	$866.94 – $1,127
Cataract removal with lens implant: rates for 3 insurance plans Aetna — PPO: $1,127 UHC — PPO: $1,044 UHC Comm Care — Medicaid: $866.94

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: Ob care antepartum vag dlvr & postpartum	Not listed in the file	Not listed in the file	$1,677.35 – $2,107.44
Vaginal delivery, with care before and after: rates for 4 insurance plans BCBS — Blue Advantage: $1,827.88 BCBS — Blue Essentials: $1,677.35 BCBS — PPO: $2,107.44 BCBS — Traditional: $2,107.44
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Ob antepartum care cesarean dlvr & postpartum	Not listed in the file	Not listed in the file	$1,860.42 – $2,337.46
Cesarean delivery (C-section), with care before and after: rates for 4 insurance plans BCBS — Blue Advantage: $2,027.39 BCBS — Blue Essentials: $1,860.42 BCBS — PPO: $2,337.46 BCBS — Traditional: $2,337.46
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Routine ob care vag dlvry & postpartum care vb	Not listed in the file	Not listed in the file	$1,765.81 – $2,218.58
Vaginal delivery after a previous C-section, with care before and after: rates for 4 insurance plans BCBS — Blue Advantage: $1,924.28 BCBS — Blue Essentials: $1,765.81 BCBS — PPO: $2,218.58 BCBS — Traditional: $2,218.58

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$107,998.98 – $159,699.22
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 10 insurance plans Aetna — Medicare Advantage: $107,998.98 Alliance — Worker Comp: $159,699.22 AM Better — EPO/HMO: $134,013.40 Corvel — Workers Comp: $159,699.22 Humana — Medicare Advantage: $107,998.98 Medicare — Medicare: $107,998.98 Triwest — Medicare Advantage: $107,998.98 UHC — Individual Exchange: $122,845.55 United — Medicare Advantage: $107,998.98 Wellcare — Medicare Advantage: $107,998.98
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$21,294.44 – $31,488.31
Hip or knee replacement (major joint of the leg), without major complications: rates for 10 insurance plans Aetna — Medicare Advantage: $21,294.44 Alliance — Worker Comp: $31,488.31 AM Better — EPO/HMO: $26,423.77 Corvel — Workers Comp: $31,488.31 Humana — Medicare Advantage: $21,294.44 Medicare — Medicare: $21,294.44 Triwest — Medicare Advantage: $21,294.44 UHC — Individual Exchange: $24,221.78 United — Medicare Advantage: $21,294.44 Wellcare — Medicare Advantage: $21,294.44
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$26,951.17 – $39,852.98
Neck (cervical) spinal fusion, without complications: rates for 10 insurance plans Aetna — Medicare Advantage: $26,951.17 Alliance — Worker Comp: $39,852.98 AM Better — EPO/HMO: $33,443.08 Corvel — Workers Comp: $39,852.98 Humana — Medicare Advantage: $26,951.17 Medicare — Medicare: $26,951.17 Triwest — Medicare Advantage: $26,951.17 UHC — Individual Exchange: $30,656.14 United — Medicare Advantage: $26,951.17 Wellcare — Medicare Advantage: $26,951.17
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$13,696.93 – $20,253.79
Uterus and ovary surgery (not for cancer), without complications: rates for 10 insurance plans Aetna — Medicare Advantage: $13,696.93 Alliance — Worker Comp: $20,253.79 AM Better — EPO/HMO: $16,996.20 Corvel — Workers Comp: $20,253.79 Humana — Medicare Advantage: $13,696.93 Medicare — Medicare: $13,696.93 Triwest — Medicare Advantage: $13,696.93 UHC — Individual Exchange: $15,579.84 United — Medicare Advantage: $13,696.93 Wellcare — Medicare Advantage: $13,696.93

Source: Matagorda Regional Medical Center’s standard charges file (matagordaregional.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 23, 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	Acute Care Hospital
Address	104 7th Street, Bay City, TX 77414
County	Matagorda County
State	Texas
Phone	(979) 245‑6383
Emergency services	Yes
Ownership	Government - Hospital District or Authority
Medicare overall rating	5 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	450465
Name in Medicare records	MATAGORDA REGIONAL MEDICAL CENTER
Profile level	Medicare data + hospital website
Official website	matagordaregional.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Matagorda Regional Medical Center — matagordaregional.org
Emergency Department | Matagorda Regional Medical Center — matagordaregional.org
Surgical Services | Matagorda Regional Medical Center — matagordaregional.org
Lab Services | Matagorda Regional Medical Center — matagordaregional.org
Medical Services - Matagorda Regional Medical Center — matagordaregional.org
Critical Care Services - Matagorda Regional Medical Center — matagordaregional.org
Radiology and Imaging | Matagorda Regional Medical Center — matagordaregional.org
Visiting Hours & Gift Shop - Matagorda Regional Medical Center — matagordaregional.org
Outpatient Rehabilitation | Matagorda Regional Medical Center — matagordaregional.org
Hospitalist Program | Matagorda Regional Medical Center — matagordaregional.org
Women's Center | Matagorda Regional Medical Center — matagordaregional.org
Patient Rights & Information | Matagorda Regional Medical Center — matagordaregional.org
Medical Records | Matagorda Regional Medical Center — matagordaregional.org
Cardio-Pulmonary Services | Matagorda Regional Medical Center — matagordaregional.org