Does Medical City Weatherford have an emergency room?

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

Where is Medical City Weatherford?

713 E Anderson St, Weatherford, TX 76086, in Parker County, Texas.

What is the phone number of Medical City Weatherford?

(682) 582-1000, as listed by Medicare (CMS).

What is the Medicare star rating of Medical City Weatherford?

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

Medical City Weatherford — Weatherford, TX

Quick answers

Does Medical City Weatherford have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Medical City Weatherford. In a medical emergency, call 911.
Where is Medical City Weatherford?: 713 E Anderson St, Weatherford, TX 76086, in Parker County, Texas.
What is the phone number of Medical City Weatherford?: (682) 582-1000, as listed by Medicare (CMS).
What is the Medicare star rating of Medical City Weatherford?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][15]

Conditions treated^[11][13][17]

Abnormal mammograms
Breast cysts
Breast pain
Fertility issues
High-risk pregnancy
Arthritis
Back pain
Carpal tunnel syndrome
Extremity numbness
Extremity weakness
Fractures
Herniated discs
Ligament injuries
Meniscus tears
Slipped discs
Asthma
Bronchitis
Chronic lung disease

Treatments^{[7][8][10][11][13][14][18]}

Angioplasty
Angiography
Cardioversion
Cardiac catheterization
Cardiac catheter ablation
Biventricular implantable cardioverter defibrillator (ICD)
Permanent and temporary pacemaker placement
Transesophageal echocardiogram
Inferior vena cava filter
Hyperbaric oxygen therapy
Negative pressure wound therapy
Biological skin substitutes
Surgical and sharp debridement
Total contact casting
Stereotactic biopsies
Ultrasound-guided biopsies
3D mammograms
Breast ultrasound
Bone densitometry
CT scan
MRI
Fluoroscopy
Nuclear medicine procedures
Endoscopy
Bronchoscopy
Upper GI imaging
Electrocardiogram (EKG)
Holter monitoring
Pulmonary function test
Stress test
Modified barium swallow
Hip replacement
Knee replacement
Robotic hysterectomy
Robotic-assisted water ablation for enlarged prostate (BPH)
Anterior cervical discectomy and fusion (ACDF)
Posterior lumbar laminectomy and discectomy

Procedures^{[8][11][12][13]}

General surgery
Breast surgery
Gynecology surgery
Orthopedic surgery
Urology surgery
Podiatry surgery
Pediatric dental surgery
Pain management
Gallbladder surgery
Gastrectomy for stomach cancer
Joint repair and replacement
Fracture care
Cesarean section

Programs and centers^{[4][6][10][11][12][13][16][17][18]}

Chest Pain Center
Cardiac rehabilitation
Pulmonary rehabilitation
Cardiac catheterization lab
Specialized spine program
Wound care and hyperbaric center
Pediatric emergency care
Prepared childbirth course
Labor and delivery

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

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level III
Stroke designation	Primary Stroke Center

Visiting and practical information

Visiting	Visiting hours 7:00am–9:00pm daily, except ICU and labor and delivery; two visitors per patient at a time^[9]
Parking	Free parking available within the hospital campus parking lot^[6]
Interpreters and languages	Page says translation services are available^[4]

Recognition^{[4][5][10][16]}

Joint Commission Gold Seal of Approval
Chest Pain Center (recognized since 2012)
Primary Stroke Center accreditation
Gold Seal of Approval (The Joint Commission)
Top Performer in Key Quality Measures (The Joint Commission)
Accredited Chest Pain Center
Cardiac rehabilitation program certified by AACVPR

Doctors and clinicians (351)

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

Main specialties

And 327 more: the button below opens the full list.

Other emergency rooms nearby

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

Texas Health Harris Methodist Hospital Azle17 mi · Azle, TX · Acute Care Hospital
Palo Pinto General Hospital19 mi · Mineral Wells, TX · Acute Care Hospital
Wellbridge Healthcare Fort Worth22 mi · Fort Worth, TX · Psychiatric Hospital
Texas Health Harris Methodist Hospital Southwest F…22 mi · Fort Worth, TX · Acute Care Hospital
Lake Granbury Medical Center23 mi · Granbury, TX · Acute Care Hospital

Other hospitals nearby

Clearsky Rehabilitation Hospital of Weatherford0.2 mi · Weatherford, TX · Inpatient Rehabilitation Hospital
Baylor Institute for Rehabilitation at Fort Worth22 mi · Fort Worth, TX · 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

Santa Fe Health & Rehabilitation Center0.3 mi · Weatherford, TX · 3 of 5 stars
Holland Lake Rehabilitation and Wellness Center0.6 mi · Weatherford, TX · 5 of 5 stars
Hilltop Park Rehabilitation and Care Center0.6 mi · Weatherford, TX · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Alpha Omega Hospice0.3 mi · Weatherford, TX · 4 of 5 stars
Beyondfaith Hospice, LLC0.3 mi · Weatherford, TX · 5 of 5 stars
St Gabriels Hospice and Palliative Care LLC9.8 mi · Weatherford, TX

All hospice providers in the state →

Home health agencies

Angels Care Home Health0.3 mi · Weatherford, TX
Beyondfaith Homecare & Rehab of Weatherford0.3 mi · Weatherford, TX · 5 of 5 stars
Centerwell Home Health0.3 mi · Weatherford, TX

All home health agencies in the state →

Dialysis facilities

DaVita Dialysis Care of Weatherford0.3 mi · Weatherford, TX · 2 of 5 stars
FKC Weatherford0.3 mi · Weatherford, TX · 2 of 5 stars
USRC Weatherford0.3 mi · Weatherford, TX · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Baylor Scott and White Surgicare Weatherford0.3 mi · Weatherford, TX
Texas Health Orthopedic and Spine Surgery Center5.5 mi · Willow Park, TX
Willow Park Endoscopy Center LLC5.5 mi · Willow Park, TX

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Northside Community Health Center23 mi · Fort Worth, TX · Community health center

Clinics and urgent care

Campbell Clinic0.3 mi · Weatherford, TX · Rural health clinic
Gupta, D.O. & Associates, LLC0.3 mi · Weatherford, TX · Urgent care center
Texas Health Urgent Care0.3 mi · Weatherford, TX · Urgent care center

Pharmacies

Albertsons LLC0.3 mi · Weatherford, TX · Community/retail pharmacy
Best Value Pharmacies Inc0.3 mi · Weatherford, TX · Community/retail pharmacy
Blue City LLC0.3 mi · Weatherford, TX · Pharmacy

Assisted living nearby

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

Autumn Hill Manor0.3 mi · Weatherford, TX
Autumn Hill Manor0.3 mi · Weatherford, TX
Brookdale Weatherford0.3 mi · Weatherford, TX
Hilltop Park Rehabilitation and Care Center0.3 mi · Weatherford, 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 Medical City Weatherford reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	69%National average: 72%
Would definitely recommend the hospital	64%National average: 71%
Nurses “always” communicated well	77%National average: 80%
Doctors “always” communicated well	77%National average: 80%
Staff “always” explained medicines before giving them	59%National average: 62%
Were given information about recovery at home	84%National average: 86%
Room and bathroom “always” clean	73%National average: 74%
Area around the room “always” quiet at night	62%National average: 60%
Completed surveys	700Response rate: 20%

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)	0No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0No different from the national benchmark
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	1.913No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	11.6%
Deaths within 30 days: heart failure patients	11.7%
Deaths within 30 days: pneumonia patients	14.7%
Deaths within 30 days: COPD patients	11%
Deaths within 30 days: stroke patients	13%
Deaths within 30 days: coronary bypass surgery (CABG)	Too few cases to report
Serious complications (patient safety indicator PSI-90)	0.91No different from the national rate
Complications after hip or knee replacement	5.7%

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	14.7%
Readmitted within 30 days: heart failure	23.3%
Readmitted within 30 days: pneumonia	18.4%
Readmitted within 30 days: COPD	20.3%
Readmitted within 30 days: coronary bypass surgery	Too few cases to report
Readmitted within 30 days: hip or knee replacement	7.3%

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)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	136 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)	69%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 80 common services exactly as Medical City Weatherford 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 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 NP	$1,121.58	$1,121.58	$841.18
New patient office visit (about 30–44 minutes): 10 of 24 insurance plan rates Aetna — ASA: $566.40 Aetna Coventry First Health — EXCLUSIVE: $642.67 Aetna Coventry First Health — NONEXCLUSIVE: $642.67 BCBS — Traditional: $464.33 Cigna — IFP: $151.41 Cigna — QHP: $157.02 Evry Health — COMM: $289.37 HealthSmart Preferred Care — PPO: $796.32 Imperial Insurance Company — MCR: $213.10 Independent Medical Systems — COMM: $1,121.58
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e	$1,121.58	$1,121.58	$213.07 – $414.52
New patient office visit (about 30–44 minutes): rates for 5 insurance plans BCBS — BlueAdvantageHMO: $213.07 BCBS — BlueEssentials: $377.33 BCBS — BlueEssentialsAccess: $377.33 BCBS — EPOSOA: $395.92 BCBS — PPO: $414.52
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 NP	$1,424.94	$1,424.94	$1,068.70
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates Aetna — ASA: $719.59 Aetna Coventry First Health — EXCLUSIVE: $816.49 Aetna Coventry First Health — NONEXCLUSIVE: $816.49 BCBS — Traditional: $589.93 Cigna — IFP: $192.37 Cigna — QHP: $199.49 Evry Health — COMM: $367.63 HealthSmart Preferred Care — PPO: $1,011.71 Imperial Insurance Company — MCR: $270.74 Independent Medical Systems — COMM: $1,424.94
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e	$1,424.94	$1,424.94	$360.75 – $701.81
New patient office visit (about 45–59 minutes): rates for 5 insurance plans BCBS — BlueAdvantageHMO: $360.75 BCBS — BlueEssentials: $638.85 BCBS — BlueEssentialsAccess: $638.85 BCBS — EPOSOA: $670.33 BCBS — PPO: $701.81
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 5 NP	$2,103.85	$2,103.85	$147.27 – $2,103.85
New patient office visit (about 60–74 minutes): 10 of 24 insurance plan rates Aetna — ASA: $1,062.44 Aetna Coventry First Health — EXCLUSIVE: $1,205.51 Aetna Coventry First Health — NONEXCLUSIVE: $1,205.51 BCBS — Traditional: $870.99 Cigna — IFP: $284.02 Cigna — QHP: $294.54 Evry Health — COMM: $542.79 HealthSmart Preferred Care — PPO: $1,493.73 Imperial Insurance Company — MCR: $399.73 Independent Medical Systems — COMM: $2,103.85
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e	$2,103.85	$2,103.85	$470.77 – $915.87
New patient office visit (about 60–74 minutes): rates for 5 insurance plans BCBS — BlueAdvantageHMO: $470.77 BCBS — BlueEssentials: $833.70 BCBS — BlueEssentialsAccess: $833.70 BCBS — EPOSOA: $874.78 BCBS — PPO: $915.87
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 EST	$1,121.58	$1,121.58	$78.51 – $1,121.58
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates Aetna — ASA: $566.40 Aetna Coventry First Health — EXCLUSIVE: $642.67 Aetna Coventry First Health — NONEXCLUSIVE: $642.67 BCBS — Traditional: $464.33 Cigna — IFP: $151.41 Cigna — QHP: $157.02 Evry Health — COMM: $289.37 HealthSmart Preferred Care — PPO: $796.32 Imperial Insurance Company — MCR: $213.10 Independent Medical Systems — COMM: $1,121.58
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history	$1,121.58	$1,121.58	$142.72 – $277.66
Established patient office visit (about 20–29 minutes): rates for 5 insurance plans BCBS — BlueAdvantageHMO: $142.72 BCBS — BlueEssentials: $252.75 BCBS — BlueEssentialsAccess: $252.75 BCBS — EPOSOA: $265.21 BCBS — PPO: $277.66
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 EST	$1,424.94	$1,424.94	$1,068.70
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates Aetna — ASA: $719.59 Aetna Coventry First Health — EXCLUSIVE: $816.49 Aetna Coventry First Health — NONEXCLUSIVE: $816.49 BCBS — Traditional: $589.93 Cigna — IFP: $192.37 Cigna — QHP: $199.49 Evry Health — COMM: $367.63 HealthSmart Preferred Care — PPO: $1,011.71 Imperial Insurance Company — MCR: $270.74 Independent Medical Systems — COMM: $1,424.94
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history	$1,424.94	$1,424.94	$220.03 – $428.05
Established patient office visit (about 30–39 minutes): rates for 5 insurance plans BCBS — BlueAdvantageHMO: $220.03 BCBS — BlueEssentials: $389.65 BCBS — BlueEssentialsAccess: $389.65 BCBS — EPOSOA: $408.85 BCBS — PPO: $428.05
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination	Not listed in the file	Not listed in the file	$267.60 – $520.61
Office consultation with a specialist (moderate): rates for 5 insurance plans BCBS — BlueAdvantageHMO: $267.60 BCBS — BlueEssentials: $473.90 BCBS — BlueEssentialsAccess: $473.90 BCBS — EPOSOA: $497.25 BCBS — PPO: $520.61
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination	Not listed in the file	Not listed in the file	$430.13 – $836.79
Office consultation with a specialist (moderate to high): rates for 5 insurance plans BCBS — BlueAdvantageHMO: $430.13 BCBS — BlueEssentials: $761.72 BCBS — BlueEssentialsAccess: $761.72 BCBS — EPOSOA: $799.26 BCBS — PPO: $836.79
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin	Not listed in the file	Not listed in the file	$68.91 – $532.16
Preventive checkup, new patient, age 18–39: rates for 6 insurance plans BCBS — BlueAdvantageHMO: $273.54 BCBS — BlueEssentials: $484.42 BCBS — BlueEssentialsAccess: $484.42 BCBS — EPOSOA: $508.29 BCBS — PPO: $532.16 TriWest Health Alliance — TRCR: $68.91
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin	Not listed in the file	Not listed in the file	$83.74 – $647.83
Preventive checkup, new patient, age 40–64: rates for 6 insurance plans BCBS — BlueAdvantageHMO: $333 BCBS — BlueEssentials: $589.71 BCBS — BlueEssentialsAccess: $589.71 BCBS — EPOSOA: $618.77 BCBS — PPO: $647.83 TriWest Health Alliance — TRCR: $83.74
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	$2,235.82	$2,235.82	$350 – $2,931
Emergency room visit (moderate): 10 of 40 insurance plan rates Aetna — COMM: $1,100 Aetna — Meritain: $1,100 Aetna — NewBusiness: $1,030 Aetna — OON: $1,301 Aetna Better Health — CHIP: $77.04 Aetna Better Health — MCD: $77.04 Amerigroup — CHIP: $363 Amerigroup — MGMCD: $363 BCBS — BlueAdvantageHMO: $1,148 BCBS — BlueEssentials: $1,470
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LVL 3 EMER DEPT	$2,235.82	$2,235.82	$301.84 – $2,235.82
Emergency room visit (moderate): 10 of 12 insurance plan rates Aetna — ASA: $1,129.09 Aetna Coventry First Health — EXCLUSIVE: $1,281.12 Aetna Coventry First Health — NONEXCLUSIVE: $1,281.12 BCBS — Traditional: $925.63 Cigna — IFP: $301.84 Cigna — QHP: $313.01 HealthSmart Preferred Care — PPO: $1,587.43 Independent Medical Systems — COMM: $2,235.82 National Healthcare Solutions — COMM: $2,235.82 Parker County — LOGOV: $1,676.87
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: LVL 4 EMER DEPT	$3,350.48	$3,350.48	$452.31 – $3,350.48
Emergency room visit (moderately high): 10 of 12 insurance plan rates Aetna — ASA: $1,691.99 Aetna Coventry First Health — EXCLUSIVE: $1,919.83 Aetna Coventry First Health — NONEXCLUSIVE: $1,919.83 BCBS — Traditional: $1,387.10 Cigna — IFP: $452.31 Cigna — QHP: $469.07 HealthSmart Preferred Care — PPO: $2,378.84 Independent Medical Systems — COMM: $3,350.48 National Healthcare Solutions — COMM: $3,350.48 Parker County — LOGOV: $2,512.86
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	Not listed in the file	Not listed in the file	$77.04 – $3,786
Emergency room visit (moderately high): 10 of 31 insurance plan rates Aetna — COMM: $3,200 Aetna — Meritain: $3,200 Aetna — NewBusiness: $2,995 Aetna — OON: $3,786 Aetna Better Health — CHIP: $77.04 Aetna Better Health — MCD: $77.04 Amerigroup — CHIP: $363 Amerigroup — MGMCD: $363 BCBS — BlueAdvantageHMO: $2,880 BCBS — BlueEssentials: $3,920
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: LVL 5 EMER DEPT	$4,445.68	$4,445.68	$600.17 – $4,445.68
Emergency room visit (high): 10 of 12 insurance plan rates Aetna — ASA: $2,245.07 Aetna Coventry First Health — EXCLUSIVE: $2,547.37 Aetna Coventry First Health — NONEXCLUSIVE: $2,547.37 BCBS — Traditional: $1,840.51 Cigna — IFP: $600.17 Cigna — QHP: $622.40 HealthSmart Preferred Care — PPO: $3,156.43 Independent Medical Systems — COMM: $4,445.68 National Healthcare Solutions — COMM: $4,445.68 Parker County — LOGOV: $3,334.26
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	Not listed in the file	Not listed in the file	$363 – $5,030
Emergency room visit (high): 10 of 31 insurance plan rates Aetna — COMM: $5,800 Aetna — Meritain: $5,800 Aetna — NewBusiness: $5,429 Aetna — OON: $6,861 Aetna Better Health — CHIP: $77.04 Aetna Better Health — MCD: $77.04 Amerigroup — CHIP: $363 Amerigroup — MGMCD: $363 BCBS — BlueAdvantageHMO: $6,600 BCBS — BlueEssentials: $7,520

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch	$1,386.65	$1,386.65	$5.08 – $45.64
Basic metabolic panel (blood test): 10 of 73 insurance plan rates Aetna — COMM: $10.21 Aetna — MCR: $8.53 Aetna — Meritain: $10.21 Aetna — NewBusiness: $9.55 Aetna — OON: $12.09 Aetna Better Health — CHIP: $10.52 Aetna Better Health — MCD: $10.52 American Health Plan of Texas, Inc. — MGMCR: $8.88 Amerigroup — CHIP: $9.74 Amerigroup — DualEligible: $8.46
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP TOTAL CALCIUM	$1,386.65	$1,386.65	$97.07 – $1,386.65
Basic metabolic panel (blood test): 10 of 18 insurance plan rates Aetna — ASA: $700.26 Aetna Coventry First Health — EXCLUSIVE: $794.55 Aetna Coventry First Health — NONEXCLUSIVE: $794.55 BCBS — Traditional: $574.07 Cigna — IFP: $187.20 Cigna — QHP: $194.13 Evry Health — COMM: $357.76 HealthSmart Preferred Care — PPO: $984.52 Independent Medical Systems — COMM: $1,386.65 National Healthcare Solutions — COMM: $1,386.65
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon	$1,724.04	$1,724.04	$11.09
Comprehensive metabolic panel (blood test): 10 of 73 insurance plan rates Aetna — COMM: $12.74 Aetna — MCR: $10.65 Aetna — Meritain: $12.74 Aetna — NewBusiness: $11.92 Aetna — OON: $15.09 Aetna Better Health — CHIP: $10.17 Aetna Better Health — MCD: $10.17 American Health Plan of Texas, Inc. — MGMCR: $11.09 Amerigroup — CHIP: $9.42 Amerigroup — DualEligible: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL	$1,724.04	$1,724.04	$120.68 – $1,724.04
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates Aetna — ASA: $870.64 Aetna Coventry First Health — EXCLUSIVE: $987.87 Aetna Coventry First Health — NONEXCLUSIVE: $987.87 BCBS — Traditional: $713.75 Cigna — IFP: $232.75 Cigna — QHP: $241.37 Evry Health — COMM: $444.80 HealthSmart Preferred Care — PPO: $1,224.07 Independent Medical Systems — COMM: $1,724.04 National Healthcare Solutions — COMM: $1,724.04
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or	Not listed in the file	Not listed in the file	$47.81
Obstetric blood test panel: 10 of 61 insurance plan rates Aetna — COMM: $57.67 Aetna — MCR: $48.22 Aetna — Meritain: $57.67 Aetna — NewBusiness: $53.94 Aetna — OON: $68.28 American Health Plan of Texas, Inc. — MGMCR: $50.20 Amerigroup — DualEligible: $47.81 BCBS — BlueAdvantageHMO: $83.67 BCBS — BlueEssentials: $118.09 BCBS — BlueEssentialsAccess: $118.09
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester	$836.80	$836.80	$13.39
Cholesterol panel (lipid panel): 10 of 73 insurance plan rates Aetna — COMM: $16.14 Aetna — MCR: $13.50 Aetna — Meritain: $16.14 Aetna — NewBusiness: $15.10 Aetna — OON: $19.11 Aetna Better Health — CHIP: $8.27 Aetna Better Health — MCD: $8.27 American Health Plan of Texas, Inc. — MGMCR: $14.06 Amerigroup — CHIP: $7.66 Amerigroup — DualEligible: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL	$836.80	$836.80	$58.58 – $836.80
Cholesterol panel (lipid panel): 10 of 18 insurance plan rates Aetna — ASA: $422.58 Aetna Coventry First Health — EXCLUSIVE: $479.49 Aetna Coventry First Health — NONEXCLUSIVE: $479.49 BCBS — Traditional: $346.44 Cigna — IFP: $112.97 Cigna — QHP: $117.15 Evry Health — COMM: $215.89 HealthSmart Preferred Care — PPO: $594.13 Independent Medical Systems — COMM: $836.80 National Healthcare Solutions — COMM: $836.80
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo	$1,473.39	$1,473.39	$8.68
Kidney function panel: 10 of 73 insurance plan rates Aetna — COMM: $10.47 Aetna — MCR: $8.75 Aetna — Meritain: $10.47 Aetna — NewBusiness: $9.79 Aetna — OON: $12.40 Aetna Better Health — CHIP: $6.49 Aetna Better Health — MCD: $6.49 American Health Plan of Texas, Inc. — MGMCR: $9.11 Amerigroup — CHIP: $6.01 Amerigroup — DualEligible: $8.68
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$1,473.39	$1,473.39	$103.14 – $1,473.39
Kidney function panel: 10 of 18 insurance plan rates Aetna — ASA: $744.06 Aetna Coventry First Health — EXCLUSIVE: $844.25 Aetna Coventry First Health — NONEXCLUSIVE: $844.25 BCBS — Traditional: $609.98 Cigna — IFP: $198.91 Cigna — QHP: $206.27 Evry Health — COMM: $380.13 HealthSmart Preferred Care — PPO: $1,046.11 Independent Medical Systems — COMM: $1,473.39 National Healthcare Solutions — COMM: $1,473.39
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase	$1,604.83	$1,604.83	$8.17
Liver function panel: 10 of 73 insurance plan rates Aetna — COMM: $9.85 Aetna — MCR: $8.24 Aetna — Meritain: $9.85 Aetna — NewBusiness: $9.21 Aetna — OON: $11.66 Aetna Better Health — CHIP: $6.49 Aetna Better Health — MCD: $6.49 American Health Plan of Texas, Inc. — MGMCR: $8.58 Amerigroup — CHIP: $6.01 Amerigroup — DualEligible: $8.17
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL	$1,604.83	$1,604.83	$112.34 – $1,604.83
Liver function panel: 10 of 18 insurance plan rates Aetna — ASA: $810.44 Aetna Coventry First Health — EXCLUSIVE: $919.57 Aetna Coventry First Health — NONEXCLUSIVE: $919.57 BCBS — Traditional: $664.40 Cigna — IFP: $216.65 Cigna — QHP: $224.68 Evry Health — COMM: $414.05 HealthSmart Preferred Care — PPO: $1,139.43 Independent Medical Systems — COMM: $1,604.83 National Healthcare Solutions — COMM: $1,604.83
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$485.64	$485.64	$3.17
Urine test (automated, with microscope): 10 of 73 insurance plan rates Aetna — COMM: $3.82 Aetna — MCR: $3.20 Aetna — Meritain: $3.82 Aetna — NewBusiness: $3.57 Aetna — OON: $4.52 Aetna Better Health — CHIP: $2.87 Aetna Better Health — MCD: $2.87 American Health Plan of Texas, Inc. — MGMCR: $3.33 Amerigroup — CHIP: $2.66 Amerigroup — DualEligible: $3.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO	$485.64	$485.64	$33.99 – $485.64
Urine test (automated, with microscope): 10 of 18 insurance plan rates Aetna — ASA: $245.25 Aetna Coventry First Health — EXCLUSIVE: $278.27 Aetna Coventry First Health — NONEXCLUSIVE: $278.27 BCBS — Traditional: $201.05 Cigna — IFP: $65.56 Cigna — QHP: $67.99 Evry Health — COMM: $125.30 HealthSmart Preferred Care — PPO: $344.80 Independent Medical Systems — COMM: $485.64 National Healthcare Solutions — COMM: $485.64
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: ACETONE UA MANUAL	$246.08	$246.08	$17.23 – $246.08
Urine test (manual, without microscope): 10 of 18 insurance plan rates Aetna — ASA: $124.27 Aetna Coventry First Health — EXCLUSIVE: $141 Aetna Coventry First Health — NONEXCLUSIVE: $141 BCBS — Traditional: $101.88 Cigna — IFP: $33.22 Cigna — QHP: $34.45 Evry Health — COMM: $63.49 HealthSmart Preferred Care — PPO: $174.72 Independent Medical Systems — COMM: $246.08 National Healthcare Solutions — COMM: $246.08
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: GLUC UR QUAL MANUAL	$246.08	$246.08	$17.23 – $246.08
Urine test (manual, without microscope): 10 of 18 insurance plan rates Aetna — ASA: $124.27 Aetna Coventry First Health — EXCLUSIVE: $141 Aetna Coventry First Health — NONEXCLUSIVE: $141 BCBS — Traditional: $101.88 Cigna — IFP: $33.22 Cigna — QHP: $34.45 Evry Health — COMM: $63.49 HealthSmart Preferred Care — PPO: $174.72 Independent Medical Systems — COMM: $246.08 National Healthcare Solutions — COMM: $246.08
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	Not listed in the file	Not listed in the file	$3.48
Urine test (manual, without microscope): 10 of 73 insurance plan rates Aetna — COMM: $4.20 Aetna — MCR: $3.51 Aetna — Meritain: $4.20 Aetna — NewBusiness: $3.93 Aetna — OON: $4.97 Aetna Better Health — CHIP: $3.15 Aetna Better Health — MCD: $3.15 American Health Plan of Texas, Inc. — MGMCR: $3.65 Amerigroup — CHIP: $2.92 Amerigroup — DualEligible: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W O MICRO AUTO	$224.68	$224.68	$15.73 – $224.68
Urine test (automated, without microscope): 10 of 18 insurance plan rates Aetna — ASA: $113.46 Aetna Coventry First Health — EXCLUSIVE: $128.74 Aetna Coventry First Health — NONEXCLUSIVE: $128.74 BCBS — Traditional: $93.02 Cigna — IFP: $30.33 Cigna — QHP: $31.46 Evry Health — COMM: $57.97 HealthSmart Preferred Care — PPO: $159.52 Independent Medical Systems — COMM: $224.68 National Healthcare Solutions — COMM: $224.68
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: SPEC GRAV UR AUTO	$224.68	$224.68	$15.73 – $224.68
Urine test (automated, without microscope): 10 of 18 insurance plan rates Aetna — ASA: $113.46 Aetna Coventry First Health — EXCLUSIVE: $128.74 Aetna Coventry First Health — NONEXCLUSIVE: $128.74 BCBS — Traditional: $93.02 Cigna — IFP: $30.33 Cigna — QHP: $31.46 Evry Health — COMM: $57.97 HealthSmart Preferred Care — PPO: $159.52 Independent Medical Systems — COMM: $224.68 National Healthcare Solutions — COMM: $224.68
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: KETONES UR AUTO	$224.68	$224.68	$15.73 – $224.68
Urine test (automated, without microscope): 10 of 18 insurance plan rates Aetna — ASA: $113.46 Aetna Coventry First Health — EXCLUSIVE: $128.74 Aetna Coventry First Health — NONEXCLUSIVE: $128.74 BCBS — Traditional: $93.02 Cigna — IFP: $30.33 Cigna — QHP: $31.46 Evry Health — COMM: $57.97 HealthSmart Preferred Care — PPO: $159.52 Independent Medical Systems — COMM: $224.68 National Healthcare Solutions — COMM: $224.68
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROS SPEC AG (PSA) TOTAL	$836.80	$836.80	$58.58 – $836.80
PSA (prostate specific antigen) blood test: 10 of 18 insurance plan rates Aetna — ASA: $422.58 Aetna Coventry First Health — EXCLUSIVE: $479.49 Aetna Coventry First Health — NONEXCLUSIVE: $479.49 BCBS — Traditional: $346.44 Cigna — IFP: $112.97 Cigna — QHP: $117.15 Evry Health — COMM: $215.89 HealthSmart Preferred Care — PPO: $594.13 Independent Medical Systems — COMM: $836.80 National Healthcare Solutions — COMM: $836.80
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total	Not listed in the file	Not listed in the file	$18.39
PSA (prostate specific antigen) blood test: 10 of 67 insurance plan rates Aetna — COMM: $22.17 Aetna — MCR: $18.55 Aetna — Meritain: $22.17 Aetna — NewBusiness: $20.74 Aetna — OON: $26.25 Aetna Better Health — CHIP: $16.69 Aetna Better Health — MCD: $16.69 American Health Plan of Texas, Inc. — MGMCR: $19.31 Amerigroup — CHIP: $15.45 Amerigroup — DualEligible: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total Other Outpatient	Not listed in the file	Not listed in the file	$19.31
PSA (prostate specific antigen) blood test: rates for 6 insurance plans Superior Health Plan — MGMCRDualEligible: $19.31 Superior Health Plan — MGMCRHMO: $19.31 Superior Health Plan — MGMCRPFFS: $19.31 Superior Health Plan — MGMCRPOS: $19.31 Superior Health Plan — MGMCRPPO: $19.31 Superior Health Plan — MGMCRSNP: $19.31
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH)	$1,004.16	$1,004.16	$16.80
Thyroid stimulating hormone (TSH) test: 10 of 67 insurance plan rates Aetna — COMM: $20.26 Aetna — MCR: $16.94 Aetna — Meritain: $20.26 Aetna — NewBusiness: $18.95 Aetna — OON: $23.99 Aetna Better Health — CHIP: $15.24 Aetna Better Health — MCD: $15.24 American Health Plan of Texas, Inc. — MGMCR: $17.64 Amerigroup — CHIP: $14.11 Amerigroup — DualEligible: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH	$1,004.16	$1,004.16	$70.29 – $1,004.16
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates Aetna — ASA: $507.10 Aetna Coventry First Health — EXCLUSIVE: $575.38 Aetna Coventry First Health — NONEXCLUSIVE: $575.38 BCBS — Traditional: $415.72 Cigna — IFP: $135.56 Cigna — QHP: $140.58 Evry Health — COMM: $259.07 HealthSmart Preferred Care — PPO: $712.95 Independent Medical Systems — COMM: $1,004.16 National Healthcare Solutions — COMM: $1,004.16
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH) Other Outpatient	$1,004.16	$1,004.16	$17.64
Thyroid stimulating hormone (TSH) test: rates for 6 insurance plans Superior Health Plan — MGMCRDualEligible: $17.64 Superior Health Plan — MGMCRHMO: $17.64 Superior Health Plan — MGMCRPFFS: $17.64 Superior Health Plan — MGMCRPOS: $17.64 Superior Health Plan — MGMCRPPO: $17.64 Superior Health Plan — MGMCRSNP: $17.64
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count	Not listed in the file	Not listed in the file	$7.77
Complete blood count (CBC) with differential: 10 of 73 insurance plan rates Aetna — COMM: $9.37 Aetna — MCR: $7.84 Aetna — Meritain: $9.37 Aetna — NewBusiness: $8.76 Aetna — OON: $11.09 Aetna Better Health — CHIP: $7.05 Aetna Better Health — MCD: $7.05 American Health Plan of Texas, Inc. — MGMCR: $8.16 Amerigroup — CHIP: $6.53 Amerigroup — DualEligible: $7.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)	$659.51	$659.51	$6.47
Complete blood count (CBC), automated: 10 of 67 insurance plan rates Aetna — COMM: $7.80 Aetna — MCR: $6.52 Aetna — Meritain: $7.80 Aetna — NewBusiness: $7.29 Aetna — OON: $9.23 Aetna Better Health — CHIP: $5.86 Aetna Better Health — MCD: $5.86 American Health Plan of Texas, Inc. — MGMCR: $6.79 Amerigroup — CHIP: $5.43 Amerigroup — DualEligible: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC AUTOMATED	$659.51	$659.51	$46.17 – $659.51
Complete blood count (CBC), automated: 10 of 18 insurance plan rates Aetna — ASA: $333.05 Aetna Coventry First Health — EXCLUSIVE: $377.90 Aetna Coventry First Health — NONEXCLUSIVE: $377.90 BCBS — Traditional: $273.04 Cigna — IFP: $89.03 Cigna — QHP: $92.33 Evry Health — COMM: $170.15 HealthSmart Preferred Care — PPO: $468.25 Independent Medical Systems — COMM: $659.51 National Healthcare Solutions — COMM: $659.51
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) Other Outpatient	$659.51	$659.51	$6.79
Complete blood count (CBC), automated: rates for 6 insurance plans Superior Health Plan — MGMCRDualEligible: $6.79 Superior Health Plan — MGMCRHMO: $6.79 Superior Health Plan — MGMCRPFFS: $6.79 Superior Health Plan — MGMCRPOS: $6.79 Superior Health Plan — MGMCRPPO: $6.79 Superior Health Plan — MGMCRSNP: $6.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME	$438.28	$438.28	$30.68 – $438.28
Blood clotting time test (prothrombin time, PT): 10 of 18 insurance plan rates Aetna — ASA: $221.33 Aetna Coventry First Health — EXCLUSIVE: $251.13 Aetna Coventry First Health — NONEXCLUSIVE: $251.13 BCBS — Traditional: $181.45 Cigna — IFP: $59.17 Cigna — QHP: $61.36 Evry Health — COMM: $113.08 HealthSmart Preferred Care — PPO: $311.18 Independent Medical Systems — COMM: $438.28 National Healthcare Solutions — COMM: $438.28
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time;	Not listed in the file	Not listed in the file	$4.29
Blood clotting time test (prothrombin time, PT): 10 of 67 insurance plan rates Aetna — COMM: $5.17 Aetna — MCR: $4.33 Aetna — Meritain: $5.17 Aetna — NewBusiness: $4.83 Aetna — OON: $6.12 Aetna Better Health — CHIP: $3.89 Aetna Better Health — MCD: $3.89 American Health Plan of Texas, Inc. — MGMCR: $4.50 Amerigroup — CHIP: $3.60 Amerigroup — DualEligible: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time; Other Outpatient	Not listed in the file	Not listed in the file	$4.50
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans Superior Health Plan — MGMCRDualEligible: $4.50 Superior Health Plan — MGMCRHMO: $4.50 Superior Health Plan — MGMCRPFFS: $4.50 Superior Health Plan — MGMCRPOS: $4.50 Superior Health Plan — MGMCRPPO: $4.50 Superior Health Plan — MGMCRSNP: $4.50
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT	$580.78	$580.78	$40.65 – $580.78
Blood clotting test (partial thromboplastin time, PTT): 10 of 18 insurance plan rates Aetna — ASA: $293.29 Aetna Coventry First Health — EXCLUSIVE: $332.79 Aetna Coventry First Health — NONEXCLUSIVE: $332.79 BCBS — Traditional: $240.44 Cigna — IFP: $78.41 Cigna — QHP: $81.31 Evry Health — COMM: $149.84 HealthSmart Preferred Care — PPO: $412.35 Independent Medical Systems — COMM: $580.78 National Healthcare Solutions — COMM: $580.78
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood	Not listed in the file	Not listed in the file	$6.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 67 insurance plan rates Aetna — COMM: $7.26 Aetna — MCR: $6.06 Aetna — Meritain: $7.26 Aetna — NewBusiness: $6.79 Aetna — OON: $8.59 Aetna Better Health — CHIP: $5.45 Aetna Better Health — MCD: $5.45 American Health Plan of Texas, Inc. — MGMCR: $6.31 Amerigroup — CHIP: $5.05 Amerigroup — DualEligible: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood Other Outpatient	Not listed in the file	Not listed in the file	$6.31
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans Superior Health Plan — MGMCRDualEligible: $6.31 Superior Health Plan — MGMCRHMO: $6.31 Superior Health Plan — MGMCRPFFS: $6.31 Superior Health Plan — MGMCRPOS: $6.31 Superior Health Plan — MGMCRPPO: $6.31 Superior Health Plan — MGMCRSNP: $6.31

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: Computed tomography, head or brain; without contrast material	$5,078.49	$5,078.49	$154.52 – $245.18
CT scan of the head or brain, without contrast: 10 of 26 insurance plan rates Aetna — COMM: $856 Aetna — Meritain: $856 Aetna — NewBusiness: $801 Aetna — OON: $1,013 Aetna Better Health — CHIP: $113.13 Aetna Better Health — MCD: $113.13 Amerigroup — CHIP: $104.75 Amerigroup — MGMCD: $104.75 BCBS — BlueAdvantageHMO: $141.22 BCBS — BlueEssentials: $435.99
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD/BRAIN W/O CONT	$5,078.49	$5,078.49	$355.49 – $5,078.49
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates Aetna — ASA: $2,564.64 Aetna Coventry First Health — EXCLUSIVE: $2,909.97 Aetna Coventry First Health — NONEXCLUSIVE: $2,909.97 BCBS — Traditional: $2,102.49 Cigna — IFP: $685.60 Cigna — QHP: $710.99 HealthSmart Preferred Care — PPO: $3,605.73 Independent Medical Systems — COMM: $5,078.49 National Healthcare Solutions — COMM: $5,078.49 Parker County — LOGOV: $3,808.87
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth	$9,817.05	$9,817.05	$616.10 – $828.27
MRI of the brain, before and after contrast: 10 of 26 insurance plan rates Aetna — COMM: $1,117 Aetna — Meritain: $1,117 Aetna — NewBusiness: $1,046 Aetna — OON: $1,321 Aetna Better Health — CHIP: $354.36 Aetna Better Health — MCD: $354.36 Amerigroup — CHIP: $328.11 Amerigroup — MGMCD: $328.11 BCBS — BlueAdvantageHMO: $481.13 BCBS — BlueEssentials: $1,485.40
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W&WO CONT	$9,817.05	$9,817.05	$687.19 – $9,817.05
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates Aetna — ASA: $4,957.61 Aetna Coventry First Health — EXCLUSIVE: $5,625.17 Aetna Coventry First Health — NONEXCLUSIVE: $5,625.17 BCBS — Traditional: $4,064.26 Cigna — IFP: $1,325.30 Cigna — QHP: $1,374.39 HealthSmart Preferred Care — PPO: $6,970.11 Independent Medical Systems — COMM: $9,817.05 National Healthcare Solutions — COMM: $9,817.05 Parker County — LOGOV: $7,362.79
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiologic examination, chest; 2 views	$976.92	$976.92	$83.86 – $182.03
Chest X-ray, 2 views: 10 of 28 insurance plan rates Aetna Better Health — CHIP: $36.45 Aetna Better Health — MCD: $36.45 Amerigroup — CHIP: $33.75 Amerigroup — MGMCD: $33.75 BCBS — BlueAdvantageHMO: $109.34 BCBS — BlueEssentials: $325.62 BCBS — BlueEssentialsAccess: $325.62 BCBS — EPOSOA: $341.59 BCBS — PPO: $357.55 Cigna — AllOther: $127.40
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST XRAY 2 V	$976.92	$976.92	$68.38 – $976.92
Chest X-ray, 2 views: 10 of 18 insurance plan rates Aetna — ASA: $493.34 Aetna Coventry First Health — EXCLUSIVE: $559.78 Aetna Coventry First Health — NONEXCLUSIVE: $559.78 BCBS — Traditional: $404.44 Cigna — IFP: $131.88 Cigna — QHP: $136.77 Evry Health — COMM: $252.05 HealthSmart Preferred Care — PPO: $693.61 Independent Medical Systems — COMM: $976.92 National Healthcare Solutions — COMM: $976.92
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination, chest; 2 views	$976.92	$976.92	$53.12 – $67.15
Chest X-ray, 2 views: rates for 4 insurance plans Aetna — COMM: $56.74 Aetna — Meritain: $56.74 Aetna — NewBusiness: $53.12 Aetna — OON: $67.15
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views	$2,114.57	$2,114.57	$52.13 – $502.12
X-ray of the lower spine, at least 4 views: 10 of 28 insurance plan rates Aetna Better Health — CHIP: $56.30 Aetna Better Health — MCD: $56.30 Amerigroup — CHIP: $52.13 Amerigroup — MGMCD: $52.13 BCBS — BlueAdvantageHMO: $153.55 BCBS — BlueEssentials: $457.29 BCBS — BlueEssentialsAccess: $457.29 BCBS — EPOSOA: $479.70 BCBS — PPO: $502.12 Cigna — AllOther: $213.19
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR L-SPINE 4 + VIEWS	$2,114.57	$2,114.57	$148.02 – $2,114.57
X-ray of the lower spine, at least 4 views: 10 of 18 insurance plan rates Aetna — ASA: $1,067.86 Aetna Coventry First Health — EXCLUSIVE: $1,211.65 Aetna Coventry First Health — NONEXCLUSIVE: $1,211.65 BCBS — Traditional: $875.43 Cigna — IFP: $285.47 Cigna — QHP: $296.04 Evry Health — COMM: $545.56 HealthSmart Preferred Care — PPO: $1,501.34 Independent Medical Systems — COMM: $2,114.57 National Healthcare Solutions — COMM: $2,114.57
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views	$2,114.57	$2,114.57	$89.51 – $113.16
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans Aetna — COMM: $95.62 Aetna — Meritain: $95.62 Aetna — NewBusiness: $89.51 Aetna — OON: $113.16
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	$9,537.01	$9,537.01	$313.62 – $517.79
MRI of the lower back (lumbar spine), without contrast: 10 of 26 insurance plan rates Aetna — COMM: $1,117 Aetna — Meritain: $1,117 Aetna — NewBusiness: $1,046 Aetna — OON: $1,321 Aetna Better Health — CHIP: $212.91 Aetna Better Health — MCD: $212.91 Amerigroup — CHIP: $197.14 Amerigroup — MGMCD: $197.14 BCBS — BlueAdvantageHMO: $293.63 BCBS — BlueEssentials: $906.53
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI L-SPINE W/O CONT	$9,537.01	$9,537.01	$667.59 – $9,537.01
MRI of the lower back (lumbar spine), without contrast: 10 of 17 insurance plan rates Aetna — ASA: $4,816.19 Aetna Coventry First Health — EXCLUSIVE: $5,464.71 Aetna Coventry First Health — NONEXCLUSIVE: $5,464.71 BCBS — Traditional: $3,948.32 Cigna — IFP: $1,287.50 Cigna — QHP: $1,335.18 HealthSmart Preferred Care — PPO: $6,771.28 Independent Medical Systems — COMM: $9,537.01 National Healthcare Solutions — COMM: $9,537.01 Parker County — LOGOV: $7,152.76
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Computed tomography, pelvis; with contrast material(s)	$5,246.93	$5,246.93	$341.20 – $401.74
CT scan of the pelvis, with contrast: 10 of 26 insurance plan rates Aetna — COMM: $856 Aetna — Meritain: $856 Aetna — NewBusiness: $801 Aetna — OON: $1,013 Aetna Better Health — CHIP: $189.06 Aetna Better Health — MCD: $189.06 Amerigroup — CHIP: $175.06 Amerigroup — MGMCD: $175.06 BCBS — BlueAdvantageHMO: $229.60 BCBS — BlueEssentials: $708.84
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST	$5,246.93	$5,246.93	$367.29 – $5,246.93
CT scan of the pelvis, with contrast: 10 of 17 insurance plan rates Aetna — ASA: $2,649.70 Aetna Coventry First Health — EXCLUSIVE: $3,006.49 Aetna Coventry First Health — NONEXCLUSIVE: $3,006.49 BCBS — Traditional: $2,172.23 Cigna — IFP: $708.34 Cigna — QHP: $734.57 HealthSmart Preferred Care — PPO: $3,725.32 Independent Medical Systems — COMM: $5,246.93 National Healthcare Solutions — COMM: $5,246.93 Parker County — LOGOV: $3,935.20
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material	Not listed in the file	Not listed in the file	$313.62 – $517.79
MRI of a leg joint (such as the knee), without contrast: 10 of 26 insurance plan rates Aetna — COMM: $1,117 Aetna — Meritain: $1,117 Aetna — NewBusiness: $1,046 Aetna — OON: $1,321 Aetna Better Health — CHIP: $225.55 Aetna Better Health — MCD: $225.55 Amerigroup — CHIP: $208.84 Amerigroup — MGMCD: $208.84 BCBS — BlueAdvantageHMO: $293.63 BCBS — BlueEssentials: $906.53
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier 50 In the file: MRI LW JNT W/O CONT BI	$19,074.02	$19,074.02	$1,335.18 – $19,074.02
MRI of a leg joint (such as the knee), without contrast: 10 of 17 insurance plan rates Aetna — ASA: $9,632.38 Aetna Coventry First Health — EXCLUSIVE: $10,929.41 Aetna Coventry First Health — NONEXCLUSIVE: $10,929.41 BCBS — Traditional: $7,896.64 Cigna — IFP: $2,574.99 Cigna — QHP: $2,670.36 HealthSmart Preferred Care — PPO: $13,542.55 Independent Medical Systems — COMM: $19,074.02 National Healthcare Solutions — COMM: $19,074.02 Parker County — LOGOV: $14,305.51
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier LT In the file: MRI LW JNT W/O CONT LT	$9,537.01	$9,537.01	$667.59 – $9,537.01
MRI of a leg joint (such as the knee), without contrast: 10 of 17 insurance plan rates Aetna — ASA: $4,816.19 Aetna Coventry First Health — EXCLUSIVE: $5,464.71 Aetna Coventry First Health — NONEXCLUSIVE: $5,464.71 BCBS — Traditional: $3,948.32 Cigna — IFP: $1,287.50 Cigna — QHP: $1,335.18 HealthSmart Preferred Care — PPO: $6,771.28 Independent Medical Systems — COMM: $9,537.01 National Healthcare Solutions — COMM: $9,537.01 Parker County — LOGOV: $7,152.76
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: Computed tomography, abdomen and pelvis; with contrast material(s)	$10,683.54	$10,683.54	$341.20 – $828.27
CT scan of the abdomen and pelvis, with contrast: 10 of 26 insurance plan rates Aetna — COMM: $856 Aetna — Meritain: $856 Aetna — NewBusiness: $801 Aetna — OON: $1,013 Aetna Better Health — CHIP: $337.05 Aetna Better Health — MCD: $337.05 Amerigroup — CHIP: $312.08 Amerigroup — MGMCD: $312.08 BCBS — BlueAdvantageHMO: $481.13 BCBS — BlueEssentials: $1,485.40
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD&PELVIS W/CONT	$10,683.54	$10,683.54	$747.85 – $10,683.54
CT scan of the abdomen and pelvis, with contrast: 10 of 17 insurance plan rates Aetna — ASA: $5,395.19 Aetna Coventry First Health — EXCLUSIVE: $6,121.67 Aetna Coventry First Health — NONEXCLUSIVE: $6,121.67 BCBS — Traditional: $4,422.99 Cigna — IFP: $1,442.28 Cigna — QHP: $1,495.70 HealthSmart Preferred Care — PPO: $7,585.31 Independent Medical Systems — COMM: $10,683.54 National Healthcare Solutions — COMM: $10,683.54 Parker County — LOGOV: $8,012.66
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Ultrasound, abdominal, real time with image documentation; complete	$3,603.34	$3,603.34	$154.52 – $245.18
Ultrasound of the abdomen, complete: 10 of 28 insurance plan rates Aetna Better Health — CHIP: $113.13 Aetna Better Health — MCD: $113.13 Amerigroup — CHIP: $104.75 Amerigroup — MGMCD: $104.75 BCBS — BlueAdvantageHMO: $153.55 BCBS — BlueEssentials: $457.29 BCBS — BlueEssentialsAccess: $457.29 BCBS — EPOSOA: $479.70 BCBS — PPO: $502.12 Cigna — AllOther: $432.22
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE	$3,603.34	$3,603.34	$252.23 – $3,603.34
Ultrasound of the abdomen, complete: 10 of 18 insurance plan rates Aetna — ASA: $1,819.69 Aetna Coventry First Health — EXCLUSIVE: $2,064.71 Aetna Coventry First Health — NONEXCLUSIVE: $2,064.71 BCBS — Traditional: $1,491.78 Cigna — IFP: $486.45 Cigna — QHP: $504.47 Evry Health — COMM: $929.66 HealthSmart Preferred Care — PPO: $2,558.37 Independent Medical Systems — COMM: $3,603.34 National Healthcare Solutions — COMM: $3,603.34
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, abdominal, real time with image documentation; complete	$3,603.34	$3,603.34	$184.84 – $233.67
Ultrasound of the abdomen, complete: rates for 4 insurance plans Aetna — COMM: $197.44 Aetna — Meritain: $197.44 Aetna — NewBusiness: $184.84 Aetna — OON: $233.67
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREG AFTER 1ST TRI	$4,296.30	$4,296.30	$300.74 – $4,296.30
Pregnancy ultrasound (after the first trimester): 10 of 18 insurance plan rates Aetna — ASA: $2,169.63 Aetna Coventry First Health — EXCLUSIVE: $2,461.78 Aetna Coventry First Health — NONEXCLUSIVE: $2,461.78 BCBS — Traditional: $1,778.67 Cigna — IFP: $580 Cigna — QHP: $601.48 Evry Health — COMM: $1,108.45 HealthSmart Preferred Care — PPO: $3,050.37 Independent Medical Systems — COMM: $4,296.30 National Healthcare Solutions — COMM: $4,296.30
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day	Not listed in the file	Not listed in the file	$154.52 – $245.18
Pregnancy ultrasound (after the first trimester): 10 of 28 insurance plan rates Aetna Better Health — CHIP: $113.13 Aetna Better Health — MCD: $113.13 Amerigroup — CHIP: $104.75 Amerigroup — MGMCD: $104.75 BCBS — BlueAdvantageHMO: $125.41 BCBS — BlueEssentials: $373.48 BCBS — BlueEssentialsAccess: $373.48 BCBS — EPOSOA: $391.79 BCBS — PPO: $410.10 Cigna — AllOther: $486.66
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day	Not listed in the file	Not listed in the file	$204.97 – $259.12
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans Aetna — COMM: $218.94 Aetna — Meritain: $218.94 Aetna — NewBusiness: $204.97 Aetna — OON: $259.12
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound, transvaginal	$3,434.74	$3,434.74	$104.75 – $477.87
Transvaginal ultrasound: 10 of 28 insurance plan rates Aetna Better Health — CHIP: $113.13 Aetna Better Health — MCD: $113.13 Amerigroup — CHIP: $104.75 Amerigroup — MGMCD: $104.75 BCBS — BlueAdvantageHMO: $120.97 BCBS — BlueEssentials: $360.26 BCBS — BlueEssentialsAccess: $360.26 BCBS — EPOSOA: $377.92 BCBS — PPO: $395.58 Cigna — AllOther: $477.87
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANSVAGINAL	$3,434.74	$3,434.74	$240.43 – $3,434.74
Transvaginal ultrasound: 10 of 18 insurance plan rates Aetna — ASA: $1,734.54 Aetna Coventry First Health — EXCLUSIVE: $1,968.11 Aetna Coventry First Health — NONEXCLUSIVE: $1,968.11 BCBS — Traditional: $1,421.98 Cigna — IFP: $463.69 Cigna — QHP: $480.86 Evry Health — COMM: $886.16 HealthSmart Preferred Care — PPO: $2,438.67 Independent Medical Systems — COMM: $3,434.74 National Healthcare Solutions — COMM: $3,434.74
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, transvaginal	$3,434.74	$3,434.74	$203.42 – $257.17
Transvaginal ultrasound: rates for 4 insurance plans Aetna — COMM: $217.29 Aetna — Meritain: $217.29 Aetna — NewBusiness: $203.42 Aetna — OON: $257.17
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral	$842.27	$842.27	$129.76 – $205.70
Diagnostic mammogram, one breast: 10 of 48 insurance plan rates Aetna — MCR: $82.45 American Health Plan of Texas, Inc. — MGMCR: $85.85 Amerigroup — DualEligible: $81.76 BCBS — BlueAdvantageHMO: $128.86 BCBS — BlueEssentials: $383.76 BCBS — BlueEssentialsAccess: $383.76 BCBS — EPOSOA: $402.58 BCBS — MCRPPO: $81.76 BCBS — MGMCRHMO: $81.76 BCBS — PPO: $421.39
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAMMO DIAG CAD UNI	$842.27	$842.27	$58.96 – $842.27
Diagnostic mammogram, one breast: 10 of 18 insurance plan rates Aetna — ASA: $425.35 Aetna Coventry First Health — EXCLUSIVE: $482.62 Aetna Coventry First Health — NONEXCLUSIVE: $482.62 BCBS — Traditional: $348.70 Cigna — IFP: $113.71 Cigna — QHP: $117.92 Evry Health — COMM: $217.31 HealthSmart Preferred Care — PPO: $598.01 Independent Medical Systems — COMM: $842.27 National Healthcare Solutions — COMM: $842.27
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier TC In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral	$842.27	$842.27	$202.65 – $256.19
Diagnostic mammogram, one breast: rates for 4 insurance plans Aetna — COMM: $216.46 Aetna — Meritain: $216.46 Aetna — NewBusiness: $202.65 Aetna — OON: $256.19
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	$1,059.43	$1,059.43	$165.73 – $263
Diagnostic mammogram, both breasts: 10 of 48 insurance plan rates Aetna — MCR: $105.78 American Health Plan of Texas, Inc. — MGMCR: $110.13 Amerigroup — DualEligible: $104.89 BCBS — BlueAdvantageHMO: $164.91 BCBS — BlueEssentials: $491.11 BCBS — BlueEssentialsAccess: $491.11 BCBS — EPOSOA: $515.18 BCBS — MCRPPO: $104.89 BCBS — MGMCRHMO: $104.89 BCBS — PPO: $539.26
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMMO DIAG CAD BI	$1,059.43	$1,059.43	$74.16 – $1,059.43
Diagnostic mammogram, both breasts: 10 of 18 insurance plan rates Aetna — ASA: $535.01 Aetna Coventry First Health — EXCLUSIVE: $607.05 Aetna Coventry First Health — NONEXCLUSIVE: $607.05 BCBS — Traditional: $438.60 Cigna — IFP: $143.02 Cigna — QHP: $148.32 Evry Health — COMM: $273.33 HealthSmart Preferred Care — PPO: $752.20 Independent Medical Systems — COMM: $1,059.43 National Healthcare Solutions — COMM: $1,059.43
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier TC In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	$1,059.43	$1,059.43	$258.44 – $326.72
Diagnostic mammogram, both breasts: rates for 4 insurance plans Aetna — COMM: $276.06 Aetna — Meritain: $276.06 Aetna — NewBusiness: $258.44 Aetna — OON: $326.72
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed Other Outpatient	$920.84	$920.84	$90.85
Screening mammogram, both breasts: 10 of 48 insurance plan rates Aetna — MCR: $87.26 American Health Plan of Texas, Inc. — MGMCR: $90.85 Amerigroup — DualEligible: $86.52 BCBS — BlueAdvantageHMO: $136.27 BCBS — BlueEssentials: $405.84 BCBS — BlueEssentialsAccess: $405.84 BCBS — EPOSOA: $425.73 BCBS — MCRPPO: $86.52 BCBS — MGMCRHMO: $86.52 BCBS — PPO: $445.63
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCR CAD BI	$920.84	$920.84	$64.46 – $920.84
Screening mammogram, both breasts: 10 of 18 insurance plan rates Aetna — ASA: $465.02 Aetna Coventry First Health — EXCLUSIVE: $527.64 Aetna Coventry First Health — NONEXCLUSIVE: $527.64 BCBS — Traditional: $381.23 Cigna — IFP: $124.31 Cigna — QHP: $128.92 Evry Health — COMM: $237.58 HealthSmart Preferred Care — PPO: $653.80 Independent Medical Systems — COMM: $920.84 National Healthcare Solutions — COMM: $920.84
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier TC In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed	$920.84	$920.84	$213.49 – $269.89
Screening mammogram, both breasts: rates for 4 insurance plans Aetna — COMM: $228.04 Aetna — Meritain: $228.04 Aetna — NewBusiness: $213.49 Aetna — OON: $269.89

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	Not listed in the file	Not listed in the file	$12.61 – $1,514
Electrocardiogram (ECG/EKG) with reading: rates for 10 insurance plans Aetna — COMM: $1,280 Aetna — Meritain: $1,280 Aetna — NewBusiness: $1,198 Aetna — OON: $1,514 BCBS — BlueAdvantageHMO: $30.28 BCBS — BlueEssentials: $42.73 BCBS — BlueEssentialsAccess: $42.73 BCBS — EPOSOA: $44.81 BCBS — PPO: $46.88 TriWest Health Alliance — TRCR: $12.61
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: CATH HRT LT/INJ L VENT	$18,617.01	$18,617.01	$2,513.30 – $18,617.01
Left heart catheterization (diagnostic): 10 of 11 insurance plan rates Aetna Coventry First Health — EXCLUSIVE: $10,667.55 Aetna Coventry First Health — NONEXCLUSIVE: $10,667.55 BCBS — Traditional: $7,707.44 Cigna — IFP: $2,513.30 Cigna — QHP: $2,606.38 HealthSmart Preferred Care — PPO: $13,218.08 Independent Medical Systems — COMM: $18,617.01 National Healthcare Solutions — COMM: $18,617.01 Parker County — LOGOV: $13,962.76 United — GlobalBenefitPlan: $8,377.65
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe	Not listed in the file	Not listed in the file	$16,817
Left heart catheterization (diagnostic): 10 of 26 insurance plan rates Aetna — COMM: $17,770 Aetna — Meritain: $17,770 Aetna — NewBusiness: $16,633 Aetna — OON: $21,022 BCBS — BlueAdvantageHMO: $9,119.84 BCBS — BlueEssentials: $12,596.78 BCBS — BlueEssentialsAccess: $12,596.78 BCBS — EPOSOA: $13,223.77 BCBS — PPO: $13,850.76 Cigna — AllOther: $28,286
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · modifier 59 In the file: CATH HRT LT/INJ L VENT59	$18,617.01	$18,617.01	$2,513.30 – $18,617.01
Left heart catheterization (diagnostic): 10 of 11 insurance plan rates Aetna Coventry First Health — EXCLUSIVE: $10,667.55 Aetna Coventry First Health — NONEXCLUSIVE: $10,667.55 BCBS — Traditional: $7,707.44 Cigna — IFP: $2,513.30 Cigna — QHP: $2,606.38 HealthSmart Preferred Care — PPO: $13,218.08 Independent Medical Systems — COMM: $18,617.01 National Healthcare Solutions — COMM: $18,617.01 Parker County — LOGOV: $13,962.76 United — GlobalBenefitPlan: $8,377.65
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recor	$29,809.32	$29,809.32	$25,253 – $33,939
Heart rhythm study (electrophysiology evaluation): 10 of 19 insurance plan rates BCBS — BlueAdvantageHMO: $16,185.70 BCBS — BlueEssentials: $28,663.41 BCBS — BlueEssentialsAccess: $28,663.41 BCBS — EPOSOA: $30,075.98 BCBS — PPO: $31,488.55 Evry Health — COMM: $29,597 Oscar — HIX: $29,429 Superior Health Plan — CHIP: $7,818 Superior Health Plan — MCDSTAR: $7,818 Superior Health Plan — STARHealth: $7,818
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: EP W/O ARRHYTHMIA	$29,809.32	$29,809.32	$4,024.26 – $29,809.32
Heart rhythm study (electrophysiology evaluation): 10 of 18 insurance plan rates Aetna — ASA: $15,053.71 Aetna Coventry First Health — EXCLUSIVE: $17,080.74 Aetna Coventry First Health — NONEXCLUSIVE: $17,080.74 BCBS — Traditional: $12,341.06 Cigna — AllOther: $11,118.88 Cigna — HMO: $8,793.75 Cigna — IFP: $4,024.26 Cigna — LocalPlus: $7,869.66 Cigna — NetworkBenefit: $8,793.75 Cigna — NewBusiness: $7,869.66
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters,	$80,095.45	$80,095.45	$7,668 – $53,131.70
Heart rhythm study with ablation for atrial fibrillation: 10 of 19 insurance plan rates BCBS — BlueAdvantageHMO: $41,483.60 BCBS — BlueEssentials: $48,431.59 BCBS — BlueEssentialsAccess: $48,431.59 BCBS — EPOSOA: $50,883.82 BCBS — PPO: $53,131.70 Evry Health — COMM: $29,597 Oscar — HIX: $7,668 Superior Health Plan — CHIP: $7,818 Superior Health Plan — MCDSTAR: $7,818 Superior Health Plan — STARHealth: $7,818
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: COM EP REPO CTH TX AFIB	$80,095.45	$80,095.45	$10,812.89 – $80,095.45
Heart rhythm study with ablation for atrial fibrillation: 10 of 18 insurance plan rates Aetna — ASA: $40,448.20 Aetna Coventry First Health — EXCLUSIVE: $45,894.69 Aetna Coventry First Health — NONEXCLUSIVE: $45,894.69 BCBS — Traditional: $33,159.52 Cigna — AllOther: $29,875.60 Cigna — HMO: $23,628.16 Cigna — IFP: $10,812.89 Cigna — LocalPlus: $21,145.20 Cigna — NetworkBenefit: $23,628.16 Cigna — NewBusiness: $21,145.20
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist	Not listed in the file	Not listed in the file	$1,927 – $3,130
Sleep study (overnight, in a sleep lab): 10 of 12 insurance plan rates Aetna — COMM: $850 Aetna — Meritain: $850 Aetna — NewBusiness: $796 Aetna — OON: $1,006 BCBS — BlueAdvantageHMO: $1,377.59 BCBS — BlueEssentials: $2,439.58 BCBS — BlueEssentialsAccess: $2,439.58 BCBS — EPOSOA: $2,559.80 BCBS — PPO: $2,680.03 United — AllPayerAppendix: $3,130

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib	Not listed in the file	Not listed in the file	$29.75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 45 insurance plan rates Aetna — MCR: $28.57 American Health Plan of Texas, Inc. — MGMCR: $29.75 Amerigroup — DualEligible: $28.33 BCBS — BlueAdvantageHMO: $86.21 BCBS — BlueEssentials: $152.67 BCBS — BlueEssentialsAccess: $152.67 BCBS — EPOSOA: $160.20 BCBS — MCRPPO: $28.33 BCBS — MGMCRHMO: $28.33 BCBS — PPO: $167.72
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO In the file: THER EXERCISES 15 MIN OT	$119.32	$119.32	$8.35 – $119.32
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 18 insurance plan rates Aetna — ASA: $60.26 Aetna Coventry First Health — EXCLUSIVE: $68.37 Aetna Coventry First Health — NONEXCLUSIVE: $68.37 BCBS — Traditional: $49.40 Cigna — IFP: $16.11 Cigna — QHP: $16.70 HealthSmart Preferred Care — PPO: $84.72 Independent Medical Systems — COMM: $119.32 National Healthcare Solutions — COMM: $119.32 Oscar — HIX: $24.82
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: THER EXERCISES 15 MIN PT	$395.98	$395.98	$27.72 – $395.98
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 18 insurance plan rates Aetna — ASA: $199.97 Aetna Coventry First Health — EXCLUSIVE: $226.90 Aetna Coventry First Health — NONEXCLUSIVE: $226.90 BCBS — Traditional: $163.94 Cigna — IFP: $53.46 Cigna — QHP: $55.44 HealthSmart Preferred Care — PPO: $281.15 Independent Medical Systems — COMM: $395.98 National Healthcare Solutions — COMM: $395.98 Oscar — HIX: $82.36
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact	$1,190.89	$1,190.89	$93.57 – $462.72
Physical therapy evaluation (low complexity): 10 of 45 insurance plan rates Aetna — MCR: $96.29 American Health Plan of Texas, Inc. — MGMCR: $100.25 Amerigroup — DualEligible: $95.48 BCBS — BlueAdvantageHMO: $237.85 BCBS — BlueEssentials: $421.21 BCBS — BlueEssentialsAccess: $421.21 BCBS — EPOSOA: $441.96 BCBS — MCRPPO: $95.48 BCBS — MGMCRHMO: $95.48 BCBS — PPO: $462.72
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact	$1,190.89	$1,190.89	$82.34 – $220.14
Physical therapy evaluation (low complexity): 10 of 39 insurance plan rates Aetna — MCR: $84.74 American Health Plan of Texas, Inc. — MGMCR: $88.22 Amerigroup — DualEligible: $84.02 BCBS — MCRPPO: $84.02 BCBS — MGMCRHMO: $84.02 BCBS — TriWestGOV: $82.34 Care N Care — MGMCR: $84.86 Cigna Healthspring — MGMCR: $85.70 Devoted Health — HMO: $84.02 Devoted Health — MCR: $84.02
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT LOW COMPLEX	$1,190.89	$1,190.89	$83.36 – $1,190.89
Physical therapy evaluation (low complexity): 10 of 18 insurance plan rates Aetna — ASA: $601.40 Aetna Coventry First Health — EXCLUSIVE: $682.38 Aetna Coventry First Health — NONEXCLUSIVE: $682.38 BCBS — Traditional: $493.03 Cigna — IFP: $160.77 Cigna — QHP: $166.72 HealthSmart Preferred Care — PPO: $845.53 Independent Medical Systems — COMM: $1,190.89 National Healthcare Solutions — COMM: $1,190.89 Oscar — HIX: $247.71
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or	$1,190.89	$1,190.89	$100.25
Physical therapy evaluation (moderate complexity): 10 of 45 insurance plan rates Aetna — MCR: $96.29 American Health Plan of Texas, Inc. — MGMCR: $100.25 Amerigroup — DualEligible: $95.48 BCBS — BlueAdvantageHMO: $237.85 BCBS — BlueEssentials: $421.21 BCBS — BlueEssentialsAccess: $421.21 BCBS — EPOSOA: $441.96 BCBS — MCRPPO: $95.48 BCBS — MGMCRHMO: $95.48 BCBS — PPO: $462.72
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or	$1,190.89	$1,190.89	$82.34 – $220.14
Physical therapy evaluation (moderate complexity): 10 of 39 insurance plan rates Aetna — MCR: $84.74 American Health Plan of Texas, Inc. — MGMCR: $88.22 Amerigroup — DualEligible: $84.02 BCBS — MCRPPO: $84.02 BCBS — MGMCRHMO: $84.02 BCBS — TriWestGOV: $82.34 Care N Care — MGMCR: $84.86 Cigna Healthspring — MGMCR: $85.70 Devoted Health — HMO: $84.02 Devoted Health — MCR: $84.02
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT MOD COMPLEX	$1,190.89	$1,190.89	$83.36 – $1,190.89
Physical therapy evaluation (moderate complexity): 10 of 18 insurance plan rates Aetna — ASA: $601.40 Aetna Coventry First Health — EXCLUSIVE: $682.38 Aetna Coventry First Health — NONEXCLUSIVE: $682.38 BCBS — Traditional: $493.03 Cigna — IFP: $160.77 Cigna — QHP: $166.72 HealthSmart Preferred Care — PPO: $845.53 Independent Medical Systems — COMM: $1,190.89 National Healthcare Solutions — COMM: $1,190.89 Oscar — HIX: $247.71
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o	$1,190.89	$1,190.89	$93.57 – $462.72
Physical therapy evaluation (high complexity): 10 of 45 insurance plan rates Aetna — MCR: $96.29 American Health Plan of Texas, Inc. — MGMCR: $100.25 Amerigroup — DualEligible: $95.48 BCBS — BlueAdvantageHMO: $237.85 BCBS — BlueEssentials: $421.21 BCBS — BlueEssentialsAccess: $421.21 BCBS — EPOSOA: $441.96 BCBS — MCRPPO: $95.48 BCBS — MGMCRHMO: $95.48 BCBS — PPO: $462.72
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o	$1,190.89	$1,190.89	$88.22
Physical therapy evaluation (high complexity): 10 of 39 insurance plan rates Aetna — MCR: $84.74 American Health Plan of Texas, Inc. — MGMCR: $88.22 Amerigroup — DualEligible: $84.02 BCBS — MCRPPO: $84.02 BCBS — MGMCRHMO: $84.02 BCBS — TriWestGOV: $82.34 Care N Care — MGMCR: $84.86 Cigna Healthspring — MGMCR: $85.70 Devoted Health — HMO: $84.02 Devoted Health — MCR: $84.02
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT HIGH COMPLEX	$1,190.89	$1,190.89	$83.36 – $1,190.89
Physical therapy evaluation (high complexity): 10 of 18 insurance plan rates Aetna — ASA: $601.40 Aetna Coventry First Health — EXCLUSIVE: $682.38 Aetna Coventry First Health — NONEXCLUSIVE: $682.38 BCBS — Traditional: $493.03 Cigna — IFP: $160.77 Cigna — QHP: $166.72 HealthSmart Preferred Care — PPO: $845.53 Independent Medical Systems — COMM: $1,190.89 National Healthcare Solutions — COMM: $1,190.89 Oscar — HIX: $247.71

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: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19	Not listed in the file	Not listed in the file	$5,381 – $8,910
Removal of breast growth (open surgery): 10 of 40 insurance plan rates Aetna — COMM: $7,532 Aetna — Meritain: $7,532 Aetna — NewBusiness: $7,050 Aetna — OON: $8,910 Aetna Better Health — CHIP: $1,156.39 Aetna Better Health — MCD: $1,156.39 Amerigroup — CHIP: $1,011.84 Amerigroup — MGMCD: $1,011.84 BCBS — BlueAdvantageHMO: $6,149.99 BCBS — BlueEssentials: $7,180.03
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft	Not listed in the file	Not listed in the file	$12,000 – $55,933.34
Total hip replacement: 10 of 30 insurance plan rates Aetna — COMM: $58,760 Aetna — Meritain: $58,760 Aetna — NewBusiness: $54,999 Aetna — OON: $69,513 American Health Plan of Texas, Inc. — MGMCR: $12,000 BCBS — BlueAdvantageHMO: $44,627.66 BCBS — BlueEssentials: $50,935.04 BCBS — BlueEssentialsAccess: $50,935.04 BCBS — EPOSOA: $53,434.19 BCBS — PPO: $55,933.34
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)	Not listed in the file	Not listed in the file	$12,000 – $55,933.34
Total knee replacement: 10 of 30 insurance plan rates Aetna — COMM: $58,760 Aetna — Meritain: $58,760 Aetna — NewBusiness: $54,999 Aetna — OON: $69,513 American Health Plan of Texas, Inc. — MGMCR: $12,000 BCBS — BlueAdvantageHMO: $44,627.66 BCBS — BlueEssentials: $50,935.04 BCBS — BlueEssentialsAccess: $50,935.04 BCBS — EPOSOA: $53,434.19 BCBS — PPO: $55,933.34
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) rele	Not listed in the file	Not listed in the file	$1,580 – $8,485
Shoulder arthroscopy: shaving of shoulder bone: 10 of 21 insurance plan rates Aetna — COMM: $26,100 Aetna — Meritain: $26,100 Aetna — NewBusiness: $24,430 Aetna — OON: $30,876 Cigna — AllOther: $8,485 Cigna — HMO: $6,708 Cigna — LocalPlus: $6,004 Cigna — NetworkBenefit: $6,708 Cigna — NewBusiness: $6,010 Cigna — OpenAccessPlus: $6,708
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articula	Not listed in the file	Not listed in the file	$7,168
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 40 insurance plan rates Aetna — COMM: $26,100 Aetna — Meritain: $26,100 Aetna — NewBusiness: $24,430 Aetna — OON: $30,876 Aetna Better Health — CHIP: $1,305.92 Aetna Better Health — MCD: $1,305.92 Amerigroup — CHIP: $1,142.68 Amerigroup — MGMCD: $1,142.68 BCBS — BlueAdvantageHMO: $5,557.02 BCBS — BlueEssentials: $6,487.76
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Tonsillectomy and adenoidectomy; younger than age 12	Not listed in the file	Not listed in the file	$7,050 – $8,910
Removal of tonsils and adenoids (under age 12): 10 of 35 insurance plan rates Aetna — COMM: $7,532 Aetna — Meritain: $7,532 Aetna — NewBusiness: $7,050 Aetna — OON: $8,910 Aetna Better Health — CHIP: $2,345.06 Aetna Better Health — MCD: $2,345.06 Amerigroup — CHIP: $2,051.93 Amerigroup — MGMCD: $2,051.93 BCBS — BlueAdvantageHMO: $9,846.58 BCBS — BlueEssentials: $11,495.76
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (sep	Not listed in the file	Not listed in the file	$351.70 – $4,850
Upper GI endoscopy (diagnostic): 10 of 35 insurance plan rates Aetna — COMM: $4,100 Aetna — Meritain: $4,100 Aetna — NewBusiness: $3,838 Aetna — OON: $4,850 Aetna Better Health — CHIP: $401.94 Aetna Better Health — MCD: $401.94 Amerigroup — CHIP: $351.70 Amerigroup — MGMCD: $351.70 BCBS — BlueAdvantageHMO: $1,595.42 BCBS — BlueEssentials: $1,862.63
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	Not listed in the file	Not listed in the file	$4,568 – $5,773
Upper GI endoscopy with biopsy: 10 of 35 insurance plan rates Aetna — COMM: $4,880 Aetna — Meritain: $4,880 Aetna — NewBusiness: $4,568 Aetna — OON: $5,773 Aetna Better Health — CHIP: $401.94 Aetna Better Health — MCD: $401.94 Amerigroup — CHIP: $351.70 Amerigroup — MGMCD: $351.70 BCBS — BlueAdvantageHMO: $1,595.42 BCBS — BlueEssentials: $1,862.63
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)	Not listed in the file	Not listed in the file	$4,568 – $5,773
Colonoscopy (diagnostic): 10 of 35 insurance plan rates Aetna — COMM: $4,880 Aetna — Meritain: $4,880 Aetna — NewBusiness: $4,568 Aetna — OON: $5,773 Aetna Better Health — CHIP: $394.20 Aetna Better Health — MCD: $394.20 Amerigroup — CHIP: $344.93 Amerigroup — MGMCD: $344.93 BCBS — BlueAdvantageHMO: $1,550.68 BCBS — BlueEssentials: $1,810.40
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with biopsy, single or multiple	Not listed in the file	Not listed in the file	$1,740 – $5,773
Colonoscopy with biopsy: 10 of 35 insurance plan rates Aetna — COMM: $4,880 Aetna — Meritain: $4,880 Aetna — NewBusiness: $4,568 Aetna — OON: $5,773 Aetna Better Health — CHIP: $515.11 Aetna Better Health — MCD: $515.11 Amerigroup — CHIP: $450.72 Amerigroup — MGMCD: $450.72 BCBS — BlueAdvantageHMO: $2,038.57 BCBS — BlueEssentials: $2,380
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	Not listed in the file	Not listed in the file	$429.26 – $1,208.10
Colonoscopy with removal of polyps (snare): 10 of 35 insurance plan rates Aetna — COMM: $4,880 Aetna — Meritain: $4,880 Aetna — NewBusiness: $4,568 Aetna — OON: $5,773 Aetna Better Health — CHIP: $515.11 Aetna Better Health — MCD: $515.11 Amerigroup — CHIP: $450.72 Amerigroup — MGMCD: $450.72 BCBS — BlueAdvantageHMO: $2,038.57 BCBS — BlueEssentials: $2,380
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and	Not listed in the file	Not listed in the file	$450.72 – $5,773
Ultrasound of the lower bowel by endoscope: 10 of 35 insurance plan rates Aetna — COMM: $4,880 Aetna — Meritain: $4,880 Aetna — NewBusiness: $4,568 Aetna — OON: $5,773 Aetna Better Health — CHIP: $515.11 Aetna Better Health — MCD: $515.11 Amerigroup — CHIP: $450.72 Amerigroup — MGMCD: $450.72 BCBS — BlueAdvantageHMO: $2,038.57 BCBS — BlueEssentials: $2,380
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	Not listed in the file	Not listed in the file	$4,568 – $5,773
Screening colonoscopy (not high risk): 10 of 34 insurance plan rates Aetna — COMM: $4,880 Aetna — Meritain: $4,880 Aetna — NewBusiness: $4,568 Aetna — OON: $5,773 Aetna Better Health — CHIP: $354.78 Aetna Better Health — MCD: $354.78 Amerigroup — CHIP: $328.50 Amerigroup — MGMCD: $328.50 BCBS — BlueAdvantageHMO: $1,550.68 BCBS — BlueEssentials: $1,810.40
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical; cholecystectomy	Not listed in the file	Not listed in the file	$1,983.29 – $16,960
Gallbladder removal by laparoscope: 10 of 40 insurance plan rates Aetna — COMM: $9,850 Aetna — Meritain: $9,850 Aetna — NewBusiness: $9,220 Aetna — OON: $11,653 Aetna Better Health — CHIP: $2,266.62 Aetna Better Health — MCD: $2,266.62 Amerigroup — CHIP: $1,983.29 Amerigroup — MGMCD: $1,983.29 BCBS — BlueAdvantageHMO: $9,812.43 BCBS — BlueEssentials: $11,455.89
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair initial inguinal hernia, age 5 years or older; reducible	Not listed in the file	Not listed in the file	$5,020 – $11,138
Groin (inguinal) hernia repair, age 5 or older: 10 of 40 insurance plan rates Aetna — COMM: $9,415 Aetna — Meritain: $9,415 Aetna — NewBusiness: $8,812 Aetna — OON: $11,138 Aetna Better Health — CHIP: $1,381.85 Aetna Better Health — MCD: $1,381.85 Amerigroup — CHIP: $1,209.12 Amerigroup — MGMCD: $1,209.12 BCBS — BlueAdvantageHMO: $6,311.96 BCBS — BlueEssentials: $7,369.14
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy, prostate; needle or punch, single or multiple, any approach	Not listed in the file	Not listed in the file	$4,723
Prostate biopsy: 10 of 16 insurance plan rates Aetna Better Health — CHIP: $783.36 Aetna Better Health — MCD: $783.36 Amerigroup — CHIP: $685.44 Amerigroup — MGMCD: $685.44 Cigna Healthspring — MGMCD: $685.44 Cook Childrens Health Plan — CHIP: $652.80 Cook Childrens Health Plan — STAR: $652.80 Evry Health — COMM: $2,356 Humana — MGMCD: $816 Oscar — HIX: $4,723
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;	Not listed in the file	Not listed in the file	$12,413 – $21,874.09
Prostate removal by laparoscope (radical prostatectomy): 10 of 21 insurance plan rates Aetna — COMM: $9,850 Aetna — Meritain: $9,850 Aetna — NewBusiness: $9,220 Aetna — OON: $11,653 BCBS — BlueAdvantageHMO: $17,078.61 BCBS — BlueEssentials: $19,939.07 BCBS — BlueEssentialsAccess: $19,939.07 BCBS — EPOSOA: $20,948.64 BCBS — PPO: $21,874.09 Cigna — AllOther: $19,388
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C	Not listed in the file	Not listed in the file	$5,381
Hysteroscopy with biopsy of the uterus lining: 10 of 40 insurance plan rates Aetna — COMM: $8,310 Aetna — Meritain: $8,310 Aetna — NewBusiness: $7,778 Aetna — OON: $9,831 Aetna Better Health — CHIP: $1,276.22 Aetna Better Health — MCD: $1,276.22 Amerigroup — CHIP: $1,116.70 Amerigroup — MGMCD: $1,116.70 BCBS — BlueAdvantageHMO: $5,071.14 BCBS — BlueEssentials: $5,920.50
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neur	Not listed in the file	Not listed in the file	$276 – $4,850
Spinal injection, lower back (epidural), with imaging guidance: 10 of 35 insurance plan rates Aetna — COMM: $4,100 Aetna — Meritain: $4,100 Aetna — NewBusiness: $3,838 Aetna — OON: $4,850 Aetna Better Health — CHIP: $315.43 Aetna Better Health — MCD: $315.43 Amerigroup — CHIP: $276 Amerigroup — MGMCD: $276 BCBS — BlueAdvantageHMO: $1,268.85 BCBS — BlueEssentials: $1,481.37
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing	Not listed in the file	Not listed in the file	$357.81 – $4,850
Nerve root injection, lower back, with imaging guidance: 10 of 35 insurance plan rates Aetna — COMM: $4,100 Aetna — Meritain: $4,100 Aetna — NewBusiness: $3,838 Aetna — OON: $4,850 Aetna Better Health — CHIP: $408.92 Aetna Better Health — MCD: $408.92 Amerigroup — CHIP: $357.81 Amerigroup — MGMCD: $357.81 BCBS — BlueAdvantageHMO: $1,648.46 BCBS — BlueEssentials: $1,924.56
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel	Not listed in the file	Not listed in the file	$2,467 – $3,486
Carpal tunnel release: 10 of 40 insurance plan rates Aetna — COMM: $4,880 Aetna — Meritain: $4,880 Aetna — NewBusiness: $4,568 Aetna — OON: $5,773 Aetna Better Health — CHIP: $791.93 Aetna Better Health — MCD: $791.93 Amerigroup — CHIP: $692.94 Amerigroup — MGMCD: $692.94 BCBS — BlueAdvantageHMO: $3,490.28 BCBS — BlueEssentials: $4,074.86
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or	Not listed in the file	Not listed in the file	$218.75 – $5,773
Laser treatment of clouding after cataract surgery: 10 of 35 insurance plan rates Aetna — COMM: $4,880 Aetna — Meritain: $4,880 Aetna — NewBusiness: $4,568 Aetna — OON: $5,773 Aetna Better Health — CHIP: $250 Aetna Better Health — MCD: $250 Amerigroup — CHIP: $218.75 Amerigroup — MGMCD: $218.75 BCBS — BlueAdvantageHMO: $1,029.07 BCBS — BlueEssentials: $1,201.42
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irriga	Not listed in the file	Not listed in the file	$892.44 – $18,490
Cataract removal with lens implant: 10 of 35 insurance plan rates Aetna — COMM: $15,630 Aetna — Meritain: $15,630 Aetna — NewBusiness: $14,630 Aetna — OON: $18,490 Aetna Better Health — CHIP: $1,019.93 Aetna Better Health — MCD: $1,019.93 Amerigroup — CHIP: $892.44 Amerigroup — MGMCD: $892.44 BCBS — BlueAdvantageHMO: $4,104.38 BCBS — BlueEssentials: $4,791.81

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: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care	Not listed in the file	Not listed in the file	$2,287 – $45,538.63
Vaginal delivery, with care before and after: rates for 8 insurance plans BCBS — BlueAdvantageHMO: $41,444.30 BCBS — BlueEssentials: $41,444.30 BCBS — BlueEssentialsAccess: $41,444.30 BCBS — EPOSOA: $43,491.46 BCBS — PPO: $45,538.63 Evry Health — COMM: $2,287 Oscar — HIX: $6,587 WellMed — MGMCR: 100.5% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, cesarean delivery, and postpartum care	Not listed in the file	Not listed in the file	$2,287 – $50,489.70
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans BCBS — BlueAdvantageHMO: $45,950.22 BCBS — BlueEssentials: $45,950.22 BCBS — BlueEssentialsAccess: $45,950.22 BCBS — EPOSOA: $48,219.96 BCBS — PPO: $50,489.70 Evry Health — COMM: $2,287 Oscar — HIX: $6,587 WellMed — MGMCR: 100.5% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after p	Not listed in the file	Not listed in the file	$2,287 – $47,784.37
Vaginal delivery after a previous C-section, with care before and after: rates for 8 insurance plans BCBS — BlueAdvantageHMO: $43,488.12 BCBS — BlueEssentials: $43,488.12 BCBS — BlueEssentialsAccess: $43,488.12 BCBS — EPOSOA: $45,636.24 BCBS — PPO: $47,784.37 Evry Health — COMM: $2,287 Oscar — HIX: $6,587 WellMed — MGMCR: 100.5% (a percentage in the contract, not a dollar amount)

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 CATHETERIZA	Not listed in the file	Not listed in the file	$57,468 – $60,493
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 70 insurance plan rates Aetna — COMM: $144,400 Aetna — MCR: $77,198.83 Aetna — Meritain: $144,400 Aetna — NewBusiness: $135,158 Aetna — OON: $170,825 Aetna Coventry First Health — EXCLUSIVE: $57,468 Aetna Coventry First Health — NONEXCLUSIVE: $60,493 American Health Plan of Texas, Inc. — MGMCR: $82,126.41 Amerigroup — DualEligible: $78,215.63 BCBS — BlueAdvantageHMO: $151,535.25
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	Not listed in the file	Not listed in the file	$1,198
Hip or knee replacement (major joint of the leg), without major complications: 10 of 70 insurance plan rates Aetna — COMM: $76,500 Aetna — MCR: $16,027.38 Aetna — Meritain: $76,500 Aetna — NewBusiness: $71,604 Aetna — OON: $90,500 Aetna Coventry First Health — EXCLUSIVE: $2,429 Aetna Coventry First Health — NONEXCLUSIVE: $2,555 American Health Plan of Texas, Inc. — MGMCR: $17,050.40 Amerigroup — DualEligible: $16,238.48 BCBS — BlueAdvantageHMO: $41,874.43
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 Pediatric	Not listed in the file	Not listed in the file	$41,025.77 – $57,984.66
Hip or knee replacement (major joint of the leg), without major complications: rates for 6 insurance plans Cigna — AllOther: $57,984.66 Cigna — HMO: $45,838.38 Cigna — LocalPlus: $41,025.77 Cigna — NetworkBenefit: $45,838.38 Cigna — NewBusiness: $41,066.28 Cigna — OpenAccessPlus: $45,838.38
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	$1,198
Neck (cervical) spinal fusion, without complications: 10 of 70 insurance plan rates Aetna — COMM: $76,830 Aetna — MCR: $20,018.29 Aetna — Meritain: $76,830 Aetna — NewBusiness: $71,913 Aetna — OON: $90,890 Aetna Coventry First Health — EXCLUSIVE: $2,429 Aetna Coventry First Health — NONEXCLUSIVE: $2,555 American Health Plan of Texas, Inc. — MGMCR: $1,275 Amerigroup — DualEligible: $20,281.96 BCBS — BlueAdvantageHMO: $46,770.06
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Pediatric	Not listed in the file	Not listed in the file	$51,924.01 – $73,387.92
Neck (cervical) spinal fusion, without complications: rates for 6 insurance plans Cigna — AllOther: $73,387.92 Cigna — HMO: $58,015.05 Cigna — LocalPlus: $51,924.01 Cigna — NetworkBenefit: $58,015.05 Cigna — NewBusiness: $51,975.28 Cigna — OpenAccessPlus: $58,015.05
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	$1,198
Uterus and ovary surgery (not for cancer), without complications: 10 of 70 insurance plan rates Aetna — COMM: $17,000 Aetna — MCR: $10,667.21 Aetna — Meritain: $17,000 Aetna — NewBusiness: $15,912 Aetna — OON: $20,111 Aetna Coventry First Health — EXCLUSIVE: $2,429 Aetna Coventry First Health — NONEXCLUSIVE: $2,555 American Health Plan of Texas, Inc. — MGMCR: $11,348.10 Amerigroup — DualEligible: $10,807.71 BCBS — BlueAdvantageHMO: $11,661.52
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 Pediatric	Not listed in the file	Not listed in the file	$26,388.45 – $37,296.68
Uterus and ovary surgery (not for cancer), without complications: rates for 6 insurance plans Cigna — AllOther: $37,296.68 Cigna — HMO: $29,483.99 Cigna — LocalPlus: $26,388.45 Cigna — NetworkBenefit: $29,483.99 Cigna — NewBusiness: $26,414.50 Cigna — OpenAccessPlus: $29,483.99

Source: Medical City Weatherford’s standard charges file (stctrprodsnsvc00455826e6.blob.core.windows.net, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 1, 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	713 E Anderson St, Weatherford, TX 76086
County	Parker County
State	Texas
Phone	(682) 582‑1000
Emergency services	Yes
Ownership	Proprietary
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	450203
Name in Medicare records	MEDICAL CITY WEATHERFORD
Profile level	Medicare data + hospital website
Name on the hospital’s website	Medical City Weatherford Hospital
Official website	medicalcityhealthcare.com
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 2026-10-29.

About - Medical City Weatherford Hospital — medicalcityhealthcare.com
Medical City Weatherford Hospital | Medical City Weatherford Hospital — medicalcityhealthcare.com
Emergency Care | Medical City Weatherford Hospital — medicalcityhealthcare.com
Radiology and Imaging | Medical City Weatherford Hospital — medicalcityhealthcare.com
Surgical Care | Medical City Weatherford Hospital — medicalcityhealthcare.com
For Visitors | Medical City Weatherford Hospital — medicalcityhealthcare.com
Cardiology | Medical City Weatherford Hospital — medicalcityhealthcare.com
Advanced Joint Care | Medical City Weatherford Hospital — medicalcityhealthcare.com
Labor and Delivery | Medical City Weatherford Hospital — medicalcityhealthcare.com
Women's Care | Medical City Weatherford Hospital — medicalcityhealthcare.com
Diagnostic Testing | Medical City Weatherford Hospital — medicalcityhealthcare.com
Specialties | Medical City Weatherford Hospital — medicalcityhealthcare.com
Cardiac Rehabilitation | Medical City Weatherford Hospital — medicalcityhealthcare.com
Pulmonary Rehabilitation | Medical City Weatherford Hospital — medicalcityhealthcare.com
Wound Treatment | Medical City Weatherford Hospital — medicalcityhealthcare.com

Medical City Weatherford

Summary

Profile from official sources

At a glance