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Critical Access Hospital

Memorial Hospital

Also listed as: Moore County Hospital District

Dumas, Texas · Moore County · Emergency services listed

Memorial Hospital is a critical access hospital at 224 E Second Street, Dumas, TX 79029. Phone: (806) 935-7171. It has an emergency department.

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

Summary

Memorial Hospital is a critical access hospital in Dumas, Texas. Medicare data lists emergency services. Its official website lists 28 services, specialties and programs. Medicare lists 92 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is a critical access hospital?

A small rural hospital with 24-hour emergency care, designated by Medicare to keep care available far from big cities. More about hospital types

Compare

Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
Not ratedNot rated by CMSMedicare rating
YesBirthing-friendly (CMS)
28Services listed

Quick answers

Does Memorial Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Memorial Hospital. In a medical emergency, call 911.
Where is Memorial Hospital?
224 E Second Street, Dumas, TX 79029, in Moore County, Texas.
What is the phone number of Memorial Hospital?
(806) 935-7171, as listed by Medicare (CMS).
What is the Medicare star rating of Memorial Hospital?
CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas[4][6][7][8][9]

  • Emergency services
  • Imaging and mammograms
  • Laboratory services
  • Therapy services
  • Swing bed services
  • Hospice care
  • Telenursing services
  • Inpatient care (Med/Surg and ICU)
  • Outpatient surgery
  • Post-acute services
  • Social services
  • Physician clinics
  • Emergency medical services (EMS)

Procedures[6][9][10]

Programs and centers[6][7][11][12]

  • Swing bed program
  • Telenursing / population health program
  • Hospice care
  • Post-acute services
  • EMS continuing education classes

Emergency care (hospital website)[6]

Emergency roomYes

Visiting and practical information

VisitingNo formal visiting hours; patients choose their visitors. Some patients may be restricted until cleared by the physician[5]
Patient portalPatient Portal

Recognition[12]

  • Chartis National Top 100 Critical Access Hospital (2024, 2025)
  • Chartis Performance Leadership Award (2022–2025)
  • Chartis National Top 20 Critical Access Hospital in Quality (2023, 2024)
  • 5-Star Honor Roll, National Rural Rating System (2025, 2026)
  • Press Ganey Guardian of Excellence Award
  • Texas EMS Agency of the Year (2023)
  • Distinguished Designation for Early Hearing Detection and Prevention (2024)

Doctors and clinicians (92)

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

Main specialties

Doctors with a page on this site (92)

And 68 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Dumas

Hospitals in Moore County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Dialysis facilities

All dialysis facilities in the state →

Community care nearby

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

Clinics and urgent care

Pharmacies

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

What patients said (patient survey)

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

Rated the hospital 9 or 10 out of 1078%National average: 72%
Would definitely recommend the hospital82%National average: 71%
Nurses “always” communicated well84%National average: 80%
Doctors “always” communicated well83%National average: 80%
“Always” got help as soon as they wanted78%National average: 64%
Staff “always” explained medicines before giving them68%National average: 62%
Were given information about recovery at home89%National average: 86%
Room and bathroom “always” clean79%National average: 73%
Not reported to MedicareSummary star rating (all survey topics); Overall rating of the hospital; Would recommend the hospital; Nurses communicated well; Doctors communicated well; Patients got help quickly from staff; Staff explained medicines; Information about recovery at home; Room and bathroom kept clean; Restfulness of Environment; Care Coordination; Symptoms After Stay
Completed surveys62Response rate: 12%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 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)16.1%
Readmitted within 30 days: pneumonia16.9%
Not reported to MedicareReadmitted within 30 days: heart attack; Readmitted within 30 days: coronary bypass surgery
Too few cases to reportReadmitted within 30 days: heart failure; Readmitted within 30 days: COPD; Readmitted within 30 days: hip or knee replacement

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)79 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)0%National average: 2%
Not reported to MedicareSepsis patients who got all the recommended early care (SEP-1)

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

Not reported to Medicare: infections caught in the hospital, complications and deaths. For these topics Medicare shows no result for this hospital (not reported, or too few cases).

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.

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 54 common services exactly as Memorial Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Show the prices of 54 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OUTPT VISIT NEW-PT MODERATE $247 $197.60 $37.05 – $222.30
New patient office visit (about 30–44 minutes): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $185.25
  • AETNA_MEDICARE — MEDICARE: $71.63
  • AETNA_PPO — COMMERCIAL: $185.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $209.95
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $185.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $73.05
  • BCBS_OF_TEXAS — COMMERCIAL: $197.60
  • CIGNA — COMMERCIAL: $135.85
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $135.85
  • CIGNA_HEALTHSMART — COMMERCIAL: $135.85
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OUTPT VISIT NEW-PT MOD TO HIGH $326 $260.80 $48.90 – $293.40
New patient office visit (about 45–59 minutes): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $244.50
  • AETNA_MEDICARE — MEDICARE: $94.54
  • AETNA_PPO — COMMERCIAL: $244.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $277.10
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $244.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $125.03
  • BCBS_OF_TEXAS — COMMERCIAL: $260.80
  • CIGNA — COMMERCIAL: $179.30
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $179.30
  • CIGNA_HEALTHSMART — COMMERCIAL: $179.30
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OUTPT VISIT NEW-PT HIGH SEVERI $419 $335.20 $62.85 – $377.10
New patient office visit (about 60–74 minutes): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $314.25
  • AETNA_MEDICARE — MEDICARE: $121.51
  • AETNA_PPO — COMMERCIAL: $314.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $356.15
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $314.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $161.39
  • BCBS_OF_TEXAS — COMMERCIAL: $335.20
  • CIGNA — COMMERCIAL: $230.45
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $230.45
  • CIGNA_HEALTHSMART — COMMERCIAL: $230.45
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OUTPT VISIT EST LOW SEVERITY $191 $152.80 $28.65 – $171.90
Established patient office visit (about 20–29 minutes): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $143.25
  • AETNA_MEDICARE — MEDICARE: $55.39
  • AETNA_PPO — COMMERCIAL: $143.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $162.35
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $143.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $48.93
  • BCBS_OF_TEXAS — COMMERCIAL: $152.80
  • CIGNA — COMMERCIAL: $105.05
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $105.05
  • CIGNA_HEALTHSMART — COMMERCIAL: $105.05
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OUTPT VISIT EST MODERATE SEVER $247 $197.60 $37.05 – $222.30
Established patient office visit (about 30–39 minutes): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $185.25
  • AETNA_MEDICARE — MEDICARE: $71.63
  • AETNA_PPO — COMMERCIAL: $185.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $209.95
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $185.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $75.09
  • BCBS_OF_TEXAS — COMMERCIAL: $197.60
  • CIGNA — COMMERCIAL: $135.85
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $135.85
  • CIGNA_HEALTHSMART — COMMERCIAL: $135.85
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: EMERGENCY ROOM - LEVEL 3 $459 $367.20 $68.85 – $413.10
Emergency room visit (moderate): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $344.25
  • AETNA_MEDICARE — MEDICARE: $133.11
  • AETNA_PPO — COMMERCIAL: $344.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $390.15
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $344.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $166.45
  • BCBS_OF_TEXAS — COMMERCIAL: $367.20
  • CIGNA — COMMERCIAL: $252.45
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $252.45
  • CIGNA_HEALTHSMART — COMMERCIAL: $252.45
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: EMER DEPT PHYSICIAN CHARGE 3 $204 $163.20 $30.60 – $153
Emergency room visit (moderate): 10 of 29 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $153
  • AETNA_MEDICARE — MEDICARE: $67.28
  • AETNA_PPO — COMMERCIAL: $153
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $30.60
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $30.60
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $67.27
  • BCBS_OF_TEXAS — COMMERCIAL: $67.27
  • CIGNA — COMMERCIAL: $112.20
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $112.20
  • CIGNA_HEALTHSMART — COMMERCIAL: $112.20
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: EMERGENCY ROOM - LEVEL 4 $773 $618.40 $115.95 – $695.70
Emergency room visit (moderately high): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $579.75
  • AETNA_MEDICARE — MEDICARE: $224.17
  • AETNA_PPO — COMMERCIAL: $579.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $657.05
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $579.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $293.71
  • BCBS_OF_TEXAS — COMMERCIAL: $618.40
  • CIGNA — COMMERCIAL: $425.15
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $425.15
  • CIGNA_HEALTHSMART — COMMERCIAL: $425.15
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: EMER DEPT PHYSICIAN CHARGE 4 $383 $306.40 $57.45 – $291
Emergency room visit (moderately high): 10 of 29 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $291
  • AETNA_MEDICARE — MEDICARE: $114.81
  • AETNA_PPO — COMMERCIAL: $291
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $57.45
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $57.45
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $127.62
  • BCBS_OF_TEXAS — COMMERCIAL: $127.62
  • CIGNA — COMMERCIAL: $210.65
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $210.65
  • CIGNA_HEALTHSMART — COMMERCIAL: $210.65
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: EMERGENCY ROOM - LEVEL 5 $1,114 $891.20 $167.10 – $1,002.60
Emergency room visit (high): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $835.50
  • AETNA_MEDICARE — MEDICARE: $323.06
  • AETNA_PPO — COMMERCIAL: $835.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $946.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $835.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $455.93
  • BCBS_OF_TEXAS — COMMERCIAL: $891.20
  • CIGNA — COMMERCIAL: $612.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $612.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $612.70
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: EMER DEPT PHYSICIAN CHARGE 5 $563 $450.40 $84.45 – $429
Emergency room visit (high): 10 of 29 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $429
  • AETNA_MEDICARE — MEDICARE: $166.52
  • AETNA_PPO — COMMERCIAL: $429
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $84.45
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $84.45
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $188.36
  • BCBS_OF_TEXAS — COMMERCIAL: $188.36
  • CIGNA — COMMERCIAL: $309.65
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $309.65
  • CIGNA_HEALTHSMART — COMMERCIAL: $309.65

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BASIC METABOLIC PANEL $226 $180.80 $10.39 – $203.40
Basic metabolic panel (blood test): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $169.50
  • AETNA_MEDICARE — MEDICARE: $8.46
  • AETNA_PPO — COMMERCIAL: $169.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $192.10
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $169.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $11.54
  • BCBS_OF_TEXAS — COMMERCIAL: $180.80
  • CIGNA — COMMERCIAL: $124.30
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $124.30
  • CIGNA_HEALTHSMART — COMMERCIAL: $124.30
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREHENSIVE METAB (PART) $337 $269.60 $12.97 – $303.30
Comprehensive metabolic panel (blood test): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $252.75
  • AETNA_MEDICARE — MEDICARE: $10.56
  • AETNA_PPO — COMMERCIAL: $252.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $286.45
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $252.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $14.41
  • BCBS_OF_TEXAS — COMMERCIAL: $269.60
  • CIGNA — COMMERCIAL: $185.35
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $185.35
  • CIGNA_HEALTHSMART — COMMERCIAL: $185.35
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREHENSIVE METABOLIC $337 $269.60 $12.97 – $303.30
Comprehensive metabolic panel (blood test): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $252.75
  • AETNA_MEDICARE — MEDICARE: $10.56
  • AETNA_PPO — COMMERCIAL: $252.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $286.45
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $252.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $14.41
  • BCBS_OF_TEXAS — COMMERCIAL: $269.60
  • CIGNA — COMMERCIAL: $185.35
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $185.35
  • CIGNA_HEALTHSMART — COMMERCIAL: $185.35
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: OBSTETRICS PANEL $381 $304.80 $33.02 – $342.90
Obstetric blood test panel: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $285.75
  • AETNA_MEDICARE — MEDICARE: $47.81
  • AETNA_PPO — COMMERCIAL: $285.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $323.85
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $285.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $36.69
  • BCBS_OF_TEXAS — COMMERCIAL: $304.80
  • CIGNA — COMMERCIAL: $209.55
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $209.55
  • CIGNA_HEALTHSMART — COMMERCIAL: $209.55
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL $191 $152.80 $16.44 – $171.90
Cholesterol panel (lipid panel): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $143.25
  • AETNA_MEDICARE — MEDICARE: $13.39
  • AETNA_PPO — COMMERCIAL: $143.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $162.35
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $143.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $18.27
  • BCBS_OF_TEXAS — COMMERCIAL: $152.80
  • CIGNA — COMMERCIAL: $105.05
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $105.05
  • CIGNA_HEALTHSMART — COMMERCIAL: $105.05
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL (HEALTHFAIR) $48 $38.40 $7.20 – $43.20
Cholesterol panel (lipid panel): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $36
  • AETNA_MEDICARE — MEDICARE: $13.39
  • AETNA_PPO — COMMERCIAL: $36
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $40.80
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $36
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $18.27
  • BCBS_OF_TEXAS — COMMERCIAL: $38.40
  • CIGNA — COMMERCIAL: $26.40
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $26.40
  • CIGNA_HEALTHSMART — COMMERCIAL: $26.40
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL $269 $215.20 $10.67 – $242.10
Kidney function panel: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $201.75
  • AETNA_MEDICARE — MEDICARE: $8.68
  • AETNA_PPO — COMMERCIAL: $201.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $228.65
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $201.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $11.85
  • BCBS_OF_TEXAS — COMMERCIAL: $215.20
  • CIGNA — COMMERCIAL: $147.95
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $147.95
  • CIGNA_HEALTHSMART — COMMERCIAL: $147.95
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEP.(LIVER) FUNCTION PANEL $226 $180.80 $10.03 – $203.40
Liver function panel: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $169.50
  • AETNA_MEDICARE — MEDICARE: $8.17
  • AETNA_PPO — COMMERCIAL: $169.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $192.10
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $169.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $11.14
  • BCBS_OF_TEXAS — COMMERCIAL: $180.80
  • CIGNA — COMMERCIAL: $124.30
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $124.30
  • CIGNA_HEALTHSMART — COMMERCIAL: $124.30
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA/COMPLETE W/MICRO $85 $68 $3.89 – $76.50
Urine test (automated, with microscope): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $63.75
  • AETNA_MEDICARE — MEDICARE: $3.17
  • AETNA_PPO — COMMERCIAL: $63.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $72.25
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $63.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $4.32
  • BCBS_OF_TEXAS — COMMERCIAL: $68
  • CIGNA — COMMERCIAL: $46.75
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $46.75
  • CIGNA_HEALTHSMART — COMMERCIAL: $46.75
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: FHC-URINE DIPSTICK $24 $19.20 $3.14 – $21.60
Urine test (manual, without microscope): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $18
  • AETNA_MEDICARE — MEDICARE: $6.96
  • AETNA_PPO — COMMERCIAL: $18
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $20.40
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $18
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $3.49
  • BCBS_OF_TEXAS — COMMERCIAL: $19.20
  • CIGNA — COMMERCIAL: $13.20
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $13.20
  • CIGNA_HEALTHSMART — COMMERCIAL: $13.20
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W/O MICRO $61 $48.80 $2.75 – $54.90
Urine test (automated, without microscope): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $45.75
  • AETNA_MEDICARE — MEDICARE: $2.25
  • AETNA_PPO — COMMERCIAL: $45.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $51.85
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $45.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $3.06
  • BCBS_OF_TEXAS — COMMERCIAL: $48.80
  • CIGNA — COMMERCIAL: $33.55
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $33.55
  • CIGNA_HEALTHSMART — COMMERCIAL: $33.55
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: URINE PH $54 $43.20 $2.75 – $48.60
Urine test (automated, without microscope): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $40.50
  • AETNA_MEDICARE — MEDICARE: $2.25
  • AETNA_PPO — COMMERCIAL: $40.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $45.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $40.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $3.06
  • BCBS_OF_TEXAS — COMMERCIAL: $43.20
  • CIGNA — COMMERCIAL: $29.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $29.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $29.70
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: GLUCOSE RANDOM URINE $48 $38.40 $2.75 – $43.20
Urine test (automated, without microscope): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $36
  • AETNA_MEDICARE — MEDICARE: $2.25
  • AETNA_PPO — COMMERCIAL: $36
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $40.80
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $36
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $3.06
  • BCBS_OF_TEXAS — COMMERCIAL: $38.40
  • CIGNA — COMMERCIAL: $26.40
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $26.40
  • CIGNA_HEALTHSMART — COMMERCIAL: $26.40
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA-PROSTATIC SPEC $231 $184.80 $22.58 – $207.90
PSA (prostate specific antigen) blood test: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $173.25
  • AETNA_MEDICARE — MEDICARE: $18.39
  • AETNA_PPO — COMMERCIAL: $173.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $196.35
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $173.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $25.09
  • BCBS_OF_TEXAS — COMMERCIAL: $184.80
  • CIGNA — COMMERCIAL: $127.05
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $127.05
  • CIGNA_HEALTHSMART — COMMERCIAL: $127.05
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA-PROSTATIC SPEC (PART) $231 $184.80 $22.58 – $207.90
PSA (prostate specific antigen) blood test: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $173.25
  • AETNA_MEDICARE — MEDICARE: $18.39
  • AETNA_PPO — COMMERCIAL: $173.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $196.35
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $173.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $25.09
  • BCBS_OF_TEXAS — COMMERCIAL: $184.80
  • CIGNA — COMMERCIAL: $127.05
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $127.05
  • CIGNA_HEALTHSMART — COMMERCIAL: $127.05
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: CHRONIC URTICARIA PANEL 2 $99 $79.20 $14.85 – $89.10
Thyroid stimulating hormone (TSH) test: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $74.25
  • AETNA_MEDICARE — MEDICARE: $16.80
  • AETNA_PPO — COMMERCIAL: $74.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $84.15
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $74.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $22.93
  • BCBS_OF_TEXAS — COMMERCIAL: $79.20
  • CIGNA — COMMERCIAL: $54.45
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $54.45
  • CIGNA_HEALTHSMART — COMMERCIAL: $54.45
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH/THYROID STIM HORMONE $219 $175.20 $20.64 – $197.10
Thyroid stimulating hormone (TSH) test: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $164.25
  • AETNA_MEDICARE — MEDICARE: $16.80
  • AETNA_PPO — COMMERCIAL: $164.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $186.15
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $164.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $22.93
  • BCBS_OF_TEXAS — COMMERCIAL: $175.20
  • CIGNA — COMMERCIAL: $120.45
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $120.45
  • CIGNA_HEALTHSMART — COMMERCIAL: $120.45
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CBC/ AUTO DIFF $135 $108 $9.55 – $121.50
Complete blood count (CBC) with differential: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $101.25
  • AETNA_MEDICARE — MEDICARE: $7.77
  • AETNA_PPO — COMMERCIAL: $101.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $114.75
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $101.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $10.61
  • BCBS_OF_TEXAS — COMMERCIAL: $108
  • CIGNA — COMMERCIAL: $74.25
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $74.25
  • CIGNA_HEALTHSMART — COMMERCIAL: $74.25
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC AUTO HEMOGRAM $122 $97.60 $7.95 – $109.80
Complete blood count (CBC), automated: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $91.50
  • AETNA_MEDICARE — MEDICARE: $6.47
  • AETNA_PPO — COMMERCIAL: $91.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $103.70
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $91.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $8.83
  • BCBS_OF_TEXAS — COMMERCIAL: $97.60
  • CIGNA — COMMERCIAL: $67.10
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $67.10
  • CIGNA_HEALTHSMART — COMMERCIAL: $67.10
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTHROMBIN TIME $114 $91.20 $4.83 – $102.60
Blood clotting time test (prothrombin time, PT): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $85.50
  • AETNA_MEDICARE — MEDICARE: $4.29
  • AETNA_PPO — COMMERCIAL: $85.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $96.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $85.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $5.37
  • BCBS_OF_TEXAS — COMMERCIAL: $91.20
  • CIGNA — COMMERCIAL: $62.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $62.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $62.70
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT (PART) $114 $91.20 $7.37 – $102.60
Blood clotting test (partial thromboplastin time, PTT): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $85.50
  • AETNA_MEDICARE — MEDICARE: $6.01
  • AETNA_PPO — COMMERCIAL: $85.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $96.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $85.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $8.19
  • BCBS_OF_TEXAS — COMMERCIAL: $91.20
  • CIGNA — COMMERCIAL: $62.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $62.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $62.70
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: VON WILLEBRAND (PART PANEL) $21 $16.80 $3.15 – $18.90
Blood clotting test (partial thromboplastin time, PTT): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $15.75
  • AETNA_MEDICARE — MEDICARE: $6.01
  • AETNA_PPO — COMMERCIAL: $15.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $17.85
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $15.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $8.19
  • BCBS_OF_TEXAS — COMMERCIAL: $16.80
  • CIGNA — COMMERCIAL: $11.55
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $11.55
  • CIGNA_HEALTHSMART — COMMERCIAL: $11.55
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: P T T $114 $91.20 $7.37 – $102.60
Blood clotting test (partial thromboplastin time, PTT): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $85.50
  • AETNA_MEDICARE — MEDICARE: $6.01
  • AETNA_PPO — COMMERCIAL: $85.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $96.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $85.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $8.19
  • BCBS_OF_TEXAS — COMMERCIAL: $91.20
  • CIGNA — COMMERCIAL: $62.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $62.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $62.70

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: RR CT HEAD WO CONTRAST $134 $107.20 $20.10 – $126.47
CT scan of the head or brain, without contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $100.50
  • AETNA_MEDICARE — MEDICARE: $38.86
  • AETNA_PPO — COMMERCIAL: $100.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $113.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $100.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $126.47
  • BCBS_OF_TEXAS — COMMERCIAL: $107.20
  • CIGNA — COMMERCIAL: $73.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $73.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $73.70
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD W/O CONTRAST $2,567 $2,053.60 $113.82 – $2,310.30
CT scan of the head or brain, without contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $1,925.25
  • AETNA_MEDICARE — MEDICARE: $744.43
  • AETNA_PPO — COMMERCIAL: $1,925.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,181.95
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $1,925.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $126.47
  • BCBS_OF_TEXAS — COMMERCIAL: $2,053.60
  • CIGNA — COMMERCIAL: $1,411.85
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,411.85
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,411.85
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: COMPUTERIZED AXIAL TOMOGRAPHY $226 $180.80 $33.90 – $362
CT scan of the head or brain, without contrast: 10 of 29 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $362
  • AETNA_MEDICARE — MEDICARE: $100.83
  • AETNA_PPO — COMMERCIAL: $362
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $33.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $33.90
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $111.82
  • BCBS_OF_TEXAS — COMMERCIAL: $111.82
  • CIGNA — COMMERCIAL: $124.30
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $124.30
  • CIGNA_HEALTHSMART — COMMERCIAL: $124.30
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: RR BRAIN W/WO CONTRAST $327 $261.60 $49.05 – $492.92
MRI of the brain, before and after contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $245.25
  • AETNA_MEDICARE — MEDICARE: $94.83
  • AETNA_PPO — COMMERCIAL: $245.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $277.95
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $245.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $492.92
  • BCBS_OF_TEXAS — COMMERCIAL: $261.60
  • CIGNA — COMMERCIAL: $179.85
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $179.85
  • CIGNA_HEALTHSMART — COMMERCIAL: $179.85
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W&W/O CONTRAST $4,123 $3,298.40 $443.63 – $3,710.70
MRI of the brain, before and after contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $3,092.25
  • AETNA_MEDICARE — MEDICARE: $1,195.67
  • AETNA_PPO — COMMERCIAL: $3,092.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $3,504.55
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $3,092.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $492.92
  • BCBS_OF_TEXAS — COMMERCIAL: $3,298.40
  • CIGNA — COMMERCIAL: $2,267.65
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $2,267.65
  • CIGNA_HEALTHSMART — COMMERCIAL: $2,267.65
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI IACs W/WO $4,123 $3,298.40 $443.63 – $3,710.70
MRI of the brain, before and after contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $3,092.25
  • AETNA_MEDICARE — MEDICARE: $1,195.67
  • AETNA_PPO — COMMERCIAL: $3,092.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $3,504.55
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $3,092.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $492.92
  • BCBS_OF_TEXAS — COMMERCIAL: $3,298.40
  • CIGNA — COMMERCIAL: $2,267.65
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $2,267.65
  • CIGNA_HEALTHSMART — COMMERCIAL: $2,267.65
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST 2 VIEW $388 $310.40 $55.90 – $349.20
Chest X-ray, 2 views: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $291
  • AETNA_MEDICARE — MEDICARE: $112.52
  • AETNA_PPO — COMMERCIAL: $291
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $329.80
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $291
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $62.11
  • BCBS_OF_TEXAS — COMMERCIAL: $310.40
  • CIGNA — COMMERCIAL: $213.40
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $213.40
  • CIGNA_HEALTHSMART — COMMERCIAL: $213.40
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: LUMBAR MIN 4V $525 $420 $78.75 – $472.50
X-ray of the lower spine, at least 4 views: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $393.75
  • AETNA_MEDICARE — MEDICARE: $152.25
  • AETNA_PPO — COMMERCIAL: $393.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $446.25
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $393.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $90.89
  • BCBS_OF_TEXAS — COMMERCIAL: $420
  • CIGNA — COMMERCIAL: $288.75
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $288.75
  • CIGNA_HEALTHSMART — COMMERCIAL: $288.75
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: RR LUMBAR SPINE COMPLETE $134 $107.20 $20.10 – $120.60
X-ray of the lower spine, at least 4 views: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $100.50
  • AETNA_MEDICARE — MEDICARE: $38.86
  • AETNA_PPO — COMMERCIAL: $100.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $113.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $100.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $90.89
  • BCBS_OF_TEXAS — COMMERCIAL: $107.20
  • CIGNA — COMMERCIAL: $73.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $73.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $73.70
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: INITIAL INTERPRETATION OF $103 $82.40 $15.45 – $85
X-ray of the lower spine, at least 4 views: 10 of 29 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $85
  • AETNA_MEDICARE — MEDICARE: $48.14
  • AETNA_PPO — COMMERCIAL: $85
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $15.45
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $15.45
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $47.04
  • BCBS_OF_TEXAS — COMMERCIAL: $47.04
  • CIGNA — COMMERCIAL: $56.65
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $56.65
  • CIGNA_HEALTHSMART — COMMERCIAL: $56.65
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: RR MRI LUMBAR W/O CONTRAST $247 $197.60 $37.05 – $294.78
MRI of the lower back (lumbar spine), without contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $185.25
  • AETNA_MEDICARE — MEDICARE: $71.63
  • AETNA_PPO — COMMERCIAL: $185.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $209.95
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $185.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $294.78
  • BCBS_OF_TEXAS — COMMERCIAL: $197.60
  • CIGNA — COMMERCIAL: $135.85
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $135.85
  • CIGNA_HEALTHSMART — COMMERCIAL: $135.85
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI LUMBAR W/O CONTRAST $3,381 $2,704.80 $265.30 – $3,042.90
MRI of the lower back (lumbar spine), without contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $2,535.75
  • AETNA_MEDICARE — MEDICARE: $980.49
  • AETNA_PPO — COMMERCIAL: $2,535.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,873.85
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $2,535.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $294.78
  • BCBS_OF_TEXAS — COMMERCIAL: $2,704.80
  • CIGNA — COMMERCIAL: $1,859.55
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,859.55
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,859.55
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST $2,682 $2,145.60 $224.10 – $2,413.80
CT scan of the pelvis, with contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $2,011.50
  • AETNA_MEDICARE — MEDICARE: $777.78
  • AETNA_PPO — COMMERCIAL: $2,011.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,279.70
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $2,011.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $249
  • BCBS_OF_TEXAS — COMMERCIAL: $2,145.60
  • CIGNA — COMMERCIAL: $1,475.10
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,475.10
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,475.10
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: PROFEE CT PELVIS W CONTRAST $307 $245.60 $46.05 – $490.97
CT scan of the pelvis, with contrast: 10 of 28 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $260.95
  • AETNA_MEDICARE — MEDICARE: $212.95
  • AETNA_PPO — COMMERCIAL: $260.95
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $46.05
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $46.05
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $217.49
  • BCBS_OF_TEXAS — COMMERCIAL: $217.49
  • CIGNA — COMMERCIAL: $168.85
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $168.85
  • CIGNA_HEALTHSMART — COMMERCIAL: $168.85
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: RR ANY JOINT LOWER EXT WO $193 $154.40 $28.95 – $294.78
MRI of a leg joint (such as the knee), without contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $144.75
  • AETNA_MEDICARE — MEDICARE: $55.97
  • AETNA_PPO — COMMERCIAL: $144.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $164.05
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $144.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $294.78
  • BCBS_OF_TEXAS — COMMERCIAL: $154.40
  • CIGNA — COMMERCIAL: $106.15
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $106.15
  • CIGNA_HEALTHSMART — COMMERCIAL: $106.15
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI LT HIP W/O LTD $432 $345.60 $64.80 – $388.80
MRI of a leg joint (such as the knee), without contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $324
  • AETNA_MEDICARE — MEDICARE: $125.28
  • AETNA_PPO — COMMERCIAL: $324
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $367.20
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $324
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $294.78
  • BCBS_OF_TEXAS — COMMERCIAL: $345.60
  • CIGNA — COMMERCIAL: $237.60
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $237.60
  • CIGNA_HEALTHSMART — COMMERCIAL: $237.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI KNEE LT W/O $2,766 $2,212.80 $265.30 – $2,489.40
MRI of a leg joint (such as the knee), without contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $2,074.50
  • AETNA_MEDICARE — MEDICARE: $802.14
  • AETNA_PPO — COMMERCIAL: $2,074.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,351.10
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $2,074.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $294.78
  • BCBS_OF_TEXAS — COMMERCIAL: $2,212.80
  • CIGNA — COMMERCIAL: $1,521.30
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,521.30
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,521.30
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: RR ABDOMEN AND PELVIS W CONTRA $254 $203.20 $38.10 – $390.13
CT scan of the abdomen and pelvis, with contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $190.50
  • AETNA_MEDICARE — MEDICARE: $73.66
  • AETNA_PPO — COMMERCIAL: $190.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $215.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $190.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $390.13
  • BCBS_OF_TEXAS — COMMERCIAL: $203.20
  • CIGNA — COMMERCIAL: $139.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $139.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $139.70
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT RENALS W/CONTRAST $3,175 $2,540 $351.12 – $2,857.50
CT scan of the abdomen and pelvis, with contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $2,381.25
  • AETNA_MEDICARE — MEDICARE: $920.75
  • AETNA_PPO — COMMERCIAL: $2,381.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,698.75
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $2,381.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $390.13
  • BCBS_OF_TEXAS — COMMERCIAL: $2,540
  • CIGNA — COMMERCIAL: $1,746.25
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,746.25
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,746.25
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD & PELVIS W $5,716 $4,572.80 $351.12 – $5,144.40
CT scan of the abdomen and pelvis, with contrast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $4,287
  • AETNA_MEDICARE — MEDICARE: $1,657.64
  • AETNA_PPO — COMMERCIAL: $4,287
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $4,858.60
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $4,287
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $390.13
  • BCBS_OF_TEXAS — COMMERCIAL: $4,572.80
  • CIGNA — COMMERCIAL: $3,143.80
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $3,143.80
  • CIGNA_HEALTHSMART — COMMERCIAL: $3,143.80
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE $939 $751.20 $121.11 – $845.10
Ultrasound of the abdomen, complete: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $704.25
  • AETNA_MEDICARE — MEDICARE: $272.31
  • AETNA_PPO — COMMERCIAL: $704.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $798.15
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $704.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $134.57
  • BCBS_OF_TEXAS — COMMERCIAL: $751.20
  • CIGNA — COMMERCIAL: $516.45
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $516.45
  • CIGNA_HEALTHSMART — COMMERCIAL: $516.45
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: RR SONO OB PREGNANCY >14 WEEKS $145 $116 $21.75 – $130.50
Pregnancy ultrasound (after the first trimester): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $108.75
  • AETNA_MEDICARE — MEDICARE: $42.05
  • AETNA_PPO — COMMERCIAL: $108.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $123.25
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $108.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $92.76
  • BCBS_OF_TEXAS — COMMERCIAL: $116
  • CIGNA — COMMERCIAL: $79.75
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $79.75
  • CIGNA_HEALTHSMART — COMMERCIAL: $79.75
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US OB MORE THAN 14 WEEKS $684 $547.20 $83.48 – $615.60
Pregnancy ultrasound (after the first trimester): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $513
  • AETNA_MEDICARE — MEDICARE: $198.36
  • AETNA_PPO — COMMERCIAL: $513
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $581.40
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $513
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $92.76
  • BCBS_OF_TEXAS — COMMERCIAL: $547.20
  • CIGNA — COMMERCIAL: $376.20
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $376.20
  • CIGNA_HEALTHSMART — COMMERCIAL: $376.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: PROFEE OB SONO >14WKS $204 $163.20 $30.60 – $205.76
Pregnancy ultrasound (after the first trimester): 10 of 29 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $173.40
  • AETNA_MEDICARE — MEDICARE: $124.62
  • AETNA_PPO — COMMERCIAL: $173.40
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $30.60
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $30.60
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $138.41
  • BCBS_OF_TEXAS — COMMERCIAL: $138.41
  • CIGNA — COMMERCIAL: $112.20
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $112.20
  • CIGNA_HEALTHSMART — COMMERCIAL: $112.20
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: RR US ENDOVAGINAL PELVIS $134 $107.20 $20.10 – $120.60
Transvaginal ultrasound: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $100.50
  • AETNA_MEDICARE — MEDICARE: $38.86
  • AETNA_PPO — COMMERCIAL: $100.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $113.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $100.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $88
  • BCBS_OF_TEXAS — COMMERCIAL: $107.20
  • CIGNA — COMMERCIAL: $73.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $73.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $73.70
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US ENDOVAGINAL PELVIC $649 $519.20 $79.20 – $584.10
Transvaginal ultrasound: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $486.75
  • AETNA_MEDICARE — MEDICARE: $188.21
  • AETNA_PPO — COMMERCIAL: $486.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $551.65
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $486.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $88
  • BCBS_OF_TEXAS — COMMERCIAL: $519.20
  • CIGNA — COMMERCIAL: $356.95
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $356.95
  • CIGNA_HEALTHSMART — COMMERCIAL: $356.95
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: PROFEE US PELVIS TRANSVAGINAL $109 $87.20 $16.35 – $162.96
Transvaginal ultrasound: 10 of 29 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $92.65
  • AETNA_MEDICARE — MEDICARE: $109
  • AETNA_PPO — COMMERCIAL: $92.65
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $16.35
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $16.35
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $118.63
  • BCBS_OF_TEXAS — COMMERCIAL: $118.63
  • CIGNA — COMMERCIAL: $59.95
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $59.95
  • CIGNA_HEALTHSMART — COMMERCIAL: $59.95
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: DIGITAL DIAGNOSTIC RIGHT CLIP $436 $348.80 $54.06 – $392.40
Diagnostic mammogram, one breast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $327
  • AETNA_MEDICARE — MEDICARE: $126.44
  • AETNA_PPO — COMMERCIAL: $327
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $370.60
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $327
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $60.07
  • BCBS_OF_TEXAS — COMMERCIAL: $348.80
  • CIGNA — COMMERCIAL: $239.80
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $239.80
  • CIGNA_HEALTHSMART — COMMERCIAL: $239.80
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: DIGITAL DIAGNOSTIC LEFT CLIP $436 $348.80 $54.06 – $392.40
Diagnostic mammogram, one breast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $327
  • AETNA_MEDICARE — MEDICARE: $126.44
  • AETNA_PPO — COMMERCIAL: $327
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $370.60
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $327
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $60.07
  • BCBS_OF_TEXAS — COMMERCIAL: $348.80
  • CIGNA — COMMERCIAL: $239.80
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $239.80
  • CIGNA_HEALTHSMART — COMMERCIAL: $239.80
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: DIGITAL DIAGNOSTIC LEFT TOMO $436 $348.80 $54.06 – $392.40
Diagnostic mammogram, one breast: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $327
  • AETNA_MEDICARE — MEDICARE: $126.44
  • AETNA_PPO — COMMERCIAL: $327
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $370.60
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $327
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $60.07
  • BCBS_OF_TEXAS — COMMERCIAL: $348.80
  • CIGNA — COMMERCIAL: $239.80
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $239.80
  • CIGNA_HEALTHSMART — COMMERCIAL: $239.80
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: DIAGNOSTIC MAMO W IV CONTRAST $534 $427.20 $69.51 – $480.60
Diagnostic mammogram, both breasts: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $400.50
  • AETNA_MEDICARE — MEDICARE: $154.86
  • AETNA_PPO — COMMERCIAL: $400.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $453.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $400.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $77.23
  • BCBS_OF_TEXAS — COMMERCIAL: $427.20
  • CIGNA — COMMERCIAL: $293.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $293.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $293.70
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: DIGITAL DX BILAT CLIP PLACEMEN $773 $618.40 $69.51 – $695.70
Diagnostic mammogram, both breasts: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $579.75
  • AETNA_MEDICARE — MEDICARE: $224.17
  • AETNA_PPO — COMMERCIAL: $579.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $657.05
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $579.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $77.23
  • BCBS_OF_TEXAS — COMMERCIAL: $618.40
  • CIGNA — COMMERCIAL: $425.15
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $425.15
  • CIGNA_HEALTHSMART — COMMERCIAL: $425.15
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: DIGITAL DIAGNOSTIC BILAT TOMO $518 $414.40 $69.51 – $466.20
Diagnostic mammogram, both breasts: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $388.50
  • AETNA_MEDICARE — MEDICARE: $150.22
  • AETNA_PPO — COMMERCIAL: $388.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $440.30
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $388.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $77.23
  • BCBS_OF_TEXAS — COMMERCIAL: $414.40
  • CIGNA — COMMERCIAL: $284.90
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $284.90
  • CIGNA_HEALTHSMART — COMMERCIAL: $284.90
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCREENING LEFT ONLY $218 $174.40 $32.70 – $196.20
Screening mammogram, both breasts: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $163.50
  • AETNA_MEDICARE — MEDICARE: $63.22
  • AETNA_PPO — COMMERCIAL: $163.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $185.30
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $163.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $52.56
  • BCBS_OF_TEXAS — COMMERCIAL: $174.40
  • CIGNA — COMMERCIAL: $119.90
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $119.90
  • CIGNA_HEALTHSMART — COMMERCIAL: $119.90
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCREENING RIGHT ONLY $218 $174.40 $32.70 – $196.20
Screening mammogram, both breasts: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $163.50
  • AETNA_MEDICARE — MEDICARE: $63.22
  • AETNA_PPO — COMMERCIAL: $163.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $185.30
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $163.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $52.56
  • BCBS_OF_TEXAS — COMMERCIAL: $174.40
  • CIGNA — COMMERCIAL: $119.90
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $119.90
  • CIGNA_HEALTHSMART — COMMERCIAL: $119.90
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: DIGITAL SCREENING BILAT TOMO $480 $384 $47.30 – $432
Screening mammogram, both breasts: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $360
  • AETNA_MEDICARE — MEDICARE: $139.20
  • AETNA_PPO — COMMERCIAL: $360
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $408
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $360
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $52.56
  • BCBS_OF_TEXAS — COMMERCIAL: $384
  • CIGNA — COMMERCIAL: $264
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $264
  • CIGNA_HEALTHSMART — COMMERCIAL: $264

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: ECG 12 LEADS $59 $47.20 $8.85 – $46.55
Electrocardiogram (ECG/EKG) with reading: 10 of 29 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $20.26
  • AETNA_MEDICARE — MEDICARE: $13.43
  • AETNA_PPO — COMMERCIAL: $20.26
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $8.85
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $8.85
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $26.53
  • BCBS_OF_TEXAS — COMMERCIAL: $26.53
  • CIGNA — COMMERCIAL: $32.45
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $32.45
  • CIGNA_HEALTHSMART — COMMERCIAL: $32.45

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: THERAPUTIC EXC 15 MIN $169 $135.20 $25.35 – $152.10
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $126.75
  • AETNA_MEDICARE — MEDICARE: $49.01
  • AETNA_PPO — COMMERCIAL: $126.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $143.65
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $126.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $30.58
  • BCBS_OF_TEXAS — COMMERCIAL: $135.20
  • CIGNA — COMMERCIAL: $92.95
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $92.95
  • CIGNA_HEALTHSMART — COMMERCIAL: $92.95
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: THERAPUTIC EXC 15 MIN UB MODIF $169 $135.20 $25.35 – $152.10
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $126.75
  • AETNA_MEDICARE — MEDICARE: $49.01
  • AETNA_PPO — COMMERCIAL: $126.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $143.65
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $126.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $30.58
  • BCBS_OF_TEXAS — COMMERCIAL: $135.20
  • CIGNA — COMMERCIAL: $92.95
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $92.95
  • CIGNA_HEALTHSMART — COMMERCIAL: $92.95
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: THERAPUTIC EXC 15 MIN U5 $169 $135.20 $25.35 – $152.10
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $126.75
  • AETNA_MEDICARE — MEDICARE: $49.01
  • AETNA_PPO — COMMERCIAL: $126.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $143.65
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $126.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $30.58
  • BCBS_OF_TEXAS — COMMERCIAL: $135.20
  • CIGNA — COMMERCIAL: $92.95
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $92.95
  • CIGNA_HEALTHSMART — COMMERCIAL: $92.95
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT EVAL LOW COMP 20 MIN $262 $209.60 $39.30 – $235.80
Physical therapy evaluation (low complexity): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $196.50
  • AETNA_MEDICARE — MEDICARE: $75.98
  • AETNA_PPO — COMMERCIAL: $196.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $222.70
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $196.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $81.52
  • BCBS_OF_TEXAS — COMMERCIAL: $209.60
  • CIGNA — COMMERCIAL: $144.10
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $144.10
  • CIGNA_HEALTHSMART — COMMERCIAL: $144.10
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT EVAL 30 MIN $262 $209.60 $39.30 – $235.80
Physical therapy evaluation (moderate complexity): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $196.50
  • AETNA_MEDICARE — MEDICARE: $75.98
  • AETNA_PPO — COMMERCIAL: $196.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $222.70
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $196.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $81.52
  • BCBS_OF_TEXAS — COMMERCIAL: $209.60
  • CIGNA — COMMERCIAL: $144.10
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $144.10
  • CIGNA_HEALTHSMART — COMMERCIAL: $144.10
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: EVAL MOD COMPLEXITY $262 $209.60 $39.30 – $235.80
Physical therapy evaluation (moderate complexity): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $196.50
  • AETNA_MEDICARE — MEDICARE: $75.98
  • AETNA_PPO — COMMERCIAL: $196.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $222.70
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $196.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $81.52
  • BCBS_OF_TEXAS — COMMERCIAL: $209.60
  • CIGNA — COMMERCIAL: $144.10
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $144.10
  • CIGNA_HEALTHSMART — COMMERCIAL: $144.10
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVAL HIGH COMP 45 MIN $262 $209.60 $39.30 – $235.80
Physical therapy evaluation (high complexity): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $196.50
  • AETNA_MEDICARE — MEDICARE: $75.98
  • AETNA_PPO — COMMERCIAL: $196.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $222.70
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $196.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $81.52
  • BCBS_OF_TEXAS — COMMERCIAL: $209.60
  • CIGNA — COMMERCIAL: $144.10
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $144.10
  • CIGNA_HEALTHSMART — COMMERCIAL: $144.10

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: REMOVE BREAST LESION $7,931 $6,344.80 $1,189.65 – $7,137.90
Removal of breast growth (open surgery): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $5,948.25
  • AETNA_MEDICARE — MEDICARE: $2,299.99
  • AETNA_PPO — COMMERCIAL: $5,948.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $6,741.35
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $5,948.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $1,974.26
  • BCBS_OF_TEXAS — COMMERCIAL: $6,344.80
  • CIGNA — COMMERCIAL: $4,362.05
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $4,362.05
  • CIGNA_HEALTHSMART — COMMERCIAL: $4,362.05
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: EGD DIAGNOSTIC ENDO $2,673 $2,138.40 $400.95 – $2,405.70
Upper GI endoscopy (diagnostic): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $2,004.75
  • AETNA_MEDICARE — MEDICARE: $775.17
  • AETNA_PPO — COMMERCIAL: $2,004.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,272.05
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $2,004.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $670.47
  • BCBS_OF_TEXAS — COMMERCIAL: $2,138.40
  • CIGNA — COMMERCIAL: $1,470.15
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,470.15
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,470.15
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: UPPER GI ENDO W/BX $2,673 $2,138.40 $400.95 – $2,405.70
Upper GI endoscopy with biopsy: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $2,004.75
  • AETNA_MEDICARE — MEDICARE: $775.17
  • AETNA_PPO — COMMERCIAL: $2,004.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,272.05
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $2,004.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $670.47
  • BCBS_OF_TEXAS — COMMERCIAL: $2,138.40
  • CIGNA — COMMERCIAL: $1,470.15
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,470.15
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,470.15
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: DIAGNOSTIC COLONOSCOPY $2,946 $2,356.80 $441.90 – $2,651.40
Colonoscopy (diagnostic): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $2,209.50
  • AETNA_MEDICARE — MEDICARE: $854.34
  • AETNA_PPO — COMMERCIAL: $2,209.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,504.10
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $2,209.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $736.84
  • BCBS_OF_TEXAS — COMMERCIAL: $2,356.80
  • CIGNA — COMMERCIAL: $1,620.30
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,620.30
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,620.30
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/BX $2,946 $2,356.80 $441.90 – $2,651.40
Colonoscopy with biopsy: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $2,209.50
  • AETNA_MEDICARE — MEDICARE: $854.34
  • AETNA_PPO — COMMERCIAL: $2,209.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,504.10
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $2,209.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $736.84
  • BCBS_OF_TEXAS — COMMERCIAL: $2,356.80
  • CIGNA — COMMERCIAL: $1,620.30
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,620.30
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,620.30
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY LESION REMOVE $2,946 $2,356.80 $441.90 – $2,651.40
Colonoscopy with removal of polyps (snare): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $2,209.50
  • AETNA_MEDICARE — MEDICARE: $854.34
  • AETNA_PPO — COMMERCIAL: $2,209.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,504.10
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $2,209.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $736.84
  • BCBS_OF_TEXAS — COMMERCIAL: $2,356.80
  • CIGNA — COMMERCIAL: $1,620.30
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,620.30
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,620.30
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLONOSCOPY $2,607 $2,085.60 $391.05 – $2,346.30
Screening colonoscopy (not high risk): 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $1,955.25
  • AETNA_MEDICARE — MEDICARE: $756.03
  • AETNA_PPO — COMMERCIAL: $1,955.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,215.95
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $1,955.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $646.73
  • BCBS_OF_TEXAS — COMMERCIAL: $2,085.60
  • CIGNA — COMMERCIAL: $1,433.85
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,433.85
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,433.85
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAP CHOLE $14,840 $11,872 $2,226 – $13,356
Gallbladder removal by laparoscope: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $11,130
  • AETNA_MEDICARE — MEDICARE: $4,303.60
  • AETNA_PPO — COMMERCIAL: $11,130
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $12,614
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $11,130
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $3,648.49
  • BCBS_OF_TEXAS — COMMERCIAL: $11,872
  • CIGNA — COMMERCIAL: $8,162
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $8,162
  • CIGNA_HEALTHSMART — COMMERCIAL: $8,162
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: REPAIR INGUINAL HERNIA $10,339 $8,271.20 $1,550.85 – $9,305.10
Groin (inguinal) hernia repair, age 5 or older: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $7,754.25
  • AETNA_MEDICARE — MEDICARE: $2,998.31
  • AETNA_PPO — COMMERCIAL: $7,754.25
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $8,788.15
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $7,754.25
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $2,599.64
  • BCBS_OF_TEXAS — COMMERCIAL: $8,271.20
  • CIGNA — COMMERCIAL: $5,686.45
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $5,686.45
  • CIGNA_HEALTHSMART — COMMERCIAL: $5,686.45
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: BILAT INGUINAL HERNIA REPAIR $9,777 $7,821.60 $1,466.55 – $8,799.30
Groin (inguinal) hernia repair, age 5 or older: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $7,332.75
  • AETNA_MEDICARE — MEDICARE: $2,835.33
  • AETNA_PPO — COMMERCIAL: $7,332.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $8,310.45
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $7,332.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $2,599.64
  • BCBS_OF_TEXAS — COMMERCIAL: $7,821.60
  • CIGNA — COMMERCIAL: $5,377.35
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $5,377.35
  • CIGNA_HEALTHSMART — COMMERCIAL: $5,377.35
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTROSCOPY W/BX $7,161 $5,728.80 $1,074.15 – $6,444.90
Hysteroscopy with biopsy of the uterus lining: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $5,370.75
  • AETNA_MEDICARE — MEDICARE: $2,076.69
  • AETNA_PPO — COMMERCIAL: $5,370.75
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $6,086.85
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $5,370.75
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $1,763.37
  • BCBS_OF_TEXAS — COMMERCIAL: $5,728.80
  • CIGNA — COMMERCIAL: $3,938.55
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $3,938.55
  • CIGNA_HEALTHSMART — COMMERCIAL: $3,938.55
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: LUMBAR INJECTION SINGLE LEVEL $2,674 $2,139.20 $401.10 – $2,406.60
Nerve root injection, lower back, with imaging guidance: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $2,005.50
  • AETNA_MEDICARE — MEDICARE: $775.46
  • AETNA_PPO — COMMERCIAL: $2,005.50
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $2,272.90
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $2,005.50
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $669.91
  • BCBS_OF_TEXAS — COMMERCIAL: $2,139.20
  • CIGNA — COMMERCIAL: $1,470.70
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $1,470.70
  • CIGNA_HEALTHSMART — COMMERCIAL: $1,470.70

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: OB Delivery ALS $1,048 $838.40 $157.20 – $2,071.20
Vaginal delivery, with care before and after: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $786
  • AETNA_MEDICARE — MEDICARE: $303.92
  • AETNA_PPO — COMMERCIAL: $786
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $890.80
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $786
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $2,071.20
  • BCBS_OF_TEXAS — COMMERCIAL: $838.40
  • CIGNA — COMMERCIAL: $576.40
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $576.40
  • CIGNA_HEALTHSMART — COMMERCIAL: $576.40
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: OB DELIVERY BLS $1,048 $838.40 $157.20 – $2,071.20
Vaginal delivery, with care before and after: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $786
  • AETNA_MEDICARE — MEDICARE: $303.92
  • AETNA_PPO — COMMERCIAL: $786
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $890.80
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $786
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $2,071.20
  • BCBS_OF_TEXAS — COMMERCIAL: $838.40
  • CIGNA — COMMERCIAL: $576.40
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $576.40
  • CIGNA_HEALTHSMART — COMMERCIAL: $576.40
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: OB DELIVERY ALS2 $1,048 $838.40 $157.20 – $2,071.20
Vaginal delivery, with care before and after: 10 of 31 insurance plan rates
  • AETNA_HMO — COMMERCIAL: $786
  • AETNA_MEDICARE — MEDICARE: $303.92
  • AETNA_PPO — COMMERCIAL: $786
  • ALLIED_BENEFIT_MCHD_EMPLOYEE — COMMERCIAL: $890.80
  • ALLIED_GROUP_INSURANCE — COMMERCIAL: $786
  • BCBS_HMO_BAV_ADVANTAGE — COMMERCIAL: $2,071.20
  • BCBS_OF_TEXAS — COMMERCIAL: $838.40
  • CIGNA — COMMERCIAL: $576.40
  • CIGNA_HEALTH_CARE_TX — COMMERCIAL: $576.40
  • CIGNA_HEALTHSMART — COMMERCIAL: $576.40

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

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

Hospital information

Hospital typeCritical Access Hospital
Address224 E Second Street, Dumas, TX 79029
CountyMoore County
StateTexas
Phone(806) 935‑7171
Emergency servicesYes
OwnershipGovernment - Hospital District or Authority
Medicare overall ratingNot rated by CMS
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number451386
Name in Medicare recordsMEMORIAL HOSPITAL
Profile levelMedicare data + hospital website
Name on the hospital’s websiteMoore County Hospital District
Official websitemchd.net
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Moore County Hospital District — mchd.net
  2. Visitor Information — mchd.net
  3. Services — mchd.net
  4. Emergency – Moore County Hospital District — mchd.net
  5. Inpatient – Moore County Hospital District — mchd.net
  6. Outpatient – Moore County Hospital District — mchd.net
  7. Lab – Moore County Hospital District — mchd.net
  8. Moore County Hospital District – Exceptional Care. Always — mchd.net
  9. Awards – Moore County Hospital District — mchd.net