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?

209 Northwest 8th Street, Seminole, TX 79360, in Gaines County, Texas.

What is the phone number of Memorial Hospital?

(432) 758-5811, 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.

Memorial Hospital — Phone, Address, ER & Ratings

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?: 209 Northwest 8th Street, Seminole, TX 79360, in Gaines County, Texas.
What is the phone number of Memorial Hospital?: (432) 758-5811, 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][5][6][12][14][16]}

Emergency and trauma
General surgery
Labor, delivery and postpartum
Prenatal care
Women's services
Radiology
Physical therapy
Speech therapy
Cardiac therapy
Interventional pain management
Swing bed care
Outpatient infusion
Emergency medicine
Mammography
Clinical laboratory
Cardiac rehabilitation

Conditions treated^{[7][10][14][18][19]}

Osteoporosis
Multiple sclerosis
Rheumatoid arthritis
Anemia
Asthma
Crohn's disease
CIDP
Ulcerative colitis
Skin or bone infection
Congestive heart failure
Stable angina
Heart attack
Coronary artery bypass graft (CABG) recovery
Pelvic organ prolapse
Stroke
Transient ischemic attack
Traumatic brain injury
Head and neck cancer
Vocal cord damage
Vertigo

Treatments^{[9][10][14][18][19]}

Outpatient IV infusion therapy
Cardiac rehabilitation
ECG monitoring
Wound care
Laser therapy
Spinal decompression
Kinesiotaping
Instrument assisted soft tissue management (IASTM)
Balance training and fall prevention
Amputee rehabilitation
Modified barium swallow study
Fiberoptic endoscopic evaluation of swallowing (FEES)
Videostroboscopy
Vital stimulation treatment
Lee Silverman Voice Treatment (LSVT)
McNeil Dysphagia Treatment Program (MDTP)
Myofascial release for swallow

Procedures^{[4][7][8][9][12][15]}

CT scans
MRI
Mammography
Sleep study
Breast biopsy
Colposcopy
Dilation and curettage (D&C)
Endometrial biopsy
Endometrial ablation
Essure tubal occlusion
Hysterectomy
Tubal ligation
Appendectomy
Gallbladder surgery
Upper endoscopy (EGD) and colonoscopy
Hernia repair
Sigmoidoscopy
Skin grafts
Cystoscopy
Routine X-ray and fluoroscopy
CT (computed tomography)
Ultrasound
Adult echocardiogram
Bone density (DEXA) scan
Clinical laboratory testing (chemistry, hematology, microbiology, histology, cytology and others)

Programs and centers^{[5][10][11][14][17][19]}

Cardiac rehabilitation
Outpatient infusion services
Trauma team
M.S. Doss Fitness Center
Seminole Community Pharmacy
Speech therapy support groups

Emergency care (hospital website)^[4][5][6][9]

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

Visiting and practical information

Patient portal	Patient Portal (Access Your Care)

Recognition^[5][16]

Level IV Trauma Center (Texas)
Certified by the State of Texas for 2D and 3D breast mammography

Doctors and clinicians (47)

47 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 (47)

Asif Farooq, MDInternal Medicine
Atul B. Joshi, MDOrthopedic Surgery
Benjamin L. Fluhman, DPMPodiatry
Brock Morris, NPNurse Practitioner
Brooke S. Harvey, CNACertified Registered Nurse Anesthetist (CRNA)
Cadyn A. Crawford, MDEmergency Medicine
Cameron P. Smith, DODiagnostic Radiology
Candice Thomas, NPNurse Practitioner
Carl L. Britton Jr., MDUrology
Charles J. Taylor, DOEmergency Medicine
Christopher D. Cotton, MDGeneral Practice
David Donaldson, MDDiagnostic Radiology
Enedina Gracia, NPNurse Practitioner
Frank L. Quattromani, MDDiagnostic Radiology
Gilbert Sayegh, MDObstetrics/Gynecology
Gregory Taroyan, MDEmergency Medicine
Isabel Molina, MDFamily Practice
Jennifer J. Shivers, PAPhysician Assistant
Jennifer M. Porubsky, DOEmergency Medicine
John L. Andrew, MDDiagnostic Radiology
Joseph S. Houghton, CNACertified Registered Nurse Anesthetist (CRNA)
Josiah Wrensford, MDFamily Practice
Joy Turner, MDEmergency Medicine
Karim Jabbar, MDEmergency Medicine

And 23 more: the button below opens the full list.

Other emergency rooms nearby

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

Yoakum County Hospital20 mi · Denver City, TX · Critical Access Hospital
Permian Regional Medical Center Andrews County Ho27 mi · Andrews, TX · Acute Care Hospital
Covenant Health Hobbs Hospital31 mi · Hobbs, NM · Acute Care Hospital
Brownfield Regional Medical Center39 mi · Brownfield, TX · Acute Care Hospital
Medical Arts Hospital40 mi · Lamesa, TX · Acute Care Hospital

Find the closest emergency room to where you are →

Other hospitals near Seminole

Nor-Lea Hospital District44 mi · Lovington, NM · Critical Access Hospital

Hospitals in Gaines 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

Memorial Health Care Center0.4 mi · Seminole, TX · 4 of 5 stars
Shinnery Oaks Community19 mi · Denver City, TX · 5 of 5 stars

All nursing homes in the state →

Dialysis facilities

Dialysis Services of West Texas21 mi · Denver City, TX · 1 of 5 stars

All dialysis facilities in the state →

Community care nearby

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

Clinics and urgent care

Seminole Family Medical Clinic4.6 mi · Seminole, TX · Rural health clinic
West Texas Medical Center21 mi · Denver City, TX · Rural health clinic

Pharmacies

Gaines Care Pharmacy LLC4.6 mi · Seminole, TX · Community/retail pharmacy
Seminole Hospital District of Gaines County Texas4.6 mi · Seminole, TX · Community/retail pharmacy
Wal-Mart Stores Texas LLC4.6 mi · Seminole, TX · Community/retail pharmacy

Assisted living nearby

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

Sunland Retirement Center4.6 mi · Seminole, 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 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.

Not reported to Medicare: the patient survey, infections caught in the hospital, complications and deaths, readmissions, emergency room times and sepsis care. 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.

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 62 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 62 common services

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: OV/OP VISIT NP L3	$259	$263.43	$118.46 – $233.10
New patient office visit (about 30–44 minutes): 10 of 11 insurance plan rates AETNA — AETNA: $181.30 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $127.74 BCBSTX — BCBS OF TEXAS PPO/PAR: $233.10 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $233.10 CIGNA — CIGNA: $207.20 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $127.74 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $146.90 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $127.74 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $127.74 TRICARE — TRICARE: $118.46
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OV/OP VISIT NP L4	$398	$446.01	$182.03 – $358.20
New patient office visit (about 45–59 minutes): 10 of 11 insurance plan rates AETNA — AETNA: $278.60 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $193.06 BCBSTX — BCBS OF TEXAS PPO/PAR: $358.20 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $358.20 CIGNA — CIGNA: $318.40 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $193.06 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $222.02 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $193.06 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $193.06 TRICARE — TRICARE: $182.03
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: PM NEW VISIT LEVEL-5	$520	$582.05	$78.62 – $468
New patient office visit (about 60–74 minutes): 10 of 14 insurance plan rates AETNA — AETNA: $364 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $161.20 BCBSTX — BCBS OF TEXAS PPO/PAR: $468 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $468 CIGNA — CIGNA: $416 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $78.62 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $161.20 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $185.38 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $161.20 SUPERIOR_MDCD — SUPERIOR MEDICAID - TEXAS: $78.62
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: RHC OB OV/OP VISIT NP L-5	$499	$582.05	$154.69 – $449.10
New patient office visit (about 60–74 minutes): 10 of 11 insurance plan rates AETNA — AETNA: $349.30 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $154.69 BCBSTX — BCBS OF TEXAS PPO/PAR: $449.10 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $449.10 CIGNA — CIGNA: $399.20 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $154.69 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $177.89 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $154.69 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $154.69 TRICARE — TRICARE: $228.23
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: RHC OV/OP VISIT NP L-5	$499	$582.05	$154.69 – $449.10
New patient office visit (about 60–74 minutes): 10 of 11 insurance plan rates AETNA — AETNA: $349.30 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $154.69 BCBSTX — BCBS OF TEXAS PPO/PAR: $449.10 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $449.10 CIGNA — CIGNA: $399.20 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $154.69 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $177.89 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $154.69 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $154.69 TRICARE — TRICARE: $228.23
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: PM NEW VISIT LEVEL-3	$165	$176.46	$24.95 – $176.46
Established patient office visit (about 20–29 minutes): 10 of 14 insurance plan rates AETNA — AETNA: $115.50 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $51.15 BCBSTX — BCBS OF TEXAS PPO/PAR: $148.50 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $148.50 CIGNA — CIGNA: $132 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $24.95 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $51.15 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $58.82 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $51.15 SUPERIOR_MDCD — SUPERIOR MEDICAID - TEXAS: $24.95
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: PM EST VISIT LEVEL-3	$216.03	$176.46	$24.95 – $176.46
Established patient office visit (about 20–29 minutes): 10 of 14 insurance plan rates AETNA — AETNA: $151.22 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $66.97 BCBSTX — BCBS OF TEXAS PPO/PAR: $176.46 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $158.81 CIGNA — CIGNA: $172.82 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $32.66 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $66.97 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $77.01 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $66.97 SUPERIOR_MDCD — SUPERIOR MEDICAID - TEXAS: $32.66
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: TREATMENT ROOM LEVEL III	$216.03	$176.46	$32.66 – $172.82
Established patient office visit (about 20–29 minutes): 10 of 14 insurance plan rates AETNA — AETNA: $151.22 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $66.97 BCBSTX — BCBS OF TEXAS PPO/PAR: $50 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $158.81 CIGNA — CIGNA: $172.82 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $32.66 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $66.97 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $77.01 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $66.97 SUPERIOR_MDCD — SUPERIOR MEDICAID - TEXAS: $32.66
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: PM EST VISIT LEVEL-4	$414.45	$272.03	$62.66 – $372
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates AETNA — AETNA: $290.12 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $128.48 BCBSTX — BCBS OF TEXAS PPO/PAR: $272.03 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $244.83 CIGNA — CIGNA: $331.56 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $62.66 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $128.48 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $147.75 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $128.48 SUPERIOR_MDCD — SUPERIOR MEDICAID - TEXAS: $62.66
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: PM NEW VISIT LEVEL-4	$465	$272.03	$62.66 – $372
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates AETNA — AETNA: $325.50 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $144.15 BCBSTX — BCBS OF TEXAS PPO/PAR: $272.03 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $244.83 CIGNA — CIGNA: $372 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $70.31 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $144.15 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $165.77 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $144.15 SUPERIOR_MDCD — SUPERIOR MEDICAID - TEXAS: $70.31
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: TREATMENT ROOM LEVEL IV	$414.95	$272.03	$50 – $331.96
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates AETNA — AETNA: $290.47 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $128.63 BCBSTX — BCBS OF TEXAS PPO/PAR: $50 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $244.83 CIGNA — CIGNA: $331.96 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $62.74 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $128.63 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $147.93 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $128.63 SUPERIOR_MDCD — SUPERIOR MEDICAID - TEXAS: $62.74
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: PRO OV/OP CONSULT L3	$237	$330.85	$108.40 – $213.30
Office consultation with a specialist (moderate): 10 of 11 insurance plan rates AETNA — AETNA: $165.90 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $122.88 BCBSTX — BCBS OF TEXAS PPO/PAR: $213.30 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $213.30 CIGNA — CIGNA: $189.60 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $122.88 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $141.32 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $122.88 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $122.88 TRICARE — TRICARE: $108.40
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: RHC OV PREVENTIVE NEW EXAM 18-39 YR	$243	$338.20	$75.33 – $218.70
Preventive checkup, new patient, age 18–39: 10 of 15 insurance plan rates AETNA — AETNA: $170.10 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $137.55 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $75.33 BCBSTX — BCBS OF TEXAS PPO/PAR: $218.70 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $218.70 CIGNA — CIGNA: $194.40 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $137.55 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $75.33 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $86.63 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $75.33
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: RHC OV PREVENTIVE NEW EXAM 40-64YR	$369	$411.71	$114.39 – $332.10
Preventive checkup, new patient, age 40–64: 10 of 11 insurance plan rates AETNA — AETNA: $258.30 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $114.39 BCBSTX — BCBS OF TEXAS PPO/PAR: $332.10 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $332.10 CIGNA — CIGNA: $295.20 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $114.39 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $131.55 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $114.39 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $114.39 TRICARE — TRICARE: $168.78
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ED FACILITY LEVEL 3	$1,042	$759.36	$51.36 – $937.80
Emergency room visit (moderate): 10 of 18 insurance plan rates AETNA — AETNA: $729.40 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $169.97 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $323.02 BCBSTX — BCBS OF TEXAS PPO/PAR: $531.55 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $937.80 CIGNA — CIGNA: $833.60 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $169.97 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $51.36 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $323.02 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $371.47
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ED FACILITY LEVEL 3 W PROCEDURE	$1,042	$759.36	$51.36 – $937.80
Emergency room visit (moderate): 10 of 18 insurance plan rates AETNA — AETNA: $729.40 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $169.97 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $323.02 BCBSTX — BCBS OF TEXAS PPO/PAR: $531.55 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $937.80 CIGNA — CIGNA: $833.60 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $169.97 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $51.36 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $323.02 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $371.47
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: PRO ED PHYSICIAN LEVEL 3 W PROCEDURE	$494	$759.36	$76.55 – $444.60
Emergency room visit (moderate): 10 of 14 insurance plan rates AETNA — AETNA: $345.80 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $169.97 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $76.55 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $444.60 CIGNA — CIGNA: $395.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $169.97 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $76.55 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $88.03 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $76.55 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $169.97
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ED FACILITY LEVEL 4	$1,657.96	$1,196.09	$250.68 – $1,492.16
Emergency room visit (moderately high): 10 of 18 insurance plan rates AETNA — AETNA: $1,160.57 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $270.59 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $513.97 BCBSTX — BCBS OF TEXAS PPO/PAR: $837.26 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,492.16 CIGNA — CIGNA: $1,326.37 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $270.59 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $250.68 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $513.97 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $591.06
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ED FACILITY LEVEL 4 W PROCEDURE	$1,657.96	$1,196.09	$250.68 – $1,492.16
Emergency room visit (moderately high): 10 of 18 insurance plan rates AETNA — AETNA: $1,160.57 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $270.59 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $513.97 BCBSTX — BCBS OF TEXAS PPO/PAR: $837.26 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,492.16 CIGNA — CIGNA: $1,326.37 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $270.59 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $250.68 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $513.97 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $591.06
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: PRO ED PHYSICIAN LEVEL 4 W PROCEDURE	$799	$1,196.09	$130.30 – $719.10
Emergency room visit (moderately high): 10 of 14 insurance plan rates AETNA — AETNA: $559.30 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $270.59 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $130.30 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $719.10 CIGNA — CIGNA: $639.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $270.59 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $130.30 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $149.84 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $130.30 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $270.59
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ED FACILITY LEVEL 5	$2,397.85	$1,715.33	$362.55 – $2,158.07
Emergency room visit (high): 10 of 18 insurance plan rates AETNA — AETNA: $1,678.50 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $399.80 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $743.33 BCBSTX — BCBS OF TEXAS PPO/PAR: $1,200.73 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $2,158.07 CIGNA — CIGNA: $1,918.28 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $399.80 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $362.55 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $743.33 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $854.83
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ED FACILITY LEVEL 5 W PROCEDURE	$2,397.85	$1,715.33	$362.55 – $2,158.07
Emergency room visit (high): 10 of 18 insurance plan rates AETNA — AETNA: $1,678.50 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $399.80 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $743.33 BCBSTX — BCBS OF TEXAS PPO/PAR: $1,200.73 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $2,158.07 CIGNA — CIGNA: $1,918.28 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $399.80 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $362.55 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $743.33 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $854.83
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: PRO ED PHYSICIAN LEVEL 5 W PROCEDURE	$1,164	$1,715.33	$188.93 – $1,047.60
Emergency room visit (high): 10 of 14 insurance plan rates AETNA — AETNA: $814.80 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $399.80 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $188.93 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,047.60 CIGNA — CIGNA: $931.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $399.80 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $188.93 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $217.27 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $188.93 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $399.80

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 W/EGFR	$150.42	$38.07	$4.97 – $120.34
Basic metabolic panel (blood test): 10 of 18 insurance plan rates AETNA — AETNA: $105.29 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $10.15 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $46.63 BCBSTX — BCBS OF TEXAS PPO/PAR: $38.07 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $34.26 CIGNA — CIGNA: $120.34 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $10.15 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $16.85 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $46.63 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $53.62
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BASIC METABOLIC PANEL 8	$150.42	$38.07	$4.97 – $120.34
Basic metabolic panel (blood test): 10 of 18 insurance plan rates AETNA — AETNA: $105.29 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $10.15 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $46.63 BCBSTX — BCBS OF TEXAS PPO/PAR: $38.07 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $34.26 CIGNA — CIGNA: $120.34 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $10.15 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $16.85 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $46.63 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $53.62
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPLETE METABOLIC PANEL PICCOLO	$205.39	$47.52	$6.20 – $164.31
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates AETNA — AETNA: $143.77 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $12.67 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $63.67 BCBSTX — BCBS OF TEXAS PPO/PAR: $47.52 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $42.77 CIGNA — CIGNA: $164.31 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $12.67 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $21.04 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $63.67 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $73.22
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL 14	$205.39	$47.52	$6.20 – $164.31
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates AETNA — AETNA: $143.77 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $12.67 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $63.67 BCBSTX — BCBS OF TEXAS PPO/PAR: $47.52 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $42.77 CIGNA — CIGNA: $164.31 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $12.67 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $21.04 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $63.67 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $73.22
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: XX GH COMP METABOLIC PANEL (CMP)	$205.39	$47.52	$6.20 – $164.31
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates AETNA — AETNA: $143.77 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $12.67 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $63.67 BCBSTX — BCBS OF TEXAS PPO/PAR: $47.52 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $42.77 CIGNA — CIGNA: $164.31 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $12.67 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $21.04 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $63.67 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $73.22
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: OBSTETRIC PANEL W/O HIV TEST	$411	$215.15	$20.85 – $328.80
Obstetric blood test panel: 10 of 15 insurance plan rates AETNA — AETNA: $287.70 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $57.37 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $127.41 BCBSTX — BCBS OF TEXAS PPO/PAR: $215.15 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $193.63 CIGNA — CIGNA: $328.80 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $57.37 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $127.41 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $146.52 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $127.41
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL (CALCULATED LDL)	$148.28	$60.26	$7.86 – $118.62
Cholesterol panel (lipid panel): 10 of 18 insurance plan rates AETNA — AETNA: $103.80 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $16.07 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $45.97 BCBSTX — BCBS OF TEXAS PPO/PAR: $60.26 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $54.23 CIGNA — CIGNA: $118.62 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $16.07 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $17.26 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $45.97 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $52.86
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL 10	$151	$39.06	$5.09 – $120.80
Kidney function panel: 10 of 18 insurance plan rates AETNA — AETNA: $105.70 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $10.42 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $46.81 BCBSTX — BCBS OF TEXAS PPO/PAR: $39.06 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $35.15 CIGNA — CIGNA: $120.80 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $10.42 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $17.29 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $46.81 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $53.83
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL 7	$156	$36.77	$4.80 – $124.80
Liver function panel: 10 of 18 insurance plan rates AETNA — AETNA: $109.20 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $9.80 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $48.36 BCBSTX — BCBS OF TEXAS PPO/PAR: $36.77 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $33.09 CIGNA — CIGNA: $124.80 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $9.80 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $16.28 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $48.36 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $55.61
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA CHEMICAL AND MICRO	$69	$14.27	$1.86 – $55.20
Urine test (automated, with microscope): 10 of 18 insurance plan rates AETNA — AETNA: $48.30 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $3.80 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $21.39 BCBSTX — BCBS OF TEXAS PPO/PAR: $14.27 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $12.84 CIGNA — CIGNA: $55.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $3.80 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $2.66 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $21.39 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $24.60
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: ED UA CHEMICAL AND MICRO	$69	$14.27	$1.86 – $55.20
Urine test (automated, with microscope): 10 of 18 insurance plan rates AETNA — AETNA: $48.30 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $3.80 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $21.39 BCBSTX — BCBS OF TEXAS PPO/PAR: $14.27 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $12.84 CIGNA — CIGNA: $55.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $3.80 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $2.66 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $21.39 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $24.60
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: SPECIFIC GRAVITY BODY FLUID	$25.64	$15.66	$1.50 – $20.51
Urine test (manual, without microscope): 10 of 18 insurance plan rates AETNA — AETNA: $17.95 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $4.18 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $7.95 BCBSTX — BCBS OF TEXAS PPO/PAR: $15.66 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $14.09 CIGNA — CIGNA: $20.51 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $4.18 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $2.92 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $7.95 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $9.14
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA CHEMICAL ONLY	$48	$10.13	$1.32 – $38.40
Urine test (automated, without microscope): 10 of 18 insurance plan rates AETNA — AETNA: $33.60 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $2.70 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $14.88 BCBSTX — BCBS OF TEXAS PPO/PAR: $10.13 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $9.11 CIGNA — CIGNA: $38.40 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $2.70 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $1.89 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $14.88 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $17.11
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA TOTAL + % FREE 480947	$151	$82.76	$10.79 – $120.80
PSA (prostate specific antigen) blood test: 10 of 18 insurance plan rates AETNA — AETNA: $105.70 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $22.07 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $46.81 BCBSTX — BCBS OF TEXAS PPO/PAR: $82.76 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $74.48 CIGNA — CIGNA: $120.80 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $22.07 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $15.45 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $46.81 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $53.83
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA TOTAL DIAGNOSTIC CPT 84153	$151	$82.76	$10.79 – $120.80
PSA (prostate specific antigen) blood test: 10 of 18 insurance plan rates AETNA — AETNA: $105.70 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $22.07 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $46.81 BCBSTX — BCBS OF TEXAS PPO/PAR: $82.76 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $74.48 CIGNA — CIGNA: $120.80 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $22.07 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $15.45 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $46.81 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $53.83
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROSTATE SPECIFIC ANTIGEN (PSA) TOTAL	$151	$82.76	$10.79 – $120.80
PSA (prostate specific antigen) blood test: 10 of 18 insurance plan rates AETNA — AETNA: $105.70 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $22.07 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $46.81 BCBSTX — BCBS OF TEXAS PPO/PAR: $82.76 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $74.48 CIGNA — CIGNA: $120.80 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $22.07 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $15.45 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $46.81 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $53.83
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSHLRH	$159	$75.60	$9.86 – $127.20
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates AETNA — AETNA: $111.30 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $20.16 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $49.29 BCBSTX — BCBS OF TEXAS PPO/PAR: $75.60 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $68.04 CIGNA — CIGNA: $127.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $20.16 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $14.11 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $49.29 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $56.68
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH ENZYME (PL)	$159	$75.60	$9.86 – $127.20
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates AETNA — AETNA: $111.30 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $20.16 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $49.29 BCBSTX — BCBS OF TEXAS PPO/PAR: $75.60 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $68.04 CIGNA — CIGNA: $127.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $20.16 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $14.11 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $49.29 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $56.68
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: GHP TSH (GOVERNMENT PYRS)	$159	$75.60	$9.86 – $127.20
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates AETNA — AETNA: $111.30 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $20.16 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $49.29 BCBSTX — BCBS OF TEXAS PPO/PAR: $75.60 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $68.04 CIGNA — CIGNA: $127.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $20.16 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $14.11 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $49.29 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $56.68
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: TCELL SUBSET PANEL	$102	$34.97	$4.56 – $81.60
Complete blood count (CBC) with differential: 10 of 18 insurance plan rates AETNA — AETNA: $71.40 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $9.32 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $31.62 BCBSTX — BCBS OF TEXAS PPO/PAR: $34.97 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $31.47 CIGNA — CIGNA: $81.60 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $9.32 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $6.53 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $31.62 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $36.36
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CBC COMPLETE WAUTO DIFF 005009	$102	$34.97	$4.56 – $81.60
Complete blood count (CBC) with differential: 10 of 18 insurance plan rates AETNA — AETNA: $71.40 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $9.32 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $31.62 BCBSTX — BCBS OF TEXAS PPO/PAR: $34.97 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $31.47 CIGNA — CIGNA: $81.60 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $9.32 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $6.53 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $31.62 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $36.36
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CBC WITH AUTO DIFF	$102	$34.97	$4.56 – $81.60
Complete blood count (CBC) with differential: 10 of 18 insurance plan rates AETNA — AETNA: $71.40 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $9.32 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $31.62 BCBSTX — BCBS OF TEXAS PPO/PAR: $34.97 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $31.47 CIGNA — CIGNA: $81.60 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $9.32 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $6.53 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $31.62 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $36.36
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC NO DIFF	$84.08	$29.12	$3.80 – $67.26
Complete blood count (CBC), automated: 10 of 18 insurance plan rates AETNA — AETNA: $58.86 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $7.76 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $26.06 BCBSTX — BCBS OF TEXAS PPO/PAR: $29.12 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $26.20 CIGNA — CIGNA: $67.26 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $7.76 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $5.43 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $26.06 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $29.97
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTHROMBIN TIME (PT)	$64	$19.31	$2.31 – $51.20
Blood clotting time test (prothrombin time, PT): 10 of 18 insurance plan rates AETNA — AETNA: $44.80 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $5.15 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $19.84 BCBSTX — BCBS OF TEXAS PPO/PAR: $19.31 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $17.37 CIGNA — CIGNA: $51.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $5.15 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $3.60 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $19.84 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $22.82
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT (THROMBOPLASTIN TIME PARTIAL)	$95.25	$27.05	$3.52 – $76.20
Blood clotting test (partial thromboplastin time, PTT): 10 of 18 insurance plan rates AETNA — AETNA: $66.68 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $7.21 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $29.53 BCBSTX — BCBS OF TEXAS PPO/PAR: $27.05 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $24.34 CIGNA — CIGNA: $76.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $7.21 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $5.05 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $29.53 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $33.96
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: APTT MIXING STUDIES	$95.25	$27.05	$3.52 – $76.20
Blood clotting test (partial thromboplastin time, PTT): 10 of 18 insurance plan rates AETNA — AETNA: $66.68 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $7.21 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $29.53 BCBSTX — BCBS OF TEXAS PPO/PAR: $27.05 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $24.34 CIGNA — CIGNA: $76.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $7.21 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $5.05 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $29.53 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $33.96
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT	$95.25	$27.05	$3.52 – $76.20
Blood clotting test (partial thromboplastin time, PTT): 10 of 18 insurance plan rates AETNA — AETNA: $66.68 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $7.21 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $29.53 BCBSTX — BCBS OF TEXAS PPO/PAR: $27.05 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $24.34 CIGNA — CIGNA: $76.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $7.21 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $5.05 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $29.53 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $33.96

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: CT HEAD BRAIN NO CONTRAST	$2,164.95	$578.33	$131.99 – $1,731.96
CT scan of the head or brain, without contrast: 10 of 18 insurance plan rates AETNA — AETNA: $1,515.47 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $236.52 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $671.13 BCBSTX — BCBS OF TEXAS PPO/PAR: $578.33 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $520.05 CIGNA — CIGNA: $1,731.96 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $236.52 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $131.99 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $671.13 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $771.80
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN HEAD WO WITH CONTRAST	$4,764.43	$1,970.35	$461.69 – $3,811.54
MRI of the brain, before and after contrast: 10 of 18 insurance plan rates AETNA — AETNA: $3,335.10 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $649.20 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $1,476.97 BCBSTX — BCBS OF TEXAS PPO/PAR: $1,970.35 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,771.78 CIGNA — CIGNA: $3,811.54 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $649.20 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $461.69 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $1,476.97 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,698.52
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: XR CHEST 2 VIEW PA LATERAL	$474.91	$259.38	$75.31 – $379.93
Chest X-ray, 2 views: 10 of 18 insurance plan rates AETNA — AETNA: $332.44 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $75.31 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $147.22 BCBSTX — BCBS OF TEXAS PPO/PAR: $259.38 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $233.84 CIGNA — CIGNA: $379.93 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $75.31 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $109.09 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $147.22 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $169.31
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: XR CHEST REPEAT BY SAME PHYSICIAN	$474.91	$259.38	$75.31 – $379.93
Chest X-ray, 2 views: 10 of 18 insurance plan rates AETNA — AETNA: $332.44 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $75.31 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $147.22 BCBSTX — BCBS OF TEXAS PPO/PAR: $259.38 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $233.84 CIGNA — CIGNA: $379.93 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $75.31 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $109.09 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $147.22 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $169.31
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: XR CHEST REPEAT BY DIFFERENT PHYSICIAN	$474.91	$259.38	$75.31 – $379.93
Chest X-ray, 2 views: 10 of 18 insurance plan rates AETNA — AETNA: $332.44 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $75.31 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $147.22 BCBSTX — BCBS OF TEXAS PPO/PAR: $259.38 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $233.84 CIGNA — CIGNA: $379.93 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $75.31 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $109.09 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $147.22 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $169.31
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR LUMBAR SPINE SERIES 5 VIEWS W OBLIQUE	$779.81	$364.26	$115.16 – $623.85
X-ray of the lower spine, at least 4 views: 10 of 18 insurance plan rates AETNA — AETNA: $545.87 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $115.16 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $241.74 BCBSTX — BCBS OF TEXAS PPO/PAR: $364.26 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $328.39 CIGNA — CIGNA: $623.85 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $115.16 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $131.99 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $241.74 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $278
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: DO NOT USE MRI LUMBAR SPINE W/O	$3,370.77	$1,202.49	$160 – $2,696.62
MRI of the lower back (lumbar spine), without contrast: 10 of 18 insurance plan rates AETNA — AETNA: $2,359.54 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $423.81 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $1,044.94 BCBSTX — BCBS OF TEXAS PPO/PAR: $1,202.49 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,081.31 CIGNA — CIGNA: $2,696.62 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $423.81 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $294.17 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $1,044.94 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,201.68
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI LUMBAR SPINE NO CONTRAST	$3,370.77	$1,202.49	$294.17 – $2,696.62
MRI of the lower back (lumbar spine), without contrast: 10 of 18 insurance plan rates AETNA — AETNA: $2,359.54 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $423.81 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $1,044.94 BCBSTX — BCBS OF TEXAS PPO/PAR: $1,202.49 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,081.31 CIGNA — CIGNA: $2,696.62 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $423.81 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $294.17 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $1,044.94 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,201.68
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS WITH CONTRAST	$2,587.93	$940.26	$220.58 – $2,070.34
CT scan of the pelvis, with contrast: 10 of 18 insurance plan rates AETNA — AETNA: $1,811.55 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $360.15 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $802.26 BCBSTX — BCBS OF TEXAS PPO/PAR: $940.26 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $845.50 CIGNA — CIGNA: $2,070.34 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $360.15 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $220.58 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $802.26 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $922.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI LOWER EXT JOINT LEFT NO CON	$3,259.38	$1,202.49	$294.17 – $2,607.50
MRI of a leg joint (such as the knee), without contrast: 10 of 18 insurance plan rates AETNA — AETNA: $2,281.57 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $423.81 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $1,010.41 BCBSTX — BCBS OF TEXAS PPO/PAR: $1,202.49 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,081.31 CIGNA — CIGNA: $2,607.50 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $423.81 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $294.17 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $1,010.41 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,161.97
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI LOWER EXT JOINT RIGHT NO CON	$3,259.38	$1,202.49	$294.17 – $2,607.50
MRI of a leg joint (such as the knee), without contrast: 10 of 18 insurance plan rates AETNA — AETNA: $2,281.57 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $423.81 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $1,010.41 BCBSTX — BCBS OF TEXAS PPO/PAR: $1,202.49 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,081.31 CIGNA — CIGNA: $2,607.50 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $423.81 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $294.17 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $1,010.41 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,161.97
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABDOMEN PELVIS W IV CONTR HPRADEFAULT	$4,752.64	$1,970.35	$355.76 – $3,802.11
CT scan of the abdomen and pelvis, with contrast: 10 of 18 insurance plan rates AETNA — AETNA: $3,326.85 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $355.76 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $1,473.32 BCBSTX — BCBS OF TEXAS PPO/PAR: $1,970.35 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,771.78 CIGNA — CIGNA: $3,802.11 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $355.76 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $461.69 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $1,473.32 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,694.32
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE	$1,187.81	$364.26	$117.96 – $950.25
Ultrasound of the abdomen, complete: 10 of 18 insurance plan rates AETNA — AETNA: $831.47 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $117.96 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $368.22 BCBSTX — BCBS OF TEXAS PPO/PAR: $364.26 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $328.39 CIGNA — CIGNA: $950.25 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $117.96 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $131.99 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $368.22 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $423.45
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US OB PREG COMP >= 14 WKS TRNSABD SINGLE	$945.81	$297.51	$117.96 – $756.65
Pregnancy ultrasound (after the first trimester): 10 of 18 insurance plan rates AETNA — AETNA: $662.07 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $117.96 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $293.20 BCBSTX — BCBS OF TEXAS PPO/PAR: $297.51 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $268.21 CIGNA — CIGNA: $756.65 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $117.96 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $131.99 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $293.20 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $337.18
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREG OB GREATER TH 14 WK 2ND 3RD TRIM	$945.81	$297.51	$117.96 – $756.65
Pregnancy ultrasound (after the first trimester): 10 of 18 insurance plan rates AETNA — AETNA: $662.07 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $117.96 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $293.20 BCBSTX — BCBS OF TEXAS PPO/PAR: $297.51 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $268.21 CIGNA — CIGNA: $756.65 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $117.96 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $131.99 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $293.20 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $337.18
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANSVAGINAL NON-OB	$342	$286.98	$106.02 – $731.25
Transvaginal ultrasound: 10 of 18 insurance plan rates AETNA — AETNA: $239.40 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $117.96 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $106.02 BCBSTX — BCBS OF TEXAS PPO/PAR: $286.98 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $258.72 CIGNA — CIGNA: $273.60 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $117.96 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $131.99 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $106.02 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $121.92
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US PELVIC TRANSVAGINAL NON OB	$914.06	$286.98	$106.02 – $731.25
Transvaginal ultrasound: 10 of 18 insurance plan rates AETNA — AETNA: $639.84 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $117.96 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $283.36 BCBSTX — BCBS OF TEXAS PPO/PAR: $286.98 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $258.72 CIGNA — CIGNA: $731.25 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $117.96 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $131.99 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $283.36 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $325.86
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAM MAMMOGRAM DIAGNOSTIC LEFT W WO CAD	$426.92	$305.70	$64.55 – $341.54
Diagnostic mammogram, one breast: 10 of 18 insurance plan rates AETNA — AETNA: $298.84 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $152.28 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $132.35 BCBSTX — BCBS OF TEXAS PPO/PAR: $305.70 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $275.60 CIGNA — CIGNA: $341.54 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $152.28 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $64.55 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $132.35 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $152.20
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAM MAMMOGRAM DIAGNOSTIC RIGHT W WO CAD	$426.92	$305.70	$64.55 – $341.54
Diagnostic mammogram, one breast: 10 of 18 insurance plan rates AETNA — AETNA: $298.84 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $152.28 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $132.35 BCBSTX — BCBS OF TEXAS PPO/PAR: $305.70 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $275.60 CIGNA — CIGNA: $341.54 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $152.28 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $64.55 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $132.35 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $152.20
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAM MAMMOGRAM DIAGNOSTIC BILAT W WO CAD	$538	$391.20	$75 – $430.40
Diagnostic mammogram, both breasts: 10 of 18 insurance plan rates AETNA — AETNA: $376.60 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $192.29 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $166.78 BCBSTX — BCBS OF TEXAS PPO/PAR: $391.20 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $352.68 CIGNA — CIGNA: $430.40 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $192.29 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $81.35 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $166.78 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $191.80
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAM MAMMOGRAM SCREENING BILAT W WO CAD	$433.88	$323.28	$65.60 – $347.10
Screening mammogram, both breasts: 10 of 16 insurance plan rates AETNA — AETNA: $303.72 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $154.73 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $86.52 BCBSTX — BCBS OF TEXAS PPO/PAR: $323.28 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $291.45 CIGNA — CIGNA: $347.10 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $154.73 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $65.60 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $86.52 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $154.73

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: ECG 12 LEAD W INTERPRETATION AND REPORT	$41	$77.85	$6.20 – $77.85
Electrocardiogram (ECG/EKG) with reading: 10 of 14 insurance plan rates AETNA — AETNA: $28.70 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $12.71 BCBSTX — BCBS OF TEXAS PPO/PAR: $36.90 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $36.90 CIGNA — CIGNA: $32.80 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $6.20 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $12.71 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $14.62 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $12.71 SUPERIOR_MDCD — SUPERIOR MEDICAID - TEXAS: $6.20
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: X EKG 12 LEAD LOCAL W PHY INT	$96	$77.85	$6.20 – $77.85
Electrocardiogram (ECG/EKG) with reading: 10 of 14 insurance plan rates AETNA — AETNA: $67.20 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $29.76 BCBSTX — BCBS OF TEXAS PPO/PAR: $77.85 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $70.07 CIGNA — CIGNA: $76.80 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $14.52 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $29.76 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $34.22 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $29.76 SUPERIOR_MDCD — SUPERIOR MEDICAID - TEXAS: $14.52
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: SLEEP STAGING 4+PARAMETERS 6YRS/>	$4,500	$1,703.20	$850 – $3,600
Sleep study (overnight, in a sleep lab): 10 of 15 insurance plan rates AETNA — AETNA: $3,150 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $934.29 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $1,395 BCBSTX — BCBS OF TEXAS PPO/PAR: $1,703.20 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,532.88 CIGNA — CIGNA: $3,600 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $934.29 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $1,395 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,604.25 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $1,395
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: PRO FEE SLEEP STUDY 4+PARAMETERS PSG 6/>	$809	$1,703.20	$131.56 – $728.10
Sleep study (overnight, in a sleep lab): 10 of 15 insurance plan rates AETNA — AETNA: $566.30 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $728.10 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $131.56 BCBSTX — BCBS OF TEXAS PPO/PAR: $728.10 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $728.10 CIGNA — CIGNA: $647.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $728.10 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $131.56 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $151.29 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $131.56

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: PT THERAPEUTIC EXERCISE EA 15 MIN	$146.94	$106.59	$22.22 – $117.55
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 18 insurance plan rates AETNA — AETNA: $102.86 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $50.21 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $45.55 BCBSTX — BCBS OF TEXAS PPO/PAR: $106.59 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $95.93 CIGNA — CIGNA: $117.55 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $50.21 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $22.22 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $45.55 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $52.38
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: PTA THERAPEUTIC EXERCISE EA 15 MIN	$146.94	$106.59	$22.22 – $117.55
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 18 insurance plan rates AETNA — AETNA: $102.86 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $50.21 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $45.55 BCBSTX — BCBS OF TEXAS PPO/PAR: $106.59 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $95.93 CIGNA — CIGNA: $117.55 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $50.21 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $22.22 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $45.55 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $52.38
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: OT THERAPEUTIC EXERCISE EA 15MIN	$146.94	$106.59	$22.22 – $117.55
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 18 insurance plan rates AETNA — AETNA: $102.86 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $50.21 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $45.55 BCBSTX — BCBS OF TEXAS PPO/PAR: $106.59 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $95.93 CIGNA — CIGNA: $117.55 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $50.21 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $22.22 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $45.55 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $52.38
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT INITL EVAL LOW COMPLEXITY 20 MINS	$303	$294.07	$45.81 – $272.70
Physical therapy evaluation (low complexity): 10 of 18 insurance plan rates AETNA — AETNA: $212.10 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $171.84 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $93.93 BCBSTX — BCBS OF TEXAS PPO/PAR: $272.70 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $264.66 CIGNA — CIGNA: $242.40 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $171.84 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $45.81 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $93.93 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $108.02
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT INITL EVAL MOD COMPLEXITY 30 MINS	$349	$294.07	$52.77 – $294.07
Physical therapy evaluation (moderate complexity): 10 of 18 insurance plan rates AETNA — AETNA: $244.30 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $171.84 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $108.19 BCBSTX — BCBS OF TEXAS PPO/PAR: $294.07 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $264.66 CIGNA — CIGNA: $279.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $171.84 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $52.77 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $108.19 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $124.42
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT INITL EVAL HIGH COMPLEXITY 45OR> MINS	$394	$294.07	$59.57 – $315.20
Physical therapy evaluation (high complexity): 10 of 18 insurance plan rates AETNA — AETNA: $275.80 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $171.84 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $122.14 BCBSTX — BCBS OF TEXAS PPO/PAR: $294.07 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $264.66 CIGNA — CIGNA: $315.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $171.84 MOLINA_TX_MDCD — MOLINA TEXAS MEDICAID: $59.57 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $122.14 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $140.46

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: EXCISIONBREAST LESION(S)MALE/FEMALE 1+	$6,600	$9,088.65	$963.66 – $5,940
Removal of breast growth (open surgery): 10 of 16 insurance plan rates AETNA — AETNA: $4,620 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $2,022.95 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $2,046 BCBSTX — BCBS OF TEXAS PPO/PAR: $5,940 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $5,940 CIGNA — CIGNA: $5,280 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $2,022.95 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $2,046 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $2,352.90 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $2,046
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: EXC CYST FA TUMR BT DUCT NIP AREOLAR	$4,000.24	$9,088.65	$617.71 – $3,200.19
Removal of breast growth (open surgery): 10 of 13 insurance plan rates AETNA — AETNA: $2,800.17 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $2,022.95 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $617.71 CIGNA — CIGNA: $3,200.19 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $2,022.95 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $617.71 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $710.37 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $617.71 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $2,022.95 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $617.71
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: T AND A <12 YRS	$22,992	$14,551.59	$1,954.22 – $18,393.60
Removal of tonsils and adenoids (under age 12): 10 of 16 insurance plan rates AETNA — AETNA: $16,094.40 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $2,040.27 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $7,127.52 BCBSTX — BCBS OF TEXAS PPO/PAR: $14,551.59 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $13,096.43 CIGNA — CIGNA: $18,393.60 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $2,040.27 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $7,127.52 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $8,196.65 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $7,127.52
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: EGD W/WO SPEC COLLECT BRUSH WASHING	$2,682	$2,357.76	$334.95 – $2,357.76
Upper GI endoscopy (diagnostic): 10 of 16 insurance plan rates AETNA — AETNA: $1,877.40 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $714.83 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $831.42 BCBSTX — BCBS OF TEXAS PPO/PAR: $2,357.76 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $2,121.98 CIGNA — CIGNA: $2,145.60 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $714.83 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $831.42 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $956.13 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $831.42
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: PRO EGD DX WSPECIMEN COLL IF PERFORMED	$926.63	$2,357.76	$346.42 – $741.30
Upper GI endoscopy (diagnostic): 10 of 13 insurance plan rates AETNA — AETNA: $648.64 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $714.83 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $346.42 CIGNA — CIGNA: $741.30 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $714.83 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $346.42 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $398.38 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $346.42 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $714.83 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $346.42
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: EGD W BIOPSY SINGLE OR MULTIPLE	$2,756.77	$2,357.76	$334.95 – $2,357.76
Upper GI endoscopy with biopsy: 10 of 16 insurance plan rates AETNA — AETNA: $1,929.74 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $714.83 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $854.60 BCBSTX — BCBS OF TEXAS PPO/PAR: $2,357.76 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $2,121.98 CIGNA — CIGNA: $2,205.42 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $714.83 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $854.60 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $982.79 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $854.60
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: PRO EGD DX WBX SNGL/MULTI	$926.63	$2,357.76	$423.82 – $741.30
Upper GI endoscopy with biopsy: 10 of 13 insurance plan rates AETNA — AETNA: $648.64 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $714.83 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $449.17 CIGNA — CIGNA: $741.30 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $714.83 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $449.17 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $516.54 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $449.17 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $714.83 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $449.17
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/WO SPEC COLLECTION	$2,795	$2,291.64	$328.50 – $2,291.64
Colonoscopy (diagnostic): 10 of 16 insurance plan rates AETNA — AETNA: $1,956.50 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $744.16 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $866.45 BCBSTX — BCBS OF TEXAS PPO/PAR: $2,291.64 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $2,062.48 CIGNA — CIGNA: $2,236 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $744.16 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $866.45 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $996.42 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $866.45
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: PRO COLONOSCOPY DX W/SPEC COLLECTION	$950.10	$2,291.64	$407.23 – $760.08
Colonoscopy (diagnostic): 10 of 13 insurance plan rates AETNA — AETNA: $665.07 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $744.16 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $407.23 CIGNA — CIGNA: $760.08 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $744.16 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $407.23 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $468.32 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $407.23 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $744.16 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $407.23
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY W BX SINGLE MULTIPLE	$2,963.51	$3,012.66	$429.26 – $2,667.16
Colonoscopy with biopsy: 10 of 16 insurance plan rates AETNA — AETNA: $2,074.46 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $744.16 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $918.69 BCBSTX — BCBS OF TEXAS PPO/PAR: $2,667.16 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $2,667.16 CIGNA — CIGNA: $2,370.81 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $744.16 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $918.69 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,056.49 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $918.69
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: PRO COLONOSCOPY W/BX SNGL OR MULTI	$1,222.56	$3,012.66	$516.05 – $978.05
Colonoscopy with biopsy: 10 of 13 insurance plan rates AETNA — AETNA: $855.79 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $744.16 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $516.05 CIGNA — CIGNA: $978.05 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $744.16 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $516.05 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $593.46 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $516.05 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $744.16 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $516.05
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY W REMOV LES SNARE TECH	$2,882.38	$3,012.66	$429.26 – $2,594.14
Colonoscopy with removal of polyps (snare): 10 of 16 insurance plan rates AETNA — AETNA: $2,017.67 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $744.16 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $893.54 BCBSTX — BCBS OF TEXAS PPO/PAR: $2,594.14 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $2,594.14 CIGNA — CIGNA: $2,305.90 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $744.16 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $893.54 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,027.57 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $893.54
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: PRO COLONOSCOPY W/REM TUMR/POLYPS SNARE	$1,222.56	$3,012.66	$539.08 – $978.05
Colonoscopy with removal of polyps (snare): 10 of 13 insurance plan rates AETNA — AETNA: $855.79 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $744.16 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $539.08 CIGNA — CIGNA: $978.05 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $744.16 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $539.08 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $619.95 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $539.08 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $744.16 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $539.08
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLONSCOPY CA SCREEN NOT HI RISK MCR	$2,796.75	$2,291.64	$328.50 – $2,291.64
Screening colonoscopy (not high risk): 10 of 16 insurance plan rates AETNA — AETNA: $1,957.73 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $661.30 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $866.99 BCBSTX — BCBS OF TEXAS PPO/PAR: $2,291.64 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $2,062.48 CIGNA — CIGNA: $2,237.40 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $661.30 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $866.99 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $997.04 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $866.99
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: PRO COLONOSCOPY SCRN NOT HIGH RISK	$950.10	$2,291.64	$407.57 – $760.08
Screening colonoscopy (not high risk): 10 of 13 insurance plan rates AETNA — AETNA: $665.07 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $661.30 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $407.57 CIGNA — CIGNA: $760.08 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $661.30 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $407.57 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $468.71 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $407.57 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $661.30 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $407.57
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAP CHOLECYSTECTOMY	$11,776	$14,501.13	$1,888.85 – $10,598.40
Gallbladder removal by laparoscope: 10 of 16 insurance plan rates AETNA — AETNA: $8,243.20 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $3,828.23 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $3,650.56 BCBSTX — BCBS OF TEXAS PPO/PAR: $10,598.40 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $10,598.40 CIGNA — CIGNA: $9,420.80 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $3,828.23 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $3,650.56 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $4,198.14 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $3,650.56
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: PRO LAP CHOLECYSTECTOMY	$6,176.47	$14,501.13	$686.57 – $4,941.18
Gallbladder removal by laparoscope: 10 of 13 insurance plan rates AETNA — AETNA: $4,323.53 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $3,828.23 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $686.57 CIGNA — CIGNA: $4,941.18 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $3,828.23 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $686.57 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $789.55 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $686.57 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $3,828.23 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $686.57
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: RPR INGUINAL HERNIA INITL REDUC 5YR AND >	$9,473	$9,328.02	$1,151.54 – $8,525.70
Groin (inguinal) hernia repair, age 5 or older: 10 of 16 insurance plan rates AETNA — AETNA: $6,631.10 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $2,612.76 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $2,936.63 BCBSTX — BCBS OF TEXAS PPO/PAR: $8,525.70 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $8,395.22 CIGNA — CIGNA: $7,578.40 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $2,612.76 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $2,936.63 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $3,377.12 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $2,936.63
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: RPR INIT INGUINAL HERNIA 5+ REDUC BILAT	$9,473	$9,328.02	$1,151.54 – $8,525.70
Groin (inguinal) hernia repair, age 5 or older: 10 of 16 insurance plan rates AETNA — AETNA: $6,631.10 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $2,612.76 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $2,936.63 BCBSTX — BCBS OF TEXAS PPO/PAR: $8,525.70 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $8,395.22 CIGNA — CIGNA: $7,578.40 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $2,612.76 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $2,936.63 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $3,377.12 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $2,936.63
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PRO REP INT INGUINAL HERNIA 5YO OR >	$3,657.95	$9,328.02	$551.25 – $2,926.36
Groin (inguinal) hernia repair, age 5 or older: 10 of 13 insurance plan rates AETNA — AETNA: $2,560.57 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $2,612.76 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $551.25 CIGNA — CIGNA: $2,926.36 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $2,612.76 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $551.25 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $633.94 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $551.25 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $2,612.76 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $551.25
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY W ENDOME BX POLYPECTOMY	$7,234	$7,494.30	$1,063.52 – $6,510.60
Hysteroscopy with biopsy of the uterus lining: 10 of 16 insurance plan rates AETNA — AETNA: $5,063.80 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $1,846.49 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $2,242.54 BCBSTX — BCBS OF TEXAS PPO/PAR: $6,510.60 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $6,510.60 CIGNA — CIGNA: $5,787.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $1,846.49 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $2,242.54 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $2,578.92 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $2,242.54
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: PRO HYSTEROSCOPY SURG WBIOPSY W/WO DANDC	$3,307.24	$7,494.30	$1,356.28 – $2,645.79
Hysteroscopy with biopsy of the uterus lining: 10 of 13 insurance plan rates AETNA — AETNA: $2,315.07 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $1,846.49 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $1,356.28 CIGNA — CIGNA: $2,645.79 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $1,846.49 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $1,356.28 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,559.72 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $1,356.28 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $1,846.49 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $1,356.28
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: PM ESI LUMBAR/SACRAL W/I	$2,241	$1,875.15	$262.86 – $1,875.15
Spinal injection, lower back (epidural), with imaging guidance: 10 of 16 insurance plan rates AETNA — AETNA: $1,568.70 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $614.71 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $694.71 BCBSTX — BCBS OF TEXAS PPO/PAR: $1,875.15 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $1,687.64 CIGNA — CIGNA: $1,792.80 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $614.71 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $694.71 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $798.92 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $694.71
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: PRO ESI LUMBAR/SACRAL W/I	$721.17	$1,875.15	$293.46 – $614.71
Spinal injection, lower back (epidural), with imaging guidance: 10 of 13 insurance plan rates AETNA — AETNA: $504.82 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $614.71 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $293.46 CIGNA — CIGNA: $576.94 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $614.71 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $293.46 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $337.48 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $293.46 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $614.71 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $293.46
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: PM LUMBAR/SACRAL TRANS	$2,481.84	$2,436.15	$340.77 – $2,233.66
Nerve root injection, lower back, with imaging guidance: 10 of 16 insurance plan rates AETNA — AETNA: $1,737.29 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $588.47 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $769.37 BCBSTX — BCBS OF TEXAS PPO/PAR: $2,233.66 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $2,192.54 CIGNA — CIGNA: $1,985.47 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $588.47 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $769.37 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $884.78 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $769.37
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: PRO LUMBAR/SACRAL TRANS	$903.63	$2,436.15	$284.76 – $722.90
Nerve root injection, lower back, with imaging guidance: 10 of 13 insurance plan rates AETNA — AETNA: $632.54 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $588.47 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $284.76 CIGNA — CIGNA: $722.90 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $588.47 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $284.76 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $327.48 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $284.76 PRESBYTERIAN_NM_MEDI — PRESBYTERIAN TURQUOISE MEDICAID NEW MEXICO: $588.47 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $284.76
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: NEUROPLASTY MEDIAN NERVE	$5,144	$5,158.05	$659.94 – $4,629.60
Carpal tunnel release: 10 of 16 insurance plan rates AETNA — AETNA: $3,600.80 BC_NM_MEDICAID — BLUE CROSS MEDICAID NEW MEXICO: $1,529.98 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $1,594.64 BCBSTX — BCBS OF TEXAS PPO/PAR: $4,629.60 BCBSTX_ESSENTIALS — BCBS OF TEXAS ESSENTIALS: $4,629.60 CIGNA — CIGNA: $4,115.20 MOLINA_NM_MDCD — MOLINA TURQUOISE MEDICAID NEW MEXICO: $1,529.98 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $1,594.64 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $1,833.84 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $1,594.64

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: PRO OBSTETRICAL CARE	$5,117	$6,533.52	$2,340.41 – $4,093.60
Vaginal delivery, with care before and after: rates for 9 insurance plans AETNA — AETNA: $3,581.90 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $2,406.18 CIGNA — CIGNA: $4,093.60 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $2,406.18 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $2,767.11 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $2,406.18 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $2,406.18 TRICARE — TRICARE: $2,340.41 UHC — UNITED HEALTHCARE: $2,435.69
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: PRO CSECTION DEL INC ANTE AND POST PART	$5,662	$7,243.86	$2,589.69 – $4,529.60
Cesarean delivery (C-section), with care before and after: rates for 9 insurance plans AETNA — AETNA: $3,963.40 BCBS_MAP — BCBS MEDICARE ADVANTAGE PLAN: $2,684.81 CIGNA — CIGNA: $4,529.60 MOLINA_TXMARKETPLACE — MOLINA TEXAS MARKETPLACE: $2,684.81 MOLINA_TXMCR — MOLINA TEXAS MEDICARE: $3,087.53 PRESBYTERIAN_HEALTH — PRESBYTERIAN HEALTH COMM: $2,684.81 SUPERIOR_TXMCR — SUPERIOR TEXAS MEDICARE: $2,684.81 TRICARE — TRICARE: $2,589.69 UHC — UNITED HEALTHCARE: $2,695.11

Source: Memorial Hospital’s standard charges file (seminolehospitaldistrict.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on October 6, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	209 Northwest 8th Street, Seminole, TX 79360
County	Gaines County
State	Texas
Phone	(432) 758‑5811
Emergency services	Yes
Ownership	Government - Hospital District or Authority
Medicare overall rating	Not rated by CMS
CMS Certification Number	451358
Name in Medicare records	MEMORIAL HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	Seminole Hospital District
Official website	seminolehospitaldistrict.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Seminole Hospital District — seminolehospitaldistrict.com
ER and Trauma — seminolehospitaldistrict.com
Seminole Hospital District | Stay Healthy. Stay Close — seminolehospitaldistrict.com
Seminole Hospital District | Women’s Surgery Services — seminolehospitaldistrict.com
Seminole Hospital District | General Surgery — seminolehospitaldistrict.com
Seminole Hospital District | Radiology — seminolehospitaldistrict.com
Seminole Hospital District | Outpatient Infusion Services — seminolehospitaldistrict.com
Seminole Hospital District | Fitness Center — seminolehospitaldistrict.com
Seminole Hospital District | Lab Results — seminolehospitaldistrict.com
Seminole Hospital District | Cardiac Therapy — seminolehospitaldistrict.com
Seminole Hospital District | CT Scans — seminolehospitaldistrict.com
Seminole Hospital District | Mammography — seminolehospitaldistrict.com
Seminole Hospital District | Pharmacy — seminolehospitaldistrict.com
Seminole Hospital District | Physical Therapy — seminolehospitaldistrict.com
Seminole Hospital District | Speech Therapy — seminolehospitaldistrict.com

Memorial Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas^{[4][5][6][12][14][16]}

Conditions treated^{[7][10][14][18][19]}

Treatments^{[9][10][14][18][19]}

Procedures^{[4][7][8][9][12][15]}

Programs and centers^{[5][10][11][14][17][19]}

Emergency care (hospital website)^[4][5][6][9]

Visiting and practical information

Recognition^[5][16]

Doctors and clinicians (47)

Main specialties

Doctors with a page on this site (47)

Other emergency rooms nearby

Other hospitals near Seminole

Nursing homes, hospice, home health and dialysis nearby

Nursing homes

Dialysis facilities

Community care nearby

Clinics and urgent care

Pharmacies

Assisted living nearby

About the Medicare star rating

Medicare quality data

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

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

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Pregnancy and childbirth

Hospital information

Sources

From the hospital’s website

Memorial Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas[4][5][6][12][14][16]

Conditions treated[7][10][14][18][19]

Treatments[9][10][14][18][19]

Procedures[4][7][8][9][12][15]

Programs and centers[5][10][11][14][17][19]

Emergency care (hospital website)[4][5][6][9]

Visiting and practical information

Recognition[5][16]

Doctors and clinicians (47)

Main specialties

Doctors with a page on this site (47)

Other emergency rooms nearby

Other hospitals near Seminole

Nursing homes, hospice, home health and dialysis nearby

Nursing homes

Dialysis facilities

Community care nearby

Clinics and urgent care

Pharmacies

Assisted living nearby

About the Medicare star rating

Medicare quality data

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

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

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Pregnancy and childbirth

Hospital information

Sources

From the hospital’s website

Specialties and care areas^{[4][5][6][12][14][16]}

Conditions treated^{[7][10][14][18][19]}

Treatments^{[9][10][14][18][19]}

Procedures^{[4][7][8][9][12][15]}

Programs and centers^{[5][10][11][14][17][19]}

Emergency care (hospital website)^[4][5][6][9]

Recognition^[5][16]