Does Mercy Hospital Lincoln have an emergency room?

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

Where is Mercy Hospital Lincoln?

1000 East Cherry Street, Troy, MO 63379, in Lincoln County, Missouri.

What is the phone number of Mercy Hospital Lincoln?

(636) 528-8551, as listed by Medicare (CMS).

What is the Medicare star rating of Mercy Hospital Lincoln?

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.

Mercy Hospital Lincoln — Troy, MO

Quick answers

Does Mercy Hospital Lincoln have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Mercy Hospital Lincoln. In a medical emergency, call 911.
Where is Mercy Hospital Lincoln?: 1000 East Cherry Street, Troy, MO 63379, in Lincoln County, Missouri.
What is the phone number of Mercy Hospital Lincoln?: (636) 528-8551, as listed by Medicare (CMS).
What is the Medicare star rating of Mercy Hospital Lincoln?: 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][7][8]

Cardiology
Behavioral Health
Emergency Care
Imaging services
Therapy services
Sleep lab
Wound care
Outpatient rehabilitation
Mammography

Treatments^[4]

Therapy services
Wound care
Outpatient rehabilitation
Home care

Procedures^[4][5]

Imaging services
Mammography
Sleep lab
Cardiac event/Holter monitoring
Echocardiogram
Stress electrocardiogram

Programs and centers^[8]

Parkinson's LSVT Big and Loud PT/ST Program
Urinary Incontinence/Pelvic Floor Program
Lymphedema Program
Vestibular/Balance Program
Cognitive Skills Development Program with OT/ST

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

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

Recognition^[4]

The Joint Commission (accreditation)
American College of Radiology (accreditation)
College of American Pathologists (accreditation)

Doctors and clinicians (176)

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

Main specialties

And 152 more: the button below opens the full list.

Other emergency rooms nearby

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

SSM St Joseph Hospital West17 mi · Lake Saint Louis, MO · Acute Care Hospital
Progress West Hospital24 mi · Ofallon, MO · Acute Care Hospital
Barnes-Jewish St Peters Hospital25 mi · Saint Peters, MO · Acute Care Hospital
Mercy Hospital Washington29 mi · Washington, MO · Acute Care Hospital
SSM St Joseph Health Center30 mi · Saint Charles, MO · Acute Care Hospital

Other hospitals nearby

Centerpointe Hospital25 mi · Saint Charles, MO · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Troy Manor1.3 mi · Troy, MO · 1 of 5 stars
Lincoln County Nursing & Rehab1.7 mi · Troy, MO
Warrenton Manor13 mi · Wright City, MO · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Community Loving Care Hospice14 mi · Wentzville, MO · 4 of 5 stars
SSM Health at Home Hospice14 mi · Wentzville, MO · 4 of 5 stars
Solace Hospice Care, LLC21 mi · O'fallon, MO · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Calhoun County Health Department22 mi · Hardin, IL
Angels Care Home Health24 mi · Saint Peters, MO

All home health agencies in the state →

Dialysis facilities

FMC Dialysis Services of Lincoln County1.7 mi · Troy, MO · 1 of 5 stars
FMC - Wentzville14 mi · Wentzville, MO · 2 of 5 stars
DaVita Lake St Louis Dialysis17 mi · Lake Saint Louis, MO · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Wentzville Surgery Center, LLC14 mi · Wentzville, MO
Physicians Ambulatory Surgery Center, LLC24 mi · St. Peters, MO
SSM Health Endoscopy Center24 mi · Saint Peters, MO

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Compass Health, Inc.1.1 mi · Troy, MO · Community health center
Compass Health, Inc.14 mi · Warrenton, MO · Community health center
Compass Health Inc.15 mi · Warrenton, MO · Community health center

Clinics and urgent care

Mercy Hospital Lincoln- Family Medicine1.7 mi · Troy, MO · Rural health clinic
Mercy Hospital Lincoln-Family Medicine1.7 mi · Troy, MO · Rural health clinic
Mercy Hospital Lincoln-Family Medicine and Psychiatry Troy1.7 mi · Troy, MO · Rural health clinic

Pharmacies

Mark Jay Beckwith1.7 mi · Troy, MO · Community/retail pharmacy
Mercy Hospital Lincoln1.7 mi · Troy, MO · Pharmacy
Mercy Pharmacy Services LLC1.7 mi · Troy, MO · Community/retail pharmacy

Assisted living nearby

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

Care Network of Troy1.7 mi · Troy, MO
Sugar Creek Assisted Living1.7 mi · Troy, MO
Troy Manor1.7 mi · Troy, MO
Four Seasons Assisted Living5.7 mi · Moscow Mills, MO

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	5 of 5 stars
Rated the hospital 9 or 10 out of 10	74%National average: 72%
Would definitely recommend the hospital	71%National average: 71%
Nurses “always” communicated well	76%National average: 80%
Doctors “always” communicated well	75%National average: 80%
Staff “always” explained medicines before giving them	63%National average: 62%
Were given information about recovery at home	82%National average: 86%
Room and bathroom “always” clean	69%National average: 74%
Area around the room “always” quiet at night	68%National average: 60%
Completed surveys	178Response rate: 23%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

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

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	13%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	21.7%
Readmitted within 30 days: pneumonia	16.7%
Readmitted within 30 days: COPD	20.4%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	150 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Missouri Best hospitals in Missouri

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 60 common services exactly as Mercy Hospital Lincoln lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level III New Patient	$318	$206.70	$20.67 – $318
New patient office visit (about 30–44 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $74.86 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $208.29 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $208.29 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $47.70 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $47.70 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $76.32 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $270.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $270.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $270.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $270.30
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Uc Visit Level III New Pt	$282	$183.30	$18.33 – $282
New patient office visit (about 30–44 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $66.38 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $184.71 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $184.71 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $42.30 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $42.30 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $67.68 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $239.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $239.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $239.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $239.70
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Uc Visit Level III New Pt Pf	$312	$202.80	$20.28 – $312
New patient office visit (about 30–44 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $73.44 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $204.36 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $204.36 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $46.80 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $46.80 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $74.88 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $265.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $265.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $265.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $265.20
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level IV New Pt	$294	$191.10	$19.11 – $294
New patient office visit (about 45–59 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $69.21 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $192.57 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $192.57 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $44.10 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $44.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $70.56 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $249.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $249.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $249.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $249.90
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Uc Visit Level IV New Pt Mlp	$328	$213.20	$21.32 – $328
New patient office visit (about 45–59 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $77.21 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $214.84 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $214.84 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $49.20 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $49.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $78.72 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $278.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $278.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $278.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $278.80
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level IV New Pt Mlp	$161	$104.65	$10.47 – $161
New patient office visit (about 45–59 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $37.90 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $105.46 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $105.46 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $24.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $24.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $38.64 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $136.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $136.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $136.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $136.85
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level V New Patient	$530	$344.50	$34.45 – $530
New patient office visit (about 60–74 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $124.76 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $347.15 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $347.15 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $79.50 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $79.50 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $127.20 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $450.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $450.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $450.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $450.50
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level V New Pt Pf	$526	$341.90	$34.19 – $526
New patient office visit (about 60–74 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $123.82 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $344.53 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $344.53 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $78.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $78.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $126.24 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $447.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $447.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $447.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $447.10
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Uc Visit Level V New Pt	$460	$299	$258 – $363
New patient office visit (about 60–74 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $108.28 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $301.30 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $301.30 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $69 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $69 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $110.40 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $391 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $391 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $391 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $391
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Est Pt-Level 3 Twoc	$233	$151.45	$15.15 – $233
Established patient office visit (about 20–29 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $54.85 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $152.62 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $152.62 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $34.95 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $34.95 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $55.92 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $198.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $198.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $198.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $198.05
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Level III Visit Anticoagulation	$208	$135.20	$13.52 – $208
Established patient office visit (about 20–29 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $48.96 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $136.24 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $136.24 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $31.20 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $31.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $49.92 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $176.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $176.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $176.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $176.80
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Uc Visit Level III Est Pt Pf	$215	$139.75	$13.98 – $215
Established patient office visit (about 20–29 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $50.61 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $140.83 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $140.83 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $32.25 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $32.25 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $51.60 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $182.75 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $182.75 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $182.75 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $182.75
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Est Pt-Level 4 Twoc	$310	$201.50	$20.15 – $310
Established patient office visit (about 30–39 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $72.97 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $203.05 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $203.05 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $46.50 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $46.50 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $74.40 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $263.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $263.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $263.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $263.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Level IV Visit Anticoagulation	$277	$180.05	$18.01 – $277
Established patient office visit (about 30–39 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $65.21 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $181.44 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $181.44 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $41.55 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $41.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $66.48 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $235.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $235.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $235.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $235.45
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Uc Visit Level IV Est Pt Mlp	$229	$148.85	$14.89 – $229
Established patient office visit (about 30–39 minutes): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $53.91 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $150 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $150 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $34.35 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $34.35 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $54.96 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $194.65 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $194.65 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $194.65 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $194.65
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: New/Est Office/OP Cnslt Low 30-39 Min	$202	$131.30	$13.13 – $202
Office consultation with a specialist (moderate): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $47.55 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $132.31 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $132.31 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $30.30 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $30.30 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $48.48 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $171.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $171.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $171.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $171.70
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: New/Est Office/OP Cnslt Low 30-39 Min Mlp	$140	$91	$9.10 – $140
Office consultation with a specialist (moderate): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $32.96 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $91.70 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $91.70 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $21 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $21 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $33.60 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $119 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $119 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $119 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $119
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: New/Est Office/OP Cnslt Low 30-39 Min Pf	$165	$107.25	$10.73 – $165
Office consultation with a specialist (moderate): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $38.84 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $108.08 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $108.08 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $24.75 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $24.75 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $39.60 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $140.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $140.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $140.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $140.25
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: New/Est Office/OP Cnslt Mod 40-54 Min Pf	$242	$157.30	$15.73 – $242
Office consultation with a specialist (moderate to high): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $56.97 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $158.51 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $158.51 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $36.30 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $36.30 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $58.08 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $205.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $205.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $205.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $205.70
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: New/Est Office/OP Cnslt Mod 40-54 Min	$338	$219.70	$21.97 – $338
Office consultation with a specialist (moderate to high): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $79.57 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $221.39 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $221.39 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $50.70 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $50.70 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $81.12 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $287.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $287.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $287.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $287.30
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: New/Est Office/OP Cnslt Mod 40-54 Min Mlp	$205	$133.25	$13.33 – $205
Office consultation with a specialist (moderate to high): 10 of 129 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $48.26 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $134.28 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $134.28 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $30.75 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $30.75 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $49.20 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $174.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $174.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $174.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $174.25
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 3	$2,037	$1,324.05	$1,213 – $2,894
Emergency room visit (moderate): 10 of 136 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $363.50 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $2,894 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $2,610 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $2,230 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $2,341 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $2,324 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $343.67 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $2,894 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $2,610 MEDICAID [20240] — HB LINC MO MEDICAID: $330.46
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 3 Pf	$454	$295.10	$330.46 – $363.50
Emergency room visit (moderate): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $106.87 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $297.37 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $297.37 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $68.10 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $68.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $108.96 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $385.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $385.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $385.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $385.90
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 3 Mlp	$386	$250.90	$330.46 – $363.50
Emergency room visit (moderate): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $90.86 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $252.83 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $252.83 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $57.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $57.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $92.64 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $328.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $328.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $328.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $328.10
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 4 Mlp	$646	$419.90	$508.20 – $559.02
Emergency room visit (moderately high): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $152.07 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $423.13 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $423.13 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $96.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $96.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $155.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $549.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $549.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $549.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $549.10
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 4 Pf	$761	$494.65	$508.20 – $559.02
Emergency room visit (moderately high): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $179.14 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $498.46 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $498.46 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $114.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $114.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $182.64 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $646.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $646.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $646.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $646.85
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 4	$1,254	$815.10	$81.51 – $1,254
Emergency room visit (moderately high): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $295.19 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $821.37 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $821.37 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $188.10 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $188.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $300.96 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,065.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,065.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,065.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,065.90
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 5 Mlp	$953	$619.45	$61.95 – $953
Emergency room visit (high): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $224.34 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $624.22 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $624.22 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $142.95 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $142.95 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $228.72 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $810.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $810.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $810.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $810.05
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Phys Care Level 5 Pf	$1,121	$728.65	$72.87 – $1,121
Emergency room visit (high): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $263.88 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $734.26 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $734.26 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $168.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $168.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $269.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $952.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $952.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $952.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $952.85
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 5	$1,544	$1,003.60	$100.36 – $1,544
Emergency room visit (high): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $363.46 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,011.32 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,011.32 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $231.60 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $231.60 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $370.56 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,312.40 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,312.40 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,312.40 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,312.40

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic Metabolic Pnl Calcium Total	$225	$146.25	$14.63 – $225
Basic metabolic panel (blood test): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $52.97 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $147.38 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $147.38 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.75 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.75 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $54 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $191.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $191.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $191.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $191.25
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel	$272	$176.80	$10.56 – $14.97
Comprehensive metabolic panel (blood test): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $64.03 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $178.16 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $178.16 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $40.80 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $40.80 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $65.28 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $231.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $231.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $231.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $231.20
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Panel	$74	$48.10	$11.84 – $30.13
Cholesterol panel (lipid panel): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $13.39 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $48.47 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $48.47 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $11.10 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $11.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $13.39 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $62.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $62.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $62.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $62.90
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Lipid Panel	$206	$133.90	$11.84 – $30.13
Cholesterol panel (lipid panel): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $13.39 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $134.93 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $134.93 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $30.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $30.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $13.39 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $175.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $175.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $175.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $175.10
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Function Panel	$240	$156	$8.68 – $12.30
Kidney function panel: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $56.50 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $157.20 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $157.20 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $36 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $36 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $57.60 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $204 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $204 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $204 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $204
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic Function Panel	$229	$148.85	$14.89 – $229
Liver function panel: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $53.91 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $150 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $150 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $34.35 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $34.35 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $54.96 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $194.65 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $194.65 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $194.65 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $194.65
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Automated W Micro	$58	$37.70	$3.77 – $58
Urine test (automated, with microscope): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $13.65 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $37.99 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $37.99 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $8.70 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $8.70 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $13.92 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $49.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $49.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $49.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $49.30
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Urinalysis Non-Auto	$18	$11.70	$1.17 – $18
Urine test (manual, without microscope): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $4.24 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $11.79 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $11.79 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $2.70 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $2.70 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $4.32 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $15.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $15.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $15.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $15.30
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Non Automated WO Micro	$60	$39	$2.96 – $4.82
Urine test (manual, without microscope): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $14.12 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $39.30 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $39.30 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $9 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $9 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $14.40 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $51 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $51 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $51 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $51
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Ph Nonautomated	$52	$33.80	$3.38 – $52
Urine test (manual, without microscope): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $12.24 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $34.06 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $34.06 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $7.80 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $7.80 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $12.48 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $44.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $44.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $44.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $44.20
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Urinalysis Automated W/O Micro	$12	$7.80	$2.25 – $3.13
Urine test (automated, without microscope): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $2.82 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $7.86 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $7.86 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $1.80 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $1.80 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $2.88 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $10.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $10.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $10.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $10.20
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Specific Gravity Urine Automated	$54	$35.10	$2.25 – $3.13
Urine test (automated, without microscope): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $12.71 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $35.37 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $35.37 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $8.10 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $8.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $12.96 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $45.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $45.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $45.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $45.90
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine Ph Automated	$58	$37.70	$2.25 – $3.13
Urine test (automated, without microscope): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $13.65 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $37.99 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $37.99 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $8.70 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $8.70 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $13.92 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $49.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $49.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $49.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $49.30
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Total Diagnostic	$168	$109.20	$18.39 – $26.06
PSA (prostate specific antigen) blood test: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $39.55 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $110.04 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $110.04 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $25.20 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $25.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $18.39 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $142.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $142.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $142.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $142.80
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Ultrasensitive	$198	$128.70	$12.87 – $198
PSA (prostate specific antigen) blood test: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $46.61 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $129.69 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $129.69 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $29.70 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $29.70 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $18.39 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $168.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $168.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $168.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $168.30
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh Newborn	$21	$13.65	$16.80 – $23.80
Thyroid stimulating hormone (TSH) test: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $4.94 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $13.76 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $13.76 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $3.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $3.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $5.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $17.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $17.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $17.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $17.85
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh Thyroid Stimulating Hormone	$206	$133.90	$13.39 – $206
Thyroid stimulating hormone (TSH) test: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $48.49 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $134.93 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $134.93 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $30.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $30.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $49.44 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $175.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $175.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $175.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $175.10
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc W Auto Diff	$126	$81.90	$8.19 – $126
Complete blood count (CBC) with differential: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $29.66 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $82.53 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $82.53 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $18.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $18.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $30.24 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $107.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $107.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $107.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $107.10
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc Automated WO Diff	$134	$87.10	$6.47 – $9.17
Complete blood count (CBC), automated: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $31.54 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $87.77 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $87.77 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $20.10 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $20.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $32.16 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $113.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $113.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $113.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $113.90
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time	$22	$14.30	$1.43 – $22
Blood clotting time test (prothrombin time, PT): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $5.18 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $14.41 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $14.41 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $3.30 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $3.30 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $5.28 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $18.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $18.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $18.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $18.70
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time Mixing Test	$77	$50.05	$5.01 – $77
Blood clotting time test (prothrombin time, PT): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $18.13 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $50.44 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $50.44 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $11.55 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $11.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $18.48 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $65.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $65.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $65.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $65.45
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Prothrombin Time	$22	$14.30	$4.29 – $5.94
Blood clotting time test (prothrombin time, PT): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $5.18 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $14.41 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $14.41 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $3.30 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $3.30 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $5.28 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $18.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $18.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $18.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $18.70
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ptt Partial Thromboplastin Time	$121	$78.65	$7.87 – $121
Blood clotting test (partial thromboplastin time, PTT): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $28.48 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $79.26 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $79.26 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $18.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $18.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $29.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $102.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $102.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $102.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $102.85
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ptt Mixing	$121	$78.65	$7.87 – $121
Blood clotting test (partial thromboplastin time, PTT): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $28.48 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $79.26 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $79.26 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $18.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $18.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $29.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $102.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $102.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $102.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $102.85

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) · Hospital (facility) fee In the file: CT Head/Brain WO Cont Pf	$203	$131.95	$13.20 – $203
CT scan of the head or brain, without contrast: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $47.79 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $132.97 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $132.97 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $30.45 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $30.45 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $48.72 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $172.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $172.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $172.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $172.55
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Head/Brain WO Cont	$1,808	$1,175.20	$117.52 – $1,808
CT scan of the head or brain, without contrast: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $425.60 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,184.24 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,184.24 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $271.20 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $271.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $433.92 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,536.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,536.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,536.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,536.80
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Brain W/WO Cont	$4,308	$2,800.20	$426.23 – $468.85
MRI of the brain, before and after contrast: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $1,014.10 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $2,821.74 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $2,821.74 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $646.20 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $646.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $1,033.92 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $3,661.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $3,661.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $3,661.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $3,661.80
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xr Chest 2 Views	$271	$176.15	$17.62 – $271
Chest X-ray, 2 views: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $63.79 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $177.51 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $177.51 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $40.65 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $40.65 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $65.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $230.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $230.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $230.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $230.35
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xr Spine Lumbar Min 4 Views Pf	$76	$49.40	$100.02 – $315
X-ray of the lower spine, at least 4 views: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $17.89 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $49.78 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $49.78 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $11.40 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $11.40 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $18.24 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $64.60 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $64.60 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $64.60 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $64.60
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xr Spine Lumbar Min 4 Views	$747	$485.55	$48.56 – $747
X-ray of the lower spine, at least 4 views: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $175.84 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $489.29 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $489.29 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $112.05 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $112.05 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $179.28 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $634.95 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $634.95 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $634.95 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $634.95
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Lumbar Spine WO Cont	$3,082	$2,003.30	$560
MRI of the lower back (lumbar spine), without contrast: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $725.50 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $2,018.71 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $2,018.71 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $462.30 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $462.30 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $739.68 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,619.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $2,619.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $2,619.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,619.70
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis W Cont Pf	$308	$200.20	$20.02 – $308
CT scan of the pelvis, with contrast: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $72.50 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $201.74 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $201.74 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $46.20 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $46.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $73.92 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $261.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $261.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $261.80 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $261.80
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis W Cont	$3,043	$1,977.95	$197.80 – $3,043
CT scan of the pelvis, with contrast: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $716.32 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,993.17 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,993.17 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $456.45 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $456.45 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $730.32 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,586.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $2,586.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $2,586.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,586.55
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Extr Lwr Jt WO Cont Lt	$2,911	$1,892.15	$560
MRI of a leg joint (such as the knee), without contrast: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $685.25 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,906.71 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,906.71 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $436.65 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $436.65 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $698.64 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,474.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $2,474.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $2,474.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,474.35
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Extr Lwr Jt WO Cont Rt	$2,911	$1,892.15	$189.22 – $2,911
MRI of a leg joint (such as the knee), without contrast: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $685.25 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,906.71 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,906.71 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $436.65 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $436.65 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $698.64 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,474.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $2,474.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $2,474.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,474.35
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Extr Lwr Jt WO Cont Bi	$5,697	$3,703.05	$370.31 – $5,697
MRI of a leg joint (such as the knee), without contrast: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $1,341.07 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $3,731.54 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $3,731.54 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $854.55 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $854.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $1,367.28 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $4,842.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $4,842.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $4,842.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $4,842.45
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Abd Pelvis With Contrast Pf	$443	$287.95	$28.80 – $443
CT scan of the abdomen and pelvis, with contrast: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $104.28 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $290.17 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $290.17 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $66.45 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $66.45 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $106.32 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $376.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $376.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $376.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $376.55
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Abd Pelvis With Contrast	$4,646	$3,019.90	$301.99 – $4,646
CT scan of the abdomen and pelvis, with contrast: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $1,093.67 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $3,043.13 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $3,043.13 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $696.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $696.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $1,115.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $3,949.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $3,949.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $3,949.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $3,949.10
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Complete Pf	$161	$104.65	$10.47 – $161
Ultrasound of the abdomen, complete: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $37.90 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $105.46 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $105.46 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $24.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $24.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $38.64 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $136.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $136.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $136.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $136.85
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Complete	$1,343	$872.95	$126.92 – $565
Ultrasound of the abdomen, complete: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $316.14 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $879.67 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $879.67 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $201.45 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $201.45 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $322.32 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,141.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,141.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,141.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,141.55
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Transvaginal Non OB Pf	$180	$117	$126.92 – $227.90
Transvaginal ultrasound: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $42.37 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $117.90 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $117.90 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $27 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $27 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $43.20 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $153 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $153 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $153 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $153
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Transvaginal Non OB	$975	$633.75	$63.38 – $975
Transvaginal ultrasound: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $229.52 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $638.63 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $638.63 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $146.25 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $146.25 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $234 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $828.75 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $828.75 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $828.75 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $828.75
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Unilat Lt W Cad	$400	$260	$26 – $400
Diagnostic mammogram, one breast: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $94.16 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $262 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $262 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $60 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $60 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $96 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $340 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $340 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $340 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $340
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Unilat Rt W Cad	$400	$260	$147.97 – $182.10
Diagnostic mammogram, one breast: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $94.16 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $262 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $262 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $60 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $60 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $96 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $340 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $340 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $340 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $340
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Bilat W Cad	$512	$332.80	$186.37 – $232.93
Diagnostic mammogram, both breasts: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $120.52 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $335.36 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $335.36 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $76.80 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $76.80 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $122.88 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $435.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $435.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $435.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $435.20
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Right W Cad	$424	$275.60	$86 – $192.40
Screening mammogram, both breasts: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $99.81 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $277.72 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $277.72 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $63.60 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $63.60 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $101.76 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $360.40 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $360.40 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $360.40 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $360.40
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Bilat Implant W Cad	$446	$289.90	$28.99 – $446
Screening mammogram, both breasts: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $104.99 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $292.13 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $292.13 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $66.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $66.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $107.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $379.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $379.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $379.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $379.10
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Bilateral W Cad	$446	$289.90	$28.99 – $446
Screening mammogram, both breasts: 10 of 132 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $104.99 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $292.13 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $292.13 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $66.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $66.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $107.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $379.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $379.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $379.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $379.10

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom Attended >3 Chn 6/> Yrs	$6,297	$4,093.05	$409.31 – $6,297
Sleep study (overnight, in a sleep lab): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $1,482.31 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $4,124.54 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $4,124.54 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $944.55 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $944.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $1,511.28 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $5,352.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $5,352.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $5,352.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $5,352.45

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) · Hospital (facility) fee In the file: Ot Cpm Set Up Ea 15min	$153	$99.45	$9.95 – $153
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $36.02 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $100.22 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $100.22 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $22.95 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $22.95 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $36.72 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $130.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $130.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $130.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $130.05
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ot Ther Exer 1 or > Area Ea 15m	$155	$100.75	$170 – $202
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $36.49 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $101.53 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $101.53 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $23.25 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $23.25 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $37.20 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $131.75 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $131.75 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $131.75 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $131.75
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Cpm Set Up Ea 15min	$153	$99.45	$170 – $202
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $36.02 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $100.22 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $100.22 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $22.95 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $22.95 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $36.72 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $130.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $130.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $130.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $130.05
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 105 Min	$546	$354.90	$35.49 – $546
Physical therapy evaluation (low complexity): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $128.53 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $357.63 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $357.63 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $81.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $81.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $131.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $464.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $464.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $464.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $464.10
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 15 Min	$165	$107.25	$120.65 – $132.72
Physical therapy evaluation (low complexity): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $38.84 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $108.08 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $108.08 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $24.75 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $24.75 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $39.60 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $140.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $140.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $140.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $140.25
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 150 Min	$737	$479.05	$170 – $202
Physical therapy evaluation (low complexity): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $173.49 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $482.74 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $482.74 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $110.55 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $110.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $176.88 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $626.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $626.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $626.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $626.45
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 105 Min	$584	$379.60	$37.96 – $584
Physical therapy evaluation (moderate complexity): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $137.47 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $382.52 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $382.52 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $87.60 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $87.60 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $140.16 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $496.40 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $496.40 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $496.40 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $496.40
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 135 Min	$711	$462.15	$170 – $202
Physical therapy evaluation (moderate complexity): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $167.37 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $465.71 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $465.71 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $106.65 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $106.65 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $170.64 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $604.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $604.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $604.35 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $604.35
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 90 Min	$520	$338	$120.65 – $132.72
Physical therapy evaluation (moderate complexity): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $122.41 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $340.60 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $340.60 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $78 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $78 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $124.80 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $442 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $442 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $442 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $442
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 150 Min	$822	$534.30	$53.43 – $822
Physical therapy evaluation (high complexity): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $193.50 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $538.41 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $538.41 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $123.30 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $123.30 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $197.28 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $698.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $698.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $698.70 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $698.70
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 30 Min	$313	$203.45	$20.35 – $313
Physical therapy evaluation (high complexity): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $73.68 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $205.02 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $205.02 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $46.95 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $46.95 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $75.12 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $266.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $266.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $266.05 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $266.05
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 45 Min	$377	$245.05	$170 – $202
Physical therapy evaluation (high complexity): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $88.75 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $246.94 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $246.94 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $56.55 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $56.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $90.48 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $320.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $320.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $320.45 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $320.45
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 30 Min With Patient	$221	$143.65	$14.37 – $221
Psychotherapy, 30 minutes: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $52.02 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $144.76 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $144.76 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $53.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $187.85
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 30 Min With Patient Pf	$116	$75.40	$7.54 – $116
Psychotherapy, 30 minutes: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $27.31 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $75.98 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $75.98 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $17.40 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $17.40 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $27.84 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $98.60 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $98.60 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $98.60 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $98.60
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 45 Min With Patient	$221	$143.65	$191.76 – $210.93
Psychotherapy, 45 minutes: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $52.02 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $144.76 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $144.76 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $53.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $187.85
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 45 Min With Patient Pf	$154	$100.10	$191.76 – $210.93
Psychotherapy, 45 minutes: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $36.25 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $100.87 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $100.87 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $23.10 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $23.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $36.96 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $130.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $130.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $130.90 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $130.90
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 60 Min With Patient	$221	$143.65	$14.37 – $221
Psychotherapy, 60 minutes: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $52.02 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $144.76 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $144.76 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $53.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $187.85
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 60 Min With Patient Pf	$226	$146.90	$14.69 – $226
Psychotherapy, 60 minutes: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $53.20 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $148.03 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $148.03 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.90 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $54.24 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $192.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $192.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $192.10 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $192.10
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Fam Ther W Pt 50min (Max Qty 2) Pf	$152	$98.80	$9.88 – $152
Family psychotherapy, with the patient: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $35.78 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $99.56 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $99.56 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $22.80 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $22.80 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $36.48 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $129.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $129.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $129.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $129.20
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Fam Ther W Pt 50min (Max Qty 2)	$221	$143.65	$191.76 – $210.93
Family psychotherapy, with the patient: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $52.02 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $144.76 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $144.76 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.15 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $33.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $53.04 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $187.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $187.85

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Exc Breast Lesion Open 1 or > Mlp	$438	$284.70	$208.05 – $394.20
Removal of breast growth (open surgery): 10 of 119 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $378.16 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $286.89 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $286.89 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $378.16 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $372.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $372.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $372.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $372.30 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH WOODARD DEC NEW 040124: $372.30 AMBETTER [20452] — HB LINC CENTENE EXCHANGE/AMBETTER EFF 090118: $502.40
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Exc Breast Lesion Open 1 or >Pf	$2,069	$1,344.85	$982.78 – $1,862.10
Removal of breast growth (open surgery): 10 of 119 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $378.16 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,355.20 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,355.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $378.16 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,758.65 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,758.65 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,758.65 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,758.65 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH WOODARD DEC NEW 040124: $1,758.65 AMBETTER [20452] — HB LINC CENTENE EXCHANGE/AMBETTER EFF 090118: $502.40
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Exc Breast Lesion Open 1 or >Mlp	$1,759	$1,143.35	$378.16 – $636.04
Removal of breast growth (open surgery): 10 of 119 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $378.16 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,152.15 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,152.15 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $378.16 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,495.15 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,495.15 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,495.15 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,495.15 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH WOODARD DEC NEW 040124: $1,495.15 AMBETTER [20452] — HB LINC CENTENE EXCHANGE/AMBETTER EFF 090118: $502.40
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Upper Endoscopy Complex	$2,339	$1,520.35	$1,081 – $1,618
Upper GI endoscopy (diagnostic): 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $550.60 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,532.05 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,532.05 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $350.85 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $350.85 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $561.36 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,988.15 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,988.15 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,988.15 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,988.15
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Egd W/Biopsy Pf	$9,013.30	$5,858.64	$799.25
Upper GI endoscopy with biopsy: 10 of 136 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $799.25 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $1,618 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $1,318 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $1,343 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $1,081 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $799.25 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $1,618 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 MEDICAID [20240] — HB LINC MO MEDICAID: $799.25
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ugi Endoscopy W Bx Sgl/Mlt Mlp	$1,310	$851.50	$116.61 – $1,230.85
Upper GI endoscopy with biopsy: 10 of 121 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $116.61 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $858.05 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $858.05 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $314.40 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,113.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,113.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,113.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,113.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH WOODARD DEC NEW 040124: $1,113.50 AMBETTER [20452] — HB LINC CENTENE EXCHANGE/AMBETTER EFF 090118: $153.06
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ugi Endoscopy W Bx Sgl/Mlt Pf	$1,541	$1,001.65	$116.61 – $1,230.85
Upper GI endoscopy with biopsy: 10 of 121 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $116.61 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,009.36 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,009.36 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $369.84 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,309.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,309.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,309.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,309.85 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH WOODARD DEC NEW 040124: $1,309.85 AMBETTER [20452] — HB LINC CENTENE EXCHANGE/AMBETTER EFF 090118: $153.06
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Colonoscopy	$4,909	$3,190.85	$141.38 – $2,175
Colonoscopy (diagnostic): 10 of 136 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $20.87 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $1,618 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $1,318 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $1,343 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $1,081 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $19.73 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $1,618 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 MEDICAID [20240] — HB LINC MO MEDICAID: $777.21
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Colo Biopsy Cold Pf	$8,222.30	$5,344.49	$1,081 – $1,618
Colonoscopy with biopsy: 10 of 136 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $1,005.15 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $1,618 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $1,318 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $1,343 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $1,081 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $1,005.15 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $1,618 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 MEDICAID [20240] — HB LINC MO MEDICAID: $1,005.15
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Colo Biopsy Snare Pf	$7,510.31	$4,881.70	$1,081 – $1,618
Colonoscopy with removal of polyps (snare): 10 of 136 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $1,005.15 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $1,618 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $1,318 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $1,343 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $1,081 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $1,005.15 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $1,618 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 MEDICAID [20240] — HB LINC MO MEDICAID: $1,005.15
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lap,Cholecystectomy Pf	$16,499.21	$10,724.49	$4,973.69 – $7,339.18
Gallbladder removal by laparoscope: 10 of 135 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $4,973.69 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $7,732 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $7,079 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $5,938 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $6,416 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $6,566 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $7,241.69 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $7,732 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $7,079 MEDICAID [20240] — HB LINC MO MEDICAID: $6,963.17
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Rx Ing Hernia,5+Y/O,Reducibl Pf	$18,632.71	$12,111.26	$2,087 – $3,194
Groin (inguinal) hernia repair, age 5 or older: 10 of 135 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $3,008.46 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $3,194 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $2,866 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $2,486 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $2,535 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $2,087 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $4,380.32 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $3,194 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $2,866 MEDICAID [20240] — HB LINC MO MEDICAID: $4,211.84
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$7,343.33	$4,773.16	$2,710.49 – $3,999.60
Hysteroscopy with biopsy of the uterus lining: 10 of 135 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $2,710.49 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $1,618 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $1,318 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $1,343 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $1,081 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $3,946.47 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $1,618 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 MEDICAID [20240] — HB LINC MO MEDICAID: $3,794.69
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inject Interlaminar Lumbar/Sacral W Imag Pf	$1,490	$968.50	$590.36 – $909.15
Spinal injection, lower back (epidural), with imaging guidance: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $350.75 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $975.95 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $975.95 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $223.50 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $223.50 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $357.60 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,266.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,266.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,266.50 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,266.50
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inject Interlaminar Lumbar or Sacral W Imag	$3,403.50	$2,212.27	$1,081 – $1,618
Spinal injection, lower back (epidural), with imaging guidance: 10 of 135 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $590.36 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $1,618 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $1,318 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $1,343 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $1,081 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $590.36 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $1,618 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $1,559 MEDICAID [20240] — HB LINC MO MEDICAID: $590.36
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hchg Inj Epi/Lumb/Sacral Sngl Level Bil Pf	$2,383	$1,548.95	$758.96 – $1,168.80
Nerve root injection, lower back, with imaging guidance: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $560.96 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,560.87 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,560.87 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $357.45 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $357.45 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $571.92 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,025.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $2,025.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $2,025.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,025.55
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj Epi/Lumb/Sacral Sngl Level Pf	$2,383	$1,548.95	$758.96 – $1,168.80
Nerve root injection, lower back, with imaging guidance: 10 of 136 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $560.96 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,560.87 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,560.87 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $357.45 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $357.45 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $571.92 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,025.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $2,025.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $2,025.55 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $2,025.55
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj Transforminal Epi/Lumb/Sacral Sngl Level	$2,299.02	$1,494.36	$1,138.44 – $1,679.88
Nerve root injection, lower back, with imaging guidance: 10 of 135 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $332.38 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $924.86 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $924.86 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $211.80 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $211.80 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $338.88 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,200.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,200.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,200.20 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,200.20
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplas/ Tranposit Median Nerve at Carp Tiunn Pf	$9,215.04	$5,989.78	$1,664.70 – $2,456.43
Carpal tunnel release: 10 of 135 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $1,664.70 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $7,693 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $7,042 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $5,815 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $6,284 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $6,549 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $2,423.80 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $7,693 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $7,042 MEDICAID [20240] — HB LINC MO MEDICAID: $2,330.58
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laser Yag Treatment	$1,868.90	$1,214.78	$5,815 – $7,693
Laser treatment of clouding after cataract surgery: 10 of 135 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB LINC MEDICARE/MANAGED MCR W/SEQ 98.1%: $382.53 AETNA [20008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,064.38 AETNA CONTRACTED [320008] — HB PCMH LINC AETNA COVENTRY ALL PRODUCTS: $1,064.38 AETNA MEDICAID [20009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $243.75 AETNA MEDICAID CONTRACTED [320009] — HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NE: $243.75 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB LINC AETNA/COVENTRY MCR W/O SEQ: $390 AITHER HEALTH [20449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,381.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH LACLEDE CHAIN NEW 07.01.25: $1,381.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SCHAEFER AUTOBODY DEC NEW 030121: $1,381.25 AITHER HEALTH CONTRACTED [320449] — HB LINC PCMH SHINE SOLAR DEC NEW 110320: $1,381.25
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp	$7,535	$4,897.75	$2,087 – $3,194
Cataract removal with lens implant: 10 of 135 insurance plan rates BCBS MEDICAID CONTRACTED [320046] — HB LINC MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $1,944.28 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS: $3,194 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE ACCESS CHOICE: $2,866 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM BLUE PREFERRED EFF 090118: $2,486 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM PATHWAY/EXCHANGE EFF 011520: $2,535 BLUE CROSS AND BLUE SHIELD [20053] — HB LINC ANTHEM TRADITIONAL EFF 090121: $2,087 HOME STATE MEDICAID CONTRACTED [320189] — HB LINC HOME STATE PLAN MANAGED MEDICAID: $2,830.87 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS: $3,194 MC ANTHEM [20455] — HB LINC ANTHEM BLUE ACCESS CHOICE: $2,866 MEDICAID [20240] — HB LINC MO MEDICAID: $2,721.99

Source: Mercy Hospital Lincoln’s standard charges file (mercy.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 10, 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	1000 East Cherry Street, Troy, MO 63379
County	Lincoln County
State	Missouri
Phone	(636) 528‑8551
Emergency services	Yes
Ownership	Government - Local
Medicare overall rating	Not rated by CMS
CMS Certification Number	261319
Name in Medicare records	MERCY HOSPITAL LINCOLN
Profile level	Medicare data + hospital website
Official website	mercy.net
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Mercy Hospital Lincoln Quick Facts — mercy.net
Mercy Diagnostic Cardiology Services - Lincoln | Mercy — mercy.net
Mercy Emergency Department - Lincoln | Mercy — mercy.net
Mercy Imaging Services - Lincoln | Mercy — mercy.net
Mercy Therapy Services - Lincoln | Mercy — mercy.net