Does Mercy Hospital Southeast have an emergency room?

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

Where is Mercy Hospital Southeast?

1701 Lacey St, Cape Girardeau, MO 63701, in Cape Girardeau County, Missouri.

What is the phone number of Mercy Hospital Southeast?

(573) 334-4822, as listed by Medicare (CMS).

What is the Medicare star rating of Mercy Hospital Southeast?

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

Mercy Hospital Southeast — Cape Girardeau, MO

Quick answers

Does Mercy Hospital Southeast have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Mercy Hospital Southeast. In a medical emergency, call 911.
Where is Mercy Hospital Southeast?: 1701 Lacey St, Cape Girardeau, MO 63701, in Cape Girardeau County, Missouri.
What is the phone number of Mercy Hospital Southeast?: (573) 334-4822, as listed by Medicare (CMS).
What is the Medicare star rating of Mercy Hospital Southeast?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Treatments^[4][5]

Speech, occupational and physical therapy
Lung and heart rehabilitation
Speech therapy
Occupational therapy

Procedures^[4][5]

Imaging (CT, mammography, x-ray, ultrasound)
Lab testing
CT scans
Mammograms
X-rays
Ultrasounds

Programs and centers^[4][5]

Inpatient critical care, ICU and NICU
Intensive care unit (ICU)
Neonatal intensive care unit (NICU)
Lung and heart rehab
Birth tissue donation program

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

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Interpreters and languages	Free language assistance services are available (notice in many languages)^[4]

Recognition^[4][5]

Get With The Guidelines Stroke Gold Plus (2026)
Get With The Guidelines Coronary Artery Disease NSTEMI Gold (2026)
Get With The Guidelines Stroke Gold Plus, Stroke Honor Roll 2026
Get With The Guidelines Coronary Artery Disease NSTEMI Gold, Type 2 Diabetes Honor Roll 2026
Get With The Guidelines Coronary Artery Disease Bronze Receiving Plus 2026
Ranked among America's Best Maternity Hospitals by Newsweek 2026
Gold Seal of Approval, The Joint Commission

Doctors and clinicians (510)

510 doctors and other clinicians list Mercy Hospital Southeast 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 486 more: the button below opens the full list.

Other emergency rooms nearby

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

Saint Francis Medical Center1.7 mi · Cape Girardeau, MO · Acute Care Hospital
Deaconess Illinois Union County19 mi · Anna, IL · Critical Access Hospital
Missouri Delta Medical Center29 mi · Sikeston, MO · Acute Care Hospital
Memorial Hospital of Carbondale34 mi · Carbondale, IL · Acute Care Hospital
Mercy Hospital Perry34 mi · Perryville, MO · Critical Access Hospital

Other hospitals nearby

Southeast Behavioral Hospital2.1 mi · Cape Girardeau, MO · Psychiatric Hospital
Choate Mental Health & Development Ctr20 mi · Anna, IL · 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

Ratliff Care Center0.9 mi · Cape Girardeau, MO · 4 of 5 stars
Life Care Center of Cape Girardeau1.1 mi · Cape Girardeau, MO · 2 of 5 stars
Chateau Girardeau1.5 mi · Cape Girardeau, MO · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Crown Hospice, Inc2.5 mi · Cape Girardeau, MO · 4 of 5 stars
Providence Home Health & Hospice2.5 mi · Cape Girardeau, MO · 4 of 5 stars
Saint Francis Hospice2.5 mi · Cape Girardeau, MO · 5 of 5 stars

All hospice providers in the state →

Home health agencies

Grace Reliant Health Services, LLC2.6 mi · Cape Girardeau, MO · 3 of 5 stars

All home health agencies in the state →

Dialysis facilities

Westbrook Dialysis, LLC2.5 mi · Cape Girardeau, MO · 1 of 5 stars
FMC - Cape Girardeau2.6 mi · Cape Girardeau, MO · 3 of 5 stars
FMC - Southeast Missouri2.6 mi · Cape Girardeau, MO · 1 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.

Auburn Surgery Center, Inc.2.5 mi · Cape Girardeau, MO
Doctors' Park Surgery, Inc.2.5 mi · Cape Girardeau, MO
Silver Springs Surgery Center, LLC2.5 mi · Cape Girardeau, 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

Cape Girardeau Service Site/Administrative Offices1.1 mi · Cape Girardeau, MO · Community health center
Cross Trails Medical Center1.2 mi · Cape Girardeau, MO · Community health center
Benton Medical Center15 mi · Benton, MO · Community health center

Clinics and urgent care

Alliant Medical Services, LLC2.5 mi · Cape Girardeau, MO · Urgent care center
Cape Girardeau County Public Health Center2.5 mi · Cape Girardeau, MO · Rural health clinic
DRX - East Missouri Providers, P.C.2.5 mi · Cape Girardeau, MO · Urgent care center

Pharmacies

Cape Pharmacy LLC2.5 mi · Cape Girardeau, MO · Community/retail pharmacy
Johns Pharmacy LLLP2.5 mi · Cape Girardeau, MO · Community/retail pharmacy
Mercy Pharmacy Services, LLC2.5 mi · Cape Girardeau, MO · Community/retail pharmacy

Assisted living nearby

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

Chateau Girardeau2.5 mi · Cape Girardeau, MO
Lutheran Home Assisted Living2.5 mi · Cape Girardeau, MO
Newbridge Retirement Community2.5 mi · Cape Girardeau, MO
Auburn Creek Assisted Living2.6 mi · Cape Girardeau, 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 Southeast reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	67%National average: 72%
Would definitely recommend the hospital	70%National average: 71%
Nurses “always” communicated well	76%National average: 80%
Doctors “always” communicated well	78%National average: 80%
Staff “always” explained medicines before giving them	57%National average: 62%
Were given information about recovery at home	88%National average: 86%
Room and bathroom “always” clean	65%National average: 74%
Area around the room “always” quiet at night	59%National average: 60%
Completed surveys	917Response rate: 19%

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)	0.46No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0No different from the national benchmark
Surgical site infections after colon surgery	0.631No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.506No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.567Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	12.1%
Deaths within 30 days: heart failure patients	15%
Deaths within 30 days: pneumonia patients	20.3%
Deaths within 30 days: COPD patients	12.9%
Deaths within 30 days: stroke patients	15.6%
Deaths within 30 days: coronary bypass surgery (CABG)	2%
Serious complications (patient safety indicator PSI-90)	0.92No different from the national rate
Complications after hip or knee replacement	4.1%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.7%
Readmitted within 30 days: heart failure	22.6%
Readmitted within 30 days: pneumonia	18.5%
Readmitted within 30 days: COPD	20.4%
Readmitted within 30 days: coronary bypass surgery	10.4%
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)	169 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	70%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Cape Girardeau Best hospitals in Missouri

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 65 common services exactly as Mercy Hospital Southeast 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 Pt Mlp	$108	$70.20	$68.27 – $321.23
New patient office visit (about 30–44 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $68.27 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $69.12 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $7.02 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $68.27 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $73.44 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $73.44 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $73.44 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $90.47 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $70.31 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $114.82
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 Pt Pf	$127	$82.55	$68.27 – $321.23
New patient office visit (about 30–44 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $68.27 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $81.28 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $8.26 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $68.27 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $86.36 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $86.36 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $86.36 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $90.47 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $70.31 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $114.82
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 Pt	$356	$231.40	$14,290.50
New patient office visit (about 30–44 minutes): 10 of 85 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $68.27 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $227.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $23.14 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $68.27 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $242.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $242.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $242.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $90.47 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $70.31 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $114.82
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	$111.49 – $524.61
New patient office visit (about 45–59 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $111.49 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $103.04 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $10.47 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $111.49 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $109.48 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $109.48 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $109.48 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $147.75 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $114.83 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $187.52
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 Pf	$190	$123.50	$111.49 – $524.61
New patient office visit (about 45–59 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $111.49 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $121.60 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $12.35 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $111.49 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $129.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $129.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $129.20 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $147.75 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $114.83 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $187.52
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	$592	$384.80	$14,290.50
New patient office visit (about 45–59 minutes): 10 of 85 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $111.49 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $378.88 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $38.48 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $111.49 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $402.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $402.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $402.56 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $147.75 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $114.83 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $187.52
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 Mlp	$234	$152.10	$152.72 – $718.62
New patient office visit (about 60–74 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $152.72 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $149.76 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $15.21 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $152.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $159.12 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $159.12 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $159.12 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $202.38 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $157.30 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $256.87
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	$275	$178.75	$152.72 – $718.62
New patient office visit (about 60–74 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $152.72 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $176 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $17.88 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $152.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $187 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $187 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $187 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $202.38 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $157.30 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $256.87
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	$592	$384.80	$14,290.50
New patient office visit (about 60–74 minutes): 10 of 85 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $152.72 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $378.88 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $38.48 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $152.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $402.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $402.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $402.56 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $202.38 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $157.30 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $256.87
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L&D Level II, 0-6 Hrs	$323	$209.95	$54.79 – $257.80
Established patient office visit (about 20–29 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $54.79 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $206.72 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $21 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $54.79 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $219.64 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $219.64 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $219.64 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $72.61 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $56.43 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $92.15
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L&D Level II, 12-18 Hrs	$969	$629.85	$54.79 – $257.80
Established patient office visit (about 20–29 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $54.79 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $620.16 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $62.99 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $54.79 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $658.92 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $658.92 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $658.92 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $72.61 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $56.43 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $92.15
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L&D Level II, 18-24 Hrs	$1,293	$840.45	$54.79 – $257.80
Established patient office visit (about 20–29 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $54.79 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $827.52 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $84.05 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $54.79 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $879.24 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $879.24 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $879.24 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $72.61 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $56.43 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $92.15
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level IV Est Pt Mlp	$124	$80.60	$80.66 – $379.53
Established patient office visit (about 30–39 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $80.66 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $79.36 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $8.06 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $80.66 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $84.32 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $84.32 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $84.32 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $106.89 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $83.08 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $135.66
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Visit Level IV Est Pt Pf	$145	$94.25	$80.66 – $379.53
Established patient office visit (about 30–39 minutes): 10 of 86 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $80.66 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $92.80 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $9.43 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $80.66 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $98.60 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $98.60 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $98.60 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $106.89 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $83.08 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $135.66
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lactation Consult 46-60 Minutes	$978	$635.70	$14,290.50
Established patient office visit (about 30–39 minutes): 10 of 85 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $80.66 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $625.92 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $63.57 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $80.66 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $665.04 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $665.04 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $665.04 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $106.89 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $83.08 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $135.66
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	$54.79
Office consultation with a specialist (moderate): 10 of 60 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $105.60 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $10.73 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $112.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $112.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $112.20 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $115.50 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $115.50 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $29.87 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $29.87 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $29.87
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 57 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $89.60 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $9.10 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $95.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $95.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $95.20 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $98 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $98 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $25.34 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $25.34 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $25.34
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	$14,290.50
Office consultation with a specialist (moderate): 10 of 56 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $129.28 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $13.13 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $137.36 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $137.36 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $137.36 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $141.40 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $141.40 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $36.56 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $36.56 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $36.56
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	$80.66
Office consultation with a specialist (moderate to high): 10 of 60 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $154.88 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $15.73 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $164.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $164.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $164.56 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $169.40 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $169.40 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $43.80 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $43.80 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $43.80
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 57 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $131.20 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $13.33 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $139.40 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $139.40 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $139.40 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $143.50 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $143.50 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $37.11 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $37.11 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $37.11
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	$14,290.50
Office consultation with a specialist (moderate to high): 10 of 56 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $216.32 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $21.97 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $229.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $229.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $229.84 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $236.60 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $236.60 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $61.18 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $61.18 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $61.18
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 3	$1,476	$959.40	$1,906 – $2,122
Emergency room visit (moderate): 10 of 99 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $268.22 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $268.22 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $347.05 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $276.26 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $451.14 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $536.45 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $424.87 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $268.22 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $268.22 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $1,508.47
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 4	$3,066.50	$1,993.22	$1,906 – $2,122
Emergency room visit (moderately high): 10 of 99 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $410 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $410 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $530.48 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $422.28 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $689.59 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $819.99 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $653.40 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $410 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $410 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $2,305.82
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Visit Care Level 5	$6,424	$4,175.60	$1,906 – $2,122
Emergency room visit (high): 10 of 99 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $585.16 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $585.16 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $757.12 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $602.70 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $984.21 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $1,170.32 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $940.79 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $585.16 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $585.16 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $3,290.91

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	$306	$198.90	$7.61 – $39.05
Basic metabolic panel (blood test): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $8.30 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $195.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $19.89 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $8.30 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $208.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $13.96 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $13.96 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $11 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $8.55 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $13.96
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Bmp W Calcium Total	$306	$198.90	$7.61 – $39.05
Basic metabolic panel (blood test): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $8.30 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $195.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $19.89 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $8.30 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $208.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $13.96 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $13.96 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $11 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $8.55 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $13.96
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel	$388	$252.20	$9.50 – $48.74
Comprehensive metabolic panel (blood test): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $10.36 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $248.32 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $25.22 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $10.36 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $263.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $17.42 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $17.42 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $13.73 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $10.67 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $17.42
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Panel	$280	$182	$12.05 – $61.81
Cholesterol panel (lipid panel): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $13.14 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $179.20 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $18.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $13.14 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $190.40 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $22.09 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $22.09 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $17.41 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $13.53 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $22.09
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Function Panel	$383	$248.95	$7.81 – $40.07
Kidney function panel: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $8.52 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $245.12 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $24.90 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $8.52 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $260.44 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $14.32 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $14.32 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $11.28 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $8.77 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $14.32
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic Function Panel	$283	$183.95	$7.35 – $37.71
Liver function panel: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $8.01 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $181.12 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $18.40 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $8.01 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $192.44 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $13.48 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $13.48 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $10.62 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $8.25 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $13.48
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Automated W Micro	$175	$113.75	$2.85 – $14.63
Urine test (automated, with microscope): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3.11 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $112 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $11.38 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $3.11 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $119 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $5.23 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $5.23 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $4.12 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $3.20 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $5.23
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Urinalysis Non-Auto	$7	$4.55	$3.13 – $16.06
Urine test (manual, without microscope): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3.41 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $4.48 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $0.46 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $3.41 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $4.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $5.74 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $5.74 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $4.52 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $3.52 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $5.74
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Non Automated WO Micro	$62	$40.30	$3.13 – $16.06
Urine test (manual, without microscope): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3.41 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $39.68 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $4.03 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $3.41 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $42.16 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $5.74 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $5.74 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $4.52 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $3.52 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $5.74
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	$2.03 – $10.39
Urine test (automated, without microscope): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $2.21 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $7.68 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $0.78 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $2.21 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $8.16 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $3.71 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $3.71 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $2.93 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $2.27 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $3.71
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Specific Gravity Urine Automated	$40	$26	$2.03 – $10.39
Urine test (automated, without microscope): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $2.21 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $25.60 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $2.60 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $2.21 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $27.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $3.71 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $3.71 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $2.93 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $2.27 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $3.71
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Automated W/O Micro	$125	$81.25	$2.03 – $10.39
Urine test (automated, without microscope): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $2.21 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $80 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $8.13 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $2.21 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $85 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $3.71 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $3.71 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $2.93 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $2.27 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $3.71
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Total Diagnostic	$250	$162.50	$16.55 – $84.89
PSA (prostate specific antigen) blood test: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $18.04 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $160 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $16.25 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $18.04 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $170 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $30.34 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $30.34 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $23.91 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $18.58 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $30.34
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Ultrasensitive	$172	$111.80	$16.55 – $84.89
PSA (prostate specific antigen) blood test: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $18.04 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $110.08 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $11.18 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $18.04 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $116.96 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $30.34 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $30.34 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $23.91 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $18.58 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $30.34
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh Newborn	$24	$15.60	$15.12 – $77.55
Thyroid stimulating hormone (TSH) test: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $16.48 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $15.36 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $1.56 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $16.48 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $16.32 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $27.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $27.72 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $21.84 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $16.97 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $27.72
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh Thyroid Stimulating Hormone	$292	$189.80	$15.12 – $77.55
Thyroid stimulating hormone (TSH) test: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $16.48 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $186.88 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $18.98 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $16.48 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $198.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $27.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $27.72 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $21.84 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $16.97 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $27.72
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc W Auto Diff	$239	$155.35	$6.99 – $35.87
Complete blood count (CBC) with differential: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $7.62 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $152.96 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $15.54 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $7.62 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $162.52 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $12.82 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $12.82 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $10.10 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $7.85 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $12.82
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc Automated WO Diff	$180	$117	$5.82 – $29.87
Complete blood count (CBC), automated: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $6.35 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $115.20 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $11.70 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $6.35 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $122.40 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $10.68 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $10.68 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $8.41 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $6.54 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $10.68
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time	$124	$80.60	$3.86 – $19.80
Blood clotting time test (prothrombin time, PT): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $4.21 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $79.36 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $8.06 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $4.21 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $84.32 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $7.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $7.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $5.58 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $4.33 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $7.08
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time Mixing Test	$97	$63.05	$3.86 – $19.80
Blood clotting time test (prothrombin time, PT): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $4.21 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $62.08 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $6.31 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $4.21 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $65.96 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $7.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $7.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $5.58 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $4.33 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $7.08
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ptt Mixing	$97	$63.05	$5.41 – $27.74
Blood clotting test (partial thromboplastin time, PTT): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $5.90 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $62.08 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $6.31 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $5.90 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $65.96 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $9.92 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $9.92 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $7.81 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $6.07 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $9.92
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ptt Partial Thromboplastin Time	$154	$100.10	$5.41 – $27.74
Blood clotting test (partial thromboplastin time, PTT): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $5.90 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $98.56 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $10.01 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $5.90 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $104.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $9.92 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $9.92 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $7.81 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $6.07 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $9.92

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	$2,408	$1,565.20	$90.66 – $671.83
CT scan of the head or brain, without contrast: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $102.72 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $1,541.12 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $156.52 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $102.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $1,637.44 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $1,637.44 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $1,637.44 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $132.91 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $105.80 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $172.78
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	$4,492	$2,919.80	$304.45 – $2,241.93
MRI of the brain, before and after contrast: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $342.80 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $2,874.88 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $291.98 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $342.80 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $3,054.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $3,054.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $3,054.56 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $443.54 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $353.07 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $576.57
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xr Chest 2 Views	$537	$349.05	$75.06 – $559.25
Chest X-ray, 2 views: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $85.51 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $343.68 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $34.91 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $85.51 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $365.16 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $365.16 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $365.16 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $110.64 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $88.07 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $143.82
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	$871	$566.15	$89.38 – $671.83
X-ray of the lower spine, at least 4 views: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $102.72 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $557.44 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $56.62 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $102.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $592.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $592.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $592.28 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $132.91 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $105.80 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $172.78
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	$3,588	$2,332.20	$206.06 – $1,533.30
MRI of the lower back (lumbar spine), without contrast: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $234.45 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $2,296.32 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $233.22 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $234.45 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $2,439.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $2,439.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $2,439.84 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $303.34 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $241.47 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $394.33
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis W Cont	$1,515	$984.75	$151.76 – $1,127.17
CT scan of the pelvis, with contrast: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $172.35 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $969.60 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $98.48 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $172.35 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $1,030.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $1,030.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $1,030.20 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $222.99 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $177.51 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $289.88
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	$5,376	$3,494.40	$206.06 – $1,533.30
MRI of a leg joint (such as the knee), without contrast: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $234.45 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $3,440.64 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $349.44 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $234.45 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $3,655.68 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $3,655.68 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $3,655.68 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $303.34 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $241.47 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $394.33
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	$3,840	$2,496	$206.06 – $1,533.30
MRI of a leg joint (such as the knee), without contrast: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $234.45 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $2,457.60 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $249.60 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $234.45 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $2,611.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $2,611.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $2,611.20 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $303.34 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $241.47 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $394.33
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	$3,840	$2,496	$206.06 – $1,533.30
MRI of a leg joint (such as the knee), without contrast: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $234.45 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $2,457.60 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $249.60 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $234.45 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $2,611.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $2,611.20 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $2,611.20 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $303.34 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $241.47 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $394.33
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	$1,663	$1,080.95	$304.45 – $2,241.93
CT scan of the abdomen and pelvis, with contrast: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $342.80 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $1,064.32 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $108.10 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $342.80 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $1,130.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $1,130.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $1,130.84 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $443.54 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $353.07 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $576.57
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Complete	$2,096	$1,362.40	$90.66 – $671.83
Ultrasound of the abdomen, complete: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $102.72 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $1,341.44 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $136.24 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $102.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $1,425.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $1,425.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $1,425.28 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $132.91 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $105.80 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $172.78
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Preg Uter 14 Wks Or>	$1,831	$1,190.15	$90.66 – $671.83
Pregnancy ultrasound (after the first trimester): 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $102.72 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $1,171.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $119.02 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $102.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $1,245.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $1,245.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $1,245.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $132.91 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $105.80 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $172.78
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Transvaginal Non OB	$1,393	$905.45	$90.66 – $671.83
Transvaginal ultrasound: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $102.72 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $891.52 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $90.55 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $102.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $947.24 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $947.24 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $947.24 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $132.91 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $105.80 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $172.78
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Unilat Lt W Cad	$474	$308.10	$72.91 – $343.06
Diagnostic mammogram, one breast: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $72.91 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $303.36 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $30.81 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $72.91 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $322.32 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $322.32 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $322.32 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $96.62 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $75.09 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $122.63
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Unilat Rt W Cad	$474	$308.10	$72.91 – $343.06
Diagnostic mammogram, one breast: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $72.91 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $303.36 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $30.81 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $72.91 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $322.32 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $322.32 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $322.32 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $96.62 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $75.09 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $122.63
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Diagnostic Bilat W Cad	$618	$401.70	$93.56 – $440.23
Diagnostic mammogram, both breasts: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $93.56 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $395.52 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $40.17 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $93.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $420.24 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $420.24 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $420.24 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $123.98 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $96.36 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $157.36
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Bilat Implant W Cad	$368	$239.20	$77.15 – $363
Screening mammogram, both breasts: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $77.15 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $235.52 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $23.92 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $77.15 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $250.24 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $250.24 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $250.24 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $102.23 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $79.46 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $129.76
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Bilateral W Cad	$467	$303.55	$77.15 – $363
Screening mammogram, both breasts: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $77.15 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $298.88 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $30.36 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $77.15 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $317.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $317.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $317.56 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $102.23 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $79.46 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $129.76
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mamm Scrn Left W Cad	$288	$187.20	$77.15 – $363
Screening mammogram, both breasts: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $77.15 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $184.32 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $18.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $77.15 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $195.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $195.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $195.84 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $102.23 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $79.46 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $129.76

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lt Heart Cath Including Inj Lt Ventriculography, S/I	$13,729	$8,923.85	$3,975 – $16,673
Left heart catheterization (diagnostic): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3,185.47 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $3,975 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $892.39 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $3,185.47 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $9,335.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $9,335.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $9,335.72 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $4,121.59 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $3,280.94 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $5,357.82
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comp Ep Eval Pvi W/3d Mapping	$27,091	$17,609.15	$16,673
Heart rhythm study with ablation for atrial fibrillation: 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $25,682.64 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $17,338.24 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $1,760.92 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $25,682.64 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $18,421.88 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $18,421.88 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $18,421.88 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $33,230.07 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $26,452.33 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $43,197.10
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	$7,807	$5,074.55	$400
Sleep study (overnight, in a sleep lab): 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $843.78 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $4,996.48 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $507.46 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $843.78 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $5,308.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $5,308.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $5,308.76 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $1,091.75 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $869.07 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $1,419.21
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 Hrs	$7,807	$5,074.55	$400
Sleep study (overnight, in a sleep lab): 10 of 96 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $843.78 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $4,996.48 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $507.46 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $843.78 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $5,308.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $5,308.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $5,308.76 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $1,091.75 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $869.07 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $1,419.21

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 Ther Exer 1 or > Area Ea 15m	$196	$127.40	$25.31 – $125.37
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $26.64 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $125.44 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $12.74 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $26.64 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $133.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $133.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $133.28 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $35.31 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $27.44 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $44.81
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	$196	$127.40	$25.31 – $125.37
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $26.64 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $125.44 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $12.74 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $26.64 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $133.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $133.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $133.28 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $35.31 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $27.44 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $44.81
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Ther Exer 1 or > Area Ea 15m	$196	$127.40	$25.31 – $125.37
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $26.64 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $125.44 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $12.74 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $26.64 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $133.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $133.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $133.28 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $35.31 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $27.44 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $44.81
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 105 Min	$381	$247.65	$86.18 – $422.36
Physical therapy evaluation (low complexity): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $89.76 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $243.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $24.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $89.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $259.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $118.95 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $92.45 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $150.98
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 120 Min	$381	$247.65	$86.18 – $422.36
Physical therapy evaluation (low complexity): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $89.76 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $243.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $24.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $89.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $259.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $118.95 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $92.45 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $150.98
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level I 135 Min	$381	$247.65	$86.18 – $422.36
Physical therapy evaluation (low complexity): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $89.76 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $243.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $24.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $89.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $259.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $118.95 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $92.45 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $150.98
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 105 Min	$381	$247.65	$86.18 – $422.36
Physical therapy evaluation (moderate complexity): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $89.76 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $243.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $24.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $89.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $259.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $118.95 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $92.45 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $150.98
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 120 Min	$381	$247.65	$86.18 – $422.36
Physical therapy evaluation (moderate complexity): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $89.76 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $243.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $24.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $89.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $259.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $118.95 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $92.45 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $150.98
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level II 135 Min	$381	$247.65	$86.18 – $422.36
Physical therapy evaluation (moderate complexity): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $89.76 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $243.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $24.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $89.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $259.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $118.95 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $92.45 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $150.98
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 105 Min	$381	$247.65	$86.18 – $422.36
Physical therapy evaluation (high complexity): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $89.76 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $243.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $24.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $89.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $259.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $118.95 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $92.45 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $150.98
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 120 Min	$381	$247.65	$86.18 – $422.36
Physical therapy evaluation (high complexity): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $89.76 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $243.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $24.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $89.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $259.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $118.95 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $92.45 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $150.98
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt Eval Level III 135 Min	$381	$247.65	$86.18 – $422.36
Physical therapy evaluation (high complexity): 10 of 97 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $89.76 AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $243.84 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $24.77 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $89.76 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $259.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $259.08 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $118.95 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $92.45 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $150.98
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 30 Min With Patient	$221	$143.65	$67.56 – $696.32
Psychotherapy, 30 minutes: 10 of 48 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $141.44 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $14.37 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $150.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $150.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $150.28 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $246.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $317.90 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $247.38 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $234.98 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM TRAD: $209.95
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	$67.56 – $696.32
Psychotherapy, 30 minutes: 10 of 48 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $74.24 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $7.54 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $78.88 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $78.88 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $78.88 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $246.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $317.90 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $247.38 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $234.98 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM TRAD: $110.20
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 45 Min With Patient	$221	$143.65	$89.32 – $1,140.63
Psychotherapy, 45 minutes: 10 of 52 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $141.44 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $14.37 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $150.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $150.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $150.28 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $246.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $980.84 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $696.32 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $310.66 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM TRAD: $209.95
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	$89.32 – $1,140.63
Psychotherapy, 45 minutes: 10 of 52 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $98.56 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $10.01 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $104.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $104.72 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $104.72 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $246.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $980.84 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $696.32 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $310.66 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM TRAD: $146.30
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psych Ther 60 Min With Patient	$221	$143.65	$131.55 – $1,140.63
Psychotherapy, 60 minutes: 10 of 52 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $141.44 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $14.37 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $150.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $150.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $150.28 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $246.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $980.84 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $696.32 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $457.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM TRAD: $209.95
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	$131.55 – $1,140.63
Psychotherapy, 60 minutes: 10 of 52 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $144.64 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $14.69 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $153.68 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $153.68 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $153.68 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $246.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $980.84 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $696.32 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $457.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM TRAD: $214.70
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	$100 – $696.32
Family psychotherapy, with the patient: 10 of 48 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $141.44 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $14.37 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $150.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $150.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $150.28 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $246.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $470.56 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $366.17 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $347.82 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM TRAD: $209.95
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	$100 – $696.32
Family psychotherapy, with the patient: 10 of 48 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $97.28 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $9.88 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $103.36 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $103.36 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $103.36 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $246.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $470.56 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $366.17 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $347.82 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM TRAD: $144.40

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	$365.37 – $940.71
Removal of breast growth (open surgery): 10 of 88 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $376.28 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $376.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $297.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $297.84 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $297.84 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $498.64 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $387.56 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $632.89 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $752.56 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $709.42
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	$516	$335.40	$365.37 – $940.71
Removal of breast growth (open surgery): 10 of 88 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $376.28 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $376.28 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $350.88 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $350.88 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $350.88 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $498.64 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $387.56 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $632.89 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $752.56 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $709.42
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Exc Breast Lesion Open 1 or >	$5,275	$3,428.75	$376.28 – $512.94
Removal of breast growth (open surgery): rates for 6 insurance plans BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $499.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $499.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $499.55 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM TRAD: $512.94 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $376.28 BLUE CROSS AND BLUE SHIELD [20053] — HB STLO WASH JEFN LINC SAMC CAPE STOD PCMH BCBS ASCENSION: $2,505.63
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$55,726.35	$36,222.13	$14,290.50
Shoulder arthroscopy: shaving of shoulder bone: 10 of 99 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $7,129.84 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $7,129.84 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $9,225.11 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $7,343.52 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $11,992.08 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $14,259.68 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $6,089.90 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $7,129.84 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $7,129.84 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $40,097.87
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg	$34,576.87	$22,474.97	$14,290.50
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 99 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3,215.01 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $3,215.01 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $4,159.82 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $3,311.37 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $5,407.52 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $6,430.03 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $2,765.97 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3,215.01 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3,215.01 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $18,081.10
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Upper Endoscopy Complex	$9,383.01	$6,098.96	$14,290.50
Upper GI endoscopy (diagnostic): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $891.19 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $891.19 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $1,153.09 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $917.90 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $1,498.94 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $1,782.38 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $799.25 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $891.19 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $891.19 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $5,011.99
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Egd W/Biopsy Pf	$12,159.68	$7,903.79	$14,290.50
Upper GI endoscopy with biopsy: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,885.49 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $1,885.49 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $2,439.58 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $1,941.99 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $3,171.31 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $3,770.97 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $799.25 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,885.49 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,885.49 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $10,603.88
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Colonoscopy	$8,318.01	$5,406.71	$14,290.50
Colonoscopy (diagnostic): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $913.76 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $913.76 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $1,182.29 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $941.15 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $1,536.91 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $1,827.52 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $913.76 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $913.76 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $5,138.97 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $3,648.26
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Colo Biopsy Cold Pf	$10,764	$6,996.60	$14,290.50
Colonoscopy with biopsy: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,175.80 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $1,175.80 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $1,521.34 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $1,211.04 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $1,977.65 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $2,351.60 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $1,005.15 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,175.80 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,175.80 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $6,612.63
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GI Colo Biopsy Snare Pf	$11,210.01	$7,286.51	$14,290.50
Colonoscopy with removal of polyps (snare): 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,175.80 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $1,175.80 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $1,521.34 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $1,211.04 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $1,977.65 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $2,351.60 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $1,005.15 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,175.80 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,175.80 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $6,612.63
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lap,Cholecystectomy Pf	$33,608.46	$21,845.50	$9,421 – $14,290.50
Gallbladder removal by laparoscope: 10 of 99 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $5,940.24 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $5,940.24 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $7,685.91 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $6,118.26 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $9,991.22 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $11,880.47 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $4,973.69 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $5,940.24 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $5,940.24 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $33,407.61
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	$33,279.50	$21,631.67	$14,290.50
Groin (inguinal) hernia repair, age 5 or older: 10 of 99 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3,518.04 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $3,518.04 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $4,551.90 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $3,623.48 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $5,917.20 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $7,036.09 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $3,008.46 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3,518.04 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3,518.04 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $19,785.32
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Bx Prostate Needle/Punch	$31,261.60	$20,320.04	$14,290.50
Prostate biopsy: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $51.20 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $352.20 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $66.25 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $362.76 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $1,746.31 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $352.20 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $352.20 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $386.03 CENTIVO CONTRACTED [320505] — HB CAPE CENTIVO 165% MEDICARE NEW 110124: $86.12 CIGNA HEALTHCARE CONTRACTED [320071] — HB CAPE CIGNA COMMERCIAL: $14,290.50
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps Surg Prst8ect Rpbic Rad W/Nerve Sparing	$72,031.77	$46,820.65	$14,290.50
Prostate removal by laparoscope (radical prostatectomy): 10 of 99 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $10,444.70 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $10,444.70 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $13,514.12 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $10,757.72 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $17,567.54 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $20,889.41 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $8,875.37 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $10,444.70 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $10,444.70 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $58,740.51
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	$26,881.68	$17,473.09	$14,290.50
Hysteroscopy with biopsy of the uterus lining: 10 of 99 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3,180.75 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $3,180.75 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $4,115.48 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $3,276.07 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $5,349.88 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $6,361.49 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $2,710.49 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3,180.75 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $3,180.75 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $17,888.36
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	$1,394.45	$906.39	$14,290.50
Spinal injection, lower back (epidural), with imaging guidance: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $693.59 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $693.59 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $897.41 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $714.37 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $1,166.58 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $1,387.17 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $590.36 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $693.59 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $693.59 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $3,900.72
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Bilat Inj Epi/Lumb/Sacral Sngl Level	$6,042	$3,927.30	$14,290.50
Nerve root injection, lower back, with imaging guidance: 10 of 56 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $3,274.76 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $392.73 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $4,108.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $4,108.56 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $4,108.56 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $4,229.40 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $4,229.40 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $1,093.60 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $1,093.60 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $1,093.60
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	$3,555	$2,310.75	$14,290.50
Nerve root injection, lower back, with imaging guidance: 10 of 56 insurance plan rates AETNA CONTRACTED [320008] — HB CAPE AETNA COMMERCIAL / FIRST HEALTH: $1,926.81 AETNA MEDICAID CONTRACTED [320009] — HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125: $231.08 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD LACLEDE CHAIN DEC NEW 11.01.25: $2,417.40 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD QCG QUALITY COLLISION GROUPER DEC NEW 110125: $2,417.40 AITHER HEALTH CONTRACTED [320449] — HB CAPE STOD WOODARD DEC NEW 110125: $2,417.40 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $2,488.50 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $2,488.50 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $643.46 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE PREFERRED/ALLIANCE: $643.46 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM PATHWAY/EXCHANGE: $643.46
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplas/ Tranposit Median Nerve at Carp Tiunn Pf	$19,593.60	$12,735.84	$14,290.50
Carpal tunnel release: 10 of 98 insurance plan rates ACENTRA HEALTH CONTRACTED [320527] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,918.72 AETNA MEDICARE ADVANTAGE CONTRACTED [320010] — HB CAPE AETNA MEDICARE 100%: $1,918.72 AMBETTER CONTRACTED [320452] — HB CAPE HOME STATE AMBETTER EXCHANGE BH & 130% MCR: $2,482.57 AMERICAN HEALTH ADVANTAGE OF MO MCR HMO CONTRACTED [320264] — HB CAPE AMERICAN HEALTH MEDICARE MO SELECT 103% W/SEQ: $1,976.22 AUXIANT CONTRACTED [320462] — HB CAPE CITY OF JACKSON DEC 165% W/O SEQ NEW 010125: $3,227.20 AUXIANT CONTRACTED [320462] — HB CAPE DEC BUCHHEIT IP 225% OP 200% DEFAULT 70%: $3,837.43 BCBS MEDICAID CONTRACTED [320046] — HB CAPE MISSOURI CARE HEALTH PLAN/HEALTHY BLUE: $1,664.70 BCBS MEDICARE ADVANTAGE [20047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,918.72 BCBS MEDICARE ADVANTAGE CONTRACTED [320047] — HB CAPE MEDICARE AND 100% MANAGED MEDICARE: $1,918.72 BLUE CROSS AND BLUE SHIELD [20053] — HB CAPE ANTHEM BLUE ACCESS: $10,790.78

Source: Mercy Hospital Southeast’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 11, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	1701 Lacey St, Cape Girardeau, MO 63701
County	Cape Girardeau County
State	Missouri
Phone	(573) 334‑4822
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	260110
Name in Medicare records	MERCY HOSPITAL SOUTHEAST
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 Southeast — mercy.net
Mercy Hospital Southeast | Mercy — mercy.net
Mercy Hospital Southeast Locations | Mercy — mercy.net

Mercy Hospital Southeast

Summary

Profile from official sources

At a glance