Does MercyOne Centerville Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at MercyOne Centerville Medical Center. In a medical emergency, call 911.

Where is MercyOne Centerville Medical Center?

One St Joseph's Drive, Centerville, IA 52544, in Appanoose County, Iowa.

What is the phone number of MercyOne Centerville Medical Center?

(641) 437-4111, as listed by Medicare (CMS).

What is the Medicare star rating of MercyOne Centerville Medical Center?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

MercyOne Centerville Medical Center

Quick answers

Does MercyOne Centerville Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at MercyOne Centerville Medical Center. In a medical emergency, call 911.
Where is MercyOne Centerville Medical Center?: One St Joseph's Drive, Centerville, IA 52544, in Appanoose County, Iowa.
What is the phone number of MercyOne Centerville Medical Center?: (641) 437-4111, as listed by Medicare (CMS).
What is the Medicare star rating of MercyOne Centerville Medical Center?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4][6]

Cancer care
Emergency care
Heart and vascular care
Neurosciences/neurology
Pediatrics
Primary care
Surgical care
Urgent care
Mental and behavioral health
Endocrinology
Imaging/radiology
Therapy and Rehabilitation
Pediatric Therapy
Lab Services

Treatments^[4]

Therapy and rehabilitation
Pediatric therapy
Skilled nursing

Programs and centers^[4][6]

Senior Life Solutions
Diabetes education
Nutritional counseling

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

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

Recognition^[4]

Critical access hospital

Doctors and clinicians (134)

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

Main specialties

Doctors with a page on this site (134)

Aaron M. From, MDCardiovascular Disease (Cardiology)
Abigail T. CaracciPhysician Assistant
Ahmad Babaa, DODiagnostic Radiology
Akrivi Manola, MDAdvanced Heart Failure and Transplant Cardiology
Alan T. McDaniel, MDDiagnostic Radiology
Alexander T. Stone, DODiagnostic Radiology
Amanda CondraNurse Practitioner
Amanda E. McKinley, CNACertified Registered Nurse Anesthetist (CRNA)
Amy L. WoodPhysician Assistant
Andrew M. Zeff, MDHospitalist
Angela E. Sandre, DOMedical Oncology
Ashleigh MathewsNurse Practitioner
Ashley N. BlandNurse Practitioner
Atul K. Chawla, MDInterventional Cardiology
Basima Khan, DOInternal Medicine
Bharanidhar Chandrasekaran, MDDiagnostic Radiology
Bradley A. Scott, DOOrthopedic Surgery
Brian N. Quinn, DOFamily Practice
Caitlin A. Arey, NPNurse Practitioner
Carol E. Belloma, NPNurse Practitioner
Cassie J. Parrish, NPNurse Practitioner
Chinedu G. Ifejiagwa, MDFamily Practice
Christopher D. AmburnNurse Practitioner
Christos M. Kassiotis, MDAdvanced Heart Failure and Transplant Cardiology

And 110 more: the button below opens the full list.

Other emergency rooms nearby

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

Putnam County Memorial Hospital16 mi · Unionville, MO · Critical Access Hospital
Wayne County Hospital21 mi · Corydon, IA · Critical Access Hospital
Monroe County Hospital24 mi · Albia, IA · Critical Access Hospital
Davis County Hospital26 mi · Bloomfield, IA · Critical Access Hospital
Lucas County Health Center30 mi · Chariton, IA · Critical Access Hospital

Other hospitals nearby

Ottumwa Regional Health Center35 mi · Ottumwa, IA · Acute Care 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

Golden Age Care Center2.4 mi · Centerville, IA · 1 of 5 stars
MercyOne Centerville Medical Center2.9 mi · Centerville,, IA · 2 of 5 stars
Centerville Specialty Care3.5 mi · Centerville, IA · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Care Initiatives Hospice - Albia23 mi · Albia, IA · 2 of 5 stars

All hospice providers in the state →

Home health agencies

Elara Caring0.0 mi · Centerville, IA
Wayne County Public Health Nursing Service22 mi · Corydon, IA

All home health agencies in the state →

Dialysis facilities

Wayne County Hospital ESRD22 mi · Corydon, IA · 3 of 5 stars

All dialysis facilities in the state →

Community care nearby

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

Community health centers

RHCHC Lakeview Elementary2.0 mi · Centerville, IA · Community health center
RHCHC Howar Middle School2.3 mi · Centerville, IA · Community health center
RHCHC Centerville High School2.5 mi · Centerville, IA · Community health center

Clinics and urgent care

MercyOne Centerville Medical Clinic0.0 mi · Centerville, IA · Rural health clinic
Seymour Medical Clinic12 mi · Seymour, IA · Rural health clinic
Putnam County Memorial Hospital Rural Health Clinic16 mi · Unionville, MO · Rural health clinic

Pharmacies

Hy-Vee Inc0.0 mi · Centerville, IA · Community/retail pharmacy
Midland Pharmacy, Inc0.0 mi · Centerville, IA · Community/retail pharmacy
Total Dose Centerville, LLC0.0 mi · Centerville, IA · Community/retail pharmacy

Assisted living nearby

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

Homestead of Centerville0.0 mi · Centerville, IA
Maple Grove Senior Living0.0 mi · Centerville, IA

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 MercyOne Centerville Medical Center 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)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	70%National average: 72%
Would definitely recommend the hospital	77%National average: 71%
Nurses “always” communicated well	84%National average: 80%
Doctors “always” communicated well	79%National average: 80%
Staff “always” explained medicines before giving them	70%National average: 62%
Were given information about recovery at home	92%National average: 86%
Room and bathroom “always” clean	80%National average: 74%
Area around the room “always” quiet at night	68%National average: 60%
Completed surveys	52Response rate: 26%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

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	Too few cases to report
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	14.7%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	16.3%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	130 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Iowa Best hospitals in Iowa

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 64 common services exactly as MercyOne Centerville Medical Center 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 →

$ 24 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$175	$175	$55.95 – $175
New patient office visit (about 30–44 minutes): 10 of 776 insurance plan rates AETNA — AETNA: $150.31 AETNA DOMESTIC — AETNA: $150.31 AETNA MEDICARE TRANSPLANT — MEDICARE: $65.84 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $58.03 ALIGN SENIOR CARE — MEDICARE: $65.84 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $65.84 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $140.52 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $58.03 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $65.84 ALLY ALIGN CARE ADV — MEDICARE: $65.84
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$252	$252	$56.75 – $252
New patient office visit (about 30–44 minutes): 10 of 776 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $57.90 ALIGN SENIOR CARE — MEDICARE: $91.09 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $69.16 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $69.16 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $91.09 AMBETTER — AMBETTER: $158.01 AMERIGROUP MEDICAID — MEDICAID IOWA: $69.16 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $69.16 AMERIHEALTH MEDICARE — MEDICARE: $91.09 AMISH HOSPITAL AID — AMISH MEDICAL AID: $123.62
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Visit New Low Pro 30-44 Mins (Restricted Method II CAH)	$252	$252	$69.15 – $252
New patient office visit (about 30–44 minutes): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $236.12 AETNA — AETNA: $236.12 AETNA DOMESTIC — AETNA: $236.12 AETNA EAP — AETNA: $236.12 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.26 ALLIED BENEFIT SYSTEMS — AETNA: $236.12 AMBETTER — AMBETTER MARKETPLACE: $122.77 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $97.20 ASR HEALTH BENEFITS — AETNA: $236.12 AUXIANT — MIDLANDS CHOICE PPO: $246.96
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$285	$285	$90.81 – $285
New patient office visit (about 45–59 minutes): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $108 AETNA — AETNA: $243.20 AETNA MEDICAID — AETNA MEDICAID: $90.81 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $108 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $108 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $93 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $224.58 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $93 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $108 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $108
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$386	$386	$79.75 – $386
New patient office visit (about 45–59 minutes): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $137.87 AETNA — AETNA: $257.39 AETNA DOMESTIC — AETNA: $257.39 AETNA MEDICAID — AETNA MEDICAID: $94.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $137.87 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $137.87 AETNA MEDICARE TRANSPLANT — MEDICARE: $137.87 ALIGN SENIOR CARE — MEDICARE: $137.87 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $137.87 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $282.23
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Visit New Mod Pro 45-59 Mins (Restricted Method II CAH)	$386	$386	$105.92 – $386
New patient office visit (about 45–59 minutes): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $361.68 AETNA — AETNA: $361.68 AETNA DOMESTIC — AETNA: $361.68 AETNA EAP — AETNA: $361.68 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $126.73 ALLIED BENEFIT SYSTEMS — AETNA: $361.68 AMBETTER — AMBETTER MARKETPLACE: $188.06 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $148.88 ASR HEALTH BENEFITS — AETNA: $361.68 AUXIANT — MIDLANDS CHOICE PPO: $378.28
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$388	$388	$120.31 – $388
New patient office visit (about 60–74 minutes): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $147.39 AETNA DOMESTIC — AETNA: $330.11 AETNA MEDICAID — AETNA MEDICAID: $123.49 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $120.31 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $147.39 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $120.31 ALLY ALIGN CARE ADV — MEDICARE: $147.39 AMBETTER — AMBETTER: $255.68 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $154.76 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $120.31
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$488	$488	$93 – $488
New patient office visit (about 60–74 minutes): 10 of 776 insurance plan rates AETNA — AETNA: $339.90 AETNA MEDICAID — AETNA MEDICAID: $126.74 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $183.58 AETNA MEDICARE TRANSPLANT — MEDICARE: $183.58 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $124.85 ALIGN SENIOR CARE — MEDICARE: $183.58 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $372.31 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $124.85 AMBETTER — AMBETTER: $318.46 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $183.58
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Visit New High Pro 60-74 Mins (Restricted Method II CAH)	$488	$488	$133.91 – $488
New patient office visit (about 60–74 minutes): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $457.26 AETNA — AETNA: $457.26 AETNA DOMESTIC — AETNA: $457.26 AETNA EAP — AETNA: $457.26 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $172.96 ALLIED BENEFIT SYSTEMS — AETNA: $457.26 AMBETTER — AMBETTER MARKETPLACE: $237.75 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $188.22 ASR HEALTH BENEFITS — AETNA: $457.26 AUXIANT — MIDLANDS CHOICE PPO: $478.24
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$141	$141	$26.02 – $141
Established patient office visit (about 20–29 minutes): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $45.57 AETNA DOMESTIC — AETNA: $102.74 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $45.57 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $45.57 AETNA MEDICARE TRANSPLANT — MEDICARE: $45.57 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $26.02 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $45.57 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $45.57 ALLY ALIGN CARE ADV — MEDICARE: $45.57 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $45.57
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$192	$192	$36.25 – $192
Established patient office visit (about 20–29 minutes): 10 of 776 insurance plan rates AETNA — AETNA: $139.74 AETNA DOMESTIC — AETNA: $139.74 AETNA MEDICAID — AETNA MEDICAID: $62.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $74.33 AETNA MEDICARE TRANSPLANT — MEDICARE: $74.33 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $36.75 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $36.75 ALIGN SENIOR CARE — MEDICARE: $74.33 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $74.33 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $152.53
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Visit Estab Low Pro 20-29 Mins (Restricted Method II CAH)	$182	$182	$49.94 – $182
Established patient office visit (about 20–29 minutes): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $170.53 AETNA — AETNA: $170.53 AETNA DOMESTIC — AETNA: $170.53 AETNA EAP — AETNA: $170.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $62.91 ALLIED BENEFIT SYSTEMS — AETNA: $170.53 AMBETTER — AMBETTER MARKETPLACE: $88.67 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $70.20 ASR HEALTH BENEFITS — AETNA: $170.53 AUXIANT — MIDLANDS CHOICE PPO: $178.36
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$272	$272	$56.78 – $272
Established patient office visit (about 30–39 minutes): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $105.88 AETNA — AETNA: $198.05 AETNA DOMESTIC — AETNA: $198.05 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $105.88 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $105.88 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $56.78 ALIGN SENIOR CARE — MEDICARE: $105.88 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $216.18 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $105.88 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $56.78
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$209	$209	$41.71 – $209
Established patient office visit (about 30–39 minutes): 10 of 776 insurance plan rates AETNA — AETNA: $151.94 AETNA DOMESTIC — AETNA: $151.94 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $66.93 AETNA MEDICARE TRANSPLANT — MEDICARE: $66.93 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $41.71 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $41.71 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $66.93 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $164.54 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $41.71 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $66.93
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Visit Estab Mod Pro 30-39 Mins (Restricted Method II CAH)	$258	$258	$70.80 – $258
Established patient office visit (about 30–39 minutes): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $241.75 AETNA — AETNA: $241.75 AETNA DOMESTIC — AETNA: $241.75 AETNA EAP — AETNA: $241.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.40 ALLIED BENEFIT SYSTEMS — AETNA: $241.75 AMBETTER — AMBETTER MARKETPLACE: $125.70 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $99.51 ASR HEALTH BENEFITS — AETNA: $241.75 AUXIANT — MIDLANDS CHOICE PPO: $252.84
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	$199	$199	$58.24 – $199
Preventive checkup, new patient, age 18–39: 10 of 561 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $58.24 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $76.99 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $102.04 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $183.75 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $102.04 AMBETTER — AMBETTER: $133.55 AMERIGROUP MEDICAID — MEDICAID IOWA: $102.04 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $102.04 AMPS — AMPS: $106.06 ANDRIE INC — WORKERS COMP: $199
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	$313	$313	$74.50 – $313
Preventive checkup, new patient, age 18–39: 10 of 561 insurance plan rates AETNA DOMESTIC — AETNA: $271.15 AETNA MEDICAID — AETNA MEDICAID: $104.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $124.30 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $102.04 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $253.41 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $102.04 AMBETTER — AMBETTER: $215.63 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $102.04 AMISH HOSPITAL AID — AMISH MEDICAL AID: $168.70 AMPS — AMPS: $171.23
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years	$241	$241	$66.40 – $241
Preventive checkup, new patient, age 40–64: 10 of 561 insurance plan rates AETNA — AETNA: $241 AETNA DOMESTIC — AETNA: $241 AETNA MEDICAID — AETNA MEDICAID: $66.40 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $122.89 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $222.19 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $122.89 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $122.89 AMBETTER — AMBETTER: $162.18 AMERIGROUP MEDICAID — MEDICAID IOWA: $122.89 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $122.89
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years	$363	$363	$74.50 – $363
Preventive checkup, new patient, age 40–64: 10 of 557 insurance plan rates AETNA — AETNA: $266.01 AETNA DOMESTIC — AETNA: $266.01 AETNA MEDICAID — AETNA MEDICAID: $104.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $121.98 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $104.46 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $291.84 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $104.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $104.46 AMBETTER — AMBETTER: $211.61 AMERIGROUP MEDICAID — MEDICAID IOWA: $104.46
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Low	$148	$148	$44.30 – $148
Emergency room visit (moderate): 10 of 777 insurance plan rates AETNA DOMESTIC — AETNA: $130.91 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $63.36 AETNA MEDICARE TRANSPLANT — MEDICARE: $63.36 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $59.12 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $59.12 ALIGN SENIOR CARE — MEDICARE: $63.36 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $63.36 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $134.51 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $59.12 ALLY ALIGN CARE ADV — MEDICARE: $63.36
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Low	$156	$156	$44.30 – $156
Emergency room visit (moderate): 10 of 777 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $63.36 AETNA — AETNA: $130.91 AETNA MEDICAID — AETNA MEDICAID: $49.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $63.36 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $63.36 AETNA MEDICARE TRANSPLANT — MEDICARE: $63.36 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $59.12 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $63.36 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $59.12 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $63.36
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3	$927	$927	$127.65 – $927
Emergency room visit (moderate): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $868.60 AETNA — AETNA: $868.60 AETNA DOMESTIC — AETNA: $868.60 AETNA EAP — AETNA: $868.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $268.83 ALLIED BENEFIT SYSTEMS — AETNA: $868.60 AMBETTER — AMBETTER MARKETPLACE: $451.63 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $357.54 ASR HEALTH BENEFITS — AETNA: $868.60 AUXIANT — MIDLANDS CHOICE PPO: $908.46
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Moderate	$253	$253	$75.40 – $253
Emergency room visit (moderately high): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $107.71 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $107.71 AETNA MEDICARE TRANSPLANT — MEDICARE: $107.71 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $91.03 ALIGN SENIOR CARE — MEDICARE: $107.71 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $107.71 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $225.78 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $107.71 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $113.10 AMERIGROUP MEDICAID — MEDICAID IOWA: $91.03
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Moderate	$284	$284	$75.40 – $284
Emergency room visit (moderately high): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $107.71 AETNA — AETNA: $221.33 AETNA MEDICAID — AETNA MEDICAID: $83.69 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $91.03 ALIGN SENIOR CARE — MEDICARE: $107.71 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $91.03 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $107.71 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $91.03 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $107.71 AMBETTER — AMBETTER: $186.85
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 4 Sane_Safe	$1,280	$1,280	$176.26 – $1,280
Emergency room visit (moderately high): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,199.36 AETNA — AETNA: $1,199.36 AETNA DOMESTIC — AETNA: $1,199.36 AETNA EAP — AETNA: $1,199.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $371.20 ALLIED BENEFIT SYSTEMS — AETNA: $1,199.36 AMBETTER — AMBETTER MARKETPLACE: $623.62 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $493.70 ASR HEALTH BENEFITS — AETNA: $1,199.36 AUXIANT — MIDLANDS CHOICE PPO: $1,254.40
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit High	$367	$367	$109.27 – $367
Emergency room visit (high): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $156.63 AETNA — AETNA: $321.34 AETNA DOMESTIC — AETNA: $321.34 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $156.63 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $156.63 AETNA MEDICARE TRANSPLANT — MEDICARE: $156.63 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $143.10 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $143.10 ALIGN SENIOR CARE — MEDICARE: $156.63 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $156.63
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit High	$412	$412	$109.27 – $412
Emergency room visit (high): 10 of 776 insurance plan rates AETNA DOMESTIC — AETNA: $321.34 AETNA MEDICAID — AETNA MEDICAID: $121.28 AETNA MEDICARE TRANSPLANT — MEDICARE: $156.63 ALIGN SENIOR CARE — MEDICARE: $156.63 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $156.63 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $327.87 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $143.10 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $156.63 ALLY ALIGN CARE ADV — MEDICARE: $156.63 AMBETTER — AMBETTER: $271.71
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Critical Care 30-74 Minutes - Downgrade	$1,908	$1,908	$523.56 – $1,908
Emergency room visit (high): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,787.80 AETNA — AETNA: $1,787.80 AETNA DOMESTIC — AETNA: $1,787.80 AETNA EAP — AETNA: $1,787.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $553.32 ALLIED BENEFIT SYSTEMS — AETNA: $1,787.80 AMBETTER — AMBETTER MARKETPLACE: $929.58 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $735.92 ASR HEALTH BENEFITS — AETNA: $1,787.80 AUXIANT — MIDLANDS CHOICE PPO: $1,869.84

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Basic Metabolic Panel (Calcium Total)	$159	$159	$43.63 – $159
Basic metabolic panel (blood test): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $148.98 AETNA — AETNA: $148.98 AETNA DOMESTIC — AETNA: $148.98 AETNA EAP — AETNA: $148.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $46.11 ALLIED BENEFIT SYSTEMS — AETNA: $148.98 AMBETTER — AMBETTER MARKETPLACE: $77.46 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $61.33 ASR HEALTH BENEFITS — AETNA: $148.98 AUXIANT — MIDLANDS CHOICE PPO: $155.82
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Basic Metabolic Panel (Calcium Total)	Not listed in the file	$439	$8.97
Basic metabolic panel (blood test): rates for 1 insurance plan UNITED HEALTHCARE MEDICARE — UNITED HEALTHCARE MEDICARE ADVANTAGE: $8.97
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	$194	$194	$53.23 – $194
Comprehensive metabolic panel (blood test): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $181.78 AETNA — AETNA: $181.78 AETNA DOMESTIC — AETNA: $181.78 AETNA EAP — AETNA: $181.78 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $56.26 ALLIED BENEFIT SYSTEMS — AETNA: $181.78 AMBETTER — AMBETTER MARKETPLACE: $94.52 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $74.83 ASR HEALTH BENEFITS — AETNA: $181.78 AUXIANT — MIDLANDS CHOICE PPO: $190.12
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Lipid Panel	$170	$170	$46.65 – $170
Cholesterol panel (lipid panel): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $159.29 AETNA — AETNA: $159.29 AETNA DOMESTIC — AETNA: $159.29 AETNA EAP — AETNA: $159.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $49.30 ALLIED BENEFIT SYSTEMS — AETNA: $159.29 AMBETTER — AMBETTER MARKETPLACE: $82.82 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $65.57 ASR HEALTH BENEFITS — AETNA: $159.29 AUXIANT — MIDLANDS CHOICE PPO: $166.60
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Lmpp Lipid Panel	$170	$170	$46.65 – $170
Cholesterol panel (lipid panel): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $159.29 AETNA — AETNA: $159.29 AETNA DOMESTIC — AETNA: $159.29 AETNA EAP — AETNA: $159.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $49.30 ALLIED BENEFIT SYSTEMS — AETNA: $159.29 AMBETTER — AMBETTER MARKETPLACE: $82.82 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $65.57 ASR HEALTH BENEFITS — AETNA: $159.29 AUXIANT — MIDLANDS CHOICE PPO: $166.60
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Renal Function Panel	$145	$145	$39.79 – $145
Kidney function panel: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $135.87 AETNA — AETNA: $135.87 AETNA DOMESTIC — AETNA: $135.87 AETNA EAP — AETNA: $135.87 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $42.05 ALLIED BENEFIT SYSTEMS — AETNA: $135.87 AMBETTER — AMBETTER MARKETPLACE: $70.64 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $55.93 ASR HEALTH BENEFITS — AETNA: $135.87 AUXIANT — MIDLANDS CHOICE PPO: $142.10
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Hepatic Function Panel	$170	$170	$46.65 – $170
Liver function panel: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $159.29 AETNA — AETNA: $159.29 AETNA DOMESTIC — AETNA: $159.29 AETNA EAP — AETNA: $159.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $49.30 ALLIED BENEFIT SYSTEMS — AETNA: $159.29 AMBETTER — AMBETTER MARKETPLACE: $82.82 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $65.57 ASR HEALTH BENEFITS — AETNA: $159.29 AUXIANT — MIDLANDS CHOICE PPO: $166.60
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	$68	$68	$18.66 – $68
Urine test (automated, with microscope): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $63.72 AETNA — AETNA: $63.72 AETNA DOMESTIC — AETNA: $63.72 AETNA EAP — AETNA: $63.72 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $19.72 ALLIED BENEFIT SYSTEMS — AETNA: $63.72 AMBETTER — AMBETTER MARKETPLACE: $33.13 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $26.23 ASR HEALTH BENEFITS — AETNA: $63.72 AUXIANT — MIDLANDS CHOICE PPO: $66.64
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	Not listed in the file	$503	$9.09
Urine test (automated, with microscope): rates for 1 insurance plan IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $9.09
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Automated	$10	$10	$1.80 – $10
Urine test (automated, without microscope): 10 of 769 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $2.21 AETNA DOMESTIC — AETNA: $2.90 AETNA MEDICAID — AETNA MEDICAID: $4.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $2.21 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $2.70 ALIGN SENIOR CARE — MEDICARE: $2.21 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $2.70 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $2.21 AMBETTER — AMBETTER: $3.83
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	$61	$61	$16.74 – $61
Urine test (automated, without microscope): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $57.16 AETNA — AETNA: $57.16 AETNA DOMESTIC — AETNA: $57.16 AETNA EAP — AETNA: $57.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17.69 ALLIED BENEFIT SYSTEMS — AETNA: $57.16 AMBETTER — AMBETTER MARKETPLACE: $29.72 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $23.53 ASR HEALTH BENEFITS — AETNA: $57.16 AUXIANT — MIDLANDS CHOICE PPO: $59.78
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Automated	Not listed in the file	$7.49	$1.80 – $7.49
Urine test (automated, without microscope): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $2.21 AETNA — AETNA: $3.41 AETNA DOMESTIC — AETNA: $3.41 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $2.21 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $3.18 ALIGN SENIOR CARE — MEDICARE: $2.21 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $2.71 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $2.21 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $2.21
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prostate Specific Antigen Total	$188	$188	$51.59 – $188
PSA (prostate specific antigen) blood test: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $176.16 AETNA — AETNA: $176.16 AETNA DOMESTIC — AETNA: $176.16 AETNA EAP — AETNA: $176.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $54.52 ALLIED BENEFIT SYSTEMS — AETNA: $176.16 AMBETTER — AMBETTER MARKETPLACE: $91.59 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $72.51 ASR HEALTH BENEFITS — AETNA: $176.16 AUXIANT — MIDLANDS CHOICE PPO: $184.24
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Psaft Prostate Specific Antigen Total	$188	$188	$51.59 – $188
PSA (prostate specific antigen) blood test: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $176.16 AETNA — AETNA: $176.16 AETNA DOMESTIC — AETNA: $176.16 AETNA EAP — AETNA: $176.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $54.52 ALLIED BENEFIT SYSTEMS — AETNA: $176.16 AMBETTER — AMBETTER MARKETPLACE: $91.59 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $72.51 ASR HEALTH BENEFITS — AETNA: $176.16 AUXIANT — MIDLANDS CHOICE PPO: $184.24
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thyroid Stimulating Hormone	$192	$192	$52.68 – $192
Thyroid stimulating hormone (TSH) test: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $179.90 AETNA — AETNA: $179.90 AETNA DOMESTIC — AETNA: $179.90 AETNA EAP — AETNA: $179.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $55.68 ALLIED BENEFIT SYSTEMS — AETNA: $179.90 AMBETTER — AMBETTER MARKETPLACE: $93.54 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $74.05 ASR HEALTH BENEFITS — AETNA: $179.90 AUXIANT — MIDLANDS CHOICE PPO: $188.16
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Thyroid Stimulating Hormone	$192	$192	$52.68 – $192
Thyroid stimulating hormone (TSH) test: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $179.90 AETNA — AETNA: $179.90 AETNA DOMESTIC — AETNA: $179.90 AETNA EAP — AETNA: $179.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $55.68 ALLIED BENEFIT SYSTEMS — AETNA: $179.90 AMBETTER — AMBETTER MARKETPLACE: $93.54 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $74.05 ASR HEALTH BENEFITS — AETNA: $179.90 AUXIANT — MIDLANDS CHOICE PPO: $188.16
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Thyroid Stimulating Hormone	Not listed in the file	$898	$16.46 – $17.81
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.80 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $16.63 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $16.97 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $16.46 MEDIGOLD MEDICARE ADVANTAGE — MERCYONE HEALTH PLAN MEDICARE ADVANTAGE: $17.45 UNITED HEALTHCARE MEDICARE — UNITED HEALTHCARE MEDICARE ADVANTAGE: $17.81 WELLPOINT MEDICARE ADVANTAGE — WELLPOINT MEDICARE ADVANTAGE: $17.14
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	$112	$112	$30.73 – $112
Complete blood count (CBC) with differential: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $104.94 AETNA — AETNA: $104.94 AETNA DOMESTIC — AETNA: $104.94 AETNA EAP — AETNA: $104.94 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $32.48 ALLIED BENEFIT SYSTEMS — AETNA: $104.94 AMBETTER — AMBETTER MARKETPLACE: $54.57 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $43.20 ASR HEALTH BENEFITS — AETNA: $104.94 AUXIANT — MIDLANDS CHOICE PPO: $109.76
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	Not listed in the file	$713	$9.09
Complete blood count (CBC) with differential: rates for 1 insurance plan IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $9.09
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated	$87	$87	$6.47 – $87
Complete blood count (CBC), automated: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $81.52 AETNA — AETNA: $81.52 AETNA DOMESTIC — AETNA: $81.52 AETNA EAP — AETNA: $81.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $25.23 ALLIED BENEFIT SYSTEMS — AETNA: $81.52 AMBETTER — AMBETTER MARKETPLACE: $42.39 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $33.56 ASR HEALTH BENEFITS — AETNA: $81.52 AUXIANT — MIDLANDS CHOICE PPO: $85.26
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc Automated	Not listed in the file	$643	$6.47
Complete blood count (CBC), automated: rates for 1 insurance plan IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Prothrombin Time	$10	$10	$3.32 – $10
Blood clotting time test (prothrombin time, PT): 10 of 769 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $4.20 AETNA — AETNA: $5.53 AETNA DOMESTIC — AETNA: $5.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $4.20 AETNA MEDICARE TRANSPLANT — MEDICARE: $4.20 ALIGN SENIOR CARE — MEDICARE: $4.20 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $4.20 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $5.15 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $4.20
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prothrombin Time	$66	$66	$18.11 – $66
Blood clotting time test (prothrombin time, PT): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $61.84 AETNA — AETNA: $61.84 AETNA DOMESTIC — AETNA: $61.84 AETNA EAP — AETNA: $61.84 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $19.14 ALLIED BENEFIT SYSTEMS — AETNA: $61.84 AMBETTER — AMBETTER MARKETPLACE: $32.16 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $25.46 ASR HEALTH BENEFITS — AETNA: $61.84 AUXIANT — MIDLANDS CHOICE PPO: $64.68
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Prothrombin Time	Not listed in the file	$23.88	$3.43 – $23.88
Blood clotting time test (prothrombin time, PT): 10 of 776 insurance plan rates AETNA — AETNA: $6.50 AETNA DOMESTIC — AETNA: $6.50 AETNA MEDICAID — AETNA MEDICAID: $13.52 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $4.97 ALIGN SENIOR CARE — MEDICARE: $4.20 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $5.15 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $4.97 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $4.97 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $4.20 AMBETTER — AMBETTER: $7.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thromboplastin Time Partial (Ptt)	$99	$99	$27.17 – $99
Blood clotting test (partial thromboplastin time, PTT): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $92.76 AETNA — AETNA: $92.76 AETNA DOMESTIC — AETNA: $92.76 AETNA EAP — AETNA: $92.76 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $28.71 ALLIED BENEFIT SYSTEMS — AETNA: $92.76 AMBETTER — AMBETTER MARKETPLACE: $48.23 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $38.18 ASR HEALTH BENEFITS — AETNA: $92.76 AUXIANT — MIDLANDS CHOICE PPO: $97.02
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Thromboplastin Time Partial (Ptt)	Not listed in the file	$1,078	$9.09
Blood clotting test (partial thromboplastin time, PTT): rates for 1 insurance plan IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $9.09

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 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	$2,105	$2,105	$577.61 – $2,105
CT scan of the head or brain, without contrast: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,972.39 AETNA — AETNA: $1,972.39 AETNA DOMESTIC — AETNA: $1,972.39 AETNA EAP — AETNA: $1,972.39 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $610.45 ALLIED BENEFIT SYSTEMS — AETNA: $1,972.39 AMBETTER — AMBETTER MARKETPLACE: $1,025.56 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $811.90 ASR HEALTH BENEFITS — AETNA: $1,972.39 AUXIANT — MIDLANDS CHOICE PPO: $2,062.90
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Brain W/O & W/Contrast	$5,549	$5,549	$1,522.65 – $5,549
MRI of the brain, before and after contrast: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $5,199.41 AETNA — AETNA: $5,199.41 AETNA DOMESTIC — AETNA: $5,199.41 AETNA EAP — AETNA: $5,199.41 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,609.21 ALLIED BENEFIT SYSTEMS — AETNA: $5,199.41 AMBETTER — AMBETTER MARKETPLACE: $2,703.47 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2,140.25 ASR HEALTH BENEFITS — AETNA: $5,199.41 AUXIANT — MIDLANDS CHOICE PPO: $5,438.02
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Xr Chest 2 Views	$94	$94	$6.39 – $94
Chest X-ray, 2 views: 10 of 776 insurance plan rates AETNA DOMESTIC — AETNA: $49.05 AETNA MEDICAID — AETNA MEDICAID: $87.08 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $23.02 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $23.02 ALIGN SENIOR CARE — MEDICARE: $25.41 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $23.02 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $23.02 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $25.41 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $26.68 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $23.02
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Chest 2 Views (Restricted Method II CAH)	$30	$30	$8.23 – $30
Chest X-ray, 2 views: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $28.11 AETNA — AETNA: $28.11 AETNA DOMESTIC — AETNA: $28.11 AETNA EAP — AETNA: $28.11 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $24.05 ALLIED BENEFIT SYSTEMS — AETNA: $28.11 AMBETTER — AMBETTER MARKETPLACE: $14.62 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $11.57 ASR HEALTH BENEFITS — AETNA: $28.11 AUXIANT — MIDLANDS CHOICE PPO: $29.40
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Chest 2 Views	$318	$318	$87.26 – $318
Chest X-ray, 2 views: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $297.97 AETNA — AETNA: $297.97 AETNA DOMESTIC — AETNA: $297.97 AETNA EAP — AETNA: $297.97 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.22 ALLIED BENEFIT SYSTEMS — AETNA: $297.97 AMBETTER — AMBETTER MARKETPLACE: $154.93 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $122.65 ASR HEALTH BENEFITS — AETNA: $297.97 AUXIANT — MIDLANDS CHOICE PPO: $311.64
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Xr Lumbosacral Spine >= 4 Views	$143	$143	$14.35 – $143
X-ray of the lower spine, at least 4 views: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $40.89 AETNA — AETNA: $74.70 AETNA DOMESTIC — AETNA: $74.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $40.89 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $40.89 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $39.16 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $128.51 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $40.89 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $42.93 AMERIGROUP MEDICAID — MEDICAID IOWA: $39.16
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Lumbosacral Spine >= 4 Views	$568	$568	$155.86 – $568
X-ray of the lower spine, at least 4 views: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $532.22 AETNA — AETNA: $532.22 AETNA DOMESTIC — AETNA: $532.22 AETNA EAP — AETNA: $532.22 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $164.72 ALLIED BENEFIT SYSTEMS — AETNA: $532.22 AMBETTER — AMBETTER MARKETPLACE: $276.73 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $219.08 ASR HEALTH BENEFITS — AETNA: $532.22 AUXIANT — MIDLANDS CHOICE PPO: $556.64
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Xr Lumbosacral Spine >= 4 Views	Not listed in the file	$157.16	$8.09 – $157.16
X-ray of the lower spine, at least 4 views: 10 of 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $48.11 AETNA — AETNA: $87.88 AETNA DOMESTIC — AETNA: $87.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $48.11 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $48.11 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $48.11 ALLY ALIGN CARE ADV — MEDICARE: $48.11 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $48.11 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $50.51 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $46.07
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lumbar Spine W/O Contrast	$3,998	$3,998	$1,097.05 – $3,998
MRI of the lower back (lumbar spine), without contrast: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,746.13 AETNA — AETNA: $3,746.13 AETNA DOMESTIC — AETNA: $3,746.13 AETNA EAP — AETNA: $3,746.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,159.42 ALLIED BENEFIT SYSTEMS — AETNA: $3,746.13 AMBETTER — AMBETTER MARKETPLACE: $1,947.83 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,542.03 ASR HEALTH BENEFITS — AETNA: $3,746.13 AUXIANT — MIDLANDS CHOICE PPO: $3,918.04
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Pelvis W/Contrast	$2,677	$2,677	$734.57 – $2,677
CT scan of the pelvis, with contrast: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $2,508.35 AETNA — AETNA: $2,508.35 AETNA DOMESTIC — AETNA: $2,508.35 AETNA EAP — AETNA: $2,508.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $776.33 ALLIED BENEFIT SYSTEMS — AETNA: $2,508.35 AMBETTER — AMBETTER MARKETPLACE: $1,304.23 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,032.52 ASR HEALTH BENEFITS — AETNA: $2,508.35 AUXIANT — MIDLANDS CHOICE PPO: $2,623.46
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Bl	$6,005	$6,005	$1,647.77 – $6,005
MRI of a leg joint (such as the knee), without contrast: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $5,626.69 AETNA — AETNA: $5,626.69 AETNA DOMESTIC — AETNA: $5,626.69 AETNA EAP — AETNA: $5,626.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,741.45 ALLIED BENEFIT SYSTEMS — AETNA: $5,626.69 AMBETTER — AMBETTER MARKETPLACE: $2,925.64 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2,316.13 ASR HEALTH BENEFITS — AETNA: $5,626.69 AUXIANT — MIDLANDS CHOICE PPO: $5,884.90
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Lt	$4,003	$4,003	$1,098.42 – $4,003
MRI of a leg joint (such as the knee), without contrast: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,750.81 AETNA — AETNA: $3,750.81 AETNA DOMESTIC — AETNA: $3,750.81 AETNA EAP — AETNA: $3,750.81 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,160.87 ALLIED BENEFIT SYSTEMS — AETNA: $3,750.81 AMBETTER — AMBETTER MARKETPLACE: $1,950.26 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,543.96 ASR HEALTH BENEFITS — AETNA: $3,750.81 AUXIANT — MIDLANDS CHOICE PPO: $3,922.94
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Rt	$4,003	$4,003	$1,098.42 – $4,003
MRI of a leg joint (such as the knee), without contrast: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,750.81 AETNA — AETNA: $3,750.81 AETNA DOMESTIC — AETNA: $3,750.81 AETNA EAP — AETNA: $3,750.81 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,160.87 ALLIED BENEFIT SYSTEMS — AETNA: $3,750.81 AMBETTER — AMBETTER MARKETPLACE: $1,950.26 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,543.96 ASR HEALTH BENEFITS — AETNA: $3,750.81 AUXIANT — MIDLANDS CHOICE PPO: $3,922.94
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	$5,637	$5,637	$1,546.79 – $5,637
CT scan of the abdomen and pelvis, with contrast: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $5,281.87 AETNA — AETNA: $5,281.87 AETNA DOMESTIC — AETNA: $5,281.87 AETNA EAP — AETNA: $5,281.87 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,634.73 ALLIED BENEFIT SYSTEMS — AETNA: $5,281.87 AMBETTER — AMBETTER MARKETPLACE: $2,746.35 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2,174.19 ASR HEALTH BENEFITS — AETNA: $5,281.87 AUXIANT — MIDLANDS CHOICE PPO: $5,524.26
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR US Abdomen Complete	$332	$332	$21.30 – $332
Ultrasound of the abdomen, complete: 10 of 776 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $75.90 AETNA MEDICARE TRANSPLANT — MEDICARE: $103.62 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $105.88 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $105.88 ALIGN SENIOR CARE — MEDICARE: $103.62 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $103.62 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $103.62 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $105.88 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $103.62 ALLY ALIGN CARE ADV — MEDICARE: $103.62
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Abdomen Complete	$1,066	$1,066	$292.51 – $1,066
Ultrasound of the abdomen, complete: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $998.84 AETNA — AETNA: $998.84 AETNA DOMESTIC — AETNA: $998.84 AETNA EAP — AETNA: $998.84 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $309.14 ALLIED BENEFIT SYSTEMS — AETNA: $998.84 AMBETTER — AMBETTER MARKETPLACE: $519.36 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $411.16 ASR HEALTH BENEFITS — AETNA: $998.84 AUXIANT — MIDLANDS CHOICE PPO: $1,044.68
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR US Abdomen Complete	Not listed in the file	$329.89	$23.86 – $329.89
Ultrasound of the abdomen, complete: 10 of 775 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $75.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $103.62 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $105.88 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $105.88 ALIGN SENIOR CARE — MEDICARE: $103.62 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $297.84 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $105.88 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $103.62 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $105.88 ALLY ALIGN CARE ADV — MEDICARE: $103.62
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR US Transvaginal Non Obstetric	$341	$341	$32.38 – $341
Transvaginal ultrasound: 10 of 776 insurance plan rates AETNA — AETNA: $206.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $106.27 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $106.27 AETNA MEDICARE TRANSPLANT — MEDICARE: $106.27 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $106.27 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $106.27 ALLY ALIGN CARE ADV — MEDICARE: $106.27 AMBETTER — AMBETTER: $184.35 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $85.35 AMERIHEALTH MEDICARE — MEDICARE: $106.27
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	$859	$859	$235.71 – $859
Transvaginal ultrasound: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $804.88 AETNA — AETNA: $804.88 AETNA DOMESTIC — AETNA: $804.88 AETNA EAP — AETNA: $804.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $249.11 ALLIED BENEFIT SYSTEMS — AETNA: $804.88 AMBETTER — AMBETTER MARKETPLACE: $418.50 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $331.32 ASR HEALTH BENEFITS — AETNA: $804.88 AUXIANT — MIDLANDS CHOICE PPO: $841.82
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR US Transvaginal Non Obstetric	Not listed in the file	$275.82	$20.66 – $275.82
Transvaginal ultrasound: 10 of 775 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $106.27 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $106.27 AETNA MEDICARE TRANSPLANT — MEDICARE: $106.27 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $85.35 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $85.35 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $106.27 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $106.27 ALLY ALIGN CARE ADV — MEDICARE: $106.27 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $111.58 AMERIGROUP MEDICAID — MEDICAID IOWA: $85.35
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Rt	$457	$457	$112.74 – $457
Diagnostic mammogram, one breast: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $428.21 AETNA — AETNA: $428.21 AETNA DOMESTIC — AETNA: $428.21 AETNA EAP — AETNA: $428.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $132.53 ALLIED BENEFIT SYSTEMS — AETNA: $428.21 AMBETTER — AMBETTER MARKETPLACE: $222.65 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $176.26 ASR HEALTH BENEFITS — AETNA: $428.21 AUXIANT — MIDLANDS CHOICE PPO: $447.86
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Lt	$457	$457	$112.74 – $457
Diagnostic mammogram, one breast: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $428.21 AETNA — AETNA: $428.21 AETNA DOMESTIC — AETNA: $428.21 AETNA EAP — AETNA: $428.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $132.53 ALLIED BENEFIT SYSTEMS — AETNA: $428.21 AMBETTER — AMBETTER MARKETPLACE: $222.65 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $176.26 ASR HEALTH BENEFITS — AETNA: $428.21 AUXIANT — MIDLANDS CHOICE PPO: $447.86
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Bilateral	$686	$686	$142.21 – $686
Diagnostic mammogram, both breasts: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $642.78 AETNA — AETNA: $642.78 AETNA DOMESTIC — AETNA: $642.78 AETNA EAP — AETNA: $642.78 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $198.94 ALLIED BENEFIT SYSTEMS — AETNA: $642.78 AMBETTER — AMBETTER MARKETPLACE: $334.22 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $264.59 ASR HEALTH BENEFITS — AETNA: $642.78 AUXIANT — MIDLANDS CHOICE PPO: $672.28
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$473	$473	$81.59 – $473
Screening mammogram, both breasts: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $443.20 AETNA — AETNA: $443.20 AETNA DOMESTIC — AETNA: $443.20 AETNA EAP — AETNA: $443.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $83.26 ALLIED BENEFIT SYSTEMS — AETNA: $443.20 AMBETTER — AMBETTER MARKETPLACE: $139.88 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $110.74 ASR HEALTH BENEFITS — AETNA: $443.20 AUXIANT — MIDLANDS CHOICE PPO: $463.54
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bilateral	$710	$710	$81.59 – $710
Screening mammogram, both breasts: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $665.27 AETNA — AETNA: $665.27 AETNA DOMESTIC — AETNA: $665.27 AETNA EAP — AETNA: $665.27 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $83.26 ALLIED BENEFIT SYSTEMS — AETNA: $665.27 AMBETTER — AMBETTER MARKETPLACE: $139.88 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $110.74 ASR HEALTH BENEFITS — AETNA: $665.27 AUXIANT — MIDLANDS CHOICE PPO: $695.80

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Ecg 12 Lead Interpretation & Report	$49	$49	$9.44 – $49
Electrocardiogram (ECG/EKG) with reading: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $11.83 AETNA — AETNA: $32.69 AETNA MEDICAID — AETNA MEDICAID: $40.92 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11.83 AETNA MEDICARE TRANSPLANT — MEDICARE: $11.83 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $21.80 ALIGN SENIOR CARE — MEDICARE: $11.83 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $38.43 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $21.80 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $11.83
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Ecg 12 Lead Interpretation & Report	$125	$125	$12.88 – $125
Electrocardiogram (ECG/EKG) with reading: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $117.13 AETNA — AETNA: $117.13 AETNA DOMESTIC — AETNA: $117.13 AETNA EAP — AETNA: $117.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $36.25 ALLIED BENEFIT SYSTEMS — AETNA: $117.13 AMBETTER — AMBETTER MARKETPLACE: $60.90 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $48.21 ASR HEALTH BENEFITS — AETNA: $117.13 AUXIANT — MIDLANDS CHOICE PPO: $122.50
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Ecg 12 Lead Interpretation & Report	Not listed in the file	$49	$10.72 – $50.95
Electrocardiogram (ECG/EKG) with reading: 10 of 775 insurance plan rates AETNA — AETNA: $38.45 AETNA MEDICAID — AETNA MEDICAID: $40.92 AETNA MEDICARE TRANSPLANT — MEDICARE: $13.92 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $25.65 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $13.92 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $38.43 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $25.65 ALLY ALIGN CARE ADV — MEDICARE: $13.92 AMBETTER — AMBETTER: $24.14 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $13.92
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years	$6,002	$6,002	$1,646.95 – $6,002
Sleep study (overnight, in a sleep lab): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $5,623.87 AETNA — AETNA: $5,623.87 AETNA DOMESTIC — AETNA: $5,623.87 AETNA EAP — AETNA: $5,623.87 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,740.58 ALLIED BENEFIT SYSTEMS — AETNA: $5,623.87 AMBETTER — AMBETTER MARKETPLACE: $2,924.17 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2,314.97 ASR HEALTH BENEFITS — AETNA: $5,623.87 AUXIANT — MIDLANDS CHOICE PPO: $5,881.96

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$199	$199	$54.61 – $199
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $186.46 AETNA — AETNA: $186.46 AETNA DOMESTIC — AETNA: $186.46 AETNA EAP — AETNA: $186.46 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $57.71 ALLIED BENEFIT SYSTEMS — AETNA: $186.46 AMBETTER — AMBETTER MARKETPLACE: $96.95 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $76.75 ASR HEALTH BENEFITS — AETNA: $186.46 AUXIANT — MIDLANDS CHOICE PPO: $195.02
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$199	$199	$54.61 – $199
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $186.46 AETNA — AETNA: $186.46 AETNA DOMESTIC — AETNA: $186.46 AETNA EAP — AETNA: $186.46 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $57.71 ALLIED BENEFIT SYSTEMS — AETNA: $186.46 AMBETTER — AMBETTER MARKETPLACE: $96.95 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $76.75 ASR HEALTH BENEFITS — AETNA: $186.46 AUXIANT — MIDLANDS CHOICE PPO: $195.02
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Low Complexity Patient/Family	$343	$343	$94.12 – $343
Physical therapy evaluation (low complexity): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $321.39 AETNA — AETNA: $321.39 AETNA DOMESTIC — AETNA: $321.39 AETNA EAP — AETNA: $321.39 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $99.47 ALLIED BENEFIT SYSTEMS — AETNA: $321.39 AMBETTER — AMBETTER MARKETPLACE: $167.11 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $132.30 ASR HEALTH BENEFITS — AETNA: $321.39 AUXIANT — MIDLANDS CHOICE PPO: $336.14
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity Patient/Family	$299	$299	$82.05 – $299
Physical therapy evaluation (moderate complexity): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $280.16 AETNA — AETNA: $280.16 AETNA DOMESTIC — AETNA: $280.16 AETNA EAP — AETNA: $280.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $86.71 ALLIED BENEFIT SYSTEMS — AETNA: $280.16 AMBETTER — AMBETTER MARKETPLACE: $145.67 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $115.32 ASR HEALTH BENEFITS — AETNA: $280.16 AUXIANT — MIDLANDS CHOICE PPO: $293.02
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation High Complexity Patient/Family	$303	$303	$83.14 – $303
Physical therapy evaluation (high complexity): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $283.91 AETNA — AETNA: $283.91 AETNA DOMESTIC — AETNA: $283.91 AETNA EAP — AETNA: $283.91 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $87.87 ALLIED BENEFIT SYSTEMS — AETNA: $283.91 AMBETTER — AMBETTER MARKETPLACE: $147.62 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $116.87 ASR HEALTH BENEFITS — AETNA: $283.91 AUXIANT — MIDLANDS CHOICE PPO: $296.94
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 30 Minutes	$610	$610	$167.38 – $610
Psychotherapy, 30 minutes: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $571.57 AETNA — AETNA: $571.57 AETNA DOMESTIC — AETNA: $571.57 AETNA EAP — AETNA: $571.57 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $176.90 ALLIED BENEFIT SYSTEMS — AETNA: $571.57 AMBETTER — AMBETTER MARKETPLACE: $297.19 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $235.28 ASR HEALTH BENEFITS — AETNA: $571.57 AUXIANT — MIDLANDS CHOICE PPO: $597.80
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 45 Minutes	$755	$755	$207.17 – $755
Psychotherapy, 45 minutes: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $707.44 AETNA — AETNA: $707.44 AETNA DOMESTIC — AETNA: $707.44 AETNA EAP — AETNA: $707.44 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $218.95 ALLIED BENEFIT SYSTEMS — AETNA: $707.44 AMBETTER — AMBETTER MARKETPLACE: $367.84 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $291.20 ASR HEALTH BENEFITS — AETNA: $707.44 AUXIANT — MIDLANDS CHOICE PPO: $739.90
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 60 Minutes	$770	$770	$211.29 – $770
Psychotherapy, 60 minutes: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $721.49 AETNA — AETNA: $721.49 AETNA DOMESTIC — AETNA: $721.49 AETNA EAP — AETNA: $721.49 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $223.30 ALLIED BENEFIT SYSTEMS — AETNA: $721.49 AMBETTER — AMBETTER MARKETPLACE: $375.14 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $296.99 ASR HEALTH BENEFITS — AETNA: $721.49 AUXIANT — MIDLANDS CHOICE PPO: $754.60
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Group Therapy	$772	$772	$211.84 – $772
Group psychotherapy: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $723.36 AETNA — AETNA: $723.36 AETNA DOMESTIC — AETNA: $723.36 AETNA EAP — AETNA: $723.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $223.88 ALLIED BENEFIT SYSTEMS — AETNA: $723.36 AMBETTER — AMBETTER MARKETPLACE: $376.12 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $297.76 ASR HEALTH BENEFITS — AETNA: $723.36 AUXIANT — MIDLANDS CHOICE PPO: $756.56
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Group Therapy Msw	$772	$772	$211.84 – $772
Group psychotherapy: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $723.36 AETNA — AETNA: $723.36 AETNA DOMESTIC — AETNA: $723.36 AETNA EAP — AETNA: $723.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $223.88 ALLIED BENEFIT SYSTEMS — AETNA: $723.36 AMBETTER — AMBETTER MARKETPLACE: $376.12 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $297.76 ASR HEALTH BENEFITS — AETNA: $723.36 AUXIANT — MIDLANDS CHOICE PPO: $756.56

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement	$2,825	$2,825	$37.48 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,825
Total hip replacement: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $513.18 AETNA MEDICAID — AETNA MEDICAID: $635.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $513.18 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $697.23 ALIGN SENIOR CARE — MEDICARE: $513.18 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $513.18 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $697.23 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $513.18 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $697.23 AMBETTER — AMBETTER: $890.21
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement	$4,387	$4,387	$370.52 – $4,387
Total hip replacement: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $513.18 AETNA MEDICAID — AETNA MEDICAID: $635.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $513.18 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $513.18 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $697.23 ALIGN SENIOR CARE — MEDICARE: $513.18 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $697.23 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $513.18 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $697.23 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $538.84
Total hip replacement CPT 27130 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH)	$2,890	$2,890	$793.02 – $2,890
Total hip replacement: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $2,707.93 AETNA — AETNA: $2,707.93 AETNA DOMESTIC — AETNA: $2,707.93 AETNA EAP — AETNA: $2,707.93 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,204.54 ALLIED BENEFIT SYSTEMS — AETNA: $2,707.93 AMBETTER — AMBETTER MARKETPLACE: $1,408.01 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,114.67 ASR HEALTH BENEFITS — AETNA: $2,707.93 AUXIANT — MIDLANDS CHOICE PPO: $2,832.20
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing	$2,821	$2,821	$369.66 – $2,821
Total knee replacement: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $512.45 AETNA MEDICARE TRANSPLANT — MEDICARE: $512.45 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $737.82 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $737.82 ALIGN SENIOR CARE — MEDICARE: $512.45 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $512.45 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $512.45 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $737.82 ALLY ALIGN CARE ADV — MEDICARE: $512.45 AMBETTER — AMBETTER: $888.94
Total knee replacement CPT 27447 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing	$4,383	$4,383	$369.66 – $4,383
Total knee replacement: 10 of 776 insurance plan rates AETNA — AETNA: $1,975.79 AETNA DOMESTIC — AETNA: $1,975.79 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $512.45 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $512.45 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $737.82 ALIGN SENIOR CARE — MEDICARE: $512.45 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $1,722.22 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $737.82 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $512.45 AMBETTER — AMBETTER: $888.94
Total knee replacement CPT 27447 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Bl(Rest Method II CAH)	$4,253	$4,253	$1,167.02 – $4,253
Total knee replacement: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,985.06 AETNA — AETNA: $3,985.06 AETNA DOMESTIC — AETNA: $3,985.06 AETNA EAP — AETNA: $3,985.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,202.33 ALLIED BENEFIT SYSTEMS — AETNA: $3,985.06 AMBETTER — AMBETTER MARKETPLACE: $2,072.06 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,640.38 ASR HEALTH BENEFITS — AETNA: $3,985.06 AUXIANT — MIDLANDS CHOICE PPO: $4,167.94
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroscopy Shoulder Decompr Subacromial Space W/Part Acromioplasty	$370	$370	$94.15 – $370
Shoulder arthroscopy: shaving of shoulder bone: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $130.70 AETNA MEDICAID — AETNA MEDICAID: $169.85 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $130.70 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $130.70 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $370 ALIGN SENIOR CARE — MEDICARE: $130.70 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $370 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $370 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $130.70 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $130.70
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroscopy Shoulder Decompr Subacromial Space W/Part Acromioplasty	$2,280	$2,280	$94.15 – $2,280
Shoulder arthroscopy: shaving of shoulder bone: 10 of 776 insurance plan rates AETNA — AETNA: $527.51 AETNA DOMESTIC — AETNA: $527.51 AETNA MEDICARE TRANSPLANT — MEDICARE: $130.70 ALIGN SENIOR CARE — MEDICARE: $130.70 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $130.70 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $458.78 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $130.70 ALLY ALIGN CARE ADV — MEDICARE: $130.70 AMBETTER — AMBETTER: $226.73 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $130.70
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Rt(Rest Method II CAH)	$380	$380	$104.27 – $380
Shoulder arthroscopy: shaving of shoulder bone: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $356.06 AETNA — AETNA: $356.06 AETNA DOMESTIC — AETNA: $356.06 AETNA EAP — AETNA: $356.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $153.38 ALLIED BENEFIT SYSTEMS — AETNA: $356.06 AMBETTER — AMBETTER MARKETPLACE: $185.14 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $146.57 ASR HEALTH BENEFITS — AETNA: $356.06 AUXIANT — MIDLANDS CHOICE PPO: $372.40
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage	$1,220	$1,220	$25.36 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,220
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $229.03 AETNA DOMESTIC — AETNA: $842.95 AETNA MEDICAID — AETNA MEDICAID: $267.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $229.03 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $229.03 AETNA MEDICARE TRANSPLANT — MEDICARE: $229.03 ALIGN SENIOR CARE — MEDICARE: $229.03 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $229.03 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $733.21 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $229.03
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage	$1,870	$1,870	$164.44 – $1,870
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 776 insurance plan rates AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $229.03 AETNA MEDICARE TRANSPLANT — MEDICARE: $229.03 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $243.83 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $229.03 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $733.21 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $243.83 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $229.03 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $243.83 AMERIHEALTH MEDICARE — MEDICARE: $229.03 AMISH HOSPITAL AID — AMISH MEDICAL AID: $310.83
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Bl (Rest Method II CAH)	$4,397	$4,397	$537.17 – $4,397
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $4,119.99 AETNA — AETNA: $4,119.99 AETNA DOMESTIC — AETNA: $4,119.99 AETNA EAP — AETNA: $4,119.99 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $537.17 ALLIED BENEFIT SYSTEMS — AETNA: $4,119.99 AMBETTER — AMBETTER MARKETPLACE: $2,142.22 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,695.92 ASR HEALTH BENEFITS — AETNA: $4,119.99 AUXIANT — MIDLANDS CHOICE PPO: $4,309.06
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Tonsillectomy & Adenoidectomy < Age 12 (Restricted Method II CAH)	$1,092	$1,092	$276.17 – $1,092
Removal of tonsils and adenoids (under age 12): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,023.20 AETNA — AETNA: $1,023.20 AETNA DOMESTIC — AETNA: $1,023.20 AETNA EAP — AETNA: $1,023.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $276.17 ALLIED BENEFIT SYSTEMS — AETNA: $1,023.20 AMBETTER — AMBETTER MARKETPLACE: $532.02 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $421.18 ASR HEALTH BENEFITS — AETNA: $1,023.20 AUXIANT — MIDLANDS CHOICE PPO: $1,070.16
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	$267	$267	$35.25 – $267
Upper GI endoscopy (diagnostic): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $50.37 AETNA — AETNA: $200.80 AETNA MEDICAID — AETNA MEDICAID: $59.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $50.37 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $50.37 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $69.27 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $69.27 ALIGN SENIOR CARE — MEDICARE: $50.37 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $50.37 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $161.53
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	$446	$446	$35.25 – $446
Upper GI endoscopy (diagnostic): 10 of 776 insurance plan rates AETNA — AETNA: $200.80 AETNA DOMESTIC — AETNA: $200.80 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $50.37 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $69.27 ALIGN SENIOR CARE — MEDICARE: $50.37 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $50.37 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $161.53 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $50.37 ALLY ALIGN CARE ADV — MEDICARE: $50.37 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $50.37
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee · modifier 80 In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing\|ASSISTANT SURGEON	$42.72	$42.72	$5.64 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $42.72
Upper GI endoscopy (diagnostic): 10 of 777 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $8.06 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — AETNA: $32.13 AETNA MEDICARE TRANSPLANT — MEDICARE: $8.06 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $11.08 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $11.08 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $8.06 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $32.31 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $11.08 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) ALLWELL MEDICARE ADVANTAGE — MEDICARE: $8.06 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) ALLY ALIGN CARE ADV — MEDICARE: $8.06 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	$301	$301	$39.41 – $301
Upper GI endoscopy with biopsy: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $56.36 AETNA DOMESTIC — AETNA: $226.73 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $56.36 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $74.41 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $74.41 ALIGN SENIOR CARE — MEDICARE: $56.36 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $74.41 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $56.36 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $74.41 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $56.36
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	$503	$503	$39.41 – $503
Upper GI endoscopy with biopsy: 10 of 776 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $66.97 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $56.36 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $74.41 ALIGN SENIOR CARE — MEDICARE: $56.36 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $74.41 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $74.41 AMBETTER — AMBETTER: $97.77 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $56.36 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $59.18 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $74.41
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH)	$1,386	$1,386	$132.27 – $1,386
Upper GI endoscopy with biopsy: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,298.68 AETNA — AETNA: $1,298.68 AETNA DOMESTIC — AETNA: $1,298.68 AETNA EAP — AETNA: $1,298.68 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $132.27 ALLIED BENEFIT SYSTEMS — AETNA: $1,298.68 AMBETTER — AMBETTER MARKETPLACE: $675.26 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $534.58 ASR HEALTH BENEFITS — AETNA: $1,298.68 AUXIANT — MIDLANDS CHOICE PPO: $1,358.28
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	$671	$671	$52.51 – $671
Colonoscopy (diagnostic): 10 of 776 insurance plan rates AETNA — AETNA: $302.13 AETNA DOMESTIC — AETNA: $302.13 AETNA MEDICAID — AETNA MEDICAID: $89.30 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $74.78 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $104.46 ALIGN SENIOR CARE — MEDICARE: $74.78 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $253.41 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $74.78 AMBETTER — AMBETTER: $129.71 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $74.78
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH)	$1,249	$1,249	$175.49 – $1,249
Colonoscopy (diagnostic): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,170.31 AETNA — AETNA: $1,170.31 AETNA DOMESTIC — AETNA: $1,170.31 AETNA EAP — AETNA: $1,170.31 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $175.49 ALLIED BENEFIT SYSTEMS — AETNA: $1,170.31 AMBETTER — AMBETTER MARKETPLACE: $608.51 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $481.74 ASR HEALTH BENEFITS — AETNA: $1,170.31 AUXIANT — MIDLANDS CHOICE PPO: $1,224.02
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	Not listed in the file	$671	$52.51 – $671
Colonoscopy (diagnostic): 10 of 776 insurance plan rates AETNA — AETNA: $302.13 AETNA DOMESTIC — AETNA: $302.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $74.78 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $74.78 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $104.46 ALIGN SENIOR CARE — MEDICARE: $74.78 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $253.41 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $104.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $104.46 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $74.78
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	$730	$730	$56.66 – $730
Colonoscopy with biopsy: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $80.94 AETNA DOMESTIC — AETNA: $328.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $80.94 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $80.94 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $105.78 ALIGN SENIOR CARE — MEDICARE: $80.94 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $80.94 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $105.78 AMBETTER — AMBETTER: $140.40 AMISH HOSPITAL AID — AMISH MEDICAL AID: $109.84
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH)	$1,597	$1,597	$189.95 – $1,597
Colonoscopy with biopsy: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,496.39 AETNA — AETNA: $1,496.39 AETNA DOMESTIC — AETNA: $1,496.39 AETNA EAP — AETNA: $1,496.39 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $189.95 ALLIED BENEFIT SYSTEMS — AETNA: $1,496.39 AMBETTER — AMBETTER MARKETPLACE: $778.06 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $615.96 ASR HEALTH BENEFITS — AETNA: $1,496.39 AUXIANT — MIDLANDS CHOICE PPO: $1,565.06
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	Not listed in the file	$730	$56.66 – $730
Colonoscopy with biopsy: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $80.94 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $80.94 AETNA MEDICARE TRANSPLANT — MEDICARE: $80.94 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $105.78 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $105.78 ALIGN SENIOR CARE — MEDICARE: $80.94 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $105.78 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $80.94 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $80.94 AMERIGROUP MEDICAID — MEDICAID IOWA: $105.78
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	$551	$551	$71.25 – $551
Colonoscopy with removal of polyps (snare): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $102.07 AETNA — AETNA: $416.54 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.07 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $102.07 AETNA MEDICARE TRANSPLANT — MEDICARE: $102.07 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $144.11 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $144.11 ALIGN SENIOR CARE — MEDICARE: $102.07 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $102.07 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $348.29
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	$924	$924	$71.25 – $924
Colonoscopy with removal of polyps (snare): 10 of 776 insurance plan rates AETNA DOMESTIC — AETNA: $416.54 AETNA MEDICAID — AETNA MEDICAID: $122.72 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $102.07 AETNA MEDICARE TRANSPLANT — MEDICARE: $102.07 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $144.11 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $102.07 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $144.11 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $102.07 ALLY ALIGN CARE ADV — MEDICARE: $102.07 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $107.17
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH)	$1,672	$1,672	$239.55 – $1,672
Colonoscopy with removal of polyps (snare): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,566.66 AETNA — AETNA: $1,566.66 AETNA DOMESTIC — AETNA: $1,566.66 AETNA EAP — AETNA: $1,566.66 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $239.55 ALLIED BENEFIT SYSTEMS — AETNA: $1,566.66 AMBETTER — AMBETTER MARKETPLACE: $814.60 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $644.89 ASR HEALTH BENEFITS — AETNA: $1,566.66 AUXIANT — MIDLANDS CHOICE PPO: $1,638.56
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	$870	$870	$52.61 – $870
Screening colonoscopy (not high risk): 10 of 776 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $74.85 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $435 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $435 ALIGN SENIOR CARE — MEDICARE: $74.85 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $435 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $74.85 AMBETTER — AMBETTER: $129.83 AMERIGROUP MEDICAID — MEDICAID IOWA: $435 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $435 AMISH MENNONITE — MEDICAID IOWA: $435
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Colonoscopy Colorectal Cancer Screening Non High Risk Patient (Restricted Method II CAH)	$495	$495	$135.83 – $495
Screening colonoscopy (not high risk): 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $463.82 AETNA — AETNA: $463.82 AETNA DOMESTIC — AETNA: $463.82 AETNA EAP — AETNA: $463.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $175.65 ALLIED BENEFIT SYSTEMS — AETNA: $463.82 AMBETTER — AMBETTER MARKETPLACE: $241.16 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $190.92 ASR HEALTH BENEFITS — AETNA: $463.82 AUXIANT — MIDLANDS CHOICE PPO: $485.10
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	Not listed in the file	$535	$52.61 – $582.81
Screening colonoscopy (not high risk): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $74.85 AETNA — AETNA: $208.74 AETNA MEDICAID — AETNA MEDICAID: $89.53 AETNA MEDICARE TRANSPLANT — MEDICARE: $74.85 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $291.41 ALIGN SENIOR CARE — MEDICARE: $74.85 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $240.20 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $291.41 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $74.85 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $291.41
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$1,451	$1,451	$32.24 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,451
Gallbladder removal by laparoscope: 10 of 776 insurance plan rates AETNA — AETNA: $1,064.85 AETNA DOMESTIC — AETNA: $1,064.85 AETNA MEDICAID — AETNA MEDICAID: $323.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $274.84 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $274.84 ALIGN SENIOR CARE — MEDICARE: $274.84 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $274.84 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $887.54 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $317 ALLY ALIGN CARE ADV — MEDICARE: $274.84
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$2,363	$2,363	$201.50 – $2,363
Gallbladder removal by laparoscope: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $274.84 AETNA MEDICAID — AETNA MEDICAID: $323.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $274.84 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $317 ALIGN SENIOR CARE — MEDICARE: $274.84 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $317 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $274.84 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $317 AMBETTER — AMBETTER: $476.76 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $274.84
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH)	$2,363	$2,363	$645.17 – $2,363
Gallbladder removal by laparoscope: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $2,214.13 AETNA — AETNA: $2,214.13 AETNA DOMESTIC — AETNA: $2,214.13 AETNA EAP — AETNA: $2,214.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $645.17 ALLIED BENEFIT SYSTEMS — AETNA: $2,214.13 AMBETTER — AMBETTER MARKETPLACE: $1,151.25 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $911.41 ASR HEALTH BENEFITS — AETNA: $2,214.13 AUXIANT — MIDLANDS CHOICE PPO: $2,315.74
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,157	$1,157	$20.04 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,157
Groin (inguinal) hernia repair, age 5 or older: 10 of 776 insurance plan rates AETNA — AETNA: $846.47 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $221.13 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $221.13 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $705.58 AMBETTER — AMBETTER: $383.59 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $221.13 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $232.19 AMERIGROUP MEDICAID — MEDICAID IOWA: $192.74 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $192.74 AMERIHEALTH MEDICARE — MEDICARE: $221.13
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,878	$1,878	$161.99 – $1,878
Groin (inguinal) hernia repair, age 5 or older: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $221.13 AETNA — AETNA: $846.47 AETNA DOMESTIC — AETNA: $846.47 AETNA MEDICAID — AETNA MEDICAID: $193.53 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $221.13 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $192.74 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $192.74 ALIGN SENIOR CARE — MEDICARE: $221.13 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $221.13 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $705.58
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Repr Hernia Ing Init >=5yr Lt (Restricted Method II CAH)	$7,954	$7,954	$519.12 – $7,954
Groin (inguinal) hernia repair, age 5 or older: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $7,452.90 AETNA — AETNA: $7,452.90 AETNA DOMESTIC — AETNA: $7,452.90 AETNA EAP — AETNA: $7,452.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $519.12 ALLIED BENEFIT SYSTEMS — AETNA: $7,452.90 AMBETTER — AMBETTER MARKETPLACE: $3,875.19 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $3,067.86 ASR HEALTH BENEFITS — AETNA: $7,452.90 AUXIANT — MIDLANDS CHOICE PPO: $7,794.92
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach	$4,280	$4,280	$1,174.43 – $4,280
Prostate biopsy: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $4,010.36 AETNA — AETNA: $4,010.36 AETNA DOMESTIC — AETNA: $4,010.36 AETNA EAP — AETNA: $4,010.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,241.20 ALLIED BENEFIT SYSTEMS — AETNA: $4,010.36 AMBETTER — AMBETTER MARKETPLACE: $2,085.22 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,650.80 ASR HEALTH BENEFITS — AETNA: $4,010.36 AUXIANT — MIDLANDS CHOICE PPO: $4,194.40
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach	Not listed in the file	$15,599.17	$3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $377.40
Prostate biopsy: 10 of 68 insurance plan rates BCBS GENERIC — WELLMARK PPO: $3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BLUE CARE NETWORK — WELLMARK PPO: $3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BLUE CROSS - AL — WELLMARK PPO: $3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BLUE CROSS - AR — WELLMARK PPO: $3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BLUE CROSS - AZ — WELLMARK PPO: $3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BLUE CROSS - CA (ANTHEM) — WELLMARK PPO: $3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BLUE CROSS - CO (ANTHEM) — WELLMARK PPO: $3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BLUE CROSS - CT (ANTHEM) — WELLMARK PPO: $3.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Injection(S) Epidural Lumbar Needle Placement W/Guidance	$213	$213	$28.44 – $213
Spinal injection, lower back (epidural), with imaging guidance: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $41 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $41 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $45.04 ALIGN SENIOR CARE — MEDICARE: $41 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $41 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $45.04 AMISH MENNONITE — MEDICAID IOWA: $45.04 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID IOWA: $45.04 AURORA SPECIAL NEEDS — MEDICARE: $41 AVMED MEDICARE — MEDICARE: $41
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Injection(S) Epidural Lumbar Needle Placement W/Guidance	$310	$310	$28.44 – $310
Spinal injection, lower back (epidural), with imaging guidance: 10 of 776 insurance plan rates AETNA DOMESTIC — AETNA: $118.72 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $34.85 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $38.28 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $38.28 ALIGN SENIOR CARE — MEDICARE: $34.85 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $38.28 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $34.85 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $36.59 AMERIGROUP MEDICAID — MEDICAID IOWA: $38.28 AMERIHEALTH MEDICARE — MEDICARE: $34.85
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance	$1,549	$1,549	$425.05 – $1,549
Spinal injection, lower back (epidural), with imaging guidance: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,451.41 AETNA — AETNA: $1,451.41 AETNA DOMESTIC — AETNA: $1,451.41 AETNA EAP — AETNA: $1,451.41 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $449.21 ALLIED BENEFIT SYSTEMS — AETNA: $1,451.41 AMBETTER — AMBETTER MARKETPLACE: $754.67 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $597.45 ASR HEALTH BENEFITS — AETNA: $1,451.41 AUXIANT — MIDLANDS CHOICE PPO: $1,518.02
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$347	$347	$25.81 – $694
Nerve root injection, lower back, with imaging guidance: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $38.90 AETNA — AETNA: $132.93 AETNA DOMESTIC — AETNA: $132.93 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $38.90 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $38.90 AETNA MEDICARE TRANSPLANT — MEDICARE: $38.90 ALIGN SENIOR CARE — MEDICARE: $38.90 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $38.90 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $138.12 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $40.91
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl	$9,846	$9,846	$2,701.74 – $9,846
Nerve root injection, lower back, with imaging guidance: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $9,225.70 AETNA — AETNA: $9,225.70 AETNA DOMESTIC — AETNA: $9,225.70 AETNA EAP — AETNA: $9,225.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,903.56 ALLIED BENEFIT SYSTEMS — AETNA: $9,225.70 AMBETTER — AMBETTER MARKETPLACE: $4,796.97 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2,531.73 ASR HEALTH BENEFITS — AETNA: $6,150.47 AUXIANT — MIDLANDS CHOICE PPO: $9,649.08
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Inj Anes Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl (Rest Method II CAH)	$1,343	$1,343	$107.40 – $1,343
Nerve root injection, lower back, with imaging guidance: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,258.39 AETNA — AETNA: $1,258.39 AETNA DOMESTIC — AETNA: $1,258.39 AETNA EAP — AETNA: $1,258.39 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.40 ALLIED BENEFIT SYSTEMS — AETNA: $1,258.39 AMBETTER — AMBETTER MARKETPLACE: $654.31 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $518 ASR HEALTH BENEFITS — AETNA: $1,258.39 AUXIANT — MIDLANDS CHOICE PPO: $1,316.14
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$1,360	$1,360	$122.01 – $1,360
Carpal tunnel release: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $188.09 AETNA — AETNA: $613.07 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $188.09 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $163.62 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $592.69 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $188.09 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $163.62 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $188.09 ALLY ALIGN CARE ADV — MEDICARE: $188.09 AMERIGROUP MEDICAID — MEDICAID IOWA: $163.62
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$995	$995	$122.01 – $995
Carpal tunnel release: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $188.09 AETNA MEDICAID — AETNA MEDICAID: $214.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $188.09 AETNA MEDICARE TRANSPLANT — MEDICARE: $188.09 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $163.62 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $163.62 ALIGN SENIOR CARE — MEDICARE: $188.09 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $188.09 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $163.62 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $188.09
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Neuroplasty Median Nerve Carpal Bl (Restricted Method II CAH)	$4,023	$4,023	$441.44 – $4,023
Carpal tunnel release: 10 of 43 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,769.55 AETNA — AETNA: $3,769.55 AETNA DOMESTIC — AETNA: $3,769.55 AETNA EAP — AETNA: $3,769.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $441.44 ALLIED BENEFIT SYSTEMS — AETNA: $3,769.55 AMBETTER — AMBETTER MARKETPLACE: $1,960.01 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,551.67 ASR HEALTH BENEFITS — AETNA: $3,769.55 AUXIANT — MIDLANDS CHOICE PPO: $3,942.54

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	$91,384.93	$2,625.42 – $24,159.68
Hip or knee replacement (major joint of the leg), without major complications: 10 of 14 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,311 AMBETTER — AMBETTER MARKETPLACE: $5,562.48 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,403.63 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $3,277.23 CLAIMDOC — CLAIMDOC: $6,655.11 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $3,344.11 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $23,695.07 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $2,625.42 MEDIGOLD MEDICARE ADVANTAGE — MERCYONE HEALTH PLAN MEDICARE ADVANTAGE: $3,439.47 MOLINA MEDICAID — MOLINA MEDICAID: $24,043.53

Source: MercyOne Centerville Medical Center’s standard charges file (hpt.trinity-health.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 31, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	One St Joseph's Drive, Centerville, IA 52544
County	Appanoose County
State	Iowa
Phone	(641) 437‑4111
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	161377
Name in Medicare records	MERCYONE CENTERVILLE MEDICAL CENTER
Profile level	Medicare data + hospital website
Official website	mercyone.org
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 ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

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

MercyOne Centerville Medical Center — mercyone.org
Emergency Care - MercyOne — mercyone.org
MercyOne Centerville Medical Center | MercyOne — mercyone.org