Does MercyOne Dubuque Medical Center have an emergency room?

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

Where is MercyOne Dubuque Medical Center?

250 Mercy Drive, Dubuque, IA 52001, in Dubuque County, Iowa.

What is the phone number of MercyOne Dubuque Medical Center?

(563) 589-8000, as listed by Medicare (CMS).

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

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

MercyOne Dubuque Medical Center — Dubuque, IA

Quick answers

Does MercyOne Dubuque Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at MercyOne Dubuque Medical Center. In a medical emergency, call 911.
Where is MercyOne Dubuque Medical Center?: 250 Mercy Drive, Dubuque, IA 52001, in Dubuque County, Iowa.
What is the phone number of MercyOne Dubuque Medical Center?: (563) 589-8000, as listed by Medicare (CMS).
What is the Medicare star rating of MercyOne Dubuque Medical Center?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][6]

Treatments^[4][6]

Diabetes education
Cardiopulmonary rehabilitation
Diagnostic cardiac testing

Procedures^[4][6]

Robotic-assisted surgery
da Vinci Xi robotic surgery
Ion robotic surgery
Mako robotic system

Programs and centers^[4][6]

Level II Regional Neonatal Intensive Care Unit
CARF-accredited inpatient rehabilitation unit
Home health care
Cancer Center
Stroke care
Heart and vascular care

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

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

Recognition^[5][6]

Level III Trauma Care Center
Magnet hospital (nursing excellence), designated four consecutive times
CARF accreditation (inpatient rehabilitation unit)

Doctors and clinicians (256)

256 doctors and other clinicians list MercyOne Dubuque 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 (256)

Abbey J. SmithNurse Practitioner
Adam F. Sitzmann, MDNeurology
Adib Kassas, MDPsychiatry
Ahmad El-Hattab, MDGeneral Surgery
Alberto Rodriguez Hernandez, MDHospitalist
Alexander J. Jones, DOHospitalist
Allie T. ThornburgPhysician Assistant
Alyssa K. EganNurse Practitioner
Amanda P. Sifuentes-Smith, PAPhysician Assistant
Amber N. KempNurse Practitioner
Amer El Sayed, MDGastroenterology
Amy M. Winsky, MDInternal Medicine
Amy S. McDermottNurse Practitioner
Andrea Gutierrez, CNACertified Registered Nurse Anesthetist (CRNA)
Andrea L. Ries, MDInternal Medicine
Andrew C. Bland, MDNephrology
Angela D. Kelley, DOInternal Medicine
Angela K. VervoortPhysician Assistant
Angela W. HubanksPhysician Assistant
Ann M. Burkle Robison, NPNurse Practitioner
Anna M. Henningsen, CNACertified Registered Nurse Anesthetist (CRNA)
Arjun K. Ramesh, MDAnesthesiology
Armella L. WissinkNurse Practitioner
Ashley M. BiedermannNurse Practitioner

And 232 more: the button below opens the full list.

Other emergency rooms nearby

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

Finley Hospital3.9 mi · Dubuque, IA · Acute Care Hospital
Midwest Medical Center16 mi · Galena, IL · Critical Access Hospital
Southwest Health Center19 mi · Platteville, WI · Critical Access Hospital
MercyOne Dyersville Medical Center23 mi · Dyersville, IA · Critical Access Hospital
Grant Regional Health Center24 mi · Lancaster, WI · Critical Access Hospital

Other hospitals nearby

Jackson County Regional Health Center29 mi · Maquoketa, IA · Critical Access 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

Harmony Dubuque0.1 mi · Dubuque, IA · 2 of 5 stars
Mount Carmel Bluffs1.5 mi · Dubuque, IA · 5 of 5 stars
Bethany Home1.9 mi · Dubuque, IA · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice of Dubuque5.4 mi · Dubuque, IA · 5 of 5 stars
Grant County Hospice24 mi · Lancaster, WI

All hospice providers in the state →

Home health agencies

UnityPoint at Home3.9 mi · Dubuque, IA
Open Arms Home Health Care, L L C4.3 mi · Dubuque, IA
Universal Pediatrics5.4 mi · Dubuque, IA

All home health agencies in the state →

Dialysis facilities

Tri- State Dialysis - Dubuque3.9 mi · Dubuque, IA · 3 of 5 stars
FKC Dubuque Dialysis5.4 mi · Dubuque, IA
Tri State Dialysis20 mi · Platteville, WI · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Dubuque Endoscopy Center3.9 mi · Dubuque, IA
Tri-State Surgery Center, LLC5.4 mi · Dubuque, IA
Upper Mississippi Surgery Center8.3 mi · Hazel Green, WI

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Crescent Community Health Center1.2 mi · Dubuque, IA · Community health center
Crescent Community Health Center1.2 mi · Dubuque, IA · Community health center
Crescent Community Health Center1.2 mi · Dubuque, IA · Community health center

Clinics and urgent care

Southwest Health Kieler Clinic7.1 mi · Kieler, WI · Rural health clinic
Southwest Health Cuba City Clinic13 mi · Cuba City, WI · Rural health clinic
Potosi-Tennyson Medical Clinic14 mi · Potosi, WI · Rural health clinic

Pharmacies

Crescent Community Health Center Pharmacy3.9 mi · Dubuque, IA · Community/retail pharmacy
Hartig Drug Co Corp3.9 mi · Dubuque, IA · Community/retail pharmacy
Hartig Drug Co Corp3.9 mi · Dubuque, IA · Community/retail pharmacy

Assisted living nearby

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

Assisi Village Assisted Living3.9 mi · Dubuque, IA
Rose of Dubuque4.3 mi · Dubuque, IA
Eagle Pointe Place5.4 mi · Dubuque, IA
Oak Park Place5.4 mi · Dubuque, 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 Dubuque 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)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	4 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	75%National average: 72%
Would definitely recommend the hospital	77%National average: 71%
Nurses “always” communicated well	81%National average: 80%
Doctors “always” communicated well	82%National average: 80%
Staff “always” explained medicines before giving them	61%National average: 62%
Were given information about recovery at home	89%National average: 86%
Room and bathroom “always” clean	63%National average: 74%
Area around the room “always” quiet at night	53%National average: 60%
Completed surveys	846Response rate: 35%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0.776No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.752No different from the national benchmark
Surgical site infections after colon surgery	1.41No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	13.2%
Deaths within 30 days: heart failure patients	11%
Deaths within 30 days: pneumonia patients	14.9%
Deaths within 30 days: COPD patients	10.3%
Deaths within 30 days: stroke patients	12.1%
Deaths within 30 days: coronary bypass surgery (CABG)	Too few cases to report
Serious complications (patient safety indicator PSI-90)	1.31No different from the national rate
Complications after hip or knee replacement	3.7%

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	13.7%
Readmitted within 30 days: heart failure	21.7%
Readmitted within 30 days: pneumonia	17%
Readmitted within 30 days: COPD	20.7%
Readmitted within 30 days: coronary bypass surgery	10.4%
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	204 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	4%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	58%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Dubuque Best hospitals in Iowa

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 68 common services exactly as MercyOne Dubuque 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 →

$ 208 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	$180	$180	$45.58 – $180
New patient office visit (about 30–44 minutes): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $55.96 AETNA — AETNA: $127.76 AETNA MEDICAID — AETNA MEDICAID: $55.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $55.96 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $55.96 AETNA MEDICARE TRANSPLANT — MEDICARE: $55.96 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $55.96 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $140.52 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $55.96 ALLY ALIGN CARE ADV — MEDICARE: $55.96
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	$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 MEDICAID — AETNA MEDICAID: $55.95 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $58.03 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $65.84 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $140.52 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $58.03 AMERIGROUP MEDICAID — MEDICAID IOWA: $58.03 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $58.03 AMISH MENNONITE — MEDICAID IOWA: $58.03
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	$307	$307	$74.55 – $307
New patient office visit (about 45–59 minutes): 10 of 776 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $91.80 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $91.80 AETNA MEDICARE TRANSPLANT — MEDICARE: $91.80 ALIGN SENIOR CARE — MEDICARE: $91.80 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $91.80 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $79.05 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $79.05 ALLY ALIGN CARE ADV — MEDICARE: $91.80 AMERIGROUP MEDICAID — MEDICAID IOWA: $79.05 AMERIHEALTH MEDICARE — MEDICARE: $91.80
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	$285	$285	$90.81 – $285
New patient office visit (about 45–59 minutes): 10 of 776 insurance plan rates AETNA — AETNA: $243.20 AETNA DOMESTIC — 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 AETNA MEDICARE TRANSPLANT — MEDICARE: $108 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $93 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $108 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $224.58 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $93
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Visit New Mod Pro 45-59 Mins (Restricted Method II CAH)	Not listed in the file	$17,315.35	$63 – $1,626.17
New patient office visit (about 45–59 minutes): 10 of 20 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $108 AMBETTER — AMBETTER MARKETPLACE: $185.14 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $146.57 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $109.08 CENTIVO — CENTIVO: $172.57 CLAIMDOC — CLAIMDOC: $221.50 GEHA — UNITED HEALTHCARE: $63 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $111.30 IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $121.61 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $1,604.15
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$402	$402	$102.24 – $402
New patient office visit (about 60–74 minutes): 10 of 780 insurance plan rates AETNA — AETNA: $330.11 AETNA DOMESTIC — AETNA: $330.11 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $147.39 AETNA MEDICARE TRANSPLANT — MEDICARE: $147.39 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $120.31 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $147.39 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $305.05 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $120.31 ALLY ALIGN CARE ADV — MEDICARE: $147.39 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $147.39
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 MEDICAID — AETNA MEDICAID: $44.67 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $45.57 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $45.57 AETNA MEDICARE TRANSPLANT — MEDICARE: $45.57 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $45.57 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $26.02 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $45.57 ALLY ALIGN CARE ADV — 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	$140	$140	$30.61 – $140
Established patient office visit (about 20–29 minutes): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $53.61 AETNA — AETNA: $120.87 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $53.61 AETNA MEDICARE TRANSPLANT — MEDICARE: $53.61 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $30.61 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $30.61 ALIGN SENIOR CARE — MEDICARE: $53.61 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $53.61 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $111.69 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $53.61
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee · modifier AS In the file: PR Visit Office Outpatient Established Low Level\|ASSISTANT AT SURGERY SERVICE	$22.40	$22.40	$3.18 – $22.40
Established patient office visit (about 20–29 minutes): 10 of 776 insurance plan rates AETNA — AETNA: $19.34 AETNA DOMESTIC — AETNA: $19.34 AETNA MEDICARE TRANSPLANT — MEDICARE: $8.58 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $3.18 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $22.34 ALLY ALIGN CARE ADV — MEDICARE: $8.58 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $8.58 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $3.18 AMISH HOSPITAL AID — AMISH MEDICAL AID: $11.64 AMISH MENNONITE — MEDICAID IOWA: $3.18
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 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $66.93 AETNA DOMESTIC — AETNA: $151.94 AETNA MEDICAID — AETNA MEDICAID: $65.79 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $41.71 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $41.71 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $41.71 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $41.71 AMBETTER — AMBETTER: $116.11 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $70.27 AMERIGROUP MEDICAID — MEDICAID IOWA: $41.71
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	$207	$207	$49.07 – $207
Established patient office visit (about 30–39 minutes): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $78.74 AETNA — AETNA: $178.75 AETNA DOMESTIC — AETNA: $178.75 AETNA MEDICAID — AETNA MEDICAID: $65.79 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $78.74 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $78.74 AETNA MEDICARE TRANSPLANT — MEDICARE: $78.74 ALIGN SENIOR CARE — MEDICARE: $78.74 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $78.74 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $78.74
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee · modifier AS In the file: PR Visit Office Outpatient Established Moderate Level\|ASSISTANT AT SURGERY SERVICE	$33.12	$33.12	$5.10 – $33.12
Established patient office visit (about 30–39 minutes): 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $12.60 AETNA — AETNA: $28.60 AETNA DOMESTIC — AETNA: $28.60 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $12.60 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $5.10 ALIGN SENIOR CARE — MEDICARE: $12.60 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $12.60 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $32.91 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $5.10 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $12.60
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 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $53.85 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $53.85 AETNA MEDICARE TRANSPLANT — MEDICARE: $53.85 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $50.25 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $50.25 ALIGN SENIOR CARE — MEDICARE: $53.85 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $53.85 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $53.85 ALLY ALIGN CARE ADV — MEDICARE: $53.85 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $53.85
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 776 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $49.16 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $63.36 AETNA MEDICARE TRANSPLANT — MEDICARE: $63.36 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $59.12 ALIGN SENIOR CARE — MEDICARE: $63.36 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $63.36 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $59.12 AMBETTER — AMBETTER: $109.91 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $63.36 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $66.52
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3 Sane_Safe	$825	$536.25	$123.65 – $2,353
Emergency room visit (moderate): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $688.88 AETNA — AETNA: $688.88 AETNA DOMESTIC — AETNA: $688.88 AETNA EAP — AETNA: $688.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $265.93 ALLIED BENEFIT SYSTEMS — AETNA: $688.88 AMBETTER — AMBETTER MARKETPLACE: $455.88 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $360.91 ASR HEALTH BENEFITS — AETNA: $688.88 AUXIANT — MIDLANDS CHOICE PPO: $742.50
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 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $107.71 AETNA — AETNA: $221.33 AETNA MEDICAID — AETNA MEDICAID: $83.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.71 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $107.71 AETNA MEDICARE TRANSPLANT — MEDICARE: $107.71 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $91.03 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $107.71 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $225.78 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $91.03
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 775 insurance plan rates AETNA — AETNA: $221.33 AETNA DOMESTIC — AETNA: $221.33 AETNA MEDICAID — AETNA MEDICAID: $83.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.71 AETNA MEDICARE TRANSPLANT — MEDICARE: $107.71 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — 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 MEDICAID ADVANTAGE — MEDICAID IOWA: $91.03
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Full Trauma W/O Pre Notification Level 4	$4,626	$3,006.90	$189.01 – $4,626
Emergency room visit (moderately high): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,862.71 AETNA — AETNA: $3,862.71 AETNA DOMESTIC — AETNA: $3,862.71 AETNA EAP — AETNA: $3,862.71 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $406.49 ALLIED BENEFIT SYSTEMS — AETNA: $3,862.71 AMBETTER — AMBETTER MARKETPLACE: $696.85 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $551.67 ASR HEALTH BENEFITS — AETNA: $3,862.71 AUXIANT — MIDLANDS CHOICE PPO: $4,163.40
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Trauma Evaluation W/O Pre Notification Critical Care - Downgrade	$4,296	$2,792.40	$269.76 – $4,296
Emergency room visit (high): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,587.16 AETNA — AETNA: $3,587.16 AETNA DOMESTIC — AETNA: $3,587.16 AETNA EAP — AETNA: $3,587.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $580.16 ALLIED BENEFIT SYSTEMS — AETNA: $3,587.16 AMBETTER — AMBETTER MARKETPLACE: $994.56 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $787.36 ASR HEALTH BENEFITS — AETNA: $3,587.16 AUXIANT — MIDLANDS CHOICE PPO: $3,866.40
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Partial Trauma W/O Pre Notification Critical Care - Downgrade	$6,489	$4,217.85	$269.76 – $6,489
Emergency room visit (high): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $5,418.32 AETNA — AETNA: $5,418.32 AETNA DOMESTIC — AETNA: $5,418.32 AETNA EAP — AETNA: $5,418.32 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $580.16 ALLIED BENEFIT SYSTEMS — AETNA: $5,418.32 AMBETTER — AMBETTER MARKETPLACE: $994.56 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $787.36 ASR HEALTH BENEFITS — AETNA: $5,418.32 AUXIANT — MIDLANDS CHOICE PPO: $5,840.10
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Full Trauma W/O Pre Notification Level 5	$5,147	$3,345.55	$269.76 – $5,147
Emergency room visit (high): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $4,297.75 AETNA — AETNA: $4,297.75 AETNA DOMESTIC — AETNA: $4,297.75 AETNA EAP — AETNA: $4,297.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $580.16 ALLIED BENEFIT SYSTEMS — AETNA: $4,297.75 AMBETTER — AMBETTER MARKETPLACE: $994.56 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $787.36 ASR HEALTH BENEFITS — AETNA: $4,297.75 AUXIANT — MIDLANDS CHOICE PPO: $4,632.30

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)	$164	$106.60	$8.20 – $164
Basic metabolic panel (blood test): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $136.94 AETNA — AETNA: $136.94 AETNA DOMESTIC — AETNA: $136.94 AETNA EAP — AETNA: $136.94 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.29 ALLIED BENEFIT SYSTEMS — AETNA: $136.94 AMBETTER — AMBETTER MARKETPLACE: $14.21 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $11.25 ASR HEALTH BENEFITS — AETNA: $136.94 AUXIANT — MIDLANDS CHOICE PPO: $147.60
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	$18,552.49 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$2.28 – $6,308.93
Basic metabolic panel (blood test): 10 of 91 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,076 AMBETTER — AMBETTER MARKETPLACE: $5,273.14 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,174.57 BCBS GENERIC — WELLMARK PPO: $2.28 BCN DOMESTIC — WELLMARK PPO: $2.28 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $2.28 BLUE CARE NETWORK — WELLMARK PPO: $2.28 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $2.28 BLUE CROSS - AL — WELLMARK PPO: $2.28 BLUE CROSS - AR — WELLMARK PPO: $2.28
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	$336	$218.40	$10.23 – $336
Comprehensive metabolic panel (blood test): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $280.56 AETNA — AETNA: $280.56 AETNA DOMESTIC — AETNA: $280.56 AETNA EAP — AETNA: $280.56 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10.35 ALLIED BENEFIT SYSTEMS — AETNA: $280.56 AMBETTER — AMBETTER MARKETPLACE: $17.74 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $14.04 ASR HEALTH BENEFITS — AETNA: $280.56 AUXIANT — MIDLANDS CHOICE PPO: $302.40
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	Not listed in the file	$3,304.31	$2.46 – $1,320.63
Comprehensive metabolic panel (blood test): 10 of 91 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $643.89 AMBETTER — AMBETTER MARKETPLACE: $1,103.81 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $873.85 BCBS GENERIC — WELLMARK PPO: $2.46 BCN DOMESTIC — WELLMARK PPO: $2.46 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $2.46 BLUE CARE NETWORK — WELLMARK PPO: $2.46 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $2.46 BLUE CROSS - AL — WELLMARK PPO: $2.46 BLUE CROSS - AR — WELLMARK PPO: $2.46
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Lipid Panel	$142	$92.30	$12.97 – $142
Cholesterol panel (lipid panel): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $118.57 AETNA — AETNA: $118.57 AETNA DOMESTIC — AETNA: $118.57 AETNA EAP — AETNA: $118.57 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALLIED BENEFIT SYSTEMS — AETNA: $118.57 AMBETTER — AMBETTER MARKETPLACE: $22.50 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $17.81 ASR HEALTH BENEFITS — AETNA: $118.57 AUXIANT — MIDLANDS CHOICE PPO: $127.80
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Lmpp Lipid Panel	$160	$104	$12.97 – $160
Cholesterol panel (lipid panel): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $133.60 AETNA — AETNA: $133.60 AETNA DOMESTIC — AETNA: $133.60 AETNA EAP — AETNA: $133.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALLIED BENEFIT SYSTEMS — AETNA: $133.60 AMBETTER — AMBETTER MARKETPLACE: $22.50 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $17.81 ASR HEALTH BENEFITS — AETNA: $133.60 AUXIANT — MIDLANDS CHOICE PPO: $144
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Lipid Panel	Not listed in the file	$804.05	$9.09 – $26.91
Cholesterol panel (lipid panel): 10 of 21 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 AMBETTER — AMBETTER MARKETPLACE: $22.50 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $17.81 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $13.25 CENTIVO — CENTIVO: $20.97 CLAIMDOC — CLAIMDOC: $26.91 GEHA — UNITED HEALTHCARE: $13.39 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $13.52 IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $9.09 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $12.97
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Renal Function Panel	$91	$59.15	$8.42 – $91
Kidney function panel: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $75.99 AETNA — AETNA: $75.99 AETNA DOMESTIC — AETNA: $75.99 AETNA EAP — AETNA: $75.99 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.51 ALLIED BENEFIT SYSTEMS — AETNA: $75.99 AMBETTER — AMBETTER MARKETPLACE: $14.58 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $11.54 ASR HEALTH BENEFITS — AETNA: $75.99 AUXIANT — MIDLANDS CHOICE PPO: $81.90
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Hepatic Function Panel	$393	$255.45	$7.92 – $393
Liver function panel: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $328.16 AETNA — AETNA: $328.16 AETNA DOMESTIC — AETNA: $328.16 AETNA EAP — AETNA: $328.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.01 ALLIED BENEFIT SYSTEMS — AETNA: $328.16 AMBETTER — AMBETTER MARKETPLACE: $13.73 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $10.87 ASR HEALTH BENEFITS — AETNA: $328.16 AUXIANT — MIDLANDS CHOICE PPO: $353.70
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	$71	$46.15	$3.07 – $71
Urine test (automated, with microscope): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $59.29 AETNA — AETNA: $59.29 AETNA DOMESTIC — AETNA: $59.29 AETNA EAP — AETNA: $59.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.11 ALLIED BENEFIT SYSTEMS — AETNA: $59.29 AMBETTER — AMBETTER MARKETPLACE: $5.33 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4.22 ASR HEALTH BENEFITS — AETNA: $59.29 AUXIANT — MIDLANDS CHOICE PPO: $63.90
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	$529.75	$3.17 – $134.99
Urine test (automated, with microscope): 10 of 21 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $129.70 AMBETTER — AMBETTER MARKETPLACE: $5.33 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4.22 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $131 CENTIVO — CENTIVO: $4.96 CLAIMDOC — CLAIMDOC: $6.37 GEHA — UNITED HEALTHCARE: $3.17 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $133.67 IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $21.67 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $119.44
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	$27	$17.55	$2.18 – $27
Urine test (automated, without microscope): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $22.55 AETNA — AETNA: $22.55 AETNA DOMESTIC — AETNA: $22.55 AETNA EAP — AETNA: $22.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 ALLIED BENEFIT SYSTEMS — AETNA: $22.55 AMBETTER — AMBETTER MARKETPLACE: $3.78 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2.99 ASR HEALTH BENEFITS — AETNA: $22.55 AUXIANT — MIDLANDS CHOICE PPO: $24.30
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	Not listed in the file	$354.25	$2.25 – $222.34
Urine test (automated, without microscope): 10 of 21 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $129.70 AMBETTER — AMBETTER MARKETPLACE: $222.34 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2.99 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $131 CENTIVO — CENTIVO: $3.52 CLAIMDOC — CLAIMDOC: $4.52 GEHA — UNITED HEALTHCARE: $2.25 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $133.67 IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $60.36 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $119.44
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prostate Specific Antigen Total	$116	$75.40	$17.82 – $116
PSA (prostate specific antigen) blood test: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $96.86 AETNA — AETNA: $96.86 AETNA DOMESTIC — AETNA: $96.86 AETNA EAP — AETNA: $96.86 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALLIED BENEFIT SYSTEMS — AETNA: $96.86 AMBETTER — AMBETTER MARKETPLACE: $30.90 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $24.46 ASR HEALTH BENEFITS — AETNA: $96.86 AUXIANT — MIDLANDS CHOICE PPO: $104.40
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 1012090 Prostate Specific Antigen Total	$116	$75.40	$17.82 – $116
PSA (prostate specific antigen) blood test: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $96.86 AETNA — AETNA: $96.86 AETNA DOMESTIC — AETNA: $96.86 AETNA EAP — AETNA: $96.86 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALLIED BENEFIT SYSTEMS — AETNA: $96.86 AMBETTER — AMBETTER MARKETPLACE: $30.90 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $24.46 ASR HEALTH BENEFITS — AETNA: $96.86 AUXIANT — MIDLANDS CHOICE PPO: $104.40
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Psaft Prostate Specific Antigen Total	$116	$75.40	$17.82 – $116
PSA (prostate specific antigen) blood test: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $96.86 AETNA — AETNA: $96.86 AETNA DOMESTIC — AETNA: $96.86 AETNA EAP — AETNA: $96.86 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALLIED BENEFIT SYSTEMS — AETNA: $96.86 AMBETTER — AMBETTER MARKETPLACE: $30.90 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $24.46 ASR HEALTH BENEFITS — AETNA: $96.86 AUXIANT — MIDLANDS CHOICE PPO: $104.40
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Fcuip Thyroid Stimulating Hormone	$259	$168.35	$16.28 – $259
Thyroid stimulating hormone (TSH) test: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $216.27 AETNA — AETNA: $216.27 AETNA DOMESTIC — AETNA: $216.27 AETNA EAP — AETNA: $216.27 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALLIED BENEFIT SYSTEMS — AETNA: $216.27 AMBETTER — AMBETTER MARKETPLACE: $28.22 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $22.34 ASR HEALTH BENEFITS — AETNA: $216.27 AUXIANT — MIDLANDS CHOICE PPO: $233.10
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thyroid Stimulating Hormone	$259	$168.35	$16.28 – $259
Thyroid stimulating hormone (TSH) test: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $216.27 AETNA — AETNA: $216.27 AETNA DOMESTIC — AETNA: $216.27 AETNA EAP — AETNA: $216.27 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALLIED BENEFIT SYSTEMS — AETNA: $216.27 AMBETTER — AMBETTER MARKETPLACE: $28.22 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $22.34 ASR HEALTH BENEFITS — AETNA: $216.27 AUXIANT — MIDLANDS CHOICE PPO: $233.10
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	$723.45	$9.09 – $40.66
Thyroid stimulating hormone (TSH) test: 10 of 20 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 AMBETTER — AMBETTER MARKETPLACE: $28.22 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $22.34 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $13.25 CENTIVO — CENTIVO: $26.31 CLAIMDOC — CLAIMDOC: $33.77 GEHA — UNITED HEALTHCARE: $40.66 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $16.97 IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $9.09 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $16.28
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	$113	$73.45	$7.53 – $113
Complete blood count (CBC) with differential: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $94.36 AETNA — AETNA: $94.36 AETNA DOMESTIC — AETNA: $94.36 AETNA EAP — AETNA: $94.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7.61 ALLIED BENEFIT SYSTEMS — AETNA: $94.36 AMBETTER — AMBETTER MARKETPLACE: $13.05 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $10.33 ASR HEALTH BENEFITS — AETNA: $94.36 AUXIANT — MIDLANDS CHOICE PPO: $101.70
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	$15,681.39 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$2.28 – $6,477.67 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Complete blood count (CBC) with differential: 10 of 91 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,158.27 AMBETTER — AMBETTER MARKETPLACE: $5,414.17 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,286.22 BCBS GENERIC — WELLMARK PPO: $2.28 BCN DOMESTIC — WELLMARK PPO: $2.28 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $2.28 BLUE CARE NETWORK — WELLMARK PPO: $2.28 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $2.28 BLUE CROSS - AL — WELLMARK PPO: $2.28 BLUE CROSS - AR — WELLMARK PPO: $2.28
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated	$104	$67.60	$6.27 – $104
Complete blood count (CBC), automated: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $86.84 AETNA — AETNA: $86.84 AETNA DOMESTIC — AETNA: $86.84 AETNA EAP — AETNA: $86.84 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.34 ALLIED BENEFIT SYSTEMS — AETNA: $86.84 AMBETTER — AMBETTER MARKETPLACE: $10.87 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $8.61 ASR HEALTH BENEFITS — AETNA: $86.84 AUXIANT — MIDLANDS CHOICE PPO: $93.60
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	$3,818.70	$2.28 – $3,300.04
Complete blood count (CBC), automated: 10 of 91 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,608.97 AMBETTER — AMBETTER MARKETPLACE: $2,758.24 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2,183.61 BCBS GENERIC — WELLMARK PPO: $2.28 BCN DOMESTIC — WELLMARK PPO: $2.28 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $2.28 BLUE CARE NETWORK — WELLMARK PPO: $2.28 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $2.28 BLUE CROSS - AL — WELLMARK PPO: $2.28 BLUE CROSS - AR — WELLMARK PPO: $2.28
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POCT Prothrombin Time	$46	$29.90	$4.16 – $46
Blood clotting time test (prothrombin time, PT): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $38.41 AETNA — AETNA: $38.41 AETNA DOMESTIC — AETNA: $38.41 AETNA EAP — AETNA: $38.41 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALLIED BENEFIT SYSTEMS — AETNA: $38.41 AMBETTER — AMBETTER MARKETPLACE: $7.21 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $5.71 ASR HEALTH BENEFITS — AETNA: $38.41 AUXIANT — MIDLANDS CHOICE PPO: $41.40
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Albld Prothrombin Time	$57	$37.05	$4.16 – $57
Blood clotting time test (prothrombin time, PT): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $47.60 AETNA — AETNA: $47.60 AETNA DOMESTIC — AETNA: $47.60 AETNA EAP — AETNA: $47.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALLIED BENEFIT SYSTEMS — AETNA: $47.60 AMBETTER — AMBETTER MARKETPLACE: $7.21 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $5.71 ASR HEALTH BENEFITS — AETNA: $47.60 AUXIANT — MIDLANDS CHOICE PPO: $51.30
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prothrombin Time	$57	$37.05	$4.16 – $57
Blood clotting time test (prothrombin time, PT): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $47.60 AETNA — AETNA: $47.60 AETNA DOMESTIC — AETNA: $47.60 AETNA EAP — AETNA: $47.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALLIED BENEFIT SYSTEMS — AETNA: $47.60 AMBETTER — AMBETTER MARKETPLACE: $7.21 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $5.71 ASR HEALTH BENEFITS — AETNA: $47.60 AUXIANT — MIDLANDS CHOICE PPO: $51.30
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Albld Thromboplastin Time Partial (Ptt)	$130	$84.50	$5.82 – $130
Blood clotting test (partial thromboplastin time, PTT): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $108.55 AETNA — AETNA: $108.55 AETNA DOMESTIC — AETNA: $108.55 AETNA EAP — AETNA: $108.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALLIED BENEFIT SYSTEMS — AETNA: $108.55 AMBETTER — AMBETTER MARKETPLACE: $10.10 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $7.99 ASR HEALTH BENEFITS — AETNA: $108.55 AUXIANT — MIDLANDS CHOICE PPO: $117
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thromboplastin Time Partial (Ptt)	$130	$84.50	$5.82 – $130
Blood clotting test (partial thromboplastin time, PTT): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $108.55 AETNA — AETNA: $108.55 AETNA DOMESTIC — AETNA: $108.55 AETNA EAP — AETNA: $108.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALLIED BENEFIT SYSTEMS — AETNA: $108.55 AMBETTER — AMBETTER MARKETPLACE: $10.10 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $7.99 ASR HEALTH BENEFITS — AETNA: $108.55 AUXIANT — MIDLANDS CHOICE PPO: $117
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Aathr Thromboplastin Time Partial (Ptt)	$130	$84.50	$5.82 – $130
Blood clotting test (partial thromboplastin time, PTT): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $108.55 AETNA — AETNA: $108.55 AETNA DOMESTIC — AETNA: $108.55 AETNA EAP — AETNA: $108.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALLIED BENEFIT SYSTEMS — AETNA: $108.55 AMBETTER — AMBETTER MARKETPLACE: $10.10 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $7.99 ASR HEALTH BENEFITS — AETNA: $108.55 AUXIANT — MIDLANDS CHOICE PPO: $117

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	$2,213	$1,438.45	$93.79 – $2,213
CT scan of the head or brain, without contrast: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,847.86 AETNA — AETNA: $1,847.86 AETNA DOMESTIC — AETNA: $1,847.86 AETNA EAP — AETNA: $1,847.86 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $101.85 ALLIED BENEFIT SYSTEMS — AETNA: $1,847.86 AMBETTER — AMBETTER MARKETPLACE: $174.60 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $138.22 ASR HEALTH BENEFITS — AETNA: $1,847.86 AUXIANT — MIDLANDS CHOICE PPO: $1,991.70
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	Not listed in the file	$1,438.45	$4.56 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $23,066.33
CT scan of the head or brain, without contrast: 10 of 18 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $101.85 AMBETTER — AMBETTER MARKETPLACE: $174.60 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $138.22 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $102.87 CENTIVO — CENTIVO: $162.75 CLAIMDOC — CLAIMDOC: $208.89 GEHA — UNITED HEALTHCARE: $240.48 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $104.97 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $93.79 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $101.85
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier NC In the file: HC CT Head/Brain W/O Contrast\|NC	Not listed in the file	$40,312.09	$4.56 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $23,066.33
CT scan of the head or brain, without contrast: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11,246.27 AMBETTER — AMBETTER MARKETPLACE: $19,279.32 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $15,262.80 BCBS GENERIC — WELLMARK PPO: $4.56 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $4.56 (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: $4.56 (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: $4.56 (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: $4.56 (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: $4.56 (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: $4.56 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
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	$7,666	$4,982.90	$312.99 – $7,666
MRI of the brain, before and after contrast: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $6,401.11 AETNA — AETNA: $6,401.11 AETNA DOMESTIC — AETNA: $6,401.11 AETNA EAP — AETNA: $6,401.11 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $339.87 ALLIED BENEFIT SYSTEMS — AETNA: $6,401.11 AMBETTER — AMBETTER MARKETPLACE: $582.63 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $461.25 ASR HEALTH BENEFITS — AETNA: $6,401.11 AUXIANT — MIDLANDS CHOICE PPO: $6,899.40
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Chest 2 Views	$405	$263.25	$33.95 – $405
Chest X-ray, 2 views: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $338.18 AETNA — AETNA: $338.18 AETNA DOMESTIC — AETNA: $338.18 AETNA EAP — AETNA: $338.18 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $84.78 ALLIED BENEFIT SYSTEMS — AETNA: $338.18 AMBETTER — AMBETTER MARKETPLACE: $145.34 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $115.06 ASR HEALTH BENEFITS — AETNA: $338.18 AUXIANT — MIDLANDS CHOICE PPO: $364.50
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Xr Chest 2 Views	Not listed in the file	$18,409.96	$2.28 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $6,477.67
Chest X-ray, 2 views: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,158.27 AMBETTER — AMBETTER MARKETPLACE: $5,414.17 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,286.22 BCBS GENERIC — WELLMARK PPO: $2.28 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $2.28 (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: $2.28 (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: $2.28 (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: $2.28 (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: $2.28 (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: $2.28 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
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	$831	$540.15	$93.79 – $831
X-ray of the lower spine, at least 4 views: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $693.89 AETNA — AETNA: $693.89 AETNA DOMESTIC — AETNA: $693.89 AETNA EAP — AETNA: $693.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $101.85 ALLIED BENEFIT SYSTEMS — AETNA: $693.89 AMBETTER — AMBETTER MARKETPLACE: $174.60 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $138.22 ASR HEALTH BENEFITS — AETNA: $693.89 AUXIANT — MIDLANDS CHOICE PPO: $747.90
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Xr Lumbosacral Spine >= 4 Views	Not listed in the file	$540.15	$93.79 – $240.48
X-ray of the lower spine, at least 4 views: 10 of 18 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $101.85 AMBETTER — AMBETTER MARKETPLACE: $174.60 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $138.22 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $102.87 CENTIVO — CENTIVO: $162.75 CLAIMDOC — CLAIMDOC: $208.89 GEHA — UNITED HEALTHCARE: $240.48 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $104.97 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $93.79 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $101.85
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	$5,350	$3,477.50	$214.06 – $5,350
MRI of the lower back (lumbar spine), without contrast: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $4,467.25 AETNA — AETNA: $4,467.25 AETNA DOMESTIC — AETNA: $4,467.25 AETNA EAP — AETNA: $4,467.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $232.44 ALLIED BENEFIT SYSTEMS — AETNA: $4,467.25 AMBETTER — AMBETTER MARKETPLACE: $398.48 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $315.46 ASR HEALTH BENEFITS — AETNA: $4,467.25 AUXIANT — MIDLANDS CHOICE PPO: $4,815
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI Lumbar Spine W/O Contrast	Not listed in the file	$3,477.50	$214.06 – $1,399
MRI of the lower back (lumbar spine), without contrast: 10 of 19 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $232.44 AMBETTER — AMBETTER MARKETPLACE: $398.48 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $315.46 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $234.77 CENTIVO — CENTIVO: $371.44 CLAIMDOC — CLAIMDOC: $476.75 GEHA — UNITED HEALTHCARE: $525.42 HEALTH CHOICES — MEDICAL ASSOCIATES: $1,399 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $239.56 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $214.06
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Pelvis W/Contrast	$2,550	$1,657.50	$157.36 – $2,550
CT scan of the pelvis, with contrast: 10 of 124 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $2,129.25 AETNA — AETNA: $2,129.25 AETNA DOMESTIC — AETNA: $2,129.25 AETNA EAP — AETNA: $2,129.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $170.87 ALLIED BENEFIT SYSTEMS — AETNA: $2,129.25 AMBETTER — AMBETTER MARKETPLACE: $292.93 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $231.90 ASR HEALTH BENEFITS — AETNA: $2,129.25 AUXIANT — MIDLANDS CHOICE PPO: $2,295
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	$4,679	$3,041.35	$214.06 – $4,679
MRI of a leg joint (such as the knee), without contrast: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,906.97 AETNA — AETNA: $3,906.97 AETNA DOMESTIC — AETNA: $3,906.97 AETNA EAP — AETNA: $3,906.97 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $232.44 ALLIED BENEFIT SYSTEMS — AETNA: $3,906.97 AMBETTER — AMBETTER MARKETPLACE: $398.48 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $315.46 ASR HEALTH BENEFITS — AETNA: $3,906.97 AUXIANT — MIDLANDS CHOICE PPO: $4,211.10
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	$4,679	$3,041.35	$214.06 – $4,679
MRI of a leg joint (such as the knee), without contrast: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,906.97 AETNA — AETNA: $3,906.97 AETNA DOMESTIC — AETNA: $3,906.97 AETNA EAP — AETNA: $3,906.97 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $232.44 ALLIED BENEFIT SYSTEMS — AETNA: $3,906.97 AMBETTER — AMBETTER MARKETPLACE: $398.48 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $315.46 ASR HEALTH BENEFITS — AETNA: $3,906.97 AUXIANT — MIDLANDS CHOICE PPO: $4,211.10
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	$7,018	$4,561.70	$214.06 – $7,018
MRI of a leg joint (such as the knee), without contrast: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $5,860.03 AETNA — AETNA: $5,860.03 AETNA DOMESTIC — AETNA: $5,860.03 AETNA EAP — AETNA: $5,860.03 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $232.44 ALLIED BENEFIT SYSTEMS — AETNA: $5,860.03 AMBETTER — AMBETTER MARKETPLACE: $398.48 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $315.46 ASR HEALTH BENEFITS — AETNA: $5,860.03 AUXIANT — MIDLANDS CHOICE PPO: $6,316.20
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	$5,534	$3,597.10	$312.99 – $5,534
CT scan of the abdomen and pelvis, with contrast: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $4,620.89 AETNA — AETNA: $4,620.89 AETNA DOMESTIC — AETNA: $4,620.89 AETNA EAP — AETNA: $4,620.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $339.87 ALLIED BENEFIT SYSTEMS — AETNA: $4,620.89 AMBETTER — AMBETTER MARKETPLACE: $582.63 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $461.25 ASR HEALTH BENEFITS — AETNA: $4,620.89 AUXIANT — MIDLANDS CHOICE PPO: $4,980.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	Not listed in the file	$3,785.83	$312.99 – $828.97
CT scan of the abdomen and pelvis, with contrast: 10 of 18 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $339.87 AMBETTER — AMBETTER MARKETPLACE: $582.63 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $461.25 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $343.27 CENTIVO — CENTIVO: $543.10 CLAIMDOC — CLAIMDOC: $697.08 GEHA — UNITED HEALTHCARE: $828.97 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $350.27 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $312.99 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $339.87
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Abdomen Complete	$1,561	$1,014.65	$93.79 – $1,561
Ultrasound of the abdomen, complete: 10 of 124 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,303.44 AETNA — AETNA: $1,303.44 AETNA DOMESTIC — AETNA: $1,303.44 AETNA EAP — AETNA: $1,303.44 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $101.85 ALLIED BENEFIT SYSTEMS — AETNA: $1,303.44 AMBETTER — AMBETTER MARKETPLACE: $174.60 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $138.22 ASR HEALTH BENEFITS — AETNA: $1,303.44 AUXIANT — MIDLANDS CHOICE PPO: $1,404.90
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation	$1,188	$772.20	$93.79 – $1,188
Pregnancy ultrasound (after the first trimester): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $991.98 AETNA — AETNA: $991.98 AETNA DOMESTIC — AETNA: $991.98 AETNA EAP — AETNA: $991.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $101.85 ALLIED BENEFIT SYSTEMS — AETNA: $991.98 AMBETTER — AMBETTER MARKETPLACE: $174.60 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $138.22 ASR HEALTH BENEFITS — AETNA: $991.98 AUXIANT — MIDLANDS CHOICE PPO: $1,069.20
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	$993	$645.45	$93.79 – $993
Transvaginal ultrasound: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $829.16 AETNA — AETNA: $829.16 AETNA DOMESTIC — AETNA: $829.16 AETNA EAP — AETNA: $829.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $101.85 ALLIED BENEFIT SYSTEMS — AETNA: $829.16 AMBETTER — AMBETTER MARKETPLACE: $174.60 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $138.22 ASR HEALTH BENEFITS — AETNA: $829.16 AUXIANT — MIDLANDS CHOICE PPO: $893.70
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Lt	$481	$312.65	$77.11 – $481
Diagnostic mammogram, one breast: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $401.64 AETNA — AETNA: $401.64 AETNA DOMESTIC — AETNA: $401.64 AETNA EAP — AETNA: $401.64 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.11 ALLIED BENEFIT SYSTEMS — AETNA: $401.64 AMBETTER — AMBETTER MARKETPLACE: $132.18 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $104.64 ASR HEALTH BENEFITS — AETNA: $401.64 AUXIANT — MIDLANDS CHOICE PPO: $432.90
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Rt	$481	$312.65	$77.11 – $481
Diagnostic mammogram, one breast: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $401.64 AETNA — AETNA: $401.64 AETNA DOMESTIC — AETNA: $401.64 AETNA EAP — AETNA: $401.64 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.11 ALLIED BENEFIT SYSTEMS — AETNA: $401.64 AMBETTER — AMBETTER MARKETPLACE: $132.18 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $104.64 ASR HEALTH BENEFITS — AETNA: $401.64 AUXIANT — MIDLANDS CHOICE PPO: $432.90
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Bilateral	$529	$343.85	$98.79 – $529
Diagnostic mammogram, both breasts: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $441.72 AETNA — AETNA: $441.72 AETNA DOMESTIC — AETNA: $441.72 AETNA EAP — AETNA: $441.72 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $98.79 ALLIED BENEFIT SYSTEMS — AETNA: $441.72 AMBETTER — AMBETTER MARKETPLACE: $169.36 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $134.08 ASR HEALTH BENEFITS — AETNA: $441.72 AUXIANT — MIDLANDS CHOICE PPO: $476.10
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$447	$290.55	$81.59 – $447
Screening mammogram, both breasts: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $373.25 AETNA — AETNA: $373.25 AETNA DOMESTIC — AETNA: $373.25 AETNA EAP — AETNA: $373.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $81.59 ALLIED BENEFIT SYSTEMS — AETNA: $373.25 AMBETTER — AMBETTER MARKETPLACE: $139.88 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $110.74 ASR HEALTH BENEFITS — AETNA: $373.25 AUXIANT — MIDLANDS CHOICE PPO: $402.30
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bilateral	$447	$290.55	$81.59 – $447
Screening mammogram, both breasts: 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $373.25 AETNA — AETNA: $373.25 AETNA DOMESTIC — AETNA: $373.25 AETNA EAP — AETNA: $373.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $81.59 ALLIED BENEFIT SYSTEMS — AETNA: $373.25 AMBETTER — AMBETTER MARKETPLACE: $139.88 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $110.74 ASR HEALTH BENEFITS — AETNA: $373.25 AUXIANT — MIDLANDS CHOICE PPO: $402.30

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cath Lt Heart/Lv Gram	$9,067	$5,893.55	$2,908.49 – $9,067
Left heart catheterization (diagnostic): 10 of 122 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $7,570.95 AETNA — AETNA: $7,570.95 AETNA DOMESTIC — AETNA: $7,570.95 AETNA EAP — AETNA: $7,570.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,158.27 ALLIED BENEFIT SYSTEMS — AETNA: $7,570.95 AMBETTER — AMBETTER MARKETPLACE: $5,414.17 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,286.22 ASR HEALTH BENEFITS — AETNA: $7,570.95 AUXIANT — MIDLANDS CHOICE PPO: $8,160.30
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years	$1,785	$1,785	$76.25 – $1,785
Sleep study (overnight, in a sleep lab): 10 of 775 insurance plan rates AETNA — AETNA: $1,221.12 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $607.08 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $543.93 ALIGN SENIOR CARE — MEDICARE: $607.08 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $1,604.52 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $607.08 AMBETTER — AMBETTER: $1,053.10 AMERIHEALTH MEDICARE — MEDICARE: $607.08 AMISH MENNONITE — MEDICAID IOWA: $543.93 ANDRIE INC — WORKERS COMP: $1,785
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	$4,992	$3,244.80	$770.41 – $4,992
Sleep study (overnight, in a sleep lab): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $4,168.32 AETNA — AETNA: $4,168.32 AETNA DOMESTIC — AETNA: $4,168.32 AETNA EAP — AETNA: $4,168.32 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $836.58 ALLIED BENEFIT SYSTEMS — AETNA: $4,168.32 AMBETTER — AMBETTER MARKETPLACE: $1,434.14 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,135.36 ASR HEALTH BENEFITS — AETNA: $4,168.32 AUXIANT — MIDLANDS CHOICE PPO: $4,492.80
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years	Not listed in the file	$2,543	$76.25 – $2,543
Sleep study (overnight, in a sleep lab): 10 of 775 insurance plan rates AETNA DOMESTIC — AETNA: $1,221.12 AETNA MEDICAID — AETNA MEDICAID: $398.94 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $607.08 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $543.93 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $607.08 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $637.43 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $543.93 AMISH HOSPITAL AID — AMISH MEDICAL AID: $823.90 AMPS — AMPS: $836.28 ANTHEM MYCARE OHIO — MEDICARE: $607.08

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 Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$148	$96.20	$25.38 – $212
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $123.58 AETNA — AETNA: $123.58 AETNA DOMESTIC — AETNA: $123.58 AETNA EAP — AETNA: $123.58 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $27.27 ALLIED BENEFIT SYSTEMS — AETNA: $123.58 AMBETTER — AMBETTER MARKETPLACE: $46.75 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $37.01 ASR HEALTH BENEFITS — AETNA: $123.58 AUXIANT — MIDLANDS CHOICE PPO: $133.20
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	$148	$96.20	$25.38 – $231
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $123.58 AETNA — AETNA: $123.58 AETNA DOMESTIC — AETNA: $123.58 AETNA EAP — AETNA: $123.58 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $27.27 ALLIED BENEFIT SYSTEMS — AETNA: $123.58 AMBETTER — AMBETTER MARKETPLACE: $46.75 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $37.01 ASR HEALTH BENEFITS — AETNA: $123.58 AUXIANT — MIDLANDS CHOICE PPO: $133.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	Not listed in the file	$915.85	$25.38 – $231
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 18 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $27.27 AMBETTER — AMBETTER MARKETPLACE: $46.75 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $37.01 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $27.55 CENTIVO — CENTIVO: $43.58 CLAIMDOC — CLAIMDOC: $55.94 GEHA — UNITED HEALTHCARE: $231 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $28.11 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $25.38 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $27.27
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Low Complexity Patient/Family	$301	$195.65	$74.80 – $301
Physical therapy evaluation (low complexity): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $251.34 AETNA — AETNA: $251.34 AETNA DOMESTIC — AETNA: $251.34 AETNA EAP — AETNA: $251.34 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.33 ALLIED BENEFIT SYSTEMS — AETNA: $251.34 AMBETTER — AMBETTER MARKETPLACE: $158.27 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $125.30 ASR HEALTH BENEFITS — AETNA: $251.34 AUXIANT — MIDLANDS CHOICE PPO: $270.90
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity Patient/Family	$301	$195.65	$74.80 – $301
Physical therapy evaluation (moderate complexity): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $251.34 AETNA — AETNA: $251.34 AETNA DOMESTIC — AETNA: $251.34 AETNA EAP — AETNA: $251.34 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.33 ALLIED BENEFIT SYSTEMS — AETNA: $251.34 AMBETTER — AMBETTER MARKETPLACE: $158.27 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $125.30 ASR HEALTH BENEFITS — AETNA: $251.34 AUXIANT — MIDLANDS CHOICE PPO: $270.90
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity Patient/Family	Not listed in the file	$1,105.65	$74.80 – $231
Physical therapy evaluation (moderate complexity): 10 of 18 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.33 AMBETTER — AMBETTER MARKETPLACE: $158.27 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $125.30 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $93.25 CENTIVO — CENTIVO: $147.53 CLAIMDOC — CLAIMDOC: $189.36 GEHA — UNITED HEALTHCARE: $231 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $95.15 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $74.80 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $92.33
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation High Complexity Patient/Family	$301	$195.65	$74.80 – $301
Physical therapy evaluation (high complexity): 10 of 52 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $251.34 AETNA — AETNA: $251.34 AETNA DOMESTIC — AETNA: $251.34 AETNA EAP — AETNA: $251.34 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.33 ALLIED BENEFIT SYSTEMS — AETNA: $251.34 AMBETTER — AMBETTER MARKETPLACE: $158.27 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $125.30 ASR HEALTH BENEFITS — AETNA: $251.34 AUXIANT — MIDLANDS CHOICE PPO: $270.90
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 30 Minutes	$151	$98.15	$53.91 – $151
Psychotherapy, 30 minutes: 10 of 34 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $126.09 AETNA — AETNA: $126.09 AETNA DOMESTIC — AETNA: $126.09 AETNA EAP — AETNA: $126.09 ALLIED BENEFIT SYSTEMS — AETNA: $126.09 ASR HEALTH BENEFITS — AETNA: $126.09 AUXIANT — MIDLANDS CHOICE PPO: $135.90 CHRISTIAN BROTHER SERVICES — AETNA: $126.09 CIGNA — MIDLANDS CHOICE PPO: $135.90 CIGNA EAP — MIDLANDS CHOICE PPO: $135.90
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 45 Minutes	$265	$172.25	$94.61 – $265
Psychotherapy, 45 minutes: 10 of 106 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $221.28 AETNA — AETNA: $221.28 AETNA DOMESTIC — AETNA: $221.28 AETNA EAP — AETNA: $221.28 ALLIED BENEFIT SYSTEMS — AETNA: $221.28 ASR HEALTH BENEFITS — AETNA: $221.28 AUXIANT — MIDLANDS CHOICE PPO: $238.50 BCBS GENERIC — WELLMARK PPO: $181.34 BCN DOMESTIC — WELLMARK PPO: $181.34 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $181.34
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 60 Minutes	$183	$118.95	$65.33 – $183
Psychotherapy, 60 minutes: 10 of 34 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $152.81 AETNA — AETNA: $152.81 AETNA DOMESTIC — AETNA: $152.81 AETNA EAP — AETNA: $152.81 ALLIED BENEFIT SYSTEMS — AETNA: $152.81 ASR HEALTH BENEFITS — AETNA: $152.81 AUXIANT — MIDLANDS CHOICE PPO: $164.70 CHRISTIAN BROTHER SERVICES — AETNA: $152.81 CIGNA — MIDLANDS CHOICE PPO: $164.70 CIGNA EAP — MIDLANDS CHOICE PPO: $164.70
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Family W/Patient 50 Minutes	$160	$104	$57.12 – $181.34
Family psychotherapy, with the patient: 10 of 106 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $133.60 AETNA — AETNA: $133.60 AETNA DOMESTIC — AETNA: $133.60 AETNA EAP — AETNA: $133.60 ALLIED BENEFIT SYSTEMS — AETNA: $133.60 ASR HEALTH BENEFITS — AETNA: $133.60 AUXIANT — MIDLANDS CHOICE PPO: $144 BCBS GENERIC — WELLMARK PPO: $181.34 BCN DOMESTIC — WELLMARK PPO: $181.34 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $181.34
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Psychotherapy Group	$75	$75	$10.16 – $75
Group psychotherapy: 10 of 776 insurance plan rates AETNA — AETNA: $46.63 AETNA DOMESTIC — AETNA: $46.63 AETNA MEDICAID — AETNA MEDICAID: $33.70 ALIGN SENIOR CARE — MEDICARE: $23.56 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $33.63 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $23.56 AMBETTER — AMBETTER: $40.87 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $24.74 AMERIGROUP MEDICAID — MEDICAID IOWA: $10.16 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $10.16
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Group Drug Rehabilitation	$295	$191.75	$57.96 – $735.87
Group psychotherapy: 10 of 37 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $246.33 AETNA — AETNA: $246.33 AETNA DOMESTIC — AETNA: $246.33 AETNA EAP — AETNA: $246.33 ALLIED BENEFIT SYSTEMS — AETNA: $246.33 ASR HEALTH BENEFITS — AETNA: $246.33 AUXIANT — MIDLANDS CHOICE PPO: $265.50 CHRISTIAN BROTHER SERVICES — AETNA: $246.33 CIGNA — MIDLANDS CHOICE PPO: $265.50 CIGNA EAP — MIDLANDS CHOICE PPO: $265.50
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Group Therapy	$405	$263.25	$144.59 – $405
Group psychotherapy: 10 of 34 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $338.18 AETNA — AETNA: $338.18 AETNA DOMESTIC — AETNA: $338.18 AETNA EAP — AETNA: $338.18 ALLIED BENEFIT SYSTEMS — AETNA: $338.18 ASR HEALTH BENEFITS — AETNA: $338.18 AUXIANT — MIDLANDS CHOICE PPO: $364.50 CHRISTIAN BROTHER SERVICES — AETNA: $338.18 CIGNA — MIDLANDS CHOICE PPO: $364.50 CIGNA EAP — MIDLANDS CHOICE PPO: $364.50

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Excision Cyst/Fibroadenoma/Other Benign/Malignant Tumor Open Male/Female >= 1 Lesion Lt	Not listed in the file	$13,421.54	$3.36 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $7,823.39
Removal of breast growth (open surgery): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,814.39 AMBETTER — AMBETTER MARKETPLACE: $6,538.95 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $5,176.67 BCBS GENERIC — WELLMARK PPO: $3.36 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $3.36 (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: $3.36 (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: $3.36 (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: $3.36 (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: $3.36 (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: $3.36 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH)	Not listed in the file	$42,385.43	$7.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $25,652.84
Total hip replacement: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $12,507.36 AMBETTER — AMBETTER MARKETPLACE: $21,441.18 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $16,974.27 BCBS GENERIC — WELLMARK PPO: $7.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $7.65 (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: $7.65 (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: $7.65 (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: $7.65 (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: $7.65 (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: $7.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Lt(Rest Method II CAH)	Not listed in the file	$39,409.48	$1.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $25,652.84
Total knee replacement: 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $12,507.36 AMBETTER — AMBETTER MARKETPLACE: $21,441.18 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $16,974.27 BCBS GENERIC — WELLMARK PPO: $9.72 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $9.72 (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: $9.72 (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: $9.72 (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: $9.72 (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: $9.72 (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: $9.72 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Lt(Rest Method II CAH)	Not listed in the file	$26,925.68	$6,537.75
Shoulder arthroscopy: shaving of shoulder bone: 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,187.56 AMBETTER — AMBETTER MARKETPLACE: $5,464.39 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,325.97 BCBS GENERIC — WELLMARK PPO: $13.20 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $13.20 (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: $13.20 (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: $13.20 (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: $13.20 (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: $13.20 (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: $13.20 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Lt (Rest Method II CAH)	Not listed in the file	$20,569.25	$1.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $6,537.75
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,187.56 AMBETTER — AMBETTER MARKETPLACE: $5,464.39 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,325.97 BCBS GENERIC — WELLMARK PPO: $4.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Tonsillectomy & Adenoidectomy Younger Than Age 12	Not listed in the file	$16,001.63	$11,828.35
Removal of tonsils and adenoids (under age 12): 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5,767.06 AMBETTER — AMBETTER MARKETPLACE: $9,886.38 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $7,826.72 BCBS GENERIC — WELLMARK PPO: $4.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $4.50 (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: $4.50 (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: $4.50 (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: $4.50 (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: $4.50 (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: $4.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	Not listed in the file	$4,297.86	$3.51 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,812.24
Upper GI endoscopy (diagnostic): 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $883.58 AMBETTER — AMBETTER MARKETPLACE: $1,514.71 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,199.14 BCBS GENERIC — WELLMARK PPO: $4.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $4.05 (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: $4.05 (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: $4.05 (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: $4.05 (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: $4.05 (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: $4.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE	Not listed in the file	$4,349.57	$3.51 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,812.24
Upper GI endoscopy (diagnostic): 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $883.58 AMBETTER — AMBETTER MARKETPLACE: $1,514.71 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,199.14 BCBS GENERIC — WELLMARK PPO: $3.51 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $3.51 (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: $3.51 (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: $3.51 (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: $3.51 (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: $3.51 (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: $3.51 (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) · Hospital (facility) fee In the file: HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH)	Not listed in the file	$6,644.53	$4.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,834.15
Upper GI endoscopy with biopsy: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,869.39 AMBETTER — AMBETTER MARKETPLACE: $3,204.66 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2,537.02 BCBS GENERIC — WELLMARK PPO: $4.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $4.05 (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: $4.05 (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: $4.05 (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: $4.05 (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: $4.05 (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: $4.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH)	Not listed in the file	$4,111.54	$2.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,858.14
Colonoscopy (diagnostic): 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $905.96 AMBETTER — AMBETTER MARKETPLACE: $1,553.07 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,229.51 BCBS GENERIC — WELLMARK PPO: $2.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $2.46 (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: $2.46 (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: $2.46 (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: $2.46 (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: $2.46 (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: $2.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 53 In the file: HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH)\|DISCONTINUED PROCEDURE	Not listed in the file	$3,636.88	$2.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,858.14
Colonoscopy (diagnostic): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $905.96 AMBETTER — AMBETTER MARKETPLACE: $1,553.07 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,229.51 BCBS GENERIC — WELLMARK PPO: $4.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $4.05 (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: $4.05 (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: $4.05 (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: $4.05 (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: $4.05 (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: $4.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH)\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY	Not listed in the file	$3,723.43	$2.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,858.14
Colonoscopy (diagnostic): 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $905.96 AMBETTER — AMBETTER MARKETPLACE: $1,553.07 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,229.51 BCBS GENERIC — WELLMARK PPO: $3.24 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $3.24 (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: $3.24 (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: $3.24 (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: $3.24 (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: $3.24 (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: $3.24 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH)	Not listed in the file	$5,294.44	$3.33 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,391
Colonoscopy with biopsy: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,165.76 AMBETTER — AMBETTER MARKETPLACE: $1,998.45 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,582.10 BCBS GENERIC — WELLMARK PPO: $3.33 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $3.33 (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: $3.33 (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: $3.33 (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: $3.33 (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: $3.33 (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: $3.33 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · 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)	Not listed in the file	$4,950.04	$4.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,391
Colonoscopy with removal of polyps (snare): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,165.76 AMBETTER — AMBETTER MARKETPLACE: $1,998.45 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,582.10 BCBS GENERIC — WELLMARK PPO: $4.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $4.50 (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: $4.50 (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: $4.50 (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: $4.50 (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: $4.50 (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: $4.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Colorectal Cancer Screening Non High Risk Patient (Restricted Method II CAH)	Not listed in the file	$3,890.57	$2.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,858.14
Screening colonoscopy (not high risk): 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $905.96 AMBETTER — AMBETTER MARKETPLACE: $1,553.07 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,229.51 BCBS GENERIC — WELLMARK PPO: $2.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $2.46 (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: $2.46 (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: $2.46 (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: $2.46 (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: $2.46 (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: $2.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH)	Not listed in the file	$29,966.85	$12,079.51
Gallbladder removal by laparoscope: 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5,889.51 AMBETTER — AMBETTER MARKETPLACE: $10,096.30 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $7,992.91 BCBS GENERIC — WELLMARK PPO: $3.36 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $3.36 (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: $3.36 (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: $3.36 (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: $3.36 (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: $3.36 (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: $3.36 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH)\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTE	Not listed in the file	$26,992	$12,079.51
Gallbladder removal by laparoscope: 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5,889.51 AMBETTER — AMBETTER MARKETPLACE: $10,096.30 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $7,992.91 BCBS GENERIC — WELLMARK PPO: $4.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH)	Not listed in the file	$19,679.05	$1.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $7,153.96
Groin (inguinal) hernia repair, age 5 or older: 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,488 AMBETTER — AMBETTER MARKETPLACE: $5,979.43 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,733.72 BCBS GENERIC — WELLMARK PPO: $4.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
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	$9,417.49	$3.96 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Prostate biopsy: 10 of 72 insurance plan rates BCBS GENERIC — WELLMARK PPO: $3.96 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $3.96 (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: $3.96 (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: $3.96 (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: $3.96 (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: $3.96 (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: $3.96 (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: $3.96 (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: $3.96 (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: $3.96 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Lap Surg Prostatectomy Retropubic Radical Incl Nrv Sparing/Robotic Asst	Not listed in the file	$50,481.92	$7.38 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $21,239.36
Prostate removal by laparoscope (radical prostatectomy): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10,355.51 AMBETTER — AMBETTER MARKETPLACE: $17,752.30 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $14,053.91 BCBS GENERIC — WELLMARK PPO: $7.38 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $7.38 (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: $7.38 (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: $7.38 (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: $7.38 (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: $7.38 (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: $7.38 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	Not listed in the file	$18,215.92	$4.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $6,468.07
Hysteroscopy with biopsy of the uterus lining: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,153.59 AMBETTER — AMBETTER MARKETPLACE: $5,406.15 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,279.87 BCBS GENERIC — WELLMARK PPO: $4.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (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: $4.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Neuroplasty Median Nerve Carpal Rt	Not listed in the file	$10,927.21	$3,901.72
Carpal tunnel release: 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,902.33 AMBETTER — AMBETTER MARKETPLACE: $3,261.14 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2,581.74 BCBS GENERIC — WELLMARK PPO: $3.42 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $3.42 (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: $3.42 (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: $3.42 (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: $3.42 (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: $3.42 (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: $3.42 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Rem Cataract Extracapsular Insert Intraocular Lens Prosth Man/Mech Tech	Not listed in the file	$8,559.78	$4,611.24
Cataract removal with lens implant: 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2,248.27 AMBETTER — AMBETTER MARKETPLACE: $3,854.17 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $3,051.22 BCBS GENERIC — WELLMARK PPO: $3.44 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $3.44 (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: $3.44 (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: $3.44 (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: $3.44 (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: $3.44 (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: $3.44 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: PR Rem Cataract Extracapsular Insert Intraocular Lens Prosth Man/Mech Tech\|BILATERAL PROCEDURE	Not listed in the file	$14,929.23	$4,611.24
Cataract removal with lens implant: 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2,248.27 AMBETTER — AMBETTER MARKETPLACE: $3,854.17 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $3,051.22 BCBS GENERIC — WELLMARK PPO: $3.15 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCN DOMESTIC — WELLMARK PPO: $3.15 (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: $3.15 (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: $3.15 (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: $3.15 (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: $3.15 (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: $3.15 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)

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	$44,505.23	$13,800.53 – $39,705
Hip or knee replacement (major joint of the leg), without major complications: 10 of 20 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13,800.53 AMBETTER — AMBETTER MARKETPLACE: $23,658.05 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $18,729.29 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $13,938.53 CENTIVO — CENTIVO: $25,376.07 CLAIMDOC — CLAIMDOC: $28,305.16 GEHA — UNITED HEALTHCARE: $21,705.91 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $14,222.99 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $15,317.07 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $13,800.53
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	$44,684.32	$15,059.09 – $35,766.02
Neck (cervical) spinal fusion, without complications: 10 of 19 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17,438.16 AMBETTER — AMBETTER MARKETPLACE: $29,893.99 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $23,666.07 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $17,612.54 CENTIVO — CENTIVO: $32,064.86 CLAIMDOC — CLAIMDOC: $35,766.02 GEHA — UNITED HEALTHCARE: $27,471.95 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $17,971.98 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $15,059.09 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $17,438.16
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	$33,776.70	$460 – $18,284.55
Uterus and ovary surgery (not for cancer), without complications: 10 of 21 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8,914.85 AMBETTER — AMBETTER MARKETPLACE: $15,282.61 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $12,098.73 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $9,004 CENTIVO — CENTIVO: $16,392.42 CLAIMDOC — CLAIMDOC: $18,284.55 GEHA — UNITED HEALTHCARE: $13,961.60 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $9,187.76 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $6,471.21 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $8,914.85

Source: MercyOne Dubuque 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	Acute Care Hospital
Address	250 Mercy Drive, Dubuque, IA 52001
County	Dubuque County
State	Iowa
Phone	(563) 589‑8000
Emergency services	Yes
Ownership	Voluntary non-profit - Church
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	160069
Name in Medicare records	MERCYONE DUBUQUE 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 Geocoder — map position used for distances

From the hospital’s website

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

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

MercyOne Dubuque Medical Center

Summary

Profile from official sources

At a glance