Does MercyOne North Iowa Medical Center have an emergency room?

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

Where is MercyOne North Iowa Medical Center?

1000 Fourth Street SW, Mason City, IA 50401, in Cerro Gordo County, Iowa.

What is the phone number of MercyOne North Iowa Medical Center?

(641) 428-7000, as listed by Medicare (CMS).

What is the Medicare star rating of MercyOne North Iowa Medical Center?

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

MercyOne North Iowa Medical Center

Quick answers

Does MercyOne North Iowa Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at MercyOne North Iowa Medical Center. In a medical emergency, call 911.
Where is MercyOne North Iowa Medical Center?: 1000 Fourth Street SW, Mason City, IA 50401, in Cerro Gordo County, Iowa.
What is the phone number of MercyOne North Iowa Medical Center?: (641) 428-7000, as listed by Medicare (CMS).
What is the Medicare star rating of MercyOne North Iowa Medical Center?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Cancer Care
Emergency Care
Heart and Vascular Care
Maternity Care
Neurosciences/Neurology
Orthopedics Care
Pediatrics
Primary Care
Surgical Care
Therapy and Rehabilitation
Urgent Care
Weight Loss Care
Home Health, Hospice and Home Infusion Care
Cardiopulmonary
Neurology and neurosciences

Treatments^[4]

Diabetes education
Robotic surgery

Procedures^[4]

Robotic surgery (da Vinci Xi)

Programs and centers^[4]

Stroke Care
MercyOne Air Med
Diabetes education
Urgent care
Weight loss care

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes

Recognition^[4]

Joint Commission designation (as worded on page)

Doctors and clinicians (489)

489 doctors and other clinicians list MercyOne North Iowa 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

And 465 more: the button below opens the full list.

Other emergency rooms nearby

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

Mitchell County Regional Health23 mi · Osage, IA · Critical Access Hospital
Floyd County Medical Center28 mi · Charles City, IA · Critical Access Hospital
Franklin General Hospital28 mi · Hampton, IA · Critical Access Hospital
Iowa Specialty Hospital - Belmond29 mi · Belmond, IA · Critical Access Hospital
Hancock County Health System30 mi · Britt, IA · Critical Access Hospital

Other hospitals nearby

Mayo Clinic Health System - Albert Lea and Austin36 mi · Albert Lea, MN · Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

I O O F Home and Community Therapy Center1.0 mi · Mason City, IA · 5 of 5 stars
Good Shepherd Health Center1.1 mi · Mason City, IA · 2 of 5 stars
Heritage Care and Rehabilitation Center1.7 mi · Mason City, IA · 3 of 5 stars

All nursing homes in the state →

Hospice providers

MercyOne North Iowa Hospice0.9 mi · Mason City, IA · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Cerro Gordo County Department of Public Health0.9 mi · Mason City, IA
Hancock County Health System Community Health20 mi · Garner, IA
Worth County PHNS21 mi · Northwood, IA

All home health agencies in the state →

Dialysis facilities

FMC - Mason City0.9 mi · Mason City, IA · 2 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.

Mason City Ambulatory Surgery Center LLC0.9 mi · Mason City, IA

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

Community Health Center of Mason City0.8 mi · Mason City, IA · Community health center

Clinics and urgent care

Anchor Family Health Center PLC0.9 mi · Mason City, IA · Rural health clinic
Khan Medical Associates PC0.9 mi · Mason City, IA · Urgent care center
Mercy Health Services Iowa Corp.0.9 mi · Mason City, IA · Urgent care center

Pharmacies

Hy-Vee Inc0.9 mi · Mason City, IA · Community/retail pharmacy
Hy-Vee Inc0.9 mi · Mason City, IA · Community/retail pharmacy
Hy-Vee Inc0.9 mi · Mason City, IA · Community/retail pharmacy

Assisted living nearby

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

Cornerstone AL0.9 mi · Mason City, IA
Country Meadow Place, LLC0.9 mi · Mason City, IA
Homestead Assisted Living0.9 mi · Mason City, IA
Kentucky Ridge Neighborhood AL0.9 mi · Mason City, 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 North Iowa 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)	3 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	61%National average: 72%
Would definitely recommend the hospital	57%National average: 71%
Nurses “always” communicated well	77%National average: 80%
Doctors “always” communicated well	75%National average: 80%
Staff “always” explained medicines before giving them	56%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	71%National average: 74%
Area around the room “always” quiet at night	51%National average: 60%
Completed surveys	742Response rate: 30%

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)	0.583No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.093Better than the national benchmark
Surgical site infections after colon surgery	0.844No 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	0.341Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	12.7%
Deaths within 30 days: heart failure patients	15.6%
Deaths within 30 days: pneumonia patients	15.8%
Deaths within 30 days: COPD patients	11%
Deaths within 30 days: stroke patients	13.1%
Deaths within 30 days: coronary bypass surgery (CABG)	3.7%
Serious complications (patient safety indicator PSI-90)	1No different from the national rate
Complications after hip or knee replacement	3.8%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.2%
Readmitted within 30 days: heart failure	21.8%
Readmitted within 30 days: pneumonia	17.4%
Readmitted within 30 days: COPD	19.5%
Readmitted within 30 days: coronary bypass surgery	10.2%
Readmitted within 30 days: hip or knee replacement	5.6%

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)	193 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)	61%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 Iowa Best hospitals in Iowa

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 79 common services exactly as MercyOne North Iowa 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 →

$ 26 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 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$180	$180	$58.03 – $180
New patient office visit (about 30–44 minutes): 10 of 605 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $65.84 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $65.84 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $65.84 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $58.03 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $58.03 ALIGN SENIOR CARE — MEDICARE: $65.84 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $65.84 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $58.03 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $65.84 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $58.03
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	$35.78 – $180
New patient office visit (about 30–44 minutes): 10 of 603 insurance plan rates AETNA — AETNA: $127.76 AETNA DOMESTIC — AETNA: $127.76 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $55.96 AETNA MEDICARE TRANSPLANT — MEDICARE: $55.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $35.78 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $35.78 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $35.78 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $55.96 AMBETTER — AMBETTER: $97.08 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $58.76
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$180	$180	$52.19 – $180
New patient office visit (about 30–44 minutes): 10 of 174 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $55.95 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $140.52 ANDRIE INC — WORKERS COMP: $180 AUTO VELOCITY — VELOCITY AUTO: $162 AUXIANT — MIDLANDS CHOICE: $140.52 CENTIVO — CENTIVO: $130.87 CIGNA — MIDLANDS CHOICE: $140.52 CIGNA EAP — MIDLANDS CHOICE: $140.52 EAST GREENBUSH CENTRAL SCHOOL DISTRICT — WORKERS COMP: $180 FIRST CHOICE HEALTH — MIDLANDS CHOICE: $140.52
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	$79.05 – $274.33
New patient office visit (about 45–59 minutes): 10 of 605 insurance plan rates AETNA — AETNA: $206.72 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $91.80 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $79.05 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 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $91.80 ALLY ALIGN CARE ADV — MEDICARE: $91.80 AMERICAN HEALTH ADVANTAGE OF IDAHO — 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	$307	$307	$84.99 – $307
New patient office visit (about 45–59 minutes): 10 of 605 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $108 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $108 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $108 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $93 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $93 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $93 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $108 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $93 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $108 AMBETTER — AMBETTER: $187.34
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$307	$307	$90.81 – $307
New patient office visit (about 45–59 minutes): 10 of 172 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $90.81 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $224.58 ANDRIE INC — WORKERS COMP: $307 AUTO VELOCITY — VELOCITY AUTO: $276.30 AUXIANT — MIDLANDS CHOICE: $224.58 CENTIVO — CENTIVO: $214.67 CIGNA — MIDLANDS CHOICE: $224.58 CIGNA EAP — MIDLANDS CHOICE: $224.58 EAST GREENBUSH CENTRAL SCHOOL DISTRICT — WORKERS COMP: $307 FIRST CHOICE HEALTH — MIDLANDS CHOICE: $224.58
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$402	$402	$115.66 – $402
New patient office visit (about 60–74 minutes): 10 of 606 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $147.39 AETNA DOMESTIC — AETNA: $330.11 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $147.39 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $147.39 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $120.31 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $120.31 ALIGN SENIOR CARE — MEDICARE: $147.39 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $147.39 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $120.31 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $147.39
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$402	$402	$93 – $365.30
New patient office visit (about 60–74 minutes): 10 of 606 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $125.28 AETNA — AETNA: $280.59 AETNA DOMESTIC — AETNA: $280.59 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $125.28 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $125.28 AETNA MEDICARE TRANSPLANT — MEDICARE: $125.28 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $102.26 ALIGN SENIOR CARE — MEDICARE: $125.28 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $125.28 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $125.28
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	$123.49 – $402
New patient office visit (about 60–74 minutes): 10 of 173 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $123.49 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $305.05 ANDRIE INC — WORKERS COMP: $402 AUTO VELOCITY — VELOCITY AUTO: $361.80 AUXIANT — MIDLANDS CHOICE: $305.05 CENTIVO — CENTIVO: $292.98 CIGNA — MIDLANDS CHOICE: $305.05 CIGNA EAP — MIDLANDS CHOICE: $305.05 EAST GREENBUSH CENTRAL SCHOOL DISTRICT — WORKERS COMP: $402 FIRST CHOICE HEALTH — MIDLANDS CHOICE: $305.05
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	$141	$141	$30.61 – $141
Established patient office visit (about 20–29 minutes): 10 of 602 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $53.61 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $53.61 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $30.61 ALIGN SENIOR CARE — MEDICARE: $53.61 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $53.61 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $30.61 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $56.29 AMERIGROUP MEDICAID — MEDICAID IOWA: $30.61 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $30.61 AMERIHEALTH MEDICARE — MEDICARE: $53.61
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	$26.58 – $141
Established patient office visit (about 20–29 minutes): 10 of 600 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $45.57 AETNA — AETNA: $102.74 AETNA DOMESTIC — AETNA: $102.74 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $45.57 AETNA MEDICARE TRANSPLANT — MEDICARE: $45.57 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $26.58 ALIGN SENIOR CARE — MEDICARE: $45.57 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $45.57 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $45.57 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $26.58
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$141	$141	$44.67 – $141
Established patient office visit (about 20–29 minutes): 10 of 173 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $44.67 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $111.69 ANDRIE INC — WORKERS COMP: $141 AUTO VELOCITY — VELOCITY AUTO: $126.90 AUXIANT — MIDLANDS CHOICE: $111.69 CENTIVO — CENTIVO: $106.56 CIGNA — MIDLANDS CHOICE: $111.69 CIGNA EAP — MIDLANDS CHOICE: $111.69 EAST GREENBUSH CENTRAL SCHOOL DISTRICT — WORKERS COMP: $141 FIRST CHOICE HEALTH — MIDLANDS CHOICE: $111.69
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	$49.07 – $209
Established patient office visit (about 30–39 minutes): 10 of 604 insurance plan rates AETNA MEDICARE TRANSPLANT — MEDICARE: $78.74 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $49.07 ALIGN SENIOR CARE — MEDICARE: $78.74 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $49.07 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $49.07 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $78.74 AMERIGROUP MEDICAID — MEDICAID IOWA: $49.07 AMERIHEALTH MEDICARE — MEDICARE: $78.74 AMISH HOSPITAL AID — AMISH MEDICAL AID: $106.87 AMPS — AMPS: $108.47
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	$209	$209	$41.71 – $209
Established patient office visit (about 30–39 minutes): 10 of 604 insurance plan rates AETNA — AETNA: $151.94 AETNA DOMESTIC — AETNA: $151.94 ALIGN SENIOR CARE — MEDICARE: $66.93 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $41.71 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $66.93 AMBETTER — AMBETTER: $116.11 AMERIHEALTH MEDICARE — MEDICARE: $66.93 AMISH HOSPITAL AID — AMISH MEDICAL AID: $90.84 AMISH MENNONITE — MEDICAID IOWA: $41.71 AMPS — AMPS: $86.78
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$209	$209	$65.79 – $209
Established patient office visit (about 30–39 minutes): 10 of 175 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $65.79 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $164.54 ANDRIE INC — WORKERS COMP: $209 AUTO VELOCITY — VELOCITY AUTO: $188.10 AUXIANT — MIDLANDS CHOICE: $164.54 CENTIVO — CENTIVO: $156.52 CIGNA — MIDLANDS CHOICE: $164.54 CIGNA EAP — MIDLANDS CHOICE: $164.54 EAST GREENBUSH CENTRAL SCHOOL DISTRICT — WORKERS COMP: $209 FIRST CHOICE HEALTH — MIDLANDS CHOICE: $164.54
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	$237	$237	$65.44 – $237
Preventive checkup, new patient, age 18–39: 10 of 561 insurance plan rates AETNA DOMESTIC — AETNA: $169.34 AETNA MEDICAID — AETNA MEDICAID: $66.40 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $88.58 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $183.75 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $88.58 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $88.58 AMBETTER — AMBETTER: $113.52 AMERIGROUP MEDICAID — MEDICAID IOWA: $88.58 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $88.58 AMISH HOSPITAL AID — AMISH MEDICAL AID: $88.81
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: HC E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	$170	$110.50	$34 – $170
Preventive checkup, new patient, age 18–39: 10 of 40 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $89.25 AETNA — AETNA: $89.25 AETNA DOMESTIC — AETNA: $89.25 AETNA EAP — AETNA: $89.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $34 ALLIED BENEFIT SYSTEMS — AETNA: $89.25 ASR HEALTH BENEFITS — AETNA: $89.25 AUXIANT — MIDLANDS CHOICE PPO: $119 CENTIVO — CENTIVO: $53.89 CHRISTIAN BROTHER SERVICES — AETNA: $89.25
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years	$288	$288	$66.40 – $288
Preventive checkup, new patient, age 40–64: 10 of 565 insurance plan rates AETNA — AETNA: $241.72 AETNA DOMESTIC — AETNA: $241.72 AETNA MEDICAID — AETNA MEDICAID: $66.40 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $122.89 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $222.19 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $122.89 AMBETTER — AMBETTER: $162.18 AMISH MENNONITE — MEDICAID IOWA: $122.89 AMPS — AMPS: $128.79 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID IOWA: $122.89
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: HC E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years	$270	$175.50	$43 – $270
Preventive checkup, new patient, age 40–64: 10 of 40 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $141.75 AETNA — AETNA: $141.75 AETNA DOMESTIC — AETNA: $141.75 AETNA EAP — AETNA: $141.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $54 ALLIED BENEFIT SYSTEMS — AETNA: $141.75 ASR HEALTH BENEFITS — AETNA: $141.75 AUXIANT — MIDLANDS CHOICE PPO: $189 CENTIVO — CENTIVO: $85.59 CHRISTIAN BROTHER SERVICES — AETNA: $141.75
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Low	$156	$156	$44.94 – $156
Emergency room visit (moderate): 10 of 775 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $49.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $63.36 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $63.36 AETNA MEDICARE TRANSPLANT — MEDICARE: $63.36 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — 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 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $63.36 ALLY ALIGN CARE ADV — MEDICARE: $63.36
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Low	$148	$148	$44.94 – $148
Emergency room visit (moderate): 10 of 775 insurance plan rates AETNA — AETNA: $130.91 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $63.36 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $63.36 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $59.12 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $59.12 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $63.36 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $66.52 AMERIGROUP MEDICAID — MEDICAID IOWA: $59.12 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $59.12 AMERIHEALTH MEDICARE — MEDICARE: $63.36
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3 Sane_Safe	$1,127	$732.55	$133.36 – $1,727
Emergency room visit (moderate): 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $591.68 AETNA — AETNA: $591.68 AETNA DOMESTIC — AETNA: $591.68 AETNA EAP — AETNA: $591.68 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $288.34 ALLIED BENEFIT SYSTEMS — AETNA: $591.68 AMBETTER — AMBETTER MARKETPLACE: $494.30 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $391.32 ASR HEALTH BENEFITS — AETNA: $591.68 AUXIANT — MIDLANDS CHOICE PPO: $788.90
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Moderate	$284	$284	$76.68 – $284
Emergency room visit (moderately high): 10 of 775 insurance plan rates AETNA — AETNA: $221.33 AETNA DOMESTIC — AETNA: $221.33 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $107.71 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $225.78 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $91.03 AMBETTER — AMBETTER: $186.85 AMERIGROUP MEDICAID — MEDICAID IOWA: $91.03 AMISH HOSPITAL AID — AMISH MEDICAL AID: $146.18 AMPS — AMPS: $148.38 AUTO VELOCITY — VELOCITY AUTO: $255.60
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Moderate	$253	$253	$76.68 – $253
Emergency room visit (moderately high): 10 of 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $107.71 AETNA — AETNA: $221.33 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $107.71 ALIGN SENIOR CARE — MEDICARE: $107.71 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $107.71 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $91.03 AMBETTER — AMBETTER: $186.85 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $107.71 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $113.10 AMERIGROUP MEDICAID — MEDICAID IOWA: $91.03
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 4	$1,969	$1,279.85	$201.87 – $1,969
Emergency room visit (moderately high): 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,033.73 AETNA — AETNA: $1,033.73 AETNA DOMESTIC — AETNA: $1,033.73 AETNA EAP — AETNA: $1,033.73 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $440.75 ALLIED BENEFIT SYSTEMS — AETNA: $1,033.73 AMBETTER — AMBETTER MARKETPLACE: $755.57 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $598.16 ASR HEALTH BENEFITS — AETNA: $1,033.73 AUXIANT — MIDLANDS CHOICE PPO: $1,378.30
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit High	$412	$412	$111.19 – $412
Emergency room visit (high): 10 of 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $156.63 AETNA — AETNA: $321.34 AETNA DOMESTIC — AETNA: $321.34 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $156.63 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $156.63 AETNA MEDICARE TRANSPLANT — MEDICARE: $156.63 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $143.10 ALIGN SENIOR CARE — MEDICARE: $156.63 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $156.63 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $327.87
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit High	$367	$367	$111.19 – $367
Emergency room visit (high): 10 of 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $156.63 AETNA DOMESTIC — AETNA: $321.34 AETNA MEDICAID — AETNA MEDICAID: $121.28 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $156.63 AETNA MEDICARE TRANSPLANT — MEDICARE: $156.63 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $143.10 ALIGN SENIOR CARE — MEDICARE: $156.63 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $156.63 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $327.87 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $143.10
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 5 Sane_Safe	$2,800	$1,820	$288.12 – $2,800
Emergency room visit (high): 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,470 AETNA — AETNA: $1,470 AETNA DOMESTIC — AETNA: $1,470 AETNA EAP — AETNA: $1,470 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $629.06 ALLIED BENEFIT SYSTEMS — AETNA: $1,470 AMBETTER — AMBETTER MARKETPLACE: $1,078.38 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $853.72 ASR HEALTH BENEFITS — AETNA: $1,470 AUXIANT — MIDLANDS CHOICE PPO: $1,960

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)	$153	$99.45	$8.20 – $153
Basic metabolic panel (blood test): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $80.33 AETNA — AETNA: $80.33 AETNA DOMESTIC — AETNA: $80.33 AETNA EAP — AETNA: $80.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.29 ALLIED BENEFIT SYSTEMS — AETNA: $80.33 AMBETTER — AMBETTER MARKETPLACE: $14.21 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $11.25 ASR HEALTH BENEFITS — AETNA: $80.33 AUXIANT — MIDLANDS CHOICE PPO: $107.10
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	$500	$8.20 – $140.63
Basic metabolic panel (blood test): 10 of 92 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $130.58 AMBETTER — AMBETTER MARKETPLACE: $14.21 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $11.25 BCBS GENERIC — WELLMARK PPO: $136.02 BCN DOMESTIC — WELLMARK PPO: $136.02 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $136.02 BLUE CARE NETWORK — WELLMARK PPO: $136.02 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $136.02 BLUE CROSS - AL — WELLMARK PPO: $136.02 BLUE CROSS - AR — WELLMARK PPO: $136.02
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier AF In the file: HC Basic Metabolic Panel (Calcium Total)\|SPECIALTY PHYSICIAN	Not listed in the file	$429	$8.20 – $140.63
Basic metabolic panel (blood test): 10 of 20 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.29 AMBETTER — AMBETTER MARKETPLACE: $14.21 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $11.25 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $8.37 CENTIVO — CENTIVO: $10.41 CLAIMDOC — CLAIMDOC: $17 GEHA — UNITED HEALTHCARE: $8.46 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $8.54 IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $9.09 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $8.20
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	$231	$150.15	$10.23 – $231
Comprehensive metabolic panel (blood test): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $121.28 AETNA — AETNA: $121.28 AETNA DOMESTIC — AETNA: $121.28 AETNA EAP — AETNA: $121.28 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10.35 ALLIED BENEFIT SYSTEMS — AETNA: $121.28 AMBETTER — AMBETTER MARKETPLACE: $17.74 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $14.04 ASR HEALTH BENEFITS — AETNA: $121.28 AUXIANT — MIDLANDS CHOICE PPO: $161.70
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	$855	$9.09 – $21.23
Comprehensive metabolic panel (blood test): 10 of 20 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10.35 AMBETTER — AMBETTER MARKETPLACE: $17.74 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $14.04 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $10.45 CENTIVO — CENTIVO: $12.99 CLAIMDOC — CLAIMDOC: $21.23 GEHA — UNITED HEALTHCARE: $10.56 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $10.67 IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $9.09 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $10.23
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier NC In the file: HC Comprehensive Metabolic Panel\|NC	Not listed in the file	$1,770	$9.09 – $21.23
Comprehensive metabolic panel (blood test): 10 of 20 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10.35 AMBETTER — AMBETTER MARKETPLACE: $17.74 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $14.04 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $10.45 CENTIVO — CENTIVO: $12.99 CLAIMDOC — CLAIMDOC: $21.23 GEHA — UNITED HEALTHCARE: $10.56 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $10.67 IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $9.09 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $10.23
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 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $74.55 AETNA — AETNA: $74.55 AETNA DOMESTIC — AETNA: $74.55 AETNA EAP — AETNA: $74.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALLIED BENEFIT SYSTEMS — AETNA: $74.55 AMBETTER — AMBETTER MARKETPLACE: $22.50 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $17.81 ASR HEALTH BENEFITS — AETNA: $74.55 AUXIANT — MIDLANDS CHOICE PPO: $99.40
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Lmpp Lipid Panel	$86	$55.90	$12.97 – $86
Cholesterol panel (lipid panel): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $45.15 AETNA — AETNA: $45.15 AETNA DOMESTIC — AETNA: $45.15 AETNA EAP — AETNA: $45.15 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALLIED BENEFIT SYSTEMS — AETNA: $45.15 AMBETTER — AMBETTER MARKETPLACE: $22.50 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $17.81 ASR HEALTH BENEFITS — AETNA: $45.15 AUXIANT — MIDLANDS CHOICE PPO: $60.20
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Renal Function Panel	$167	$108.55	$8.42 – $167
Kidney function panel: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $87.68 AETNA — AETNA: $87.68 AETNA DOMESTIC — AETNA: $87.68 AETNA EAP — AETNA: $87.68 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.51 ALLIED BENEFIT SYSTEMS — AETNA: $87.68 AMBETTER — AMBETTER MARKETPLACE: $14.58 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $11.54 ASR HEALTH BENEFITS — AETNA: $87.68 AUXIANT — MIDLANDS CHOICE PPO: $116.90
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Renal Function Panel	Not listed in the file	$800	$8.42 – $161.50
Kidney function panel: 10 of 20 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.51 AMBETTER — AMBETTER MARKETPLACE: $14.58 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $11.54 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $8.59 CENTIVO — CENTIVO: $10.68 CLAIMDOC — CLAIMDOC: $17.45 GEHA — UNITED HEALTHCARE: $8.68 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $8.77 IOWA DEPT OF PUBLIC HEALTH — CARE FOR YOURSELF: $9.09 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $8.42
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier NC In the file: HC Renal Function Panel\|NC	Not listed in the file	$892	$8.42 – $161.50
Kidney function panel: 10 of 92 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $130.58 AMBETTER — AMBETTER MARKETPLACE: $134.99 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $106.87 BCBS GENERIC — WELLMARK PPO: $136.02 BCN DOMESTIC — WELLMARK PPO: $136.02 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $136.02 BLUE CARE NETWORK — WELLMARK PPO: $136.02 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $136.02 BLUE CROSS - AL — WELLMARK PPO: $136.02 BLUE CROSS - AR — WELLMARK PPO: $136.02
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 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $206.33 AETNA — AETNA: $206.33 AETNA DOMESTIC — AETNA: $206.33 AETNA EAP — AETNA: $206.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.01 ALLIED BENEFIT SYSTEMS — AETNA: $206.33 AMBETTER — AMBETTER MARKETPLACE: $13.73 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $10.87 ASR HEALTH BENEFITS — AETNA: $206.33 AUXIANT — MIDLANDS CHOICE PPO: $275.10
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	$79	$51.35	$3.07 – $79
Urine test (automated, with microscope): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $41.48 AETNA — AETNA: $41.48 AETNA DOMESTIC — AETNA: $41.48 AETNA EAP — AETNA: $41.48 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.11 ALLIED BENEFIT SYSTEMS — AETNA: $41.48 AMBETTER — AMBETTER MARKETPLACE: $5.33 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4.22 ASR HEALTH BENEFITS — AETNA: $41.48 AUXIANT — MIDLANDS CHOICE PPO: $55.30
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	$659	$3.07 – $6.37
Urine test (automated, with microscope): 10 of 19 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.11 AMBETTER — AMBETTER MARKETPLACE: $5.33 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4.22 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $3.14 CENTIVO — CENTIVO: $3.90 CLAIMDOC — CLAIMDOC: $6.37 GEHA — UNITED HEALTHCARE: $3.17 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $3.20 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $3.07 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $3.11
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Non-Automated	$7	$7	$2.78 – $7
Urine test (manual, without microscope): 10 of 775 insurance plan rates AETNA DOMESTIC — AETNA: $5.28 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.41 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $3.41 AETNA MEDICARE TRANSPLANT — MEDICARE: $3.41 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $3.64 ALIGN SENIOR CARE — MEDICARE: $3.41 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $3.41 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $4.18 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $3.64 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $3.41
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Nonautomated	$21	$13.65	$3.38 – $21
Urine test (manual, without microscope): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $11.03 AETNA — AETNA: $11.03 AETNA DOMESTIC — AETNA: $11.03 AETNA EAP — AETNA: $11.03 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.41 ALLIED BENEFIT SYSTEMS — AETNA: $11.03 AMBETTER — AMBETTER MARKETPLACE: $5.85 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4.63 ASR HEALTH BENEFITS — AETNA: $11.03 AUXIANT — MIDLANDS CHOICE PPO: $14.70
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Non-Automated	Not listed in the file	$9.12	$2.78 – $9.12
Urine test (manual, without microscope): 10 of 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $3.41 AETNA — AETNA: $5.28 AETNA MEDICAID — AETNA MEDICAID: $5.20 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $3.41 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $3.64 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $4.18 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $3.64 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $3.41 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $3.41 AMBETTER — AMBETTER: $5.92
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Automated	$10	$10	$1.80 – $10
Urine test (automated, without microscope): 10 of 768 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $2.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 AETNA MEDICARE TRANSPLANT — MEDICARE: $2.21 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $2.76 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $2.21 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $2.21 ALLY ALIGN CARE ADV — MEDICARE: $2.21 AMBETTER — AMBETTER: $3.83 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $2.21 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $1.97
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	$50	$32.50	$2.18 – $50
Urine test (automated, without microscope): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $26.25 AETNA — AETNA: $26.25 AETNA DOMESTIC — AETNA: $26.25 AETNA EAP — AETNA: $26.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 ALLIED BENEFIT SYSTEMS — AETNA: $26.25 AMBETTER — AMBETTER MARKETPLACE: $3.78 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2.99 ASR HEALTH BENEFITS — AETNA: $26.25 AUXIANT — MIDLANDS CHOICE PPO: $35
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Automated	Not listed in the file	$7.48	$1.80 – $7.48
Urine test (automated, without microscope): 10 of 775 insurance plan rates AETNA — AETNA: $3.41 AETNA MEDICAID — AETNA MEDICAID: $4.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $2.21 AETNA MEDICARE TRANSPLANT — MEDICARE: $2.21 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $3.18 ALIGN SENIOR CARE — MEDICARE: $2.21 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $2.21 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $2.71 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $3.18
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 1012090 Prostate Specific Antigen Total	$130	$84.50	$17.82 – $130
PSA (prostate specific antigen) blood test: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $68.25 AETNA — AETNA: $68.25 AETNA DOMESTIC — AETNA: $68.25 AETNA EAP — AETNA: $68.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALLIED BENEFIT SYSTEMS — AETNA: $68.25 AMBETTER — AMBETTER MARKETPLACE: $30.90 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $24.46 ASR HEALTH BENEFITS — AETNA: $68.25 AUXIANT — MIDLANDS CHOICE PPO: $91
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Prostate Specific Antigen Total Ultrasensitive	$130	$84.50	$17.82 – $130
PSA (prostate specific antigen) blood test: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $68.25 AETNA — AETNA: $68.25 AETNA DOMESTIC — AETNA: $68.25 AETNA EAP — AETNA: $68.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALLIED BENEFIT SYSTEMS — AETNA: $68.25 AMBETTER — AMBETTER MARKETPLACE: $30.90 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $24.46 ASR HEALTH BENEFITS — AETNA: $68.25 AUXIANT — MIDLANDS CHOICE PPO: $91
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Psaft Prostate Specific Antigen Total	$202	$131.30	$17.82 – $202
PSA (prostate specific antigen) blood test: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $106.05 AETNA — AETNA: $106.05 AETNA DOMESTIC — AETNA: $106.05 AETNA EAP — AETNA: $106.05 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALLIED BENEFIT SYSTEMS — AETNA: $106.05 AMBETTER — AMBETTER MARKETPLACE: $30.90 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $24.46 ASR HEALTH BENEFITS — AETNA: $106.05 AUXIANT — MIDLANDS CHOICE PPO: $141.40
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Fcuip Thyroid Stimulating Hormone	$190	$123.50	$16.28 – $190
Thyroid stimulating hormone (TSH) test: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $99.75 AETNA — AETNA: $99.75 AETNA DOMESTIC — AETNA: $99.75 AETNA EAP — AETNA: $99.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALLIED BENEFIT SYSTEMS — AETNA: $99.75 AMBETTER — AMBETTER MARKETPLACE: $28.22 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $22.34 ASR HEALTH BENEFITS — AETNA: $99.75 AUXIANT — MIDLANDS CHOICE PPO: $133
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thyroid Stimulating Hormone	$190	$123.50	$16.28 – $190
Thyroid stimulating hormone (TSH) test: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $99.75 AETNA — AETNA: $99.75 AETNA DOMESTIC — AETNA: $99.75 AETNA EAP — AETNA: $99.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALLIED BENEFIT SYSTEMS — AETNA: $99.75 AMBETTER — AMBETTER MARKETPLACE: $28.22 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $22.34 ASR HEALTH BENEFITS — AETNA: $99.75 AUXIANT — MIDLANDS CHOICE PPO: $133
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Thyroid Stimulating Hormone	$143	$92.95	$16.28 – $143
Thyroid stimulating hormone (TSH) test: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $75.08 AETNA — AETNA: $75.08 AETNA DOMESTIC — AETNA: $75.08 AETNA EAP — AETNA: $75.08 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALLIED BENEFIT SYSTEMS — AETNA: $75.08 AMBETTER — AMBETTER MARKETPLACE: $28.22 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $22.34 ASR HEALTH BENEFITS — AETNA: $75.08 AUXIANT — MIDLANDS CHOICE PPO: $100.10
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	$137	$89.05	$7.53 – $137
Complete blood count (CBC) with differential: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $71.93 AETNA — AETNA: $71.93 AETNA DOMESTIC — AETNA: $71.93 AETNA EAP — AETNA: $71.93 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7.61 ALLIED BENEFIT SYSTEMS — AETNA: $71.93 AMBETTER — AMBETTER MARKETPLACE: $13.05 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $10.33 ASR HEALTH BENEFITS — AETNA: $71.93 AUXIANT — MIDLANDS CHOICE PPO: $95.90
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	$809	$7.77 – $188.54
Complete blood count (CBC) with differential: 10 of 92 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $91.92 AMBETTER — AMBETTER MARKETPLACE: $157.58 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $124.75 BCBS GENERIC — WELLMARK PPO: $88.91 BCN DOMESTIC — WELLMARK PPO: $88.91 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $88.91 BLUE CARE NETWORK — WELLMARK PPO: $88.91 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $88.91 BLUE CROSS - AL — WELLMARK PPO: $88.91 BLUE CROSS - AR — WELLMARK PPO: $88.91
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated	$106	$68.90	$6.27 – $106
Complete blood count (CBC), automated: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $55.65 AETNA — AETNA: $55.65 AETNA DOMESTIC — AETNA: $55.65 AETNA EAP — AETNA: $55.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.34 ALLIED BENEFIT SYSTEMS — AETNA: $55.65 AMBETTER — AMBETTER MARKETPLACE: $10.87 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $8.61 ASR HEALTH BENEFITS — AETNA: $55.65 AUXIANT — MIDLANDS CHOICE PPO: $74.20
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	$750	$6.40 – $146.37
Complete blood count (CBC), automated: 10 of 92 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $140.63 AMBETTER — AMBETTER MARKETPLACE: $10.87 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $8.61 BCBS GENERIC — WELLMARK PPO: $136.02 BCN DOMESTIC — WELLMARK PPO: $136.02 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $136.02 BLUE CARE NETWORK — WELLMARK PPO: $136.02 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $136.02 BLUE CROSS - AL — WELLMARK PPO: $136.02 BLUE CROSS - AR — WELLMARK PPO: $136.02
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Prothrombin Time	$9	$9	$3.43 – $9
Blood clotting time test (prothrombin time, PT): 10 of 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $4.20 AETNA DOMESTIC — AETNA: $6.50 AETNA MEDICARE TRANSPLANT — MEDICARE: $4.20 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $4.97 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $4.97 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $4.20 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $4.20 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $4.97 ALLY ALIGN CARE ADV — MEDICARE: $4.20 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $4.20
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mayo Albld Prothrombin Time	$54	$35.10	$4.16 – $54
Blood clotting time test (prothrombin time, PT): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $28.35 AETNA — AETNA: $28.35 AETNA DOMESTIC — AETNA: $28.35 AETNA EAP — AETNA: $28.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALLIED BENEFIT SYSTEMS — AETNA: $28.35 AMBETTER — AMBETTER MARKETPLACE: $7.21 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $5.71 ASR HEALTH BENEFITS — AETNA: $28.35 AUXIANT — MIDLANDS CHOICE PPO: $37.80
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prothrombin Time	$54	$35.10	$4.16 – $54
Blood clotting time test (prothrombin time, PT): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $28.35 AETNA — AETNA: $28.35 AETNA DOMESTIC — AETNA: $28.35 AETNA EAP — AETNA: $28.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALLIED BENEFIT SYSTEMS — AETNA: $28.35 AMBETTER — AMBETTER MARKETPLACE: $7.21 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $5.71 ASR HEALTH BENEFITS — AETNA: $28.35 AUXIANT — MIDLANDS CHOICE PPO: $37.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thromboplastin Time Partial (Ptt)	$99	$64.35	$5.82 – $99
Blood clotting test (partial thromboplastin time, PTT): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $51.98 AETNA — AETNA: $51.98 AETNA DOMESTIC — AETNA: $51.98 AETNA EAP — AETNA: $51.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALLIED BENEFIT SYSTEMS — AETNA: $51.98 AMBETTER — AMBETTER MARKETPLACE: $10.10 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $7.99 ASR HEALTH BENEFITS — AETNA: $51.98 AUXIANT — MIDLANDS CHOICE PPO: $69.30
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)	$99	$64.35	$5.82 – $99
Blood clotting test (partial thromboplastin time, PTT): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $51.98 AETNA — AETNA: $51.98 AETNA DOMESTIC — AETNA: $51.98 AETNA EAP — AETNA: $51.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALLIED BENEFIT SYSTEMS — AETNA: $51.98 AMBETTER — AMBETTER MARKETPLACE: $10.10 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $7.99 ASR HEALTH BENEFITS — AETNA: $51.98 AUXIANT — MIDLANDS CHOICE PPO: $69.30
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)	$99	$64.35	$5.82 – $99
Blood clotting test (partial thromboplastin time, PTT): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $51.98 AETNA — AETNA: $51.98 AETNA DOMESTIC — AETNA: $51.98 AETNA EAP — AETNA: $51.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALLIED BENEFIT SYSTEMS — AETNA: $51.98 AMBETTER — AMBETTER MARKETPLACE: $10.10 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $7.99 ASR HEALTH BENEFITS — AETNA: $51.98 AUXIANT — MIDLANDS CHOICE PPO: $69.30

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	$2,429	$1,578.85	$101.16 – $2,429
CT scan of the head or brain, without contrast: 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,275.23 AETNA — AETNA: $1,275.23 AETNA DOMESTIC — AETNA: $1,275.23 AETNA EAP — AETNA: $1,275.23 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $110.43 ALLIED BENEFIT SYSTEMS — AETNA: $1,275.23 AMBETTER — AMBETTER MARKETPLACE: $189.31 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $149.87 ASR HEALTH BENEFITS — AETNA: $1,275.23 AUXIANT — MIDLANDS CHOICE PPO: $1,700.30
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	$2,574	$74.50 – $240.48
CT scan of the head or brain, without contrast: 10 of 92 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $110.43 AMBETTER — AMBETTER MARKETPLACE: $189.31 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $149.87 BCBS GENERIC — WELLMARK PPO: $106.81 BCN DOMESTIC — WELLMARK PPO: $106.81 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $106.81 BLUE CARE NETWORK — WELLMARK PPO: $106.81 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $106.81 BLUE CROSS - AL — WELLMARK PPO: $106.81 BLUE CROSS - AR — WELLMARK PPO: $106.81
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	$2,528	$1,643.20	$189.38 – $2,528
MRI of the brain, before and after contrast: 10 of 117 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,327.20 AETNA — AETNA: $1,327.20 AETNA DOMESTIC — AETNA: $1,327.20 AETNA EAP — AETNA: $1,327.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $189.38 ALLIED BENEFIT SYSTEMS — AETNA: $1,327.20 AMBETTER — AMBETTER MARKETPLACE: $324.64 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $257.01 ASR HEALTH BENEFITS — AETNA: $1,327.20 AUXIANT — MIDLANDS CHOICE PPO: $1,769.60
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI Brain W/O & W/Contrast	Not listed in the file	$2,987.90	$21.60 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $828.97
MRI of the brain, before and after contrast: 10 of 92 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $368.51 AMBETTER — AMBETTER MARKETPLACE: $631.74 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $500.12 BCBS GENERIC — WELLMARK PPO: $356.43 BCN DOMESTIC — WELLMARK PPO: $356.43 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $356.43 BLUE CARE NETWORK — WELLMARK PPO: $356.43 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $356.43 BLUE CROSS - AL — WELLMARK PPO: $356.43 BLUE CROSS - AR — WELLMARK PPO: $356.43
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier NC In the file: HC MRI Brain W/O & W/Contrast\|NC	Not listed in the file	$3,226.10	$21.60 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $828.97
MRI of the brain, before and after contrast: 10 of 92 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $368.51 AMBETTER — AMBETTER MARKETPLACE: $631.74 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $500.12 BCBS GENERIC — WELLMARK PPO: $356.43 BCN DOMESTIC — WELLMARK PPO: $356.43 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $356.43 BLUE CARE NETWORK — WELLMARK PPO: $356.43 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $356.43 BLUE CROSS - AL — WELLMARK PPO: $356.43 BLUE CROSS - AR — WELLMARK PPO: $356.43
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Chest 2 Views	$415	$269.75	$84.21 – $415
Chest X-ray, 2 views: 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $217.88 AETNA — AETNA: $217.88 AETNA DOMESTIC — AETNA: $217.88 AETNA EAP — AETNA: $217.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $91.92 ALLIED BENEFIT SYSTEMS — AETNA: $217.88 AMBETTER — AMBETTER MARKETPLACE: $157.58 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $124.75 ASR HEALTH BENEFITS — AETNA: $217.88 AUXIANT — MIDLANDS CHOICE PPO: $290.50
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	$747	$84.21 – $195.48
Chest X-ray, 2 views: 10 of 91 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $91.92 AMBETTER — AMBETTER MARKETPLACE: $157.58 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $124.75 BCBS GENERIC — WELLMARK PPO: $88.91 BCN DOMESTIC — WELLMARK PPO: $88.91 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $88.91 BLUE CARE NETWORK — WELLMARK PPO: $88.91 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $88.91 BLUE CROSS - AL — WELLMARK PPO: $88.91 BLUE CROSS - AR — WELLMARK PPO: $88.91
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Doctor (professional) fee · modifier 26 In the file: PR Xr Chest 2 Views\|PROFESSIONAL COMPONENT	$23	$23	$3.30 – $51.56
Chest X-ray, 2 views: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $9.40 AETNA MEDICARE TRANSPLANT — MEDICARE: $9.40 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $10.02 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $9.40 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $9.40 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $10.02 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $9.40 AMPS — AMPS: $12.95 ANDRIE INC — WORKERS COMP: $23 AVERA — AVERA HEALTH PLAN: $14.70
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	$576	$374.40	$101.16 – $576
X-ray of the lower spine, at least 4 views: 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $302.40 AETNA — AETNA: $302.40 AETNA DOMESTIC — AETNA: $302.40 AETNA EAP — AETNA: $302.40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $110.43 ALLIED BENEFIT SYSTEMS — AETNA: $302.40 AMBETTER — AMBETTER MARKETPLACE: $189.31 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $149.87 ASR HEALTH BENEFITS — AETNA: $302.40 AUXIANT — MIDLANDS CHOICE PPO: $403.20
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Doctor (professional) fee · modifier 26 In the file: PR Xr Lumbosacral Spine >= 4 Views\|PROFESSIONAL COMPONENT	$27	$27	$8.09 – $27
X-ray of the lower spine, at least 4 views: 10 of 776 insurance plan rates AETNA — AETNA: $22.06 AETNA DOMESTIC — AETNA: $22.06 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $11.74 AETNA MEDICARE TRANSPLANT — MEDICARE: $11.74 ALIGN SENIOR CARE — MEDICARE: $11.74 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $11.74 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $27 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $14.94 ALLY ALIGN CARE ADV — MEDICARE: $11.74 AMBETTER — AMBETTER: $20.37
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC Xr Lumbosacral Spine >= 4 Views\|TECHNICAL COMPONENT	$576	$374.40	$101.16 – $576
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $111.54 MEDIGOLD MEDICARE ADVANTAGE — MERCYONE HEALTH PLAN MEDICARE ADVANTAGE: $110.43 WELLPOINT MEDICARE ADVANTAGE — WELLPOINT MEDICARE ADVANTAGE: $114.94
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	$1,590	$1,033.50	$110.18 – $1,590
MRI of the lower back (lumbar spine), without contrast: 10 of 117 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $834.75 AETNA — AETNA: $834.75 AETNA DOMESTIC — AETNA: $834.75 AETNA EAP — AETNA: $834.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $110.18 ALLIED BENEFIT SYSTEMS — AETNA: $834.75 AMBETTER — AMBETTER MARKETPLACE: $188.88 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $149.53 ASR HEALTH BENEFITS — AETNA: $834.75 AUXIANT — MIDLANDS CHOICE PPO: $1,113
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Pelvis W/Contrast	$2,625	$1,706.25	$169.72 – $2,625
CT scan of the pelvis, with contrast: 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,378.13 AETNA — AETNA: $1,378.13 AETNA DOMESTIC — AETNA: $1,378.13 AETNA EAP — AETNA: $1,378.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $185.27 ALLIED BENEFIT SYSTEMS — AETNA: $1,378.13 AMBETTER — AMBETTER MARKETPLACE: $317.61 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $251.44 ASR HEALTH BENEFITS — AETNA: $1,378.13 AUXIANT — MIDLANDS CHOICE PPO: $1,837.50
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	$2,385	$1,550.25	$126.66 – $2,385
MRI of a leg joint (such as the knee), without contrast: 10 of 117 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,252.13 AETNA — AETNA: $1,252.13 AETNA DOMESTIC — AETNA: $1,252.13 AETNA EAP — AETNA: $1,252.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $126.66 ALLIED BENEFIT SYSTEMS — AETNA: $1,252.13 AMBETTER — AMBETTER MARKETPLACE: $217.12 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $171.89 ASR HEALTH BENEFITS — AETNA: $1,252.13 AUXIANT — MIDLANDS CHOICE PPO: $1,669.50
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	$1,590	$1,033.50	$126.66 – $1,590
MRI of a leg joint (such as the knee), without contrast: 10 of 117 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $834.75 AETNA — AETNA: $834.75 AETNA DOMESTIC — AETNA: $834.75 AETNA EAP — AETNA: $834.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $126.66 ALLIED BENEFIT SYSTEMS — AETNA: $834.75 AMBETTER — AMBETTER MARKETPLACE: $217.12 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $171.89 ASR HEALTH BENEFITS — AETNA: $834.75 AUXIANT — MIDLANDS CHOICE PPO: $1,113
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	$1,590	$1,033.50	$126.66 – $1,590
MRI of a leg joint (such as the knee), without contrast: 10 of 117 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $834.75 AETNA — AETNA: $834.75 AETNA DOMESTIC — AETNA: $834.75 AETNA EAP — AETNA: $834.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $126.66 ALLIED BENEFIT SYSTEMS — AETNA: $834.75 AMBETTER — AMBETTER MARKETPLACE: $217.12 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $171.89 ASR HEALTH BENEFITS — AETNA: $834.75 AUXIANT — MIDLANDS CHOICE PPO: $1,113
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	$6,826	$4,436.90	$337.57 – $6,826
CT scan of the abdomen and pelvis, with contrast: 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,583.65 AETNA — AETNA: $3,583.65 AETNA DOMESTIC — AETNA: $3,583.65 AETNA EAP — AETNA: $3,583.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $368.51 ALLIED BENEFIT SYSTEMS — AETNA: $3,583.65 AMBETTER — AMBETTER MARKETPLACE: $631.74 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $500.12 ASR HEALTH BENEFITS — AETNA: $3,583.65 AUXIANT — MIDLANDS CHOICE PPO: $4,778.20
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Abdomen Complete	$1,469	$954.85	$101.16 – $1,469
Ultrasound of the abdomen, complete: 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $771.23 AETNA — AETNA: $771.23 AETNA DOMESTIC — AETNA: $771.23 AETNA EAP — AETNA: $771.23 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $110.43 ALLIED BENEFIT SYSTEMS — AETNA: $771.23 AMBETTER — AMBETTER MARKETPLACE: $189.31 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $149.87 ASR HEALTH BENEFITS — AETNA: $771.23 AUXIANT — MIDLANDS CHOICE PPO: $1,028.30
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	$1,042	$677.30	$101.16 – $1,042
Pregnancy ultrasound (after the first trimester): 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $547.05 AETNA — AETNA: $547.05 AETNA DOMESTIC — AETNA: $547.05 AETNA EAP — AETNA: $547.05 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $110.43 ALLIED BENEFIT SYSTEMS — AETNA: $547.05 AMBETTER — AMBETTER MARKETPLACE: $189.31 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $149.87 ASR HEALTH BENEFITS — AETNA: $547.05 AUXIANT — MIDLANDS CHOICE PPO: $729.40
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR US Transvaginal Non Obstetric	$341	$341	$20.87 – $341
Transvaginal ultrasound: 10 of 774 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $106.27 AETNA DOMESTIC — AETNA: $206.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $106.27 AETNA MEDICARE TRANSPLANT — MEDICARE: $106.27 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $85.35 ALIGN SENIOR CARE — MEDICARE: $106.27 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $106.27 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $85.35 AMBETTER — AMBETTER: $184.35 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $106.27
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	$1,044	$678.60	$101.16 – $1,044
Transvaginal ultrasound: 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $548.10 AETNA — AETNA: $548.10 AETNA DOMESTIC — AETNA: $548.10 AETNA EAP — AETNA: $548.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $110.43 ALLIED BENEFIT SYSTEMS — AETNA: $548.10 AMBETTER — AMBETTER MARKETPLACE: $189.31 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $149.87 ASR HEALTH BENEFITS — AETNA: $548.10 AUXIANT — MIDLANDS CHOICE PPO: $730.80
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR US Transvaginal Non Obstetric	Not listed in the file	$275.82	$20.87 – $275.82
Transvaginal ultrasound: 10 of 774 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $106.27 AETNA — AETNA: $206.36 AETNA DOMESTIC — AETNA: $206.36 AETNA MEDICAID — AETNA MEDICAID: $76.76 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $106.27 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $106.27 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $85.35 ALIGN SENIOR CARE — MEDICARE: $106.27 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $106.27 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $85.35
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Lt	$454	$295.10	$77.11 – $454
Diagnostic mammogram, one breast: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $238.35 AETNA — AETNA: $238.35 AETNA DOMESTIC — AETNA: $238.35 AETNA EAP — AETNA: $238.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.11 ALLIED BENEFIT SYSTEMS — AETNA: $238.35 AMBETTER — AMBETTER MARKETPLACE: $132.18 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $104.64 ASR HEALTH BENEFITS — AETNA: $238.35 AUXIANT — MIDLANDS CHOICE PPO: $317.80
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Rt	$454	$295.10	$77.11 – $454
Diagnostic mammogram, one breast: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $238.35 AETNA — AETNA: $238.35 AETNA DOMESTIC — AETNA: $238.35 AETNA EAP — AETNA: $238.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.11 ALLIED BENEFIT SYSTEMS — AETNA: $238.35 AMBETTER — AMBETTER MARKETPLACE: $132.18 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $104.64 ASR HEALTH BENEFITS — AETNA: $238.35 AUXIANT — MIDLANDS CHOICE PPO: $317.80
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Bilateral	$648	$421.20	$98.79 – $648
Diagnostic mammogram, both breasts: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $340.20 AETNA — AETNA: $340.20 AETNA DOMESTIC — AETNA: $340.20 AETNA EAP — AETNA: $340.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $98.79 ALLIED BENEFIT SYSTEMS — AETNA: $340.20 AMBETTER — AMBETTER MARKETPLACE: $169.36 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $134.08 ASR HEALTH BENEFITS — AETNA: $340.20 AUXIANT — MIDLANDS CHOICE PPO: $453.60
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bilateral	$433	$281.45	$81.59 – $433
Screening mammogram, both breasts: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $227.33 AETNA — AETNA: $227.33 AETNA DOMESTIC — AETNA: $227.33 AETNA EAP — AETNA: $227.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $81.59 ALLIED BENEFIT SYSTEMS — AETNA: $227.33 AMBETTER — AMBETTER MARKETPLACE: $139.88 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $110.74 ASR HEALTH BENEFITS — AETNA: $227.33 AUXIANT — MIDLANDS CHOICE PPO: $303.10
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$334	$217.10	$81.59 – $334
Screening mammogram, both breasts: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $175.35 AETNA — AETNA: $175.35 AETNA DOMESTIC — AETNA: $175.35 AETNA EAP — AETNA: $175.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $81.59 ALLIED BENEFIT SYSTEMS — AETNA: $175.35 AMBETTER — AMBETTER MARKETPLACE: $139.88 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $110.74 ASR HEALTH BENEFITS — AETNA: $175.35 AUXIANT — MIDLANDS CHOICE PPO: $233.80

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Ecg 12 Lead Interpretation & Report	$63	$63	$9.44 – $63
Electrocardiogram (ECG/EKG) with reading: 10 of 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $11.83 AETNA DOMESTIC — AETNA: $32.69 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $21.80 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $11.83 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $11.83 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $21.80 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $11.83 ALLY ALIGN CARE ADV — MEDICARE: $11.83 AMBETTER — AMBETTER: $20.52 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $11.83
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Ecg 12 Lead Interpretation & Report	$232	$150.80	$12.88 – $350
Electrocardiogram (ECG/EKG) with reading: 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $121.80 AETNA — AETNA: $121.80 AETNA DOMESTIC — AETNA: $121.80 AETNA EAP — AETNA: $121.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.92 ALLIED BENEFIT SYSTEMS — AETNA: $121.80 AMBETTER — AMBETTER MARKETPLACE: $23.86 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $18.89 ASR HEALTH BENEFITS — AETNA: $121.80 AUXIANT — MIDLANDS CHOICE PPO: $162.40
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Ecg 12 Lead Interpretation & Report	Not listed in the file	$49	$10.72 – $50.92
Electrocardiogram (ECG/EKG) with reading: 10 of 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $13.92 AETNA DOMESTIC — AETNA: $38.45 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $13.92 AETNA MEDICARE TRANSPLANT — MEDICARE: $13.92 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $25.65 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $25.65 ALIGN SENIOR CARE — MEDICARE: $13.92 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $13.92 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $38.43 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $13.92
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cath Lt Heart/Lv Gram	$8,010	$5,206.50	$2,050.56 – $8,010
Left heart catheterization (diagnostic): 10 of 119 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $4,205.25 AETNA — AETNA: $4,205.25 AETNA DOMESTIC — AETNA: $4,205.25 AETNA EAP — AETNA: $4,205.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,424.43 ALLIED BENEFIT SYSTEMS — AETNA: $4,205.25 AMBETTER — AMBETTER MARKETPLACE: $5,870.45 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,647.44 ASR HEALTH BENEFITS — AETNA: $4,205.25 AUXIANT — MIDLANDS CHOICE PPO: $5,607
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cath Lt Heart/Lv Gram	Not listed in the file	$49,209.40	$2.88 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $25,010.24
Left heart catheterization (diagnostic): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $12,194.05 AMBETTER — AMBETTER MARKETPLACE: $20,904.08 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $16,549.06 BCBS GENERIC — WELLMARK PPO: $11,794.23 BCN DOMESTIC — WELLMARK PPO: $11,794.23 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $11,794.23 BLUE CARE NETWORK — WELLMARK PPO: $11,794.23 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $11,794.23 BLUE CROSS - AL — WELLMARK PPO: $11,794.23 BLUE CROSS - AR — WELLMARK PPO: $11,794.23
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Comprehensive Rt Atrial/Ventricular Pacing/Record W/O Arrhythmia	$14,192	$9,224.80	$3,633.15 – $16,897.80
Heart rhythm study (electrophysiology evaluation): 10 of 119 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $7,450.80 AETNA — AETNA: $7,450.80 AETNA DOMESTIC — AETNA: $7,450.80 AETNA EAP — AETNA: $7,450.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8,238.73 ALLIED BENEFIT SYSTEMS — AETNA: $7,450.80 AMBETTER — AMBETTER MARKETPLACE: $14,123.54 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $11,181.13 ASR HEALTH BENEFITS — AETNA: $7,450.80 AUXIANT — MIDLANDS CHOICE PPO: $9,934.40
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Electrophysiologic Comprehensive Transeptal Atrial Fibrillation	$37,863	$24,610.95	$9,692.93 – $56,627.11
Heart rhythm study with ablation for atrial fibrillation: 10 of 119 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $19,878.08 AETNA — AETNA: $19,878.08 AETNA DOMESTIC — AETNA: $19,878.08 AETNA EAP — AETNA: $19,878.08 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $27,609.24 ALLIED BENEFIT SYSTEMS — AETNA: $19,878.08 AMBETTER — AMBETTER MARKETPLACE: $47,330.12 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $37,469.68 ASR HEALTH BENEFITS — AETNA: $19,878.08 AUXIANT — MIDLANDS CHOICE PPO: $26,504.10
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years	$1,785	$1,785	$73.91 – $1,785
Sleep study (overnight, in a sleep lab): 10 of 778 insurance plan rates AETNA — AETNA: $1,221.12 AETNA MEDICARE TRANSPLANT — MEDICARE: $607.08 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $607.08 ALLY ALIGN CARE ADV — MEDICARE: $607.08 AMBETTER — AMBETTER: $1,053.10 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $607.08 AMERIGROUP MEDICAID — MEDICAID IOWA: $543.93 AMERIHEALTH MEDICARE — MEDICARE: $607.08 ANTHEM MYCARE OHIO — MEDICARE: $607.08 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID IOWA: $543.93
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	$5,814	$3,779.10	$830.91 – $5,814
Sleep study (overnight, in a sleep lab): 10 of 121 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,052.35 AETNA — AETNA: $3,052.35 AETNA DOMESTIC — AETNA: $3,052.35 AETNA EAP — AETNA: $3,052.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $907.08 ALLIED BENEFIT SYSTEMS — AETNA: $3,052.35 AMBETTER — AMBETTER MARKETPLACE: $1,555 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,231.04 ASR HEALTH BENEFITS — AETNA: $3,052.35 AUXIANT — MIDLANDS CHOICE PPO: $4,069.80
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years\|PROFESSIONAL COMPONENT	$464	$464	$73.91 – $1,785
Sleep study (overnight, in a sleep lab): 10 of 779 insurance plan rates AETNA — AETNA: $244.97 AETNA MEDICARE TRANSPLANT — MEDICARE: $112.15 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $112.15 ALLY ALIGN CARE ADV — MEDICARE: $112.15 AMBETTER — AMBETTER: $194.55 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $112.15 AMERIGROUP MEDICAID — MEDICAID IOWA: $187.59 AMERIHEALTH MEDICARE — MEDICARE: $112.15 ANTHEM MYCARE OHIO — MEDICARE: $112.15 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID IOWA: $187.59

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	$121	$78.65	$25.38 – $350
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $63.53 AETNA — AETNA: $63.53 AETNA DOMESTIC — AETNA: $63.53 AETNA EAP — AETNA: $63.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $27.27 ALLIED BENEFIT SYSTEMS — AETNA: $63.53 AMBETTER — AMBETTER MARKETPLACE: $46.75 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $37.01 ASR HEALTH BENEFITS — AETNA: $63.53 AUXIANT — MIDLANDS CHOICE PPO: $84.70
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	$121	$78.65	$25.38 – $350
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $63.53 AETNA — AETNA: $63.53 AETNA DOMESTIC — AETNA: $63.53 AETNA EAP — AETNA: $63.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $27.27 ALLIED BENEFIT SYSTEMS — AETNA: $63.53 AMBETTER — AMBETTER MARKETPLACE: $46.75 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $37.01 ASR HEALTH BENEFITS — AETNA: $63.53 AUXIANT — MIDLANDS CHOICE PPO: $84.70
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	$979	$25.38 – $350
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 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: $34.23 CLAIMDOC — CLAIMDOC: $55.94 GEHA — UNITED HEALTHCARE: $350 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	$253	$164.45	$64.77 – $350
Physical therapy evaluation (low complexity): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $132.83 AETNA — AETNA: $132.83 AETNA DOMESTIC — AETNA: $132.83 AETNA EAP — AETNA: $132.83 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.33 ALLIED BENEFIT SYSTEMS — AETNA: $132.83 AMBETTER — AMBETTER MARKETPLACE: $158.27 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $125.30 ASR HEALTH BENEFITS — AETNA: $132.83 AUXIANT — MIDLANDS CHOICE PPO: $177.10
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Evaluation Low Complexity Patient/Family	Not listed in the file	$979	$74.80 – $350
Physical therapy evaluation (low complexity): 10 of 19 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: $115.88 CLAIMDOC — CLAIMDOC: $189.36 GEHA — UNITED HEALTHCARE: $350 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 (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity Patient/Family	$253	$164.45	$64.77 – $350
Physical therapy evaluation (moderate complexity): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $132.83 AETNA — AETNA: $132.83 AETNA DOMESTIC — AETNA: $132.83 AETNA EAP — AETNA: $132.83 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.33 ALLIED BENEFIT SYSTEMS — AETNA: $132.83 AMBETTER — AMBETTER MARKETPLACE: $158.27 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $125.30 ASR HEALTH BENEFITS — AETNA: $132.83 AUXIANT — MIDLANDS CHOICE PPO: $177.10
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation High Complexity Patient/Family	$253	$164.45	$64.77 – $350
Physical therapy evaluation (high complexity): 10 of 49 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $132.83 AETNA — AETNA: $132.83 AETNA DOMESTIC — AETNA: $132.83 AETNA EAP — AETNA: $132.83 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.33 ALLIED BENEFIT SYSTEMS — AETNA: $132.83 AMBETTER — AMBETTER MARKETPLACE: $158.27 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $125.30 ASR HEALTH BENEFITS — AETNA: $132.83 AUXIANT — MIDLANDS CHOICE PPO: $177.10
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Psychotherapy Patient 30 Minutes	$189	$189	$40.83 – $189
Psychotherapy, 30 minutes: 10 of 779 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $67.52 AETNA — AETNA: $133.15 AETNA DOMESTIC — AETNA: $133.15 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $67.52 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $67.52 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $64.02 ALIGN SENIOR CARE — MEDICARE: $67.52 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $94.88 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $67.52 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $67.52
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 30 Minutes	$462	$300.30	$118.27 – $462
Psychotherapy, 30 minutes: 10 of 102 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $242.55 AETNA — AETNA: $242.55 AETNA DOMESTIC — AETNA: $242.55 AETNA EAP — AETNA: $242.55 ALLIED BENEFIT SYSTEMS — AETNA: $242.55 ASR HEALTH BENEFITS — AETNA: $242.55 AUXIANT — MIDLANDS CHOICE PPO: $323.40 BCBS GENERIC — WELLMARK PPO: $181.34 BCN DOMESTIC — WELLMARK PPO: $181.34 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $181.34
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Psychotherapy Patient 45 Minutes	$251	$251	$53.53 – $251
Psychotherapy, 45 minutes: 10 of 779 insurance plan rates AETNA — AETNA: $132.24 AETNA DOMESTIC — AETNA: $132.24 AETNA MEDICAID — AETNA MEDICAID: $180.82 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $89.15 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $126.11 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $53.53 ALLY ALIGN CARE ADV — MEDICARE: $89.15 AMBETTER — AMBETTER: $154.65 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $89.15 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $79.56
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 45 Minutes	$462	$300.30	$118.27 – $462
Psychotherapy, 45 minutes: 10 of 102 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $242.55 AETNA — AETNA: $242.55 AETNA DOMESTIC — AETNA: $242.55 AETNA EAP — AETNA: $242.55 ALLIED BENEFIT SYSTEMS — AETNA: $242.55 ASR HEALTH BENEFITS — AETNA: $242.55 AUXIANT — MIDLANDS CHOICE PPO: $323.40 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 · Doctor (professional) fee In the file: PR Psychotherapy Patient 60 Minutes	$376	$376	$79.75 – $376
Psychotherapy, 60 minutes: 10 of 424 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $131.48 AETNA MEDICAID — AETNA MEDICAID: $267.01 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $131.48 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $131.48 AETNA MEDICARE TRANSPLANT — MEDICARE: $131.48 ALIGN SENIOR CARE — MEDICARE: $131.48 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $131.48 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $186.15 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $131.48 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $131.48
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Psychotherapy Patient 60 Minutes	$376	$376	$85.75 – $342.70
Psychotherapy, 60 minutes: 10 of 355 insurance plan rates AETNA — AETNA: $259.43 AETNA DOMESTIC — AETNA: $259.43 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $121.77 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $121.77 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $121.77 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $121.77 AMERIGROUP MEDICAID — MEDICAID IOWA: $121.77 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $121.77 AMISH MENNONITE — MEDICAID IOWA: $121.77 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID IOWA: $121.77
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Psychotherapy Patient 60 Minutes	$376	$376	$74.50 – $211.30
Psychotherapy, 60 minutes: 10 of 355 insurance plan rates AETNA — AETNA: $194.57 AETNA DOMESTIC — AETNA: $194.57 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $78.61 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $78.61 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $78.61 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $78.61 AMERIGROUP MEDICAID — MEDICAID IOWA: $78.61 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $78.61 AMISH MENNONITE — MEDICAID IOWA: $78.61 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID IOWA: $78.61
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Psychotherapy Family W/O Patient 50 Minutes	$303	$303	$27.88 – $303
Family psychotherapy, without the patient: 10 of 778 insurance plan rates AETNA — AETNA: $190.24 AETNA DOMESTIC — AETNA: $190.24 AETNA MEDICAID — AETNA MEDICAID: $69.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $96.07 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $96.07 ALIGN SENIOR CARE — MEDICARE: $96.07 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $136.91 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $27.88 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $96.07 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $96.07
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Family W/O Patient 50 Minutes	$384	$249.60	$98.30 – $384
Family psychotherapy, without the patient: 10 of 102 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $201.60 AETNA — AETNA: $201.60 AETNA DOMESTIC — AETNA: $201.60 AETNA EAP — AETNA: $201.60 ALLIED BENEFIT SYSTEMS — AETNA: $201.60 ASR HEALTH BENEFITS — AETNA: $201.60 AUXIANT — MIDLANDS CHOICE PPO: $268.80 BCBS GENERIC — WELLMARK PPO: $181.34 BCN DOMESTIC — WELLMARK PPO: $181.34 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $181.34
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Psychotherapy Family W/Patient 50 Minutes	$315	$315	$27.91 – $315
Family psychotherapy, with the patient: 10 of 779 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $99.86 AETNA — AETNA: $198.46 AETNA DOMESTIC — AETNA: $198.46 AETNA MEDICAID — AETNA MEDICAID: $52.35 AETNA MEDICARE TRANSPLANT — MEDICARE: $99.86 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $27.91 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $27.91 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $99.86 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $27.91 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $99.86
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Family W/Patient 50 Minutes	$466	$302.90	$119.30 – $466
Family psychotherapy, with the patient: 10 of 102 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $244.65 AETNA — AETNA: $244.65 AETNA DOMESTIC — AETNA: $244.65 AETNA EAP — AETNA: $244.65 ALLIED BENEFIT SYSTEMS — AETNA: $244.65 ASR HEALTH BENEFITS — AETNA: $244.65 AUXIANT — MIDLANDS CHOICE PPO: $326.20 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 or outpatient · Doctor (professional) fee In the file: PR Psychotherapy Group	$75	$75	$14.38 – $75
Group psychotherapy: 10 of 779 insurance plan rates AETNA — AETNA: $34.97 AETNA DOMESTIC — AETNA: $34.97 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $23.56 AETNA MEDICARE TRANSPLANT — MEDICARE: $17.67 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $15.74 ALIGN SENIOR CARE — MEDICARE: $17.67 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $17.67 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $33.63 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $17.67 ALLY ALIGN CARE ADV — MEDICARE: $17.67
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Group Therapy	$258	$167.70	$66.05 – $258
Group psychotherapy: 10 of 102 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $135.45 AETNA — AETNA: $135.45 AETNA DOMESTIC — AETNA: $135.45 AETNA EAP — AETNA: $135.45 ALLIED BENEFIT SYSTEMS — AETNA: $135.45 ASR HEALTH BENEFITS — AETNA: $135.45 AUXIANT — MIDLANDS CHOICE PPO: $180.60 BCBS GENERIC — WELLMARK PPO: $103.79 BCN DOMESTIC — WELLMARK PPO: $103.79 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $103.79

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	$29,514.35	$371.96 – $8,482.70
Removal of breast growth (open surgery): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4,135.85 AMBETTER — AMBETTER MARKETPLACE: $7,090.02 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $5,612.93 BCBS GENERIC — WELLMARK PPO: $4,000.24 BCN DOMESTIC — WELLMARK PPO: $4,000.24 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $4,000.24 BLUE CARE NETWORK — WELLMARK PPO: $4,000.24 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $4,000.24 BLUE CROSS - AL — WELLMARK PPO: $4,000.24 BLUE CROSS - AR — WELLMARK PPO: $4,000.24
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	$81,256.87	$9.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $27,814.73
Total hip replacement: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13,561.41 AMBETTER — AMBETTER MARKETPLACE: $23,248.13 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $18,404.77 BCBS GENERIC — WELLMARK PPO: $13,116.76 BCN DOMESTIC — WELLMARK PPO: $13,116.76 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $13,116.76 BLUE CARE NETWORK — WELLMARK PPO: $13,116.76 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $13,116.76 BLUE CROSS - AL — WELLMARK PPO: $13,116.76 BLUE CROSS - AR — WELLMARK PPO: $13,116.76
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	$76,625.63	$9.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $27,814.73
Total knee replacement: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13,561.41 AMBETTER — AMBETTER MARKETPLACE: $23,248.13 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $18,404.77 BCBS GENERIC — WELLMARK PPO: $13,116.76 BCN DOMESTIC — WELLMARK PPO: $13,116.76 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $13,116.76 BLUE CARE NETWORK — WELLMARK PPO: $13,116.76 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $13,116.76 BLUE CROSS - AL — WELLMARK PPO: $13,116.76 BLUE CROSS - AR — WELLMARK PPO: $13,116.76
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	$66,795.64	$15,720.43
Shoulder arthroscopy: shaving of shoulder bone: 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7,664.69 AMBETTER — AMBETTER MARKETPLACE: $13,139.47 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $10,402.08 BCBS GENERIC — WELLMARK PPO: $7,413.38 BCN DOMESTIC — WELLMARK PPO: $7,413.38 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $7,413.38 BLUE CARE NETWORK — WELLMARK PPO: $7,413.38 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $7,413.38 BLUE CROSS - AL — WELLMARK PPO: $7,413.38 BLUE CROSS - AR — WELLMARK PPO: $7,413.38
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	$45,685.12	$1.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $7,088.72
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,456.19 AMBETTER — AMBETTER MARKETPLACE: $5,924.90 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,690.54 BCBS GENERIC — WELLMARK PPO: $3,342.87 BCN DOMESTIC — WELLMARK PPO: $3,342.87 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $3,342.87 BLUE CARE NETWORK — WELLMARK PPO: $3,342.87 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $3,342.87 BLUE CROSS - AL — WELLMARK PPO: $3,342.87 BLUE CROSS - AR — WELLMARK PPO: $3,342.87
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	$27,164.21	$12,825.18
Removal of tonsils and adenoids (under age 12): 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6,253.07 AMBETTER — AMBETTER MARKETPLACE: $10,719.56 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $8,486.32 BCBS GENERIC — WELLMARK PPO: $6,048.05 BCN DOMESTIC — WELLMARK PPO: $6,048.05 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $6,048.05 BLUE CARE NETWORK — WELLMARK PPO: $6,048.05 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $6,048.05 BLUE CROSS - AL — WELLMARK PPO: $6,048.05 BLUE CROSS - AR — WELLMARK PPO: $6,048.05
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	$10,469.95	$1,964.96
Upper GI endoscopy (diagnostic): 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $958.04 AMBETTER — AMBETTER MARKETPLACE: $1,642.36 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,300.20 BCBS GENERIC — WELLMARK PPO: $926.63 BCN DOMESTIC — WELLMARK PPO: $926.63 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $926.63 BLUE CARE NETWORK — WELLMARK PPO: $926.63 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $926.63 BLUE CROSS - AL — WELLMARK PPO: $926.63 BLUE CROSS - AR — WELLMARK PPO: $926.63
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	$17,156.61	$69.55 – $1,964.96
Upper GI endoscopy with biopsy: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $958.04 AMBETTER — AMBETTER MARKETPLACE: $1,642.36 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,300.20 BCBS GENERIC — WELLMARK PPO: $926.63 BCN DOMESTIC — WELLMARK PPO: $926.63 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $926.63 BLUE CARE NETWORK — WELLMARK PPO: $926.63 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $926.63 BLUE CROSS - AL — WELLMARK PPO: $926.63 BLUE CROSS - AR — WELLMARK PPO: $926.63
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	$13,152.95	$2,014.73
Colonoscopy (diagnostic): 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $982.31 AMBETTER — AMBETTER MARKETPLACE: $1,683.96 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,333.13 BCBS GENERIC — WELLMARK PPO: $950.10 BCN DOMESTIC — WELLMARK PPO: $950.10 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $950.10 BLUE CARE NETWORK — WELLMARK PPO: $950.10 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $950.10 BLUE CROSS - AL — WELLMARK PPO: $950.10 BLUE CROSS - AR — WELLMARK PPO: $950.10
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	$20,520.45	$69.55 – $2,592.50
Colonoscopy with biopsy: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,264 AMBETTER — AMBETTER MARKETPLACE: $2,166.86 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,715.43 BCBS GENERIC — WELLMARK PPO: $1,222.56 BCN DOMESTIC — WELLMARK PPO: $1,222.56 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $1,222.56 BLUE CARE NETWORK — WELLMARK PPO: $1,222.56 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $1,222.56 BLUE CROSS - AL — WELLMARK PPO: $1,222.56 BLUE CROSS - AR — WELLMARK PPO: $1,222.56
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 53 In the file: HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH)\|DISCONTINUED PROCEDURE	Not listed in the file	$21,494.41	$69.55 – $2,592.50
Colonoscopy with biopsy: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,264 AMBETTER — AMBETTER MARKETPLACE: $2,166.86 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,715.43 BCBS GENERIC — WELLMARK PPO: $1,222.56 BCN DOMESTIC — WELLMARK PPO: $1,222.56 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $1,222.56 BLUE CARE NETWORK — WELLMARK PPO: $1,222.56 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $1,222.56 BLUE CROSS - AL — WELLMARK PPO: $1,222.56 BLUE CROSS - AR — WELLMARK PPO: $1,222.56
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	$14,370.45	$69.55 – $2,592.50
Colonoscopy with removal of polyps (snare): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,264 AMBETTER — AMBETTER MARKETPLACE: $2,166.86 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,715.43 BCBS GENERIC — WELLMARK PPO: $1,222.56 BCN DOMESTIC — WELLMARK PPO: $1,222.56 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $1,222.56 BLUE CARE NETWORK — WELLMARK PPO: $1,222.56 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $1,222.56 BLUE CROSS - AL — WELLMARK PPO: $1,222.56 BLUE CROSS - AR — WELLMARK PPO: $1,222.56
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 53 In the file: HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH)\|DISCONTINUED PROCEDURE	Not listed in the file	$21,494.41	$69.55 – $2,592.50
Colonoscopy with removal of polyps (snare): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,264 AMBETTER — AMBETTER MARKETPLACE: $2,166.86 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,715.43 BCBS GENERIC — WELLMARK PPO: $1,222.56 BCN DOMESTIC — WELLMARK PPO: $1,222.56 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $1,222.56 BLUE CARE NETWORK — WELLMARK PPO: $1,222.56 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $1,222.56 BLUE CROSS - AL — WELLMARK PPO: $1,222.56 BLUE CROSS - AR — WELLMARK PPO: $1,222.56
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	$13,035.80	$899.83 – $2,014.73
Screening colonoscopy (not high risk): 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $982.31 AMBETTER — AMBETTER MARKETPLACE: $1,683.96 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,333.13 BCBS GENERIC — WELLMARK PPO: $950.10 BCN DOMESTIC — WELLMARK PPO: $950.10 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $950.10 BLUE CARE NETWORK — WELLMARK PPO: $950.10 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $950.10 BLUE CROSS - AL — WELLMARK PPO: $950.10 BLUE CROSS - AR — WELLMARK PPO: $950.10
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	$59,346.65	$1.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $13,097.50
Gallbladder removal by laparoscope: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6,385.85 AMBETTER — AMBETTER MARKETPLACE: $10,947.17 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $8,666.51 BCBS GENERIC — WELLMARK PPO: $6,176.47 BCN DOMESTIC — WELLMARK PPO: $6,176.47 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $6,176.47 BLUE CARE NETWORK — WELLMARK PPO: $6,176.47 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $6,176.47 BLUE CROSS - AL — WELLMARK PPO: $6,176.47 BLUE CROSS - AR — WELLMARK PPO: $6,176.47
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	$35,260.90	$7,756.86
Groin (inguinal) hernia repair, age 5 or older: 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,781.95 AMBETTER — AMBETTER MARKETPLACE: $6,483.35 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $5,132.65 BCBS GENERIC — WELLMARK PPO: $3,657.95 BCN DOMESTIC — WELLMARK PPO: $3,657.95 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $3,657.95 BLUE CARE NETWORK — WELLMARK PPO: $3,657.95 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $3,657.95 BLUE CROSS - AL — WELLMARK PPO: $3,657.95 BLUE CROSS - AR — WELLMARK PPO: $3,657.95
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach	$2,050	$1,332.50	$410 – $2,050
Prostate biopsy: 10 of 38 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $1,076.25 AETNA — AETNA: $1,076.25 AETNA DOMESTIC — AETNA: $1,076.25 AETNA EAP — AETNA: $1,076.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $410 ALLIED BENEFIT SYSTEMS — AETNA: $1,076.25 ASR HEALTH BENEFITS — AETNA: $1,076.25 AUXIANT — MIDLANDS CHOICE PPO: $1,435 CENTIVO — CENTIVO: $649.85 CHRISTIAN BROTHER SERVICES — AETNA: $1,076.25
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	$22,560.46	$2.46 (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: $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.) BLUE CROSS - AZ — 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 - CA (ANTHEM) — 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 - CO (ANTHEM) — WELLMARK PPO: $2.46 (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 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$819	$819	$30.84 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $819
Hysteroscopy with biopsy of the uterus lining: 10 of 775 insurance plan rates AETNA DOMESTIC — AETNA: $274.32 AETNA MEDICARE TRANSPLANT — MEDICARE: $91.21 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $30.84 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $91.21 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $30.84 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $91.21 ALLY ALIGN CARE ADV — MEDICARE: $91.21 AMERIGROUP MEDICAID — MEDICAID IOWA: $30.84 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $30.84 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AMISH HOSPITAL AID — AMISH MEDICAL AID: $123.79
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$9,539	$6,200.35	$2,441.98 – $9,539
Hysteroscopy with biopsy of the uterus lining: 10 of 119 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $5,007.98 AETNA — AETNA: $5,007.98 AETNA DOMESTIC — AETNA: $5,007.98 AETNA EAP — AETNA: $5,007.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,419.35 ALLIED BENEFIT SYSTEMS — AETNA: $5,007.98 AMBETTER — AMBETTER MARKETPLACE: $5,861.75 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,640.55 ASR HEALTH BENEFITS — AETNA: $5,007.98 AUXIANT — MIDLANDS CHOICE PPO: $6,677.30
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	$40,391.26	$31.45 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $7,013.16
Hysteroscopy with biopsy of the uterus lining: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,419.35 AMBETTER — AMBETTER MARKETPLACE: $5,861.75 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $4,640.55 BCBS GENERIC — WELLMARK PPO: $3,307.24 BCN DOMESTIC — WELLMARK PPO: $3,307.24 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $3,307.24 BLUE CARE NETWORK — WELLMARK PPO: $3,307.24 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $3,307.24 BLUE CROSS - AL — WELLMARK PPO: $3,307.24 BLUE CROSS - AR — WELLMARK PPO: $3,307.24
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance	$4,419	$2,872.35	$683.01 – $4,419
Spinal injection, lower back (epidural), with imaging guidance: 10 of 119 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $2,319.98 AETNA — AETNA: $2,319.98 AETNA DOMESTIC — AETNA: $2,319.98 AETNA EAP — AETNA: $2,319.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $745.62 ALLIED BENEFIT SYSTEMS — AETNA: $2,319.98 AMBETTER — AMBETTER MARKETPLACE: $1,278.20 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,011.91 ASR HEALTH BENEFITS — AETNA: $2,319.98 AUXIANT — MIDLANDS CHOICE PPO: $3,093.30
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl	$6,026	$3,916.90	$855.81 – $6,026
Nerve root injection, lower back, with imaging guidance: 10 of 119 insurance plan rates 1199 NATIONAL BENEFIT FUND — AETNA: $3,163.65 AETNA — AETNA: $3,163.65 AETNA DOMESTIC — AETNA: $3,163.65 AETNA EAP — AETNA: $2,108.93 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $934.26 ALLIED BENEFIT SYSTEMS — AETNA: $3,163.65 AMBETTER — AMBETTER MARKETPLACE: $1,601.59 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,267.93 ASR HEALTH BENEFITS — AETNA: $3,163.65 AUXIANT — MIDLANDS CHOICE PPO: $4,218.20
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee · modifier 50 In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl\|BILATERAL PROCEDURE	$6,026	$3,916.90	$855.81 – $6,026
Nerve root injection, lower back, with imaging guidance: 10 of 17 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $934.26 AMBETTER — AMBETTER MARKETPLACE: $1,601.59 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $1,267.93 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $943.61 CENTIVO — CENTIVO: $1,172.59 CLAIMDOC — CLAIMDOC: $1,916.19 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $962.86 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $855.81 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $934.26 MEDIGOLD MEDICARE ADVANTAGE — MERCYONE HEALTH PLAN MEDICARE ADVANTAGE: $934.26
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$1,360	$1,360	$122.01 – $1,360
Carpal tunnel release: 10 of 776 insurance plan rates AETNA — AETNA: $613.07 AETNA MEDICAID — AETNA MEDICAID: $214.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $188.09 AETNA MEDICARE TRANSPLANT — MEDICARE: $188.09 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $163.62 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $163.62 ALIGN SENIOR CARE — MEDICARE: $188.09 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $592.69 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $163.62 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $188.09
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$995	$995	$122.01 – $995
Carpal tunnel release: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $188.09 AETNA DOMESTIC — AETNA: $613.07 AETNA MEDICAID — AETNA MEDICAID: $214.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $188.09 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $163.62 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $163.62 ALIGN SENIOR CARE — MEDICARE: $188.09 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $163.62 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $188.09 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $163.62
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	$20,035.17	$9.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,230.54
Carpal tunnel release: 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2,062.65 AMBETTER — AMBETTER MARKETPLACE: $3,535.97 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $2,799.31 BCBS GENERIC — WELLMARK PPO: $1,995.02 BCN DOMESTIC — WELLMARK PPO: $1,995.02 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — WELLMARK PPO: $1,995.02 BLUE CARE NETWORK — WELLMARK PPO: $1,995.02 BLUE CROSS - AK (PREMERA) — WELLMARK PPO: $1,995.02 BLUE CROSS - AL — WELLMARK PPO: $1,995.02 BLUE CROSS - AR — WELLMARK PPO: $1,995.02

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care	$7,499	$7,499	$682.23 – $7,499
Vaginal delivery, with care before and after: 10 of 775 insurance plan rates AETNA — AETNA: $3,380.41 AETNA DOMESTIC — AETNA: $3,380.41 AETNA MEDICAID — AETNA MEDICAID: $920.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $954.91 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $954.91 AETNA MEDICARE TRANSPLANT — MEDICARE: $954.91 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $682.23 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $2,099.94 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $682.23 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $954.91
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care	$5,277	$5,277	$682.23 – $5,277
Vaginal delivery, with care before and after: 10 of 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $954.91 AETNA — AETNA: $3,380.41 AETNA DOMESTIC — AETNA: $3,380.41 AETNA MEDICAID — AETNA MEDICAID: $920.13 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $954.91 AETNA MEDICARE TRANSPLANT — MEDICARE: $954.91 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $682.23 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $682.23 ALIGN SENIOR CARE — MEDICARE: $954.91 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $682.23
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care	$8,236	$8,236	$707.83 – $8,236
Cesarean delivery (C-section), with care before and after: 10 of 776 insurance plan rates AETNA — AETNA: $3,712.46 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,055.97 ALIGN SENIOR CARE — MEDICARE: $1,055.97 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $2,323.32 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $775.43 AMBETTER — AMBETTER: $1,831.78 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $1,108.77 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $775.43 AMERIHEALTH MEDICARE — MEDICARE: $1,055.97 AMISH MENNONITE — MEDICAID IOWA: $775.43
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care	$5,860	$5,860	$707.83 – $5,860
Cesarean delivery (C-section), with care before and after: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,055.97 AETNA — AETNA: $3,712.46 AETNA DOMESTIC — AETNA: $3,712.46 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,055.97 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,055.97 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $775.43 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $775.43 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $2,323.32 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $1,055.97 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $775.43
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee · modifier 80 In the file: PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care\|ASSISTANT SURGEON	$937.60	$937.60	$37.48 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $937.60
Cesarean delivery (C-section), with care before and after: 10 of 776 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $168.95 AETNA — AETNA: $593.99 AETNA DOMESTIC — AETNA: $593.99 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $168.95 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $168.95 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $124.07 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $124.07 ALIGN SENIOR CARE — MEDICARE: $168.95 ALLIED BENEFIT SYSTEMS — MIDLANDS CHOICE: $464.66 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $168.95
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S	$7,792	$7,792	$707.83 – $7,792
Vaginal delivery after a previous C-section, with care before and after: 10 of 775 insurance plan rates AETNA — AETNA: $3,512.61 AETNA DOMESTIC — AETNA: $3,512.61 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $993.36 ALIGN SENIOR CARE — MEDICARE: $993.36 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $993.36 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $993.36 AMBETTER — AMBETTER: $1,723.18 AMERICAN HEALTH PLAN — AMERICAN HEALTH MEDICARE ADVANTAGE: $1,043.03 AMERIHEALTH CARITAS MEDICAID — MEDICAID IOWA: $742.54 AMISH MENNONITE — MEDICAID IOWA: $742.54
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S	Not listed in the file	$5,847.47	$707.83 – $5,847.47
Vaginal delivery after a previous C-section, with care before and after: 10 of 775 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $993.36 AETNA DOMESTIC — AETNA: $3,512.61 AETNA MEDICAID — AETNA MEDICAID: $969.09 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $993.36 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $993.36 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID IOWA: $742.54 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID IOWA: $742.54 ALLWELL MEDICAID ADVANTAGE — MEDICAID IOWA: $742.54 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $993.36 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID IOWA: $742.54

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	$453,640	$70,283.30 – $171,639.23
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 19 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $70,283.30 AMBETTER — AMBETTER MARKETPLACE: $120,485.65 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $95,384.47 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $70,986.13 CENTIVO — CENTIVO: $88,212.71 CLAIMDOC — CLAIMDOC: $144,152.48 GEHA — UNITED HEALTHCARE: $171,639.23 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $72,434.83 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $72,004.81 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $70,283.30
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	$88,100.50	$14,069.68 – $33,842.55
Hip or knee replacement (major joint of the leg), without major complications: 10 of 20 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14,069.68 AMBETTER — AMBETTER MARKETPLACE: $24,119.46 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $19,094.57 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $14,210.38 CENTIVO — CENTIVO: $17,658.89 CLAIMDOC — CLAIMDOC: $28,857.21 GEHA — UNITED HEALTHCARE: $33,842.55 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $14,500.39 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $16,408.50 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $14,069.68
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	$84,990.47	$16,132.13 – $42,832.61
Neck (cervical) spinal fusion, without complications: 10 of 20 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17,737.15 AMBETTER — AMBETTER MARKETPLACE: $30,406.54 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $24,071.84 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $17,914.52 CENTIVO — CENTIVO: $22,261.93 CLAIMDOC — CLAIMDOC: $36,379.25 GEHA — UNITED HEALTHCARE: $42,832.61 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $18,280.12 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $16,132.13 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $17,737.15
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	$44,689.41	$6,932.32 – $21,768.08
Uterus and ovary surgery (not for cancer), without complications: 10 of 20 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $9,143.94 AMBETTER — AMBETTER MARKETPLACE: $15,675.32 AMISH HOSPITAL AID — AMISH HOSPITAL AID: $12,409.63 BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE — WELLMARK MEDICARE ADVANTAGE: $9,235.38 CENTIVO — CENTIVO: $11,476.58 CLAIMDOC — CLAIMDOC: $18,754.41 GEHA — UNITED HEALTHCARE: $21,768.08 HEALTH PARTNERS MEDICARE ADVANTAGE — UNITYPOINT HEALTH PARTNERS MEDICARE ADV: $9,423.86 IOWA TOTAL CARE — IOWA TOTAL CARE MEDICAID: $6,932.32 MEDICARE MEDICAL ASSOCIATES HEALTH PLANS — MEDICAL ASSOCIATES MEDICARE ADVANTAGE: $9,143.94

Source: MercyOne North Iowa 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	1000 Fourth Street SW, Mason City, IA 50401
County	Cerro Gordo County
State	Iowa
Phone	(641) 428‑7000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	160064
Name in Medicare records	MERCYONE NORTH IOWA 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 North Iowa Medical Center — mercyone.org