Does Mt San Rafael Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Mt San Rafael Hospital. In a medical emergency, call 911.

Where is Mt San Rafael Hospital?

410 Benedicta Ave, Trinidad, CO 81082, in Las Animas County, Colorado.

What is the phone number of Mt San Rafael Hospital?

(719) 846-9213, as listed by Medicare (CMS).

What is the Medicare star rating of Mt San Rafael Hospital?

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

Mt San Rafael Hospital — Trinidad, CO

Quick answers

Does Mt San Rafael Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Mt San Rafael Hospital. In a medical emergency, call 911.
Where is Mt San Rafael Hospital?: 410 Benedicta Ave, Trinidad, CO 81082, in Las Animas County, Colorado.
What is the phone number of Mt San Rafael Hospital?: (719) 846-9213, as listed by Medicare (CMS).
What is the Medicare star rating of Mt San Rafael Hospital?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[5][6][10][11][12][13][14][15]}

Emergency medicine
Radiology
Gynecology
General surgery
Orthopaedics
Interventional pain therapy
Cardiopulmonary therapy
Rehabilitation
Laboratory/Pathology
Hospitalist medicine

Conditions treated^[8][13]

Fibroids and endometriosis
Ovarian cysts and polycystic ovary syndrome
Urinary incontinence
Menopause and perimenopause
Sexual assault
Intimate partner violence
Child abuse
Elder abuse

Treatments^{[8][10][11][12][13][14]}

Cardiac rehabilitation
Pulmonary rehabilitation
Speech therapy
Physical therapy
Oxygen therapy including CPAP/BIPAP
Ventilator care
IV therapy
IV antibiotics
Reclast infusions
Blood transfusion
Hormone replacement therapy
PTNS (percutaneous tibial neurostimulation)
Epidural steroid injection
Facet injection
Cooled radiofrequency treatment
Medical forensic exam

Procedures^{[5][10][12][13]}

3D mammography
CT scan
MRI
Ultrasound
Bone density testing
Nuclear medicine
Echocardiogram
EKG
Pulmonary function tests
Abdominal hysterectomy
Vaginal hysterectomy
Laparoscopic tubal ligation
Endometrial ablation
Dilation and curettage
LEEP
Myomectomy
Pelvic organ prolapse surgery
Gynecologic laparoscopy
Endoscopy

Programs and centers^{[4][8][10][14]}

SANE Program
Diabetic education
Cardiac rehabilitation
Pulmonary rehabilitation

Emergency care (hospital website)^[6]

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

Doctors and clinicians (137)

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

Main specialties

Doctors with a page on this site (137)

Adam Strunk, MDInterventional Cardiology
Aileen C. Swope, NPNurse Practitioner
Alonso V. Pacheco, MDHematology/Oncology
Amy C. Ford, NPNurse Practitioner
Andrew C. Glass, PAPhysician Assistant
Anthony J. Daurora Jr., PAPhysician Assistant
Antonio FelizUrology
Arlene V. Shanklin, MDPsychiatry
Ashakiran J. Sunku, MDNeurology
Audrey Gentile, NPNurse Practitioner
Austin Badeau, MDEmergency Medicine
Ayushi Mendiratta, MDInternal Medicine
Bhavith Aruni Babu, MDInterventional Cardiology
Brandie Quick, NPNurse Practitioner
Brandy Lane-GilyardNurse Practitioner
Brice Alvord, MDDiagnostic Radiology
Brittney P. Quandt, NPNurse Practitioner
Cheryl D. RobsonNurse Practitioner
Chike Onyejekwe, MDHospitalist
Christian M. Birky, PAPhysician Assistant
Christopher G. Vialpando, MDFamily Practice
Christopher L. Poland, CNACertified Registered Nurse Anesthetist (CRNA)
Craig P. Lance, MDDiagnostic Radiology
Craig S. Shapiro, MDPulmonary Disease

And 113 more: the button below opens the full list.

Other emergency rooms nearby

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

Miners' Colfax Medical Center22 mi · Raton, NM · Critical Access Hospital
Spanish Peaks Regional Health Center35 mi · Walsenburg, CO · Critical Access Hospital
St Mary-Corwin Hospital74 mi · Pueblo, CO · Acute Care Hospital
Arkansas Valley Regional Medical Center76 mi · Lajuna, CO · Critical Access Hospital
Parkview Medical Center, Inc77 mi · Pueblo, CO · Acute Care Hospital

Other hospitals nearby

Holy Cross Hospital a Div of Taos Health Systems77 mi · Taos, NM · Critical Access Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Trinidad Rehabilitation and Healthcare Center0.1 mi · Trinidad, CO · 3 of 5 stars
Miners Colfax Medical Center19 mi · Raton, NM · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Mt Rose Health Center Palliative Care and Hospice Inc.4.2 mi · Trinidad, CO

All hospice providers 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

Salud Trinidad1.8 mi · Trinidad, CO · Community health center
Salud Trinidad Dental Clinic1.9 mi · Trinidad, CO · Community health center
Raton Primary Care21 mi · Raton, NM · Community health center

Clinics and urgent care

Mt San Rafael Hospital4.2 mi · Trinidad, CO · Rural health clinic

Pharmacies

Safeway Inc4.2 mi · Trinidad, CO · Community/retail pharmacy
Walmart Inc.4.2 mi · Trinidad, CO · Community/retail pharmacy

Assisted living nearby

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

The Legacy at Trinidad4.2 mi · Trinidad, CO

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	75%National average: 72%
Would definitely recommend the hospital	82%National average: 71%
Nurses “always” communicated well	86%National average: 80%
Doctors “always” communicated well	83%National average: 80%
Staff “always” explained medicines before giving them	59%National average: 62%
Were given information about recovery at home	81%National average: 86%
Room and bathroom “always” clean	75%National average: 74%
Area around the room “always” quiet at night	75%National average: 60%
Completed surveys	52Response rate: 18%

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

Infections caught in the hospital

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

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

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	15.7%
Deaths within 30 days: COPD patients	9%
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	17.2%
Readmitted within 30 days: COPD	19.2%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	107 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	93%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 Colorado Best hospitals in Colorado

Prices

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

$ 28 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: RHC DET/DET/LOW	$275	Not listed in the file	$26.44 – $1,322
New patient office visit (about 30–44 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $77 AARP SUPPLEMENT — AARP SUPPLEMENT: $275 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $275 AETNA — AETNA: $269.50 AETNA — AETNA MEDICARE LIFE INS: $77 AETNA — AETNA SENIOR SUPPLEMENTAL: $275 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $275 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $275 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $275 ASSURANT HEALTH — ASSURANT HEALTH: $275
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: NEW PT LVL 3 OFFICE VISIT	$262	Not listed in the file	$26.44 – $1,322
New patient office visit (about 30–44 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $73.36 AARP SUPPLEMENT — AARP SUPPLEMENT: $262 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $262 AETNA — AETNA: $256.76 AETNA — AETNA MEDICARE LIFE INS: $73.36 AETNA — AETNA SENIOR SUPPLEMENTAL: $262 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $262 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $262 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $262 ASSURANT HEALTH — ASSURANT HEALTH: $262
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: OV E&M NEW PT 30 MIN	$237.50	Not listed in the file	$26.44 – $1,322
New patient office visit (about 30–44 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $66.50 AARP SUPPLEMENT — AARP SUPPLEMENT: $237.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $237.50 AETNA — AETNA: $232.75 AETNA — AETNA MEDICARE LIFE INS: $66.50 AETNA — AETNA SENIOR SUPPLEMENTAL: $237.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $237.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $237.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $237.50 ASSURANT HEALTH — ASSURANT HEALTH: $237.50
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: RHC COMP/COMP/MOD	$353.50	Not listed in the file	$40.89 – $2,044.50
New patient office visit (about 45–59 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $98.98 AARP SUPPLEMENT — AARP SUPPLEMENT: $353.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $353.50 AETNA — AETNA: $346.43 AETNA — AETNA MEDICARE LIFE INS: $98.98 AETNA — AETNA SENIOR SUPPLEMENTAL: $353.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $353.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $353.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $353.50 ASSURANT HEALTH — ASSURANT HEALTH: $353.50
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: NEW PATIENT LEVEL 4	$498	Not listed in the file	$40.89 – $2,044.50
New patient office visit (about 45–59 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $139.44 AARP SUPPLEMENT — AARP SUPPLEMENT: $498 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $498 AETNA — AETNA: $488.04 AETNA — AETNA MEDICARE LIFE INS: $139.44 AETNA — AETNA SENIOR SUPPLEMENTAL: $498 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $498 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $498 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $498 ASSURANT HEALTH — ASSURANT HEALTH: $498
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: OV E&M NEW PT 45 MIN	$405	Not listed in the file	$40.89 – $2,044.50
New patient office visit (about 45–59 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $113.40 AARP SUPPLEMENT — AARP SUPPLEMENT: $405 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $405 AETNA — AETNA: $396.90 AETNA — AETNA MEDICARE LIFE INS: $113.40 AETNA — AETNA SENIOR SUPPLEMENTAL: $405 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $405 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $405 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $405 ASSURANT HEALTH — ASSURANT HEALTH: $405
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: RHC COMP/COMP/HIGH	$495.50	Not listed in the file	$53.21 – $2,873
New patient office visit (about 60–74 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $138.74 AARP SUPPLEMENT — AARP SUPPLEMENT: $495.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $495.50 AETNA — AETNA: $485.59 AETNA — AETNA MEDICARE LIFE INS: $138.74 AETNA — AETNA SENIOR SUPPLEMENTAL: $495.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $495.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $495.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $495.50 ASSURANT HEALTH — ASSURANT HEALTH: $495.50
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: NEW PATIENT LEVEL 5	$619.50	Not listed in the file	$53.21 – $2,873
New patient office visit (about 60–74 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $173.46 AARP SUPPLEMENT — AARP SUPPLEMENT: $619.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $619.50 AETNA — AETNA: $607.11 AETNA — AETNA MEDICARE LIFE INS: $173.46 AETNA — AETNA SENIOR SUPPLEMENTAL: $619.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $619.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $619.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $619.50 ASSURANT HEALTH — ASSURANT HEALTH: $619.50
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: OV E&M NEW PT 60 MIN	$515	Not listed in the file	$53.21 – $2,873
New patient office visit (about 60–74 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $144.20 AARP SUPPLEMENT — AARP SUPPLEMENT: $515 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $515 AETNA — AETNA: $504.70 AETNA — AETNA MEDICARE LIFE INS: $144.20 AETNA — AETNA SENIOR SUPPLEMENTAL: $515 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $515 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $515 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $515 ASSURANT HEALTH — ASSURANT HEALTH: $515
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: RHC EPF/EPF/LOW 2/3	$160	Not listed in the file	$15.50 – $775
Established patient office visit (about 20–29 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $44.80 AARP SUPPLEMENT — AARP SUPPLEMENT: $160 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $160 AETNA — AETNA: $156.80 AETNA — AETNA MEDICARE LIFE INS: $44.80 AETNA — AETNA SENIOR SUPPLEMENTAL: $160 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $160 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $160 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $160 ASSURANT HEALTH — ASSURANT HEALTH: $160
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: LVL 3 OFFICE VISIT	$138	Not listed in the file	$15.50 – $775
Established patient office visit (about 20–29 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $38.64 AARP SUPPLEMENT — AARP SUPPLEMENT: $138 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $138 AETNA — AETNA: $135.24 AETNA — AETNA MEDICARE LIFE INS: $38.64 AETNA — AETNA SENIOR SUPPLEMENTAL: $138 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $138 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $138 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $138 ASSURANT HEALTH — ASSURANT HEALTH: $138
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: LEVEL 3 OFFICE VISIT ESTABLISHED	$138	Not listed in the file	$15.50 – $775
Established patient office visit (about 20–29 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $38.64 AARP SUPPLEMENT — AARP SUPPLEMENT: $138 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $138 AETNA — AETNA: $135.24 AETNA — AETNA MEDICARE LIFE INS: $38.64 AETNA — AETNA SENIOR SUPPLEMENTAL: $138 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $138 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $138 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $138 ASSURANT HEALTH — ASSURANT HEALTH: $138
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: RHC DET/SET/MOD 2/3	$249.50	Not listed in the file	$19.09 – $954.50
Established patient office visit (about 30–39 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $69.86 AARP SUPPLEMENT — AARP SUPPLEMENT: $249.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $249.50 AETNA — AETNA: $244.51 AETNA — AETNA MEDICARE LIFE INS: $69.86 AETNA — AETNA SENIOR SUPPLEMENTAL: $249.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $249.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $249.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $249.50 ASSURANT HEALTH — ASSURANT HEALTH: $249.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: EST PATIENT LEVEL 4	$304.50	Not listed in the file	$19.09 – $954.50
Established patient office visit (about 30–39 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $85.26 AARP SUPPLEMENT — AARP SUPPLEMENT: $304.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $304.50 AETNA — AETNA: $298.41 AETNA — AETNA MEDICARE LIFE INS: $85.26 AETNA — AETNA SENIOR SUPPLEMENTAL: $304.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $304.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $304.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $304.50 ASSURANT HEALTH — ASSURANT HEALTH: $304.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: LEVEL 4 OFFICE VISIT ESTABLISHED	$304.50	Not listed in the file	$19.09 – $954.50
Established patient office visit (about 30–39 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $85.26 AARP SUPPLEMENT — AARP SUPPLEMENT: $304.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $304.50 AETNA — AETNA: $298.41 AETNA — AETNA MEDICARE LIFE INS: $85.26 AETNA — AETNA SENIOR SUPPLEMENTAL: $304.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $304.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $304.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $304.50 ASSURANT HEALTH — ASSURANT HEALTH: $304.50
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: LVL 3 OFFICE CONSULT	$306	Not listed in the file	$6.12 – $306
Office consultation with a specialist (moderate): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $85.68 AARP SUPPLEMENT — AARP SUPPLEMENT: $306 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $306 AETNA — AETNA: $299.88 AETNA — AETNA MEDICARE LIFE INS: $85.68 AETNA — AETNA SENIOR SUPPLEMENTAL: $306 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $306 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $306 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $306 ASSURANT HEALTH — ASSURANT HEALTH: $306
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: OFF/OP CNSLTJ NEW/EST LOW 30	$306	Not listed in the file	$6.12 – $306
Office consultation with a specialist (moderate): rates for 7 insurance plans GEHA — GEHA: $293.76 GOLDEN RULE — GOLDEN RULE INSURANCE: $293.76 UMR MSA — UMR MSA: $293.76 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $293.76 UNITED HEALTHCARE — ALL SAVERS: $293.76 UNITED HEALTHCARE — MISC UNITED HEALTHCARE: $293.76 UNITED HEALTHCARE — UNITED HEALTHCARE: $293.76
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: OFFICE VISIT LVL 4	$338	Not listed in the file	$6.76 – $338
Office consultation with a specialist (moderate to high): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $94.64 AARP SUPPLEMENT — AARP SUPPLEMENT: $338 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $338 AETNA — AETNA: $331.24 AETNA — AETNA MEDICARE LIFE INS: $94.64 AETNA — AETNA SENIOR SUPPLEMENTAL: $338 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $338 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $338 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $338 ASSURANT HEALTH — ASSURANT HEALTH: $338
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: OFF/OP CNSLTJ NEW/EST MOD 40	$338	Not listed in the file	$6.76 – $338
Office consultation with a specialist (moderate to high): rates for 7 insurance plans GEHA — GEHA: $324.48 GOLDEN RULE — GOLDEN RULE INSURANCE: $324.48 UMR MSA — UMR MSA: $324.48 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $324.48 UNITED HEALTHCARE — ALL SAVERS: $324.48 UNITED HEALTHCARE — MISC UNITED HEALTHCARE: $324.48 UNITED HEALTHCARE — UNITED HEALTHCARE: $324.48
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: RHC NEW AGE 18-39	$348.50	Not listed in the file	$16.93 – $846.50
Preventive checkup, new patient, age 18–39: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $97.58 AARP SUPPLEMENT — AARP SUPPLEMENT: $348.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $348.50 AETNA — AETNA: $341.53 AETNA — AETNA MEDICARE LIFE INS: $97.58 AETNA — AETNA SENIOR SUPPLEMENTAL: $348.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $348.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $348.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $348.50 ASSURANT HEALTH — ASSURANT HEALTH: $348.50
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: RHC DOT PX AGE<40	$183.50	Not listed in the file	$16.93 – $846.50
Preventive checkup, new patient, age 18–39: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $51.38 AARP SUPPLEMENT — AARP SUPPLEMENT: $183.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $183.50 AETNA — AETNA: $179.83 AETNA — AETNA MEDICARE LIFE INS: $51.38 AETNA — AETNA SENIOR SUPPLEMENTAL: $183.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $183.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $183.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $183.50 ASSURANT HEALTH — ASSURANT HEALTH: $183.50
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: NEW PATIENT PREVENTIVE AGE 18-39	$314.50	Not listed in the file	$16.93 – $846.50
Preventive checkup, new patient, age 18–39: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $88.06 AARP SUPPLEMENT — AARP SUPPLEMENT: $314.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $314.50 AETNA — AETNA: $308.21 AETNA — AETNA MEDICARE LIFE INS: $88.06 AETNA — AETNA SENIOR SUPPLEMENTAL: $314.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $314.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $314.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $314.50 ASSURANT HEALTH — ASSURANT HEALTH: $314.50
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: RHC NEW AGE 40-64	$351.50	Not listed in the file	$14.49 – $724.50
Preventive checkup, new patient, age 40–64: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $98.42 AARP SUPPLEMENT — AARP SUPPLEMENT: $351.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $351.50 AETNA — AETNA: $344.47 AETNA — AETNA MEDICARE LIFE INS: $98.42 AETNA — AETNA SENIOR SUPPLEMENTAL: $351.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $351.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $351.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $351.50 ASSURANT HEALTH — ASSURANT HEALTH: $351.50
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: NEW PATIENT PREVENTIVE AGE 40-64	$373	Not listed in the file	$14.49 – $724.50
Preventive checkup, new patient, age 40–64: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $104.44 AARP SUPPLEMENT — AARP SUPPLEMENT: $373 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $373 AETNA — AETNA: $365.54 AETNA — AETNA MEDICARE LIFE INS: $104.44 AETNA — AETNA SENIOR SUPPLEMENTAL: $373 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $373 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $373 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $373 ASSURANT HEALTH — ASSURANT HEALTH: $373
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: PREV VISIT NEW AGE 40-64	$351.50	Not listed in the file	$14.49 – $724.50
Preventive checkup, new patient, age 40–64: rates for 7 insurance plans GEHA — GEHA: $337.44 GOLDEN RULE — GOLDEN RULE INSURANCE: $337.44 UMR MSA — UMR MSA: $337.44 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $337.44 UNITED HEALTHCARE — ALL SAVERS: $337.44 UNITED HEALTHCARE — MISC UNITED HEALTHCARE: $337.44 UNITED HEALTHCARE — UNITED HEALTHCARE: $337.44
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: PRO FEE EVAL MED COM	$433	Not listed in the file	$19.66 – $1,637.50
Emergency room visit (moderate): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $121.24 AARP SUPPLEMENT — AARP SUPPLEMENT: $433 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $433 AETNA — AETNA: $424.34 AETNA — AETNA MEDICARE LIFE INS: $121.24 AETNA — AETNA SENIOR SUPPLEMENTAL: $433 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $433 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $433 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $433 ASSURANT HEALTH — ASSURANT HEALTH: $433
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: LEVEL III FACILITY	$1,204.50	Not listed in the file	$19.66 – $1,637.50
Emergency room visit (moderate): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $337.26 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,204.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,204.50 AETNA — AETNA: $1,180.41 AETNA — AETNA MEDICARE LIFE INS: $337.26 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,204.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,204.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,204.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,204.50 ASSURANT HEALTH — ASSURANT HEALTH: $1,204.50
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: EMERGENCY DEPT VISIT LOW MDM	$1,204.50	Not listed in the file	$19.66 – $1,637.50
Emergency room visit (moderate): 10 of 62 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $68.37 AETNA — AETNA MEDICARE LIFE INS: $171.68 BANKERS LIFE — BANKERS LIFE: $171.68 BCBS OF NM — MEDICAID NEW MEXICO IN: $140.18 CIGNA HEALTHCARE — ALLEGIANCE: $402.69 CIGNA HEALTHCARE — CIGNA: $402.69 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $402.69 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $171.68 CIRSA — CIRSA: $77.44 CMI — CMI: $77.44
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: PRO FEE EVAL MOD COM	$641.50	Not listed in the file	$22 – $2,428
Emergency room visit (moderately high): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $179.62 AARP SUPPLEMENT — AARP SUPPLEMENT: $641.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $641.50 AETNA — AETNA: $628.67 AETNA — AETNA MEDICARE LIFE INS: $179.62 AETNA — AETNA SENIOR SUPPLEMENTAL: $641.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $641.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $641.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $641.50 ASSURANT HEALTH — ASSURANT HEALTH: $641.50
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: LEVEL IV FACILITY	$1,786.50	Not listed in the file	$22 – $2,428
Emergency room visit (moderately high): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $500.22 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,786.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,786.50 AETNA — AETNA: $1,750.77 AETNA — AETNA MEDICARE LIFE INS: $500.22 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,786.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,786.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,786.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,786.50 ASSURANT HEALTH — ASSURANT HEALTH: $1,786.50
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: EMERGENCY DEPT VISIT MOD MDM	$641.50	Not listed in the file	$22 – $2,428
Emergency room visit (moderately high): 10 of 62 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $116.51 AETNA — AETNA MEDICARE LIFE INS: $200.64 BANKERS LIFE — BANKERS LIFE: $200.64 BCBS OF NM — MEDICAID NEW MEXICO IN: $223.17 CIGNA HEALTHCARE — ALLEGIANCE: $596.59 CIGNA HEALTHCARE — CIGNA: $596.59 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $596.59 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $200.64 CIRSA — CIRSA: $131.71 CMI — CMI: $131.71
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: PRO FEE EVAL HIGH CO	$1,007	Not listed in the file	$22 – $3,611.50
Emergency room visit (high): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $281.96 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,007 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,007 AETNA — AETNA: $986.86 AETNA — AETNA MEDICARE LIFE INS: $281.96 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,007 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,007 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,007 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,007 ASSURANT HEALTH — ASSURANT HEALTH: $1,007
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: LEVEL V FACILITY	$2,604.50	Not listed in the file	$22 – $3,611.50
Emergency room visit (high): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $729.26 AARP SUPPLEMENT — AARP SUPPLEMENT: $2,604.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $2,604.50 AETNA — AETNA: $2,552.41 AETNA — AETNA MEDICARE LIFE INS: $729.26 AETNA — AETNA SENIOR SUPPLEMENTAL: $2,604.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $2,604.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $2,604.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $2,604.50 ASSURANT HEALTH — ASSURANT HEALTH: $2,604.50
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: EMERGENCY DEPT VISIT HI MDM	$2,604.50	Not listed in the file	$22 – $3,611.50
Emergency room visit (high): 10 of 62 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $168.83 AETNA — AETNA MEDICARE LIFE INS: $101.04 BANKERS LIFE — BANKERS LIFE: $101.04 BCBS OF NM — MEDICAID NEW MEXICO IN: $329.73 CIGNA HEALTHCARE — ALLEGIANCE: $936.51 CIGNA HEALTHCARE — CIGNA: $936.51 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $936.51 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $101.04 CIRSA — CIRSA: $190.72 CMI — CMI: $190.72

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC METABOLIC PROFILE	$196	Not listed in the file	$7.65 – $382.50
Basic metabolic panel (blood test): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $54.88 AARP SUPPLEMENT — AARP SUPPLEMENT: $196 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $196 AETNA — AETNA: $192.08 AETNA — AETNA MEDICARE LIFE INS: $54.88 AETNA — AETNA SENIOR SUPPLEMENTAL: $196 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $196 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $196 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $196 ASSURANT HEALTH — ASSURANT HEALTH: $196
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC METABOLIC PROFILE DUPLICATE TEST	$186.50	Not listed in the file	$7.65 – $382.50
Basic metabolic panel (blood test): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $52.22 AARP SUPPLEMENT — AARP SUPPLEMENT: $186.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $186.50 AETNA — AETNA: $182.77 AETNA — AETNA MEDICARE LIFE INS: $52.22 AETNA — AETNA SENIOR SUPPLEMENTAL: $186.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $186.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $186.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $186.50 ASSURANT HEALTH — ASSURANT HEALTH: $186.50
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC METABOLIC PNL TOTAL CA	$196	Not listed in the file	$7.65 – $382.50
Basic metabolic panel (blood test): 10 of 48 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $8.46 AETNA — AETNA MEDICARE LIFE INS: $8.46 BANKERS LIFE — BANKERS LIFE: $8.46 BCBS OF NM — MEDICAID NEW MEXICO IN: $10.15 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $8.46 CIRSA — CIRSA: $8.46 CMI — CMI: $8.46 CORVEL — CORVEL: $8.46 CTSI WOODMAN & POWERS — CTSI: $8.46 DEVOTED — DEVOTED HEALTH PLAN: $8.88
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMPLETE METABO PROF	$275	Not listed in the file	$5.85 – $292.50
Comprehensive metabolic panel (blood test): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $77 AARP SUPPLEMENT — AARP SUPPLEMENT: $275 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $275 AETNA — AETNA: $269.50 AETNA — AETNA MEDICARE LIFE INS: $77 AETNA — AETNA SENIOR SUPPLEMENTAL: $275 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $275 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $275 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $275 ASSURANT HEALTH — ASSURANT HEALTH: $275
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMPLETE METABOLIC PANEL LABCORP	$17.50	Not listed in the file	$5.85 – $292.50
Comprehensive metabolic panel (blood test): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $4.90 AARP SUPPLEMENT — AARP SUPPLEMENT: $17.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $17.50 AETNA — AETNA: $17.15 AETNA — AETNA MEDICARE LIFE INS: $4.90 AETNA — AETNA SENIOR SUPPLEMENTAL: $17.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $17.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $17.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $17.50 ASSURANT HEALTH — ASSURANT HEALTH: $17.50
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMPREHEN METABOLIC PANEL	$275	Not listed in the file	$5.85 – $292.50
Comprehensive metabolic panel (blood test): 10 of 48 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $10.56 AETNA — AETNA MEDICARE LIFE INS: $10.56 BANKERS LIFE — BANKERS LIFE: $10.56 BCBS OF NM — MEDICAID NEW MEXICO IN: $12.67 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $10.56 CIRSA — CIRSA: $10.56 CMI — CMI: $10.56 CORVEL — CORVEL: $10.56 CTSI WOODMAN & POWERS — CTSI: $10.56 DEVOTED — DEVOTED HEALTH PLAN: $11.09
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: WISEWOMAN CORONARY RISK/LIPID	$39.50	Not listed in the file	$10.97 – $548.50
Cholesterol panel (lipid panel): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $11.06 AARP SUPPLEMENT — AARP SUPPLEMENT: $39.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $39.50 AETNA — AETNA: $38.71 AETNA — AETNA MEDICARE LIFE INS: $11.06 AETNA — AETNA SENIOR SUPPLEMENTAL: $39.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $39.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $39.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $39.50 ASSURANT HEALTH — ASSURANT HEALTH: $39.50
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: VAP LIPID PANEL	$155.50	Not listed in the file	$10.97 – $548.50
Cholesterol panel (lipid panel): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $43.54 AARP SUPPLEMENT — AARP SUPPLEMENT: $155.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $155.50 AETNA — AETNA: $152.39 AETNA — AETNA MEDICARE LIFE INS: $43.54 AETNA — AETNA SENIOR SUPPLEMENTAL: $155.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $155.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $155.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $155.50 ASSURANT HEALTH — ASSURANT HEALTH: $155.50
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: CORONARY RISK/LIPID	$155.50	Not listed in the file	$10.97 – $548.50
Cholesterol panel (lipid panel): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $43.54 AARP SUPPLEMENT — AARP SUPPLEMENT: $155.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $155.50 AETNA — AETNA: $152.39 AETNA — AETNA MEDICARE LIFE INS: $43.54 AETNA — AETNA SENIOR SUPPLEMENTAL: $155.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $155.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $155.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $155.50 ASSURANT HEALTH — ASSURANT HEALTH: $155.50
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: RENAL FUNCTION PANEL	$248.50	Not listed in the file	$4.97 – $248.50
Kidney function panel: 10 of 137 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $69.58 AARP SUPPLEMENT — AARP SUPPLEMENT: $248.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $248.50 AETNA — AETNA: $243.53 AETNA — AETNA MEDICARE LIFE INS: $69.58 AETNA — AETNA SENIOR SUPPLEMENTAL: $248.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $248.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $248.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $248.50 ASSURANT HEALTH — ASSURANT HEALTH: $248.50
Kidney function panel CPT 80069 · Inpatient or outpatient · modifier QW In the file: RENAL FUNCTION PANEL	$248.50	Not listed in the file	$8.68 – $9.11
Kidney function panel: 10 of 34 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $8.68 AETNA — AETNA MEDICARE LIFE INS: $8.68 BANKERS LIFE — BANKERS LIFE: $8.68 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $8.68 CIRSA — CIRSA: $8.68 CMI — CMI: $8.68 CORVEL — CORVEL: $8.68 CTSI WOODMAN & POWERS — CTSI: $8.68 DEVOTED — DEVOTED HEALTH PLAN: $9.11 FREEDOM NETWORK SELECT — FREEDOM NETWORK SELECT: $8.68
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HEPATIC/LIVER FUNCTION PANEL	$192	Not listed in the file	$8.17 – $473.50
Liver function panel: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $53.76 AARP SUPPLEMENT — AARP SUPPLEMENT: $192 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $192 AETNA — AETNA: $188.16 AETNA — AETNA MEDICARE LIFE INS: $53.76 AETNA — AETNA SENIOR SUPPLEMENTAL: $192 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $192 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $192 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $192 ASSURANT HEALTH — ASSURANT HEALTH: $192
Liver function panel CPT 80076 · Inpatient or outpatient In the file: LIVER FIBROSIS RISK PANEL LABCORP	$87.50	Not listed in the file	$8.17 – $473.50
Liver function panel: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $24.50 AARP SUPPLEMENT — AARP SUPPLEMENT: $87.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $87.50 AETNA — AETNA: $85.75 AETNA — AETNA MEDICARE LIFE INS: $24.50 AETNA — AETNA SENIOR SUPPLEMENTAL: $87.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $87.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $87.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $87.50 ASSURANT HEALTH — ASSURANT HEALTH: $87.50
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HEPATIC FUNCTION PANEL LCA	$122	Not listed in the file	$8.17 – $473.50
Liver function panel: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $34.16 AARP SUPPLEMENT — AARP SUPPLEMENT: $122 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $122 AETNA — AETNA: $119.56 AETNA — AETNA MEDICARE LIFE INS: $34.16 AETNA — AETNA SENIOR SUPPLEMENTAL: $122 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $122 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $122 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $122 ASSURANT HEALTH — ASSURANT HEALTH: $122
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URINE DIP W/MICRO	$101	Not listed in the file	$2.02 – $101
Urine test (automated, with microscope): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $28.28 AARP SUPPLEMENT — AARP SUPPLEMENT: $101 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $101 AETNA — AETNA: $98.98 AETNA — AETNA MEDICARE LIFE INS: $28.28 AETNA — AETNA SENIOR SUPPLEMENTAL: $101 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $101 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $101 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $101 ASSURANT HEALTH — ASSURANT HEALTH: $101
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URINALYSIS AUTO W/SCOPE	$101	Not listed in the file	$2.02 – $101
Urine test (automated, with microscope): 10 of 48 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $3.17 AETNA — AETNA MEDICARE LIFE INS: $3.17 BANKERS LIFE — BANKERS LIFE: $3.17 BCBS OF NM — MEDICAID NEW MEXICO IN: $3.80 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $3.17 CIRSA — CIRSA: $3.17 CMI — CMI: $3.17 CORVEL — CORVEL: $3.17 CTSI WOODMAN & POWERS — CTSI: $3.17 DEVOTED — DEVOTED HEALTH PLAN: $3.33
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: UR DIPSTICK N-AUTOM WO MICRO	$66	Not listed in the file	$3.02 – $151
Urine test (manual, without microscope): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $18.48 AARP SUPPLEMENT — AARP SUPPLEMENT: $66 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $66 AETNA — AETNA: $64.68 AETNA — AETNA MEDICARE LIFE INS: $18.48 AETNA — AETNA SENIOR SUPPLEMENTAL: $66 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $66 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $66 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $66 ASSURANT HEALTH — ASSURANT HEALTH: $66
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: RHC URINALYSIS	$28	Not listed in the file	$3.02 – $151
Urine test (manual, without microscope): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $7.84 AARP SUPPLEMENT — AARP SUPPLEMENT: $28 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $28 AETNA — AETNA: $27.44 AETNA — AETNA MEDICARE LIFE INS: $7.84 AETNA — AETNA SENIOR SUPPLEMENTAL: $28 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $28 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $28 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $28 ASSURANT HEALTH — ASSURANT HEALTH: $28
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: NAUTOM URINALYS W/OM	$28	Not listed in the file	$3.02 – $151
Urine test (manual, without microscope): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $7.84 AARP SUPPLEMENT — AARP SUPPLEMENT: $28 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $28 AETNA — AETNA: $27.44 AETNA — AETNA MEDICARE LIFE INS: $7.84 AETNA — AETNA SENIOR SUPPLEMENTAL: $28 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $28 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $28 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $28 ASSURANT HEALTH — ASSURANT HEALTH: $28
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: URINALSYS AUTOM WO MICRO	$50.50	Not listed in the file	$1.01 – $50.50
Urine test (automated, without microscope): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $14.14 AARP SUPPLEMENT — AARP SUPPLEMENT: $50.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $50.50 AETNA — AETNA: $49.49 AETNA — AETNA MEDICARE LIFE INS: $14.14 AETNA — AETNA SENIOR SUPPLEMENTAL: $50.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $50.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $50.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $50.50 ASSURANT HEALTH — ASSURANT HEALTH: $50.50
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: URINALYSIS AUTO W/O SCOPE	$50.50	Not listed in the file	$1.01 – $50.50
Urine test (automated, without microscope): 10 of 48 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $2.25 AETNA — AETNA MEDICARE LIFE INS: $2.25 BANKERS LIFE — BANKERS LIFE: $2.25 BCBS OF NM — MEDICAID NEW MEXICO IN: $2.70 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $2.25 CIRSA — CIRSA: $2.25 CMI — CMI: $2.25 CORVEL — CORVEL: $2.25 CTSI WOODMAN & POWERS — CTSI: $2.25 DEVOTED — DEVOTED HEALTH PLAN: $2.36
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier QW In the file: URINALYSIS AUTO W/O SCOPE	$50.50	Not listed in the file	$2.25 – $2.36
Urine test (automated, without microscope): 10 of 34 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $2.25 AETNA — AETNA MEDICARE LIFE INS: $2.25 BANKERS LIFE — BANKERS LIFE: $2.25 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $2.25 CIRSA — CIRSA: $2.25 CMI — CMI: $2.25 CORVEL — CORVEL: $2.25 CTSI WOODMAN & POWERS — CTSI: $2.25 DEVOTED — DEVOTED HEALTH PLAN: $2.36 FREEDOM NETWORK SELECT — FREEDOM NETWORK SELECT: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA TOTAL	$172.50	Not listed in the file	$7.63 – $381.50
PSA (prostate specific antigen) blood test: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $48.30 AARP SUPPLEMENT — AARP SUPPLEMENT: $172.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $172.50 AETNA — AETNA: $169.05 AETNA — AETNA MEDICARE LIFE INS: $48.30 AETNA — AETNA SENIOR SUPPLEMENTAL: $172.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $172.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $172.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $172.50 ASSURANT HEALTH — ASSURANT HEALTH: $172.50
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA FREE + TOTAL LABCORP	$69.50	Not listed in the file	$7.63 – $381.50
PSA (prostate specific antigen) blood test: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $19.46 AARP SUPPLEMENT — AARP SUPPLEMENT: $69.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $69.50 AETNA — AETNA: $68.11 AETNA — AETNA MEDICARE LIFE INS: $19.46 AETNA — AETNA SENIOR SUPPLEMENTAL: $69.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $69.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $69.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $69.50 ASSURANT HEALTH — ASSURANT HEALTH: $69.50
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA TOTAL REFLEX PSA FREE	$37.50	Not listed in the file	$7.63 – $381.50
PSA (prostate specific antigen) blood test: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $10.50 AARP SUPPLEMENT — AARP SUPPLEMENT: $37.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $37.50 AETNA — AETNA: $36.75 AETNA — AETNA MEDICARE LIFE INS: $10.50 AETNA — AETNA SENIOR SUPPLEMENTAL: $37.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $37.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $37.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $37.50 ASSURANT HEALTH — ASSURANT HEALTH: $37.50
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: TSH	$172.50	Not listed in the file	$4.51 – $225.50
Thyroid stimulating hormone (TSH) test: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $48.30 AARP SUPPLEMENT — AARP SUPPLEMENT: $172.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $172.50 AETNA — AETNA: $169.05 AETNA — AETNA MEDICARE LIFE INS: $48.30 AETNA — AETNA SENIOR SUPPLEMENTAL: $172.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $172.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $172.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $172.50 ASSURANT HEALTH — ASSURANT HEALTH: $172.50
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: THYROID CASCADE PROF	$28	Not listed in the file	$4.51 – $225.50
Thyroid stimulating hormone (TSH) test: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $7.84 AARP SUPPLEMENT — AARP SUPPLEMENT: $28 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $28 AETNA — AETNA: $27.44 AETNA — AETNA MEDICARE LIFE INS: $7.84 AETNA — AETNA SENIOR SUPPLEMENTAL: $28 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $28 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $28 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $28 ASSURANT HEALTH — ASSURANT HEALTH: $28
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: THYROID CASCADE PROFILE	$25	Not listed in the file	$4.51 – $225.50
Thyroid stimulating hormone (TSH) test: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $7 AARP SUPPLEMENT — AARP SUPPLEMENT: $25 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $25 AETNA — AETNA: $24.50 AETNA — AETNA MEDICARE LIFE INS: $7 AETNA — AETNA SENIOR SUPPLEMENTAL: $25 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $25 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $25 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $25 ASSURANT HEALTH — ASSURANT HEALTH: $25
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC W/AUTO DIFF	$126	Not listed in the file	$2.52 – $126
Complete blood count (CBC) with differential: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $35.28 AARP SUPPLEMENT — AARP SUPPLEMENT: $126 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $126 AETNA — AETNA: $123.48 AETNA — AETNA MEDICARE LIFE INS: $35.28 AETNA — AETNA SENIOR SUPPLEMENTAL: $126 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $126 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $126 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $126 ASSURANT HEALTH — ASSURANT HEALTH: $126
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: COMPLETE CBC W/AUTO DIFF WBC	$126	Not listed in the file	$2.52 – $126
Complete blood count (CBC) with differential: 10 of 48 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $7.77 AETNA — AETNA MEDICARE LIFE INS: $7.77 BANKERS LIFE — BANKERS LIFE: $7.77 BCBS OF NM — MEDICAID NEW MEXICO IN: $9.32 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $7.77 CIRSA — CIRSA: $7.77 CMI — CMI: $7.77 CORVEL — CORVEL: $7.77 CTSI WOODMAN & POWERS — CTSI: $7.77 DEVOTED — DEVOTED HEALTH PLAN: $8.16
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier QW In the file: COMPLETE CBC W/AUTO DIFF WBC	$126	Not listed in the file	$7.77 – $8.16
Complete blood count (CBC) with differential: 10 of 34 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $7.77 AETNA — AETNA MEDICARE LIFE INS: $7.77 BANKERS LIFE — BANKERS LIFE: $7.77 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $7.77 CIRSA — CIRSA: $7.77 CMI — CMI: $7.77 CORVEL — CORVEL: $7.77 CTSI WOODMAN & POWERS — CTSI: $7.77 DEVOTED — DEVOTED HEALTH PLAN: $8.16 FREEDOM NETWORK SELECT — FREEDOM NETWORK SELECT: $7.77
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: CBC WITHOUT DIFF	$60	Not listed in the file	$1.20 – $60
Complete blood count (CBC), automated: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $16.80 AARP SUPPLEMENT — AARP SUPPLEMENT: $60 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $60 AETNA — AETNA: $58.80 AETNA — AETNA MEDICARE LIFE INS: $16.80 AETNA — AETNA SENIOR SUPPLEMENTAL: $60 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $60 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $60 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $60 ASSURANT HEALTH — ASSURANT HEALTH: $60
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: COMPLETE CBC AUTOMATED	$60	Not listed in the file	$1.20 – $60
Complete blood count (CBC), automated: 10 of 48 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $6.47 AETNA — AETNA MEDICARE LIFE INS: $6.47 BANKERS LIFE — BANKERS LIFE: $6.47 BCBS OF NM — MEDICAID NEW MEXICO IN: $7.76 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $6.47 CIRSA — CIRSA: $6.47 CMI — CMI: $6.47 CORVEL — CORVEL: $6.47 CTSI WOODMAN & POWERS — CTSI: $6.47 DEVOTED — DEVOTED HEALTH PLAN: $6.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PRO TIME	$77	Not listed in the file	$4.29 – $335
Blood clotting time test (prothrombin time, PT): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $21.56 AARP SUPPLEMENT — AARP SUPPLEMENT: $77 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $77 AETNA — AETNA: $75.46 AETNA — AETNA MEDICARE LIFE INS: $21.56 AETNA — AETNA SENIOR SUPPLEMENTAL: $77 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $77 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $77 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $77 ASSURANT HEALTH — ASSURANT HEALTH: $77
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PT & PTT	$27	Not listed in the file	$4.29 – $335
Blood clotting time test (prothrombin time, PT): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $7.56 AARP SUPPLEMENT — AARP SUPPLEMENT: $27 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $27 AETNA — AETNA: $26.46 AETNA — AETNA MEDICARE LIFE INS: $7.56 AETNA — AETNA SENIOR SUPPLEMENTAL: $27 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $27 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $27 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $27 ASSURANT HEALTH — ASSURANT HEALTH: $27
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: RHC PROTIME	$77	Not listed in the file	$4.29 – $335
Blood clotting time test (prothrombin time, PT): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $21.56 AARP SUPPLEMENT — AARP SUPPLEMENT: $77 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $77 AETNA — AETNA: $75.46 AETNA — AETNA MEDICARE LIFE INS: $21.56 AETNA — AETNA SENIOR SUPPLEMENTAL: $77 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $77 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $77 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $77 ASSURANT HEALTH — ASSURANT HEALTH: $77
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT-PARTIAL THROMB TIME	$151.50	Not listed in the file	$6.01 – $1,060.50
Blood clotting test (partial thromboplastin time, PTT): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $42.42 AARP SUPPLEMENT — AARP SUPPLEMENT: $151.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $151.50 AETNA — AETNA: $148.47 AETNA — AETNA MEDICARE LIFE INS: $42.42 AETNA — AETNA SENIOR SUPPLEMENTAL: $151.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $151.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $151.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $151.50 ASSURANT HEALTH — ASSURANT HEALTH: $151.50
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT MIXING STUDY	$909	Not listed in the file	$6.01 – $1,060.50
Blood clotting test (partial thromboplastin time, PTT): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $254.52 AARP SUPPLEMENT — AARP SUPPLEMENT: $909 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $909 AETNA — AETNA: $890.82 AETNA — AETNA MEDICARE LIFE INS: $254.52 AETNA — AETNA SENIOR SUPPLEMENTAL: $909 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $909 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $909 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $909 ASSURANT HEALTH — ASSURANT HEALTH: $909
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: THROMBOPLASTIN TIME PARTIAL	$151.50	Not listed in the file	$6.01 – $1,060.50
Blood clotting test (partial thromboplastin time, PTT): 10 of 48 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $6.01 AETNA — AETNA MEDICARE LIFE INS: $6.01 BANKERS LIFE — BANKERS LIFE: $6.01 BCBS OF NM — MEDICAID NEW MEXICO IN: $7.21 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $6.01 CIRSA — CIRSA: $6.01 CMI — CMI: $6.01 CORVEL — CORVEL: $6.01 CTSI WOODMAN & POWERS — CTSI: $6.01 DEVOTED — DEVOTED HEALTH PLAN: $6.31

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 In the file: CT-HEAD/BRAIN WO CONTRAST	$2,575.50	Not listed in the file	$11 – $2,575.50
CT scan of the head or brain, without contrast: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $721.14 AARP SUPPLEMENT — AARP SUPPLEMENT: $2,575.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $2,575.50 AETNA — AETNA: $2,523.99 AETNA — AETNA MEDICARE LIFE INS: $721.14 AETNA — AETNA SENIOR SUPPLEMENTAL: $2,575.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $2,575.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $2,575.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $2,575.50 ASSURANT HEALTH — ASSURANT HEALTH: $2,575.50
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT HEAD/BRAIN W/O DYE	$2,575.50	Not listed in the file	$11 – $2,575.50
CT scan of the head or brain, without contrast: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $195.07 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $2,472.48 GOLDEN RULE — GOLDEN RULE INSURANCE: $2,472.48 MEDICAID — MEDICAID NEW MEXICO IN: $195.07 MEDICAID — MEDICAID NEW MEXICO OUT: $195.07 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $195.07 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $195.07 UMR MSA — UMR MSA: $2,472.48 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $2,472.48
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN W/WO CONTRAST	$5,143.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,143.50
MRI of the brain, before and after contrast: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,440.18 AARP SUPPLEMENT — AARP SUPPLEMENT: $5,143.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $5,143.50 AETNA — AETNA: $5,040.63 AETNA — AETNA MEDICARE LIFE INS: $1,440.18 AETNA — AETNA SENIOR SUPPLEMENTAL: $5,143.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $5,143.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $5,143.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $5,143.50 ASSURANT HEALTH — ASSURANT HEALTH: $5,143.50
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN STEM W/O & W/DYE	$5,143.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,143.50
MRI of the brain, before and after contrast: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $535.42 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $4,937.76 GOLDEN RULE — GOLDEN RULE INSURANCE: $4,937.76 MEDICAID — MEDICAID NEW MEXICO IN: $535.42 MEDICAID — MEDICAID NEW MEXICO OUT: $535.42 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $535.42 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $535.42 UMR MSA — UMR MSA: $4,937.76 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $4,937.76
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: CHEST FRONTAL (PA) & LATERAL 2 VIEWS	$482.50	Not listed in the file	$9.65 – $1,220.74
Chest X-ray, 2 views: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $135.10 AARP SUPPLEMENT — AARP SUPPLEMENT: $482.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $482.50 AETNA — AETNA: $472.85 AETNA — AETNA MEDICARE LIFE INS: $135.10 AETNA — AETNA SENIOR SUPPLEMENTAL: $482.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $482.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $482.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $482.50 ASSURANT HEALTH — ASSURANT HEALTH: $482.50
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-RAY EXAM CHEST 2 VIEWS	$482.50	Not listed in the file	$9.65 – $1,220.74
Chest X-ray, 2 views: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $62.11 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $463.20 GOLDEN RULE — GOLDEN RULE INSURANCE: $463.20 MEDICAID — MEDICAID NEW MEXICO IN: $62.11 MEDICAID — MEDICAID NEW MEXICO OUT: $62.11 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $62.11 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $62.11 UMR MSA — UMR MSA: $463.20 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $463.20
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: LS SPINE MIN 4 VIEWS	$800.50	Not listed in the file	$11 – $1,220.74
X-ray of the lower spine, at least 4 views: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $224.14 AARP SUPPLEMENT — AARP SUPPLEMENT: $800.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $800.50 AETNA — AETNA: $784.49 AETNA — AETNA MEDICARE LIFE INS: $224.14 AETNA — AETNA SENIOR SUPPLEMENTAL: $800.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $800.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $800.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $800.50 ASSURANT HEALTH — ASSURANT HEALTH: $800.50
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: X-RAY EXAM L-2 SPINE 4/>VWS	$800.50	Not listed in the file	$11 – $1,220.74
X-ray of the lower spine, at least 4 views: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $94.98 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $768.48 GOLDEN RULE — GOLDEN RULE INSURANCE: $768.48 MEDICAID — MEDICAID NEW MEXICO IN: $94.98 MEDICAID — MEDICAID NEW MEXICO OUT: $94.98 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $94.98 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $94.98 UMR MSA — UMR MSA: $768.48 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $768.48
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI L/S WO CONTRAST	$2,754.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,754.50
MRI of the lower back (lumbar spine), without contrast: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $771.26 AARP SUPPLEMENT — AARP SUPPLEMENT: $2,754.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $2,754.50 AETNA — AETNA: $2,699.41 AETNA — AETNA MEDICARE LIFE INS: $771.26 AETNA — AETNA SENIOR SUPPLEMENTAL: $2,754.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $2,754.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $2,754.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $2,754.50 ASSURANT HEALTH — ASSURANT HEALTH: $2,754.50
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR SPINE W/O DYE	$2,754.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,754.50
MRI of the lower back (lumbar spine), without contrast: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $349.53 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $2,644.32 GOLDEN RULE — GOLDEN RULE INSURANCE: $2,644.32 MEDICAID — MEDICAID NEW MEXICO IN: $349.53 MEDICAID — MEDICAID NEW MEXICO OUT: $349.53 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $349.53 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $349.53 UMR MSA — UMR MSA: $2,644.32 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $2,644.32
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT-PELVIS W CONTRAST	$3,654.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,654.50
CT scan of the pelvis, with contrast: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,023.26 AARP SUPPLEMENT — AARP SUPPLEMENT: $3,654.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $3,654.50 AETNA — AETNA: $3,581.41 AETNA — AETNA MEDICARE LIFE INS: $1,023.26 AETNA — AETNA SENIOR SUPPLEMENTAL: $3,654.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $3,654.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $3,654.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $3,654.50 ASSURANT HEALTH — ASSURANT HEALTH: $3,654.50
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W/DYE	$3,654.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,654.50
CT scan of the pelvis, with contrast: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $297.03 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $3,508.32 GOLDEN RULE — GOLDEN RULE INSURANCE: $3,508.32 MEDICAID — MEDICAID NEW MEXICO IN: $297.03 MEDICAID — MEDICAID NEW MEXICO OUT: $297.03 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $297.03 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $297.03 UMR MSA — UMR MSA: $3,508.32 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $3,508.32
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI LE JNT WO CONTRAST	$3,289.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,289.50
MRI of a leg joint (such as the knee), without contrast: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $921.06 AARP SUPPLEMENT — AARP SUPPLEMENT: $3,289.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $3,289.50 AETNA — AETNA: $3,223.71 AETNA — AETNA MEDICARE LIFE INS: $921.06 AETNA — AETNA SENIOR SUPPLEMENTAL: $3,289.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $3,289.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $3,289.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $3,289.50 ASSURANT HEALTH — ASSURANT HEALTH: $3,289.50
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI JNT OF LWR EXTRE W/O DYE	$3,289.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,289.50
MRI of a leg joint (such as the knee), without contrast: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $349.53 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $3,157.92 GOLDEN RULE — GOLDEN RULE INSURANCE: $3,157.92 MEDICAID — MEDICAID NEW MEXICO IN: $349.53 MEDICAID — MEDICAID NEW MEXICO OUT: $349.53 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $349.53 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $349.53 UMR MSA — UMR MSA: $3,157.92 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $3,157.92
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD & PELVIS W/CONTRAST	$5,027	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,027
CT scan of the abdomen and pelvis, with contrast: 10 of 137 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,407.56 AARP SUPPLEMENT — AARP SUPPLEMENT: $5,027 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $5,027 AETNA — AETNA: $4,926.46 AETNA — AETNA MEDICARE LIFE INS: $1,407.56 AETNA — AETNA SENIOR SUPPLEMENTAL: $5,027 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $5,027 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $5,027 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $5,027 ASSURANT HEALTH — ASSURANT HEALTH: $5,027
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: US EXAM ABDOM COMPLETE	$1,402.50	Not listed in the file	$11 – $1,402.50
Ultrasound of the abdomen, complete: 10 of 137 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $392.70 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,402.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,402.50 AETNA — AETNA: $1,374.45 AETNA — AETNA MEDICARE LIFE INS: $392.70 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,402.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,402.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,402.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,402.50 ASSURANT HEALTH — ASSURANT HEALTH: $1,402.50
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: US NON OB TRANSVAG	$816	Not listed in the file	$11 – $1,220.74
Transvaginal ultrasound: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $228.48 AARP SUPPLEMENT — AARP SUPPLEMENT: $816 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $816 AETNA — AETNA: $799.68 AETNA — AETNA MEDICARE LIFE INS: $228.48 AETNA — AETNA SENIOR SUPPLEMENTAL: $816 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $816 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $816 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $816 ASSURANT HEALTH — ASSURANT HEALTH: $816
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: TRANSVAGINAL US NON-OB	$816	Not listed in the file	$11 – $1,220.74
Transvaginal ultrasound: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $97.29 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $783.36 GOLDEN RULE — GOLDEN RULE INSURANCE: $783.36 MEDICAID — MEDICAID NEW MEXICO IN: $97.29 MEDICAID — MEDICAID NEW MEXICO OUT: $97.29 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $97.29 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $97.29 UMR MSA — UMR MSA: $783.36 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $783.36
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: DIAG MAMMO UNILATERAL DIGITAL	$447.50	Not listed in the file	$8.95 – $1,220.74
Diagnostic mammogram, one breast: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $125.30 AARP SUPPLEMENT — AARP SUPPLEMENT: $447.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $447.50 AETNA — AETNA: $438.55 AETNA — AETNA MEDICARE LIFE INS: $125.30 AETNA — AETNA SENIOR SUPPLEMENTAL: $447.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $447.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $447.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $447.50 ASSURANT HEALTH — ASSURANT HEALTH: $447.50
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: DX MAMMO INCL CAD UNI	$447.50	Not listed in the file	$8.95 – $1,220.74
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $125.59 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $429.60 GOLDEN RULE — GOLDEN RULE INSURANCE: $429.60 MEDICAID — MEDICAID NEW MEXICO IN: $125.59 MEDICAID — MEDICAID NEW MEXICO OUT: $125.59 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $125.59 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $125.59 UMR MSA — UMR MSA: $429.60 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $429.60
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: DIAG MAMMO BILATERAL DIGITAL	$437	Not listed in the file	$10.18 – $1,220.74
Diagnostic mammogram, both breasts: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $122.36 AARP SUPPLEMENT — AARP SUPPLEMENT: $437 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $437 AETNA — AETNA: $428.26 AETNA — AETNA MEDICARE LIFE INS: $122.36 AETNA — AETNA SENIOR SUPPLEMENTAL: $437 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $437 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $437 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $437 ASSURANT HEALTH — ASSURANT HEALTH: $437
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: COMPUTER AIDED DETECTION DIAGNOSTIC	$72	Not listed in the file	$10.18 – $1,220.74
Diagnostic mammogram, both breasts: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $20.16 AARP SUPPLEMENT — AARP SUPPLEMENT: $72 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $72 AETNA — AETNA: $70.56 AETNA — AETNA MEDICARE LIFE INS: $20.16 AETNA — AETNA SENIOR SUPPLEMENTAL: $72 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $72 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $72 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $72 ASSURANT HEALTH — ASSURANT HEALTH: $72
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: DX MAMMO INCL CAD BI	$437	Not listed in the file	$10.18 – $1,220.74
Diagnostic mammogram, both breasts: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $158.59 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $419.52 GOLDEN RULE — GOLDEN RULE INSURANCE: $419.52 MEDICAID — MEDICAID NEW MEXICO IN: $158.59 MEDICAID — MEDICAID NEW MEXICO OUT: $158.59 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $158.59 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $158.59 UMR MSA — UMR MSA: $419.52 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $419.52
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: DIGITAL MAMMO SCREENING	$462.50	Not listed in the file	$31.34 – $1,567
Screening mammogram, both breasts: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $129.50 AARP SUPPLEMENT — AARP SUPPLEMENT: $462.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $462.50 AETNA — AETNA: $453.25 AETNA — AETNA MEDICARE LIFE INS: $129.50 AETNA — AETNA SENIOR SUPPLEMENTAL: $462.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $462.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $462.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $462.50 ASSURANT HEALTH — ASSURANT HEALTH: $462.50
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: COMPUTER AIDED DETECTION SCREENING	$64	Not listed in the file	$31.34 – $1,567
Screening mammogram, both breasts: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $17.92 AARP SUPPLEMENT — AARP SUPPLEMENT: $64 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $64 AETNA — AETNA: $62.72 AETNA — AETNA MEDICARE LIFE INS: $17.92 AETNA — AETNA SENIOR SUPPLEMENTAL: $64 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $64 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $64 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $64 ASSURANT HEALTH — ASSURANT HEALTH: $64
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: DIGITAL MAMMO UNILATERAL SCREENING	$462.50	Not listed in the file	$31.34 – $1,567
Screening mammogram, both breasts: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $129.50 AARP SUPPLEMENT — AARP SUPPLEMENT: $462.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $462.50 AETNA — AETNA: $453.25 AETNA — AETNA MEDICARE LIFE INS: $129.50 AETNA — AETNA SENIOR SUPPLEMENTAL: $462.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $462.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $462.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $462.50 ASSURANT HEALTH — ASSURANT HEALTH: $462.50

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: SLEEP STUDY ATTENDED	$4,773.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,773.50
Sleep study (overnight, in a sleep lab): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,336.58 AARP SUPPLEMENT — AARP SUPPLEMENT: $4,773.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $4,773.50 AETNA — AETNA: $4,678.03 AETNA — AETNA MEDICARE LIFE INS: $1,336.58 AETNA — AETNA SENIOR SUPPLEMENTAL: $4,773.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $4,773.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $4,773.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $4,773.50 ASSURANT HEALTH — ASSURANT HEALTH: $4,773.50
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: POLYSOM 6/> YRS 4/> PARAM	$4,773.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,773.50
Sleep study (overnight, in a sleep lab): 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $770.55 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $4,582.56 GOLDEN RULE — GOLDEN RULE INSURANCE: $4,582.56 MEDICAID — MEDICAID NEW MEXICO IN: $770.55 MEDICAID — MEDICAID NEW MEXICO OUT: $770.55 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $770.55 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $770.55 UMR MSA — UMR MSA: $4,582.56 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $4,582.56

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 In the file: OT THERAPY EXERCISE (15 MINUTES)	$139	$97.30	$9.13 – $1,220.74
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $38.92 AARP SUPPLEMENT — AARP SUPPLEMENT: $139 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $139 AETNA — AETNA: $136.22 AETNA — AETNA MEDICARE LIFE INS: $38.92 AETNA — AETNA SENIOR SUPPLEMENTAL: $139 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $139 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $139 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $139 ASSURANT HEALTH — ASSURANT HEALTH: $139
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: PT THERAPUETIC EXERCISE (15 MINUTES)	$120.50	$84.35	$9.13 – $1,220.74
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $33.74 AARP SUPPLEMENT — AARP SUPPLEMENT: $120.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $120.50 AETNA — AETNA: $118.09 AETNA — AETNA MEDICARE LIFE INS: $33.74 AETNA — AETNA SENIOR SUPPLEMENTAL: $120.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $120.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $120.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $120.50 ASSURANT HEALTH — ASSURANT HEALTH: $120.50
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: PT THERAPUETIC EXERCISES (45 MINUTES)	$197	$137.90	$9.13 – $1,220.74
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $55.16 AARP SUPPLEMENT — AARP SUPPLEMENT: $197 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $197 AETNA — AETNA: $193.06 AETNA — AETNA MEDICARE LIFE INS: $55.16 AETNA — AETNA SENIOR SUPPLEMENTAL: $197 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $197 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $197 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $197 ASSURANT HEALTH — ASSURANT HEALTH: $197
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: PT EVAL LOW COMPLEX	$323.50	Not listed in the file	$6.47 – $1,220.74
Physical therapy evaluation (low complexity): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $90.58 AARP SUPPLEMENT — AARP SUPPLEMENT: $323.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $323.50 AETNA — AETNA: $317.03 AETNA — AETNA MEDICARE LIFE INS: $90.58 AETNA — AETNA SENIOR SUPPLEMENTAL: $323.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $323.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $323.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $323.50 ASSURANT HEALTH — ASSURANT HEALTH: $323.50
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: PT EVAL LOW COMPLEX 20 MIN	$323.50	Not listed in the file	$6.47 – $1,220.74
Physical therapy evaluation (low complexity): 10 of 23 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $141.72 CIRSA — CIRSA: $144.10 CMI — CMI: $144.10 CORVEL — CORVEL: $144.10 CTSI WOODMAN & POWERS — CTSI: $144.10 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $310.56 GOLDEN RULE — GOLDEN RULE INSURANCE: $310.56 HALIBURTON — ESIS: $144.10 LIBERTY MUTUAL — LIBERTY MUTUAL: $144.10
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: PT EVAL MOD COMPLEX	$369.50	Not listed in the file	$7.39 – $1,220.74
Physical therapy evaluation (moderate complexity): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $103.46 AARP SUPPLEMENT — AARP SUPPLEMENT: $369.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $369.50 AETNA — AETNA: $362.11 AETNA — AETNA MEDICARE LIFE INS: $103.46 AETNA — AETNA SENIOR SUPPLEMENTAL: $369.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $369.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $369.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $369.50 ASSURANT HEALTH — ASSURANT HEALTH: $369.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: PT EVAL MOD COMPLEX 30 MIN	$369.50	Not listed in the file	$7.39 – $1,220.74
Physical therapy evaluation (moderate complexity): 10 of 23 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $141.72 CIRSA — CIRSA: $144.10 CMI — CMI: $144.10 CORVEL — CORVEL: $144.10 CTSI WOODMAN & POWERS — CTSI: $144.10 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $354.72 GOLDEN RULE — GOLDEN RULE INSURANCE: $354.72 HALIBURTON — ESIS: $144.10 LIBERTY MUTUAL — LIBERTY MUTUAL: $144.10
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: PT HOME HEALTH EVALUATION	$103	$72.10	$10.61 – $1,220.74
Physical therapy evaluation (high complexity): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $28.84 AARP SUPPLEMENT — AARP SUPPLEMENT: $103 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $103 AETNA — AETNA: $100.94 AETNA — AETNA MEDICARE LIFE INS: $28.84 AETNA — AETNA SENIOR SUPPLEMENTAL: $103 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $103 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $103 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $103 ASSURANT HEALTH — ASSURANT HEALTH: $103
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: PT EVAL HIGH COMPLEX	$427.50	Not listed in the file	$10.61 – $1,220.74
Physical therapy evaluation (high complexity): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $119.70 AARP SUPPLEMENT — AARP SUPPLEMENT: $427.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $427.50 AETNA — AETNA: $418.95 AETNA — AETNA MEDICARE LIFE INS: $119.70 AETNA — AETNA SENIOR SUPPLEMENTAL: $427.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $427.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $427.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $427.50 ASSURANT HEALTH — ASSURANT HEALTH: $427.50
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: PT EVAL HIGH COMPLEX 45 MIN	$427.50	Not listed in the file	$10.61 – $1,220.74
Physical therapy evaluation (high complexity): 10 of 23 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $141.72 CIRSA — CIRSA: $144.10 CMI — CMI: $144.10 CORVEL — CORVEL: $144.10 CTSI WOODMAN & POWERS — CTSI: $144.10 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $410.40 GOLDEN RULE — GOLDEN RULE INSURANCE: $410.40 HALIBURTON — ESIS: $144.10 LIBERTY MUTUAL — LIBERTY MUTUAL: $144.10

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: REMOVAL BREAST LESION	$1,560.50	Not listed in the file	$33 – $7,701.50
Removal of breast growth (open surgery): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $436.94 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,560.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,560.50 AETNA — AETNA: $1,529.29 AETNA — AETNA MEDICARE LIFE INS: $436.94 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,560.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,560.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,560.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,560.50 ASSURANT HEALTH — ASSURANT HEALTH: $1,560.50
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: RMV BREAST LESION	$4,280	Not listed in the file	$33 – $7,701.50
Removal of breast growth (open surgery): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,198.40 AARP SUPPLEMENT — AARP SUPPLEMENT: $4,280 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $4,280 AETNA — AETNA: $4,194.40 AETNA — AETNA MEDICARE LIFE INS: $1,198.40 AETNA — AETNA SENIOR SUPPLEMENTAL: $4,280 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $4,280 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $4,280 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $4,280 ASSURANT HEALTH — ASSURANT HEALTH: $4,280
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: REM BREAST LESION	$1,861	Not listed in the file	$33 – $7,701.50
Removal of breast growth (open surgery): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $521.08 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,861 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,861 AETNA — AETNA: $1,823.78 AETNA — AETNA MEDICARE LIFE INS: $521.08 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,861 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,861 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,861 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,861 ASSURANT HEALTH — ASSURANT HEALTH: $1,861
Total hip replacement CPT 27130 · Inpatient or outpatient In the file: TOTAL HIP ARTHRPLSTY	$4,353	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,866.82
Total hip replacement: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,218.84 AARP SUPPLEMENT — AARP SUPPLEMENT: $4,353 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $4,353 AETNA — AETNA: $4,265.94 AETNA — AETNA MEDICARE LIFE INS: $1,218.84 AETNA — AETNA SENIOR SUPPLEMENTAL: $4,353 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $4,353 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $4,353 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $4,353 ASSURANT HEALTH — ASSURANT HEALTH: $4,353
Total hip replacement CPT 27130 · Inpatient or outpatient In the file: TOTAL HIP ARTHROPLASTY	$4,353	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,866.82
Total hip replacement: 10 of 62 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,268.29 AETNA — AETNA MEDICARE LIFE INS: $1,170.46 BANKERS LIFE — BANKERS LIFE: $1,170.46 BCBS OF NM — MEDICAID NEW MEXICO IN: $11,900.71 CIGNA HEALTHCARE — ALLEGIANCE: $4,048.29 CIGNA HEALTHCARE — CIGNA: $4,048.29 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $4,048.29 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $1,170.46 CIRSA — CIRSA: $1,426.04 CMI — CMI: $1,426.04
Total hip replacement CPT 27130 · Inpatient or outpatient · modifier AS In the file: TOTAL HIP ARTHROPLASTY	$4,353	Not listed in the file	$1,122.85 – $4,048.29
Total hip replacement: 10 of 49 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,268.29 AETNA — AETNA MEDICARE LIFE INS: $1,170.46 BANKERS LIFE — BANKERS LIFE: $1,170.46 CIGNA HEALTHCARE — ALLEGIANCE: $4,048.29 CIGNA HEALTHCARE — CIGNA: $4,048.29 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $4,048.29 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $1,170.46 CIRSA — CIRSA: $1,426.04 CMI — CMI: $1,426.04 COLORADO ACCESS — COLORADO ACCESS: $1,122.85
Total knee replacement CPT 27447 · Inpatient or outpatient In the file: TOTAL KNEE ARTHROPLASTY	$10,096.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,866.82
Total knee replacement: 10 of 137 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $2,827.02 AARP SUPPLEMENT — AARP SUPPLEMENT: $10,096.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $10,096.50 AETNA — AETNA: $9,894.57 AETNA — AETNA MEDICARE LIFE INS: $2,827.02 AETNA — AETNA SENIOR SUPPLEMENTAL: $10,096.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $10,096.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $10,096.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $10,096.50 ASSURANT HEALTH — ASSURANT HEALTH: $10,096.50
Total knee replacement CPT 27447 · Inpatient or outpatient · modifier AS In the file: TOTAL KNEE ARTHROPLASTY	$10,096.50	Not listed in the file	$1,168.51 – $9,389.74
Total knee replacement: 10 of 49 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,266.66 AETNA — AETNA MEDICARE LIFE INS: $1,168.51 BANKERS LIFE — BANKERS LIFE: $1,168.51 CIGNA HEALTHCARE — ALLEGIANCE: $9,389.74 CIGNA HEALTHCARE — CIGNA: $9,389.74 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $9,389.74 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $1,168.51 CIRSA — CIRSA: $1,423.88 CMI — CMI: $1,423.88 COLORADO ACCESS — COLORADO ACCESS: $1,497.13
Total knee replacement CPT 27447 · Inpatient or outpatient · modifier LT In the file: TOTAL KNEE ARTHROPLASTY	$10,096.50	Not listed in the file	$1,168.51 – $9,389.74
Total knee replacement: 10 of 42 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,266.66 AETNA — AETNA MEDICARE LIFE INS: $1,168.51 BANKERS LIFE — BANKERS LIFE: $1,168.51 CIGNA HEALTHCARE — ALLEGIANCE: $9,389.74 CIGNA HEALTHCARE — CIGNA: $9,389.74 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $9,389.74 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $1,168.51 CIRSA — CIRSA: $1,423.88 CMI — CMI: $1,423.88 CORVEL — CORVEL: $1,423.88
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: SHO ARTHRS SRG DECOM	$729.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,290.60
Shoulder arthroscopy: shaving of shoulder bone: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $204.26 AARP SUPPLEMENT — AARP SUPPLEMENT: $729.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $729.50 AETNA — AETNA: $714.91 AETNA — AETNA MEDICARE LIFE INS: $204.26 AETNA — AETNA SENIOR SUPPLEMENTAL: $729.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $729.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $729.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $729.50 ASSURANT HEALTH — ASSURANT HEALTH: $729.50
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: SHO ARTHRS SRG DECOMPRESSION	$729.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,290.60
Shoulder arthroscopy: shaving of shoulder bone: 10 of 62 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $166.73 AETNA — AETNA MEDICARE LIFE INS: $147.24 BANKERS LIFE — BANKERS LIFE: $147.24 BCBS OF NM — MEDICAID NEW MEXICO IN: $3,290.60 CIGNA HEALTHCARE — ALLEGIANCE: $678.43 CIGNA HEALTHCARE — CIGNA: $678.43 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $678.43 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $147.24 CIRSA — CIRSA: $187.19 CMI — CMI: $187.19
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier AS In the file: SHO ARTHRS SRG DECOMPRESSION	$729.50	Not listed in the file	$147.24 – $678.43
Shoulder arthroscopy: shaving of shoulder bone: 10 of 41 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $166.73 AETNA — AETNA MEDICARE LIFE INS: $147.24 BANKERS LIFE — BANKERS LIFE: $147.24 CIGNA HEALTHCARE — ALLEGIANCE: $678.43 CIGNA HEALTHCARE — CIGNA: $678.43 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $678.43 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $147.24 CIRSA — CIRSA: $187.19 CMI — CMI: $187.19 CORVEL — CORVEL: $187.19
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: KNEE ARTHROSCOP SURG	$3,615.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,615.50
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,012.34 AARP SUPPLEMENT — AARP SUPPLEMENT: $3,615.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $3,615.50 AETNA — AETNA: $3,543.19 AETNA — AETNA MEDICARE LIFE INS: $1,012.34 AETNA — AETNA SENIOR SUPPLEMENTAL: $3,615.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $3,615.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $3,615.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $3,615.50 ASSURANT HEALTH — ASSURANT HEALTH: $3,615.50
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: ARTHRS KNE SRG MNISECTMY M/L	$3,615.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,615.50
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 62 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $546.38 AETNA — AETNA MEDICARE LIFE INS: $526.55 BANKERS LIFE — BANKERS LIFE: $526.55 BCBS OF NM — MEDICAID NEW MEXICO IN: $2,016.77 CIGNA HEALTHCARE — ALLEGIANCE: $3,362.41 CIGNA HEALTHCARE — CIGNA: $3,362.41 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $3,362.41 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $526.55 CIRSA — CIRSA: $613.98 CMI — CMI: $613.98
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · modifier AS In the file: ARTHRS KNE SRG MNISECTMY M/L	$3,615.50	Not listed in the file	$329.37 – $3,362.41
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 48 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $546.38 AETNA — AETNA MEDICARE LIFE INS: $526.55 BANKERS LIFE — BANKERS LIFE: $526.55 CIGNA HEALTHCARE — ALLEGIANCE: $3,362.41 CIGNA HEALTHCARE — CIGNA: $3,362.41 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $3,362.41 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $526.55 CIRSA — CIRSA: $613.98 CMI — CMI: $613.98 COLORADO ACCESS — COLORADO ACCESS: $329.37
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: RHC UGI DIAGNOSTIC	$506	Not listed in the file	$52.79 – $4,340.50
Upper GI endoscopy (diagnostic): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $141.68 AARP SUPPLEMENT — AARP SUPPLEMENT: $506 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $506 AETNA — AETNA: $495.88 AETNA — AETNA MEDICARE LIFE INS: $141.68 AETNA — AETNA SENIOR SUPPLEMENTAL: $506 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $506 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $506 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $506 ASSURANT HEALTH — ASSURANT HEALTH: $506
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: UPPER GI ENDOSCOPY DIAGNOSTIC	$1,515	Not listed in the file	$52.79 – $4,340.50
Upper GI endoscopy (diagnostic): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $424.20 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,515 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,515 AETNA — AETNA: $1,484.70 AETNA — AETNA MEDICARE LIFE INS: $424.20 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,515 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,515 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,515 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,515 ASSURANT HEALTH — ASSURANT HEALTH: $1,515
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: UPPER GI ENDOSCOPY	$483.50	Not listed in the file	$52.79 – $4,340.50
Upper GI endoscopy (diagnostic): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $135.38 AARP SUPPLEMENT — AARP SUPPLEMENT: $483.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $483.50 AETNA — AETNA: $473.83 AETNA — AETNA MEDICARE LIFE INS: $135.38 AETNA — AETNA SENIOR SUPPLEMENTAL: $483.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $483.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $483.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $483.50 ASSURANT HEALTH — ASSURANT HEALTH: $483.50
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: RHC UGI BX SGL/MULTI	$596	Not listed in the file	$33 – $6,953.50
Upper GI endoscopy with biopsy: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $166.88 AARP SUPPLEMENT — AARP SUPPLEMENT: $596 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $596 AETNA — AETNA: $584.08 AETNA — AETNA MEDICARE LIFE INS: $166.88 AETNA — AETNA SENIOR SUPPLEMENTAL: $596 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $596 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $596 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $596 ASSURANT HEALTH — ASSURANT HEALTH: $596
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: UPPER GI ENDOSCOPY BIOPSY	$3,057	Not listed in the file	$33 – $6,953.50
Upper GI endoscopy with biopsy: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $855.96 AARP SUPPLEMENT — AARP SUPPLEMENT: $3,057 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $3,057 AETNA — AETNA: $2,995.86 AETNA — AETNA MEDICARE LIFE INS: $855.96 AETNA — AETNA SENIOR SUPPLEMENTAL: $3,057 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $3,057 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $3,057 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $3,057 ASSURANT HEALTH — ASSURANT HEALTH: $3,057
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: EGD BIOPSY	$3,300.50	Not listed in the file	$33 – $6,953.50
Upper GI endoscopy with biopsy: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $924.14 AARP SUPPLEMENT — AARP SUPPLEMENT: $3,300.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $3,300.50 AETNA — AETNA: $3,234.49 AETNA — AETNA MEDICARE LIFE INS: $924.14 AETNA — AETNA SENIOR SUPPLEMENTAL: $3,300.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $3,300.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $3,300.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $3,300.50 ASSURANT HEALTH — ASSURANT HEALTH: $3,300.50
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: DIAGNOSTIC COLONOSCOPY	$1,604	Not listed in the file	$33 – $5,663.50
Colonoscopy (diagnostic): 10 of 137 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $449.12 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,604 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,604 AETNA — AETNA: $1,571.92 AETNA — AETNA MEDICARE LIFE INS: $449.12 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,604 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,604 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,604 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,604 ASSURANT HEALTH — ASSURANT HEALTH: $1,604
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: RHC COLNSCPY FLEX DX	$759	Not listed in the file	$33 – $5,663.50
Colonoscopy (diagnostic): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $212.52 AARP SUPPLEMENT — AARP SUPPLEMENT: $759 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $759 AETNA — AETNA: $743.82 AETNA — AETNA MEDICARE LIFE INS: $212.52 AETNA — AETNA SENIOR SUPPLEMENTAL: $759 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $759 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $759 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $759 ASSURANT HEALTH — ASSURANT HEALTH: $759
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: COLONSCOPY FLEX; DX	$3,300.50	Not listed in the file	$33 – $5,663.50
Colonoscopy (diagnostic): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $924.14 AARP SUPPLEMENT — AARP SUPPLEMENT: $3,300.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $3,300.50 AETNA — AETNA: $3,234.49 AETNA — AETNA MEDICARE LIFE INS: $924.14 AETNA — AETNA SENIOR SUPPLEMENTAL: $3,300.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $3,300.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $3,300.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $3,300.50 ASSURANT HEALTH — ASSURANT HEALTH: $3,300.50
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: COLONOSCOPY AND BIOPSY	$4,035	Not listed in the file	$33 – $8,988
Colonoscopy with biopsy: 10 of 137 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,129.80 AARP SUPPLEMENT — AARP SUPPLEMENT: $4,035 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $4,035 AETNA — AETNA: $3,954.30 AETNA — AETNA MEDICARE LIFE INS: $1,129.80 AETNA — AETNA SENIOR SUPPLEMENTAL: $4,035 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $4,035 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $4,035 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $4,035 ASSURANT HEALTH — ASSURANT HEALTH: $4,035
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: RHC COLNSCPY BX SGL/MULTI	$918	Not listed in the file	$33 – $8,988
Colonoscopy with biopsy: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $257.04 AARP SUPPLEMENT — AARP SUPPLEMENT: $918 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $918 AETNA — AETNA: $899.64 AETNA — AETNA MEDICARE LIFE INS: $257.04 AETNA — AETNA SENIOR SUPPLEMENTAL: $918 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $918 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $918 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $918 ASSURANT HEALTH — ASSURANT HEALTH: $918
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: COLONOSCOPY BIOPSY	$4,035	Not listed in the file	$33 – $8,988
Colonoscopy with biopsy: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,129.80 AARP SUPPLEMENT — AARP SUPPLEMENT: $4,035 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $4,035 AETNA — AETNA: $3,954.30 AETNA — AETNA MEDICARE LIFE INS: $1,129.80 AETNA — AETNA SENIOR SUPPLEMENTAL: $4,035 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $4,035 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $4,035 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $4,035 ASSURANT HEALTH — ASSURANT HEALTH: $4,035
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: RHC COLNSCPY REM LESION SNARE	$1,098	Not listed in the file	$44 – $12,445
Colonoscopy with removal of polyps (snare): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $307.44 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,098 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,098 AETNA — AETNA: $1,076.04 AETNA — AETNA MEDICARE LIFE INS: $307.44 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,098 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,098 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,098 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,098 ASSURANT HEALTH — ASSURANT HEALTH: $1,098
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: PRO FEE/LESION REMOVAL COLONOSCOPY	$4,768.50	Not listed in the file	$44 – $12,445
Colonoscopy with removal of polyps (snare): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,335.18 AARP SUPPLEMENT — AARP SUPPLEMENT: $4,768.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $4,768.50 AETNA — AETNA: $4,673.13 AETNA — AETNA MEDICARE LIFE INS: $1,335.18 AETNA — AETNA SENIOR SUPPLEMENTAL: $4,768.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $4,768.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $4,768.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $4,768.50 ASSURANT HEALTH — ASSURANT HEALTH: $4,768.50
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: COLONOSCOPY LESION REMOVAL SECOND PROC	$1,810	Not listed in the file	$44 – $12,445
Colonoscopy with removal of polyps (snare): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $506.80 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,810 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,810 AETNA — AETNA: $1,773.80 AETNA — AETNA MEDICARE LIFE INS: $506.80 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,810 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,810 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,810 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,810 ASSURANT HEALTH — ASSURANT HEALTH: $1,810
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient In the file: COLONOSCOPY W/ENDOSCOPE US	$1,132	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,220.74
Ultrasound of the lower bowel by endoscope: 10 of 137 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $316.96 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,132 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,132 AETNA — AETNA: $1,109.36 AETNA — AETNA MEDICARE LIFE INS: $316.96 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,132 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,132 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,132 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,132 ASSURANT HEALTH — ASSURANT HEALTH: $1,132
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: RHC SCR COLNSCPY MCARE NOT HI RISK PT	$759	Not listed in the file	$13.81 – $5,391.50
Screening colonoscopy (not high risk): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $212.52 AARP SUPPLEMENT — AARP SUPPLEMENT: $759 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $759 AETNA — AETNA: $743.82 AETNA — AETNA MEDICARE LIFE INS: $212.52 AETNA — AETNA SENIOR SUPPLEMENTAL: $759 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $759 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $759 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $759 ASSURANT HEALTH — ASSURANT HEALTH: $759
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: COLON CA SCRN NOT HIGH RISK	$1,332	Not listed in the file	$13.81 – $5,391.50
Screening colonoscopy (not high risk): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $372.96 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,332 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,332 AETNA — AETNA: $1,305.36 AETNA — AETNA MEDICARE LIFE INS: $372.96 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,332 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,332 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,332 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,332 ASSURANT HEALTH — ASSURANT HEALTH: $1,332
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: COLONOSCOPY SCREEN	$3,300.50	Not listed in the file	$13.81 – $5,391.50
Screening colonoscopy (not high risk): 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $924.14 AARP SUPPLEMENT — AARP SUPPLEMENT: $3,300.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $3,300.50 AETNA — AETNA: $3,234.49 AETNA — AETNA MEDICARE LIFE INS: $924.14 AETNA — AETNA SENIOR SUPPLEMENTAL: $3,300.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $3,300.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $3,300.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $3,300.50 ASSURANT HEALTH — ASSURANT HEALTH: $3,300.50
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: LAPAROSCOPIC CHOLECYSTECTOMY	$7,676	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $7,676
Gallbladder removal by laparoscope: 10 of 137 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $2,149.28 AARP SUPPLEMENT — AARP SUPPLEMENT: $7,676 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $7,676 AETNA — AETNA: $7,522.48 AETNA — AETNA MEDICARE LIFE INS: $2,149.28 AETNA — AETNA SENIOR SUPPLEMENTAL: $7,676 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $7,676 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $7,676 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $7,676 ASSURANT HEALTH — ASSURANT HEALTH: $7,676
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · modifier AS In the file: LAPAROSCOPIC CHOLECYSTECTOMY	$7,676	Not listed in the file	$632.30 – $6,524.60
Gallbladder removal by laparoscope: 10 of 26 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $648.87 AETNA — AETNA MEDICARE LIFE INS: $632.30 BANKERS LIFE — BANKERS LIFE: $632.30 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $632.30 DEVOTED — DEVOTED HEALTH PLAN: $648.87 FREEDOM NETWORK SELECT — FREEDOM NETWORK SELECT: $632.30 HEALTH NET LIFE INS CO — HEALTH NET LIFE INS CO: $632.30 HUMANA — HUMANA COMMERCIAL: $6,524.60 HUMANA GOLD CHOICE — HUMANA GOLD CHOICE: $648.87 HUMANA GOLD CHOICE — HUMANA LIFE1: $632.30
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: PRP I/HERN INIT REDUC >5 YR	$4,096.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,096.50
Groin (inguinal) hernia repair, age 5 or older: 10 of 137 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,147.02 AARP SUPPLEMENT — AARP SUPPLEMENT: $4,096.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $4,096.50 AETNA — AETNA: $4,014.57 AETNA — AETNA MEDICARE LIFE INS: $1,147.02 AETNA — AETNA SENIOR SUPPLEMENTAL: $4,096.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $4,096.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $4,096.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $4,096.50 ASSURANT HEALTH — ASSURANT HEALTH: $4,096.50
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier LT In the file: PRP I/HERN INIT REDUC >5 YR	$4,096.50	Not listed in the file	$397.87 – $3,809.74
Groin (inguinal) hernia repair, age 5 or older: 10 of 49 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $516.80 AETNA — AETNA MEDICARE LIFE INS: $509.96 BANKERS LIFE — BANKERS LIFE: $509.96 CIGNA HEALTHCARE — ALLEGIANCE: $3,809.74 CIGNA HEALTHCARE — CIGNA: $3,809.74 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $3,809.74 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $509.96 CIRSA — CIRSA: $581.12 CMI — CMI: $581.12 COLORADO ACCESS — COLORADO ACCESS: $397.87
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier SG In the file: PRP I/HERN INIT REDUC >5 YR	$4,096.50	Not listed in the file	$600.43
Groin (inguinal) hernia repair, age 5 or older: rates for 7 insurance plans COLORADO ACCESS — COLORADO ACCESS: $600.43 DENVER HEALTH MED PLAN — DENVER HEALTH MED PLAN: $600.43 MEDICAID — MEDICAID BEACON HEALTH: $600.43 MEDICAID — MEDICAID COLORADO: $600.43 MEDICAID — MISC MEDICAID GET NAME: $600.43 UHC COMMUNITY PLAN — UHC COMMUNITY PLAN: $600.43 WELLPOINT (AMGRP) — WELLPOINT (AMGRP): $600.43
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: HYSTEROSCOPY BIOPSY	$3,751.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,751.50
Hysteroscopy with biopsy of the uterus lining: 10 of 137 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,050.42 AARP SUPPLEMENT — AARP SUPPLEMENT: $3,751.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $3,751.50 AETNA — AETNA: $3,676.47 AETNA — AETNA MEDICARE LIFE INS: $1,050.42 AETNA — AETNA SENIOR SUPPLEMENTAL: $3,751.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $3,751.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $3,751.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $3,751.50 ASSURANT HEALTH — ASSURANT HEALTH: $3,751.50
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · modifier FP In the file: HYSTEROSCOPY BIOPSY	$3,751.50	Not listed in the file	$204.64 – $3,188.77
Hysteroscopy with biopsy of the uterus lining: 10 of 26 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $225.12 AETNA — AETNA MEDICARE LIFE INS: $204.64 BANKERS LIFE — BANKERS LIFE: $204.64 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $204.64 DEVOTED — DEVOTED HEALTH PLAN: $225.12 FREEDOM NETWORK SELECT — FREEDOM NETWORK SELECT: $204.64 HEALTH NET LIFE INS CO — HEALTH NET LIFE INS CO: $204.64 HUMANA — HUMANA COMMERCIAL: $3,188.77 HUMANA GOLD CHOICE — HUMANA GOLD CHOICE: $225.12 HUMANA GOLD CHOICE — HUMANA LIFE1: $204.64
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: INJ SPINE LUMBAR/SAC	$611	Not listed in the file	$22 – $1,666.50
Spinal injection, lower back (epidural), with imaging guidance: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $171.08 AARP SUPPLEMENT — AARP SUPPLEMENT: $611 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $611 AETNA — AETNA: $598.78 AETNA — AETNA MEDICARE LIFE INS: $171.08 AETNA — AETNA SENIOR SUPPLEMENTAL: $611 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $611 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $611 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $611 ASSURANT HEALTH — ASSURANT HEALTH: $611
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: INJ EPID SINGLE LUMBAR SACRAL	$1,055.50	Not listed in the file	$22 – $1,666.50
Spinal injection, lower back (epidural), with imaging guidance: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $295.54 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,055.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,055.50 AETNA — AETNA: $1,034.39 AETNA — AETNA MEDICARE LIFE INS: $295.54 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,055.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,055.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,055.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,055.50 ASSURANT HEALTH — ASSURANT HEALTH: $1,055.50
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: NJX INTERLAMINAR LMBR/SAC	$611	Not listed in the file	$22 – $1,666.50
Spinal injection, lower back (epidural), with imaging guidance: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $506.98 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $1,220.74 GEHA — GEHA: $586.56 GOLDEN RULE — GOLDEN RULE INSURANCE: $586.56 MEDICAID — MEDICAID NEW MEXICO IN: $506.98 MEDICAID — MEDICAID NEW MEXICO OUT: $506.98 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $506.98 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $506.98 UMR MSA — UMR MSA: $586.56 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $586.56
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: INJ FORAMEN EPID L/S	$437	Not listed in the file	$8.74 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,220.74
Nerve root injection, lower back, with imaging guidance: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $122.36 AARP SUPPLEMENT — AARP SUPPLEMENT: $437 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $437 AETNA — AETNA: $428.26 AETNA — AETNA MEDICARE LIFE INS: $122.36 AETNA — AETNA SENIOR SUPPLEMENTAL: $437 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $437 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $437 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $437 ASSURANT HEALTH — ASSURANT HEALTH: $437
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: NJX AA&/STRD TFRM EPI L/S 1	$437	Not listed in the file	$8.74 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,220.74
Nerve root injection, lower back, with imaging guidance: 10 of 62 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $109.49 AETNA — AETNA MEDICARE LIFE INS: $101.59 BANKERS LIFE — BANKERS LIFE: $101.59 BCBS OF NM — MEDICAID NEW MEXICO IN: $485.34 CIGNA HEALTHCARE — ALLEGIANCE: $406.41 CIGNA HEALTHCARE — CIGNA: $406.41 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $406.41 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $101.59 CIRSA — CIRSA: $39.20 CMI — CMI: $39.20
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier 50 In the file: NJX AA&/STRD TFRM EPI L/S 1	$437	Not listed in the file	$39.20 – $406.41
Nerve root injection, lower back, with imaging guidance: 10 of 48 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $109.49 AETNA — AETNA MEDICARE LIFE INS: $101.59 BANKERS LIFE — BANKERS LIFE: $101.59 CIGNA HEALTHCARE — ALLEGIANCE: $406.41 CIGNA HEALTHCARE — CIGNA: $406.41 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $406.41 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $101.59 CIRSA — CIRSA: $39.20 CMI — CMI: $39.20 COLORADO ACCESS — COLORADO ACCESS: $126.90
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: CARPEL TUNNEL SURG	$1,375.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,952.77
Carpal tunnel release: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $385.14 AARP SUPPLEMENT — AARP SUPPLEMENT: $1,375.50 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $1,375.50 AETNA — AETNA: $1,347.99 AETNA — AETNA MEDICARE LIFE INS: $385.14 AETNA — AETNA SENIOR SUPPLEMENTAL: $1,375.50 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $1,375.50 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $1,375.50 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $1,375.50 ASSURANT HEALTH — ASSURANT HEALTH: $1,375.50
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: CARPAL TUNNEL SURGERY	$1,375.50	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,952.77
Carpal tunnel release: 10 of 62 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $445.01 AETNA — AETNA MEDICARE LIFE INS: $434.65 BANKERS LIFE — BANKERS LIFE: $434.65 BCBS OF NM — MEDICAID NEW MEXICO IN: $1,261.84 CIGNA HEALTHCARE — ALLEGIANCE: $1,279.21 CIGNA HEALTHCARE — CIGNA: $1,279.21 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $1,279.21 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $434.65 CIRSA — CIRSA: $508.63 CMI — CMI: $508.63
Carpal tunnel release CPT 64721 · Inpatient or outpatient · modifier AS In the file: CARPAL TUNNEL SURGERY	$1,375.50	Not listed in the file	$224.58 – $1,279.21
Carpal tunnel release: 10 of 49 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $445.01 AETNA — AETNA MEDICARE LIFE INS: $434.65 BANKERS LIFE — BANKERS LIFE: $434.65 CIGNA HEALTHCARE — ALLEGIANCE: $1,279.21 CIGNA HEALTHCARE — CIGNA: $1,279.21 CIGNA HEALTHCARE — CIGNA HEALTHCARE: $1,279.21 CIGNA HEALTHSPRING — CIGNA HEALTHSPRING: $434.65 CIRSA — CIRSA: $508.63 CMI — CMI: $508.63 COLORADO ACCESS — COLORADO ACCESS: $224.58
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient In the file: CATARACT REMOVAL	$3,668	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,668
Cataract removal with lens implant: 10 of 131 insurance plan rates AARP SUPPLEMENT — AARP MC ADVANTAGE: $1,027.04 AARP SUPPLEMENT — AARP SUPPLEMENT: $3,668 AARP SUPPLEMENT — AARP SUPPLEMENTAL: $3,668 AETNA — AETNA: $3,594.64 AETNA — AETNA MEDICARE LIFE INS: $1,027.04 AETNA — AETNA SENIOR SUPPLEMENTAL: $3,668 ALLSTATE INSURANCE CO. — ALLSTATE INSURANCE CO: $3,668 AMERICAN FAMILY INS GROUP — AMERICAN FAMILY INSURANCE: $3,668 AMERICAN REPUBLIC — AMERICAN REPUBLIC INS: $3,668 ASSURANT HEALTH — ASSURANT HEALTH: $3,668
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient In the file: XCAPSL CTRC RMVL W/O ECP	$3,668	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,668
Cataract removal with lens implant: 10 of 14 insurance plan rates BCBS OF NM — MEDICAID NEW MEXICO IN: $1,637.15 DISCOUNT CARE PROGRAM CO — DISCOUNT CARE PROGRAM CO: $2,280.73 GEHA — GEHA: $3,521.28 GOLDEN RULE — GOLDEN RULE INSURANCE: $3,521.28 MEDICAID — MEDICAID NEW MEXICO IN: $1,637.15 MEDICAID — MEDICAID NEW MEXICO OUT: $1,637.15 MOLINA NM MEDICAID — MOLINA NM MEDICAID: $1,637.15 PRESBYTERIAN CENTENNIAL — PRESBYTERIAN CENTENIAL MD: $1,637.15 UMR MSA — UMR MSA: $3,521.28 UMWA THE FUNDS 2ND ALWAYS — UMWA COMMERCIAL: $3,521.28

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 or outpatient In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCE	Not listed in the file	Not listed in the file	$59,938.11
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 1 insurance plan FRIDAY HEALTH PLAN — FRIDAY HEALTH PLAN: $59,938.11
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient or outpatient In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$22,411.53
Spinal fusion (not neck), without major complications: rates for 1 insurance plan FRIDAY HEALTH PLAN — FRIDAY HEALTH PLAN: $22,411.53
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient or outpatient In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHME	Not listed in the file	Not listed in the file	$11,818.15
Hip or knee replacement (major joint of the leg), without major complications: rates for 1 insurance plan FRIDAY HEALTH PLAN — FRIDAY HEALTH PLAN: $11,818.15
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient or outpatient In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$14,957.56
Neck (cervical) spinal fusion, without complications: rates for 1 insurance plan FRIDAY HEALTH PLAN — FRIDAY HEALTH PLAN: $14,957.56
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient or outpatient In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY W	Not listed in the file	Not listed in the file	$7,601.62
Uterus and ovary surgery (not for cancer), without complications: rates for 1 insurance plan FRIDAY HEALTH PLAN — FRIDAY HEALTH PLAN: $7,601.62

Source: Mt San Rafael Hospital’s standard charges file (msrhc.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on July 23, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	410 Benedicta Ave, Trinidad, CO 81082
County	Las Animas County
State	Colorado
Phone	(719) 846‑9213
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	5 of 5 stars
CMS Certification Number	061321
Name in Medicare records	MT SAN RAFAEL HOSPITAL
Profile level	Medicare data + hospital website
Official website	msrhc.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 2026-10-31.

Outpatient Specialty Clinics — msrhc.org
Diagnostic Imaging — msrhc.org
Emergency Care — msrhc.org
SANE Program — msrhc.org
Cardiopulmonary — msrhc.org
Medical/Surgical Unit & Infusion Suite — msrhc.org
Surgical Services — msrhc.org
Gynecology/Women's Health — msrhc.org
Rehabilitation and Therapy Services — msrhc.org
Pathology — msrhc.org

Mt San Rafael Hospital

Summary

Profile from official sources

At a glance