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Acute Care Hospital

National Park Medical Center

Hot Springs, Arkansas · Garland County · Emergency services listed

Summary

National Park Medical Center is an acute care hospital in Hot Springs, Arkansas. Medicare data lists emergency services. CMS overall star rating: 2 of 5 stars. Its official website lists 31 services, specialties and programs. Medicare lists 214 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

A general hospital for short-term care: emergencies, surgery, illness and injury. Most patients stay a few days. More about hospital types

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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-11-02). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
2 of 5 stars2 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
166Beds (hospital website)
31Services listed

Quick answers

Does National Park Medical Center have an emergency room?
Yes. Medicare (CMS) data lists emergency services at National Park Medical Center. In a medical emergency, call 911.
Where is National Park Medical Center?
1910 Malvern Avenue, Hot Springs, AR 71901, in Garland County, Arkansas.
What is the phone number of National Park Medical Center?
(501) 321-1000, as listed by Medicare (CMS).
What is the Medicare star rating of National Park Medical Center?
2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][5]

Conditions treated[4]

Treatments[4]

  • Telestroke
  • Teleneurology
  • TelePsychiatry
  • TeleSANE
  • Drug-coated balloon therapy

Procedures[4][5]

  • Bypass surgery
  • Heart valve repair and replacement
  • Minimally invasive and open aortic aneurysm repair
  • Endovascular procedures
  • Digital mammography

Programs and centers[4][5]

  • Heart and Vascular Center of Central Arkansas
  • The Family Maternity Center
  • Center for Sleep Disorders
  • Skilled nursing facility

Emergency care (hospital website)[4]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

Patient portalPatient Portal

Recognition[4][5]

  • Chest Pain Center (American College of Cardiology)
  • The Joint Commission accreditation

Doctors and clinicians (214)

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

Main specialties

Doctors with a page on this site (214)

And 190 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

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

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

  • ARcare - 490.1 mi · Hot Springs National Park, AR · Community health center
  • ARcare-1660.1 mi · Hot Springs National Park, AR · Community health center
  • ARcare - 0830.1 mi · Hot Springs National Park, AR · Community health center

Clinics and urgent care

Pharmacies

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 2 of 5 stars
Overall rating of the hospital2 of 5 stars
Would recommend the hospital2 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines1 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean3 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1060%National average: 72%
Would definitely recommend the hospital60%National average: 71%
Nurses “always” communicated well71%National average: 80%
Doctors “always” communicated well69%National average: 80%
Staff “always” explained medicines before giving them53%National average: 62%
Were given information about recovery at home81%National average: 86%
Room and bathroom “always” clean67%National average: 74%
Area around the room “always” quiet at night51%National average: 60%
Completed surveys705Response 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)0No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)1.158No different from the national benchmark
Surgical site infections after colon surgery3.191Worse than the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients13.8%
Deaths within 30 days: heart failure patients13.1%
Deaths within 30 days: pneumonia patients18.4%
Deaths within 30 days: COPD patients11%
Deaths within 30 days: stroke patients19.4%
Deaths within 30 days: coronary bypass surgery (CABG)3.8%
Serious complications (patient safety indicator PSI-90)1.07No different from the national rate
Complications after hip or knee replacement4.1%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack14.9%
Readmitted within 30 days: heart failure21.2%
Readmitted within 30 days: pneumonia18.6%
Readmitted within 30 days: COPD19.1%
Readmitted within 30 days: coronary bypass surgery11.6%
Readmitted within 30 days: hip or knee replacement7.8%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)153 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)54%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.

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 75 common services exactly as National Park Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean
Hospital charge
The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price
The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates
The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees
A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

$ 6 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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Level iii intermed $246.79 Not listed in the file $246.79
New patient office visit (about 30–44 minutes): 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Office/outpatient visit new $246.79 Not listed in the file $246.79
New patient office visit (about 30–44 minutes): 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: Level iv extended $246.79 Not listed in the file $246.79
New patient office visit (about 45–59 minutes): 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: Office/outpatient visit new $246.79 Not listed in the file $246.79
New patient office visit (about 45–59 minutes): 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Level v comp $246.79 Not listed in the file $246.79
New patient office visit (about 60–74 minutes): 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Office/outpatient visit new $246.79 Not listed in the file $246.79
New patient office visit (about 60–74 minutes): 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: E&m-ep lvl 3 $669 Not listed in the file $669
Established patient office visit (about 20–29 minutes): 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Office/outpatient visit est $669 Not listed in the file $669
Established patient office visit (about 20–29 minutes): 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: E&m-ep lvl 4 $936 Not listed in the file $936
Established patient office visit (about 30–39 minutes): 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Office/outpatient visit est $936 Not listed in the file $936
Established patient office visit (about 30–39 minutes): 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: Emergency dept visit $2,161 Not listed in the file $250.63 – $2,161
Emergency room visit (moderate): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $250.63
  • CIGNA_MEDICARE_ADV — 36676_1: $250.63
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $250.63
  • HUMANA_MEDICARE_SNF — 56581_1: $250.63
  • MEDICARE_A_&_B — 1251_1: $250.63
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $250.63
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $250.63
  • MEDICARE_PART_A_ONLY — 1254_1: $250.63
  • MEDICARE_PSYCH_PPS — 1273_1: $250.63
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $250.63
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: Er visit lvl iii $2,161 Not listed in the file $250.63 – $2,161
Emergency room visit (moderate): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $250.63
  • CIGNA_MEDICARE_ADV — 36676_1: $250.63
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $250.63
  • HUMANA_MEDICARE_SNF — 56581_1: $250.63
  • MEDICARE_A_&_B — 1251_1: $250.63
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $250.63
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $250.63
  • MEDICARE_PART_A_ONLY — 1254_1: $250.63
  • MEDICARE_PSYCH_PPS — 1273_1: $250.63
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $250.63
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Emergency dept visit $3,724 Not listed in the file $385.44 – $3,724
Emergency room visit (moderately high): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $385.44
  • CIGNA_MEDICARE_ADV — 36676_1: $385.44
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $385.44
  • HUMANA_MEDICARE_SNF — 56581_1: $385.44
  • MEDICARE_A_&_B — 1251_1: $385.44
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $385.44
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $385.44
  • MEDICARE_PART_A_ONLY — 1254_1: $385.44
  • MEDICARE_PSYCH_PPS — 1273_1: $385.44
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $385.44
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Er visit lvl iv $3,724 Not listed in the file $385.44 – $3,724
Emergency room visit (moderately high): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $385.44
  • CIGNA_MEDICARE_ADV — 36676_1: $385.44
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $385.44
  • HUMANA_MEDICARE_SNF — 56581_1: $385.44
  • MEDICARE_A_&_B — 1251_1: $385.44
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $385.44
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $385.44
  • MEDICARE_PART_A_ONLY — 1254_1: $385.44
  • MEDICARE_PSYCH_PPS — 1273_1: $385.44
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $385.44
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: Emergency dept visit $5,192 Not listed in the file $554.96 – $5,192
Emergency room visit (high): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $554.96
  • CIGNA_MEDICARE_ADV — 36676_1: $554.96
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $554.96
  • HUMANA_MEDICARE_SNF — 56581_1: $554.96
  • MEDICARE_A_&_B — 1251_1: $554.96
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $554.96
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $554.96
  • MEDICARE_PART_A_ONLY — 1254_1: $554.96
  • MEDICARE_PSYCH_PPS — 1273_1: $554.96
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $554.96
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: Er visit lvl v $5,192 Not listed in the file $554.96 – $5,192
Emergency room visit (high): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $554.96
  • CIGNA_MEDICARE_ADV — 36676_1: $554.96
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $554.96
  • HUMANA_MEDICARE_SNF — 56581_1: $554.96
  • MEDICARE_A_&_B — 1251_1: $554.96
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $554.96
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $554.96
  • MEDICARE_PART_A_ONLY — 1254_1: $554.96
  • MEDICARE_PSYCH_PPS — 1273_1: $554.96
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $554.96

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Basic metabolic panel $1,538 Not listed in the file $54.39 – $1,538
Basic metabolic panel (blood test): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $54.39
  • QUALCHOICE_IQ_HIX — 83669_1: $54.39
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $54.39
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Metabolic panel total ca $1,538 Not listed in the file $54.39 – $1,538
Basic metabolic panel (blood test): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $54.39
  • QUALCHOICE_IQ_HIX — 83669_1: $54.39
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $54.39
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Comp metabolic panel $2,367 Not listed in the file $67.89 – $2,367
Comprehensive metabolic panel (blood test): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $67.89
  • QUALCHOICE_IQ_HIX — 83669_1: $67.89
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $67.89
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Comprehen metabolic panel $2,367 Not listed in the file $67.89 – $2,367
Comprehensive metabolic panel (blood test): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $67.89
  • QUALCHOICE_IQ_HIX — 83669_1: $67.89
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $67.89
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: Lipid panel $1,084 Not listed in the file $13.39 – $1,084
Cholesterol panel (lipid panel): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $13.39
  • CIGNA_MEDICARE_ADV — 36676_1: $13.39
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $13.39
  • HUMANA_MEDICARE_SNF — 56581_1: $13.39
  • MEDICARE_A_&_B — 1251_1: $13.39
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $13.39
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $13.39
  • MEDICARE_PART_A_ONLY — 1254_1: $13.39
  • MEDICARE_PSYCH_PPS — 1273_1: $13.39
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $13.39
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: Renal function panel $755 Not listed in the file $55.86 – $755
Kidney function panel: 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $55.86
  • QUALCHOICE_IQ_HIX — 83669_1: $55.86
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $55.86
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Inpatient or outpatient In the file: Hepatic function panel $294 Not listed in the file $52.50 – $294
Liver function panel: 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $52.50
  • QUALCHOICE_IQ_HIX — 83669_1: $52.50
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $52.50
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: Ua non-auto w/o micro $276 Not listed in the file $16.44 – $276
Urine test (manual, without microscope): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $16.44
  • QUALCHOICE_IQ_HIX — 83669_1: $16.44
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $16.44
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: Urinalysis nonauto w/o scope $276 Not listed in the file $16.44 – $276
Urine test (manual, without microscope): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $16.44
  • QUALCHOICE_IQ_HIX — 83669_1: $16.44
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $16.44
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: Hemoglobin free urine $429 Not listed in the file $14.47 – $429
Urine test (automated, without microscope): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $14.47
  • QUALCHOICE_IQ_HIX — 83669_1: $14.47
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $14.47
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: Urinalysis auto w/o scope $429 Not listed in the file $14.47 – $429
Urine test (automated, without microscope): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $14.47
  • QUALCHOICE_IQ_HIX — 83669_1: $14.47
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $14.47
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Assay of psa total $1,171 Not listed in the file $118.27 – $1,171
PSA (prostate specific antigen) blood test: 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $118.27
  • QUALCHOICE_IQ_HIX — 83669_1: $118.27
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $118.27
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Psa total $1,171 Not listed in the file $118.27 – $1,171
PSA (prostate specific antigen) blood test: 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $118.27
  • QUALCHOICE_IQ_HIX — 83669_1: $118.27
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $118.27
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: Assay thyroid stim hormone $1,088 Not listed in the file $108.07 – $1,088
Thyroid stimulating hormone (TSH) test: 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $108.07
  • QUALCHOICE_IQ_HIX — 83669_1: $108.07
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $108.07
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: Tsh $1,088 Not listed in the file $108.07 – $1,088
Thyroid stimulating hormone (TSH) test: 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $108.07
  • QUALCHOICE_IQ_HIX — 83669_1: $108.07
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $108.07
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: Cbc/plt/auto diff (5) $534 Not listed in the file $50 – $534
Complete blood count (CBC) with differential: 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $50
  • QUALCHOICE_IQ_HIX — 83669_1: $50
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $50
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: Complete cbc w/auto diff wbc $534 Not listed in the file $50 – $534
Complete blood count (CBC) with differential: 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $50
  • QUALCHOICE_IQ_HIX — 83669_1: $50
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $50
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Cbc $534 Not listed in the file $41.62 – $534
Complete blood count (CBC), automated: 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $41.62
  • QUALCHOICE_IQ_HIX — 83669_1: $41.62
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $41.62
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Complete cbc automated $534 Not listed in the file $41.62 – $534
Complete blood count (CBC), automated: 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $41.62
  • QUALCHOICE_IQ_HIX — 83669_1: $41.62
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $41.62
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: Prothrombin time $366 Not listed in the file $25.28 – $366
Blood clotting time test (prothrombin time, PT): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $25.28
  • QUALCHOICE_IQ_HIX — 83669_1: $25.28
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $25.28
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Ptt $302 Not listed in the file $38.60 – $302
Blood clotting test (partial thromboplastin time, PTT): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $38.60
  • QUALCHOICE_IQ_HIX — 83669_1: $38.60
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $38.60
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Thromboplastin time partial $302 Not listed in the file $38.60 – $302
Blood clotting test (partial thromboplastin time, PTT): 10 of 21 insurance plan rates
  • QUALCHOICE_HMO — 83401_1: $38.60
  • QUALCHOICE_IQ_HIX — 83669_1: $38.60
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: $38.60
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: Ct head/br w/o cm $3,538 Not listed in the file $192.42 – $3,538
CT scan of the head or brain, without contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $203.26
  • CIGNA_MEDICARE_ADV — 36676_1: $203.26
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $203.26
  • HUMANA_MEDICARE_SNF — 56581_1: $203.26
  • MEDICARE_A_&_B — 1251_1: $203.26
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $203.26
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $203.26
  • MEDICARE_PART_A_ONLY — 1254_1: $203.26
  • MEDICARE_PSYCH_PPS — 1273_1: $203.26
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $203.26
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: Ct head/brain w/o dye $3,538 Not listed in the file $192.42 – $3,538
CT scan of the head or brain, without contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $203.26
  • CIGNA_MEDICARE_ADV — 36676_1: $203.26
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $203.26
  • HUMANA_MEDICARE_SNF — 56581_1: $203.26
  • MEDICARE_A_&_B — 1251_1: $203.26
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $203.26
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $203.26
  • MEDICARE_PART_A_ONLY — 1254_1: $203.26
  • MEDICARE_PSYCH_PPS — 1273_1: $203.26
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $203.26
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Mri br/head w/wo cm $9,103 Not listed in the file $690.46 – $9,103
MRI of the brain, before and after contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $773.77
  • CIGNA_MEDICARE_ADV — 36676_1: $773.77
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $773.77
  • HUMANA_MEDICARE_SNF — 56581_1: $773.77
  • MEDICARE_A_&_B — 1251_1: $773.77
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $773.77
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $773.77
  • MEDICARE_PART_A_ONLY — 1254_1: $773.77
  • MEDICARE_PSYCH_PPS — 1273_1: $773.77
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $773.77
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Mri brain stem w/o & w/dye $9,103 Not listed in the file $690.46 – $9,103
MRI of the brain, before and after contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $773.77
  • CIGNA_MEDICARE_ADV — 36676_1: $773.77
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $773.77
  • HUMANA_MEDICARE_SNF — 56581_1: $773.77
  • MEDICARE_A_&_B — 1251_1: $773.77
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $773.77
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $773.77
  • MEDICARE_PART_A_ONLY — 1254_1: $773.77
  • MEDICARE_PSYCH_PPS — 1273_1: $773.77
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $773.77
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: Chest 2 views $1,897 Not listed in the file $57.90 – $1,897
Chest X-ray, 2 views: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $762.71
  • CIGNA_MEDICARE_ADV — 36676_1: $762.71
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $762.71
  • HUMANA_MEDICARE_SNF — 56581_1: $762.71
  • MEDICARE_A_&_B — 1251_1: $762.71
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $762.71
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $762.71
  • MEDICARE_PART_A_ONLY — 1254_1: $762.71
  • MEDICARE_PSYCH_PPS — 1273_1: $762.71
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $762.71
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-ray exam chest 2 views $1,897 Not listed in the file $57.90 – $1,897
Chest X-ray, 2 views: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $762.71
  • CIGNA_MEDICARE_ADV — 36676_1: $762.71
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $762.71
  • HUMANA_MEDICARE_SNF — 56581_1: $762.71
  • MEDICARE_A_&_B — 1251_1: $762.71
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $762.71
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $762.71
  • MEDICARE_PART_A_ONLY — 1254_1: $762.71
  • MEDICARE_PSYCH_PPS — 1273_1: $762.71
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $762.71
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: Spinelumbar min 4vws $4,487 Not listed in the file $85.85 – $4,487
X-ray of the lower spine, at least 4 views: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $96.26
  • CIGNA_MEDICARE_ADV — 36676_1: $96.26
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $96.26
  • HUMANA_MEDICARE_SNF — 56581_1: $96.26
  • MEDICARE_A_&_B — 1251_1: $96.26
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $96.26
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $96.26
  • MEDICARE_PART_A_ONLY — 1254_1: $96.26
  • MEDICARE_PSYCH_PPS — 1273_1: $96.26
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $96.26
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 $4,487 Not listed in the file $85.85 – $4,487
X-ray of the lower spine, at least 4 views: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $96.26
  • CIGNA_MEDICARE_ADV — 36676_1: $96.26
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $96.26
  • HUMANA_MEDICARE_SNF — 56581_1: $96.26
  • MEDICARE_A_&_B — 1251_1: $96.26
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $96.26
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $96.26
  • MEDICARE_PART_A_ONLY — 1254_1: $96.26
  • MEDICARE_PSYCH_PPS — 1273_1: $96.26
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $96.26
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: Mri lumbar spine w/o dye $5,476 Not listed in the file $387.68 – $5,476
MRI of the lower back (lumbar spine), without contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $489.04
  • CIGNA_MEDICARE_ADV — 36676_1: $489.04
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $489.04
  • HUMANA_MEDICARE_SNF — 56581_1: $489.04
  • MEDICARE_A_&_B — 1251_1: $489.04
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $489.04
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $489.04
  • MEDICARE_PART_A_ONLY — 1254_1: $489.04
  • MEDICARE_PSYCH_PPS — 1273_1: $489.04
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $489.04
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: Mri sp lumb w/o cm $5,476 Not listed in the file $387.68 – $5,476
MRI of the lower back (lumbar spine), without contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $489.04
  • CIGNA_MEDICARE_ADV — 36676_1: $489.04
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $489.04
  • HUMANA_MEDICARE_SNF — 56581_1: $489.04
  • MEDICARE_A_&_B — 1251_1: $489.04
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $489.04
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $489.04
  • MEDICARE_PART_A_ONLY — 1254_1: $489.04
  • MEDICARE_PSYCH_PPS — 1273_1: $489.04
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $489.04
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: Ct pelvis w/cm $3,824 Not listed in the file $393.86 – $3,824
CT scan of the pelvis, with contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $393.86
  • CIGNA_MEDICARE_ADV — 36676_1: $393.86
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $393.86
  • HUMANA_MEDICARE_SNF — 56581_1: $393.86
  • MEDICARE_A_&_B — 1251_1: $393.86
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $393.86
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $393.86
  • MEDICARE_PART_A_ONLY — 1254_1: $393.86
  • MEDICARE_PSYCH_PPS — 1273_1: $393.86
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $393.86
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: Ct pelvis w/dye $3,824 Not listed in the file $393.86 – $3,824
CT scan of the pelvis, with contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $393.86
  • CIGNA_MEDICARE_ADV — 36676_1: $393.86
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $393.86
  • HUMANA_MEDICARE_SNF — 56581_1: $393.86
  • MEDICARE_A_&_B — 1251_1: $393.86
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $393.86
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $393.86
  • MEDICARE_PART_A_ONLY — 1254_1: $393.86
  • MEDICARE_PSYCH_PPS — 1273_1: $393.86
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $393.86
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 $9,276 Not listed in the file $439.55 – $9,276
MRI of a leg joint (such as the knee), without contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $489.04
  • CIGNA_MEDICARE_ADV — 36676_1: $489.04
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $489.04
  • HUMANA_MEDICARE_SNF — 56581_1: $489.04
  • MEDICARE_A_&_B — 1251_1: $489.04
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $489.04
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $489.04
  • MEDICARE_PART_A_ONLY — 1254_1: $489.04
  • MEDICARE_PSYCH_PPS — 1273_1: $489.04
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $489.04
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: Mri lw jnt w/o cont bi $9,276 Not listed in the file $439.55 – $9,276
MRI of a leg joint (such as the knee), without contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $489.04
  • CIGNA_MEDICARE_ADV — 36676_1: $489.04
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $489.04
  • HUMANA_MEDICARE_SNF — 56581_1: $489.04
  • MEDICARE_A_&_B — 1251_1: $489.04
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $489.04
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $489.04
  • MEDICARE_PART_A_ONLY — 1254_1: $489.04
  • MEDICARE_PSYCH_PPS — 1273_1: $489.04
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $489.04
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Ct abd & pelv w/contrast $13,595 Not listed in the file $393.86 – $13,595
CT scan of the abdomen and pelvis, with contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $393.86
  • CIGNA_MEDICARE_ADV — 36676_1: $393.86
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $393.86
  • HUMANA_MEDICARE_SNF — 56581_1: $393.86
  • MEDICARE_A_&_B — 1251_1: $393.86
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $393.86
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $393.86
  • MEDICARE_PART_A_ONLY — 1254_1: $393.86
  • MEDICARE_PSYCH_PPS — 1273_1: $393.86
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $393.86
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Ct abd pelvis chest with $13,595 Not listed in the file $393.86 – $13,595
CT scan of the abdomen and pelvis, with contrast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $393.86
  • CIGNA_MEDICARE_ADV — 36676_1: $393.86
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $393.86
  • HUMANA_MEDICARE_SNF — 56581_1: $393.86
  • MEDICARE_A_&_B — 1251_1: $393.86
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $393.86
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $393.86
  • MEDICARE_PART_A_ONLY — 1254_1: $393.86
  • MEDICARE_PSYCH_PPS — 1273_1: $393.86
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $393.86
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: Us abdomen complete $4,551 Not listed in the file $218.84 – $4,551
Ultrasound of the abdomen, complete: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $277.43
  • CIGNA_MEDICARE_ADV — 36676_1: $277.43
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $277.43
  • HUMANA_MEDICARE_SNF — 56581_1: $277.43
  • MEDICARE_A_&_B — 1251_1: $277.43
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $277.43
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $277.43
  • MEDICARE_PART_A_ONLY — 1254_1: $277.43
  • MEDICARE_PSYCH_PPS — 1273_1: $277.43
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $277.43
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: Us exam abdom complete $4,551 Not listed in the file $218.84 – $4,551
Ultrasound of the abdomen, complete: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $277.43
  • CIGNA_MEDICARE_ADV — 36676_1: $277.43
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $277.43
  • HUMANA_MEDICARE_SNF — 56581_1: $277.43
  • MEDICARE_A_&_B — 1251_1: $277.43
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $277.43
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $277.43
  • MEDICARE_PART_A_ONLY — 1254_1: $277.43
  • MEDICARE_PSYCH_PPS — 1273_1: $277.43
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $277.43
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: Ob us >= 14 wks sngl fetus $3,483 Not listed in the file $96.26 – $3,483
Pregnancy ultrasound (after the first trimester): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $96.26
  • CIGNA_MEDICARE_ADV — 36676_1: $96.26
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $96.26
  • HUMANA_MEDICARE_SNF — 56581_1: $96.26
  • MEDICARE_A_&_B — 1251_1: $96.26
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $96.26
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $96.26
  • MEDICARE_PART_A_ONLY — 1254_1: $96.26
  • MEDICARE_PSYCH_PPS — 1273_1: $96.26
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $96.26
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: Us ob comp>14wk sgl gest $3,483 Not listed in the file $96.26 – $3,483
Pregnancy ultrasound (after the first trimester): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $96.26
  • CIGNA_MEDICARE_ADV — 36676_1: $96.26
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $96.26
  • HUMANA_MEDICARE_SNF — 56581_1: $96.26
  • MEDICARE_A_&_B — 1251_1: $96.26
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $96.26
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $96.26
  • MEDICARE_PART_A_ONLY — 1254_1: $96.26
  • MEDICARE_PSYCH_PPS — 1273_1: $96.26
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $96.26
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Transvaginal us non-ob $4,656 Not listed in the file $96.26 – $4,656
Transvaginal ultrasound: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $96.26
  • CIGNA_MEDICARE_ADV — 36676_1: $96.26
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $96.26
  • HUMANA_MEDICARE_SNF — 56581_1: $96.26
  • MEDICARE_A_&_B — 1251_1: $96.26
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $96.26
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $96.26
  • MEDICARE_PART_A_ONLY — 1254_1: $96.26
  • MEDICARE_PSYCH_PPS — 1273_1: $96.26
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $96.26
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Us transvaginal $4,656 Not listed in the file $96.26 – $4,656
Transvaginal ultrasound: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $96.26
  • CIGNA_MEDICARE_ADV — 36676_1: $96.26
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $96.26
  • HUMANA_MEDICARE_SNF — 56581_1: $96.26
  • MEDICARE_A_&_B — 1251_1: $96.26
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $96.26
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $96.26
  • MEDICARE_PART_A_ONLY — 1254_1: $96.26
  • MEDICARE_PSYCH_PPS — 1273_1: $96.26
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $96.26
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: Dx mammo incl cad uni $336 Not listed in the file $107.88 – $336
Diagnostic mammogram, one breast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $107.88
  • CIGNA_MEDICARE_ADV — 36676_1: $107.88
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $107.88
  • HUMANA_MEDICARE_SNF — 56581_1: $107.88
  • MEDICARE_A_&_B — 1251_1: $107.88
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $107.88
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $107.88
  • MEDICARE_PART_A_ONLY — 1254_1: $107.88
  • MEDICARE_PSYCH_PPS — 1273_1: $107.88
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $107.88
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: Mammogm diag uni lt cad $336 Not listed in the file $107.88 – $336
Diagnostic mammogram, one breast: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $107.88
  • CIGNA_MEDICARE_ADV — 36676_1: $107.88
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $107.88
  • HUMANA_MEDICARE_SNF — 56581_1: $107.88
  • MEDICARE_A_&_B — 1251_1: $107.88
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $107.88
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $107.88
  • MEDICARE_PART_A_ONLY — 1254_1: $107.88
  • MEDICARE_PSYCH_PPS — 1273_1: $107.88
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $107.88
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: Dx mammo incl cad bi $669 Not listed in the file $136 – $669
Diagnostic mammogram, both breasts: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $136
  • CIGNA_MEDICARE_ADV — 36676_1: $136
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $136
  • HUMANA_MEDICARE_SNF — 56581_1: $136
  • MEDICARE_A_&_B — 1251_1: $136
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $136
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $136
  • MEDICARE_PART_A_ONLY — 1254_1: $136
  • MEDICARE_PSYCH_PPS — 1273_1: $136
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $136
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: Mammogm diag bi cad $669 Not listed in the file $136 – $669
Diagnostic mammogram, both breasts: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $136
  • CIGNA_MEDICARE_ADV — 36676_1: $136
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $136
  • HUMANA_MEDICARE_SNF — 56581_1: $136
  • MEDICARE_A_&_B — 1251_1: $136
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $136
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $136
  • MEDICARE_PART_A_ONLY — 1254_1: $136
  • MEDICARE_PSYCH_PPS — 1273_1: $136
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $136
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: Mammogm scr bi cad $514 Not listed in the file $109.99 – $514
Screening mammogram, both breasts: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $109.99
  • CIGNA_MEDICARE_ADV — 36676_1: $109.99
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $109.99
  • HUMANA_MEDICARE_SNF — 56581_1: $109.99
  • MEDICARE_A_&_B — 1251_1: $109.99
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $109.99
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $109.99
  • MEDICARE_PART_A_ONLY — 1254_1: $109.99
  • MEDICARE_PSYCH_PPS — 1273_1: $109.99
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $109.99
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: Scr mammo bi incl cad $514 Not listed in the file $109.99 – $514
Screening mammogram, both breasts: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $109.99
  • CIGNA_MEDICARE_ADV — 36676_1: $109.99
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $109.99
  • HUMANA_MEDICARE_SNF — 56581_1: $109.99
  • MEDICARE_A_&_B — 1251_1: $109.99
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $109.99
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $109.99
  • MEDICARE_PART_A_ONLY — 1254_1: $109.99
  • MEDICARE_PSYCH_PPS — 1273_1: $109.99
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $109.99

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: Cath hrt lt/inj l vent $34,368 Not listed in the file $2,911.40 – $34,368
Left heart catheterization (diagnostic): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $2,911.40
  • CIGNA_MEDICARE_ADV — 36676_1: $2,911.40
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $2,911.40
  • HUMANA_MEDICARE_SNF — 56581_1: $2,911.40
  • MEDICARE_A_&_B — 1251_1: $2,911.40
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $2,911.40
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $2,911.40
  • MEDICARE_PART_A_ONLY — 1254_1: $2,911.40
  • MEDICARE_PSYCH_PPS — 1273_1: $2,911.40
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $2,911.40
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: Left hrt cath w/ventrclgrphy $34,368 Not listed in the file $2,911.40 – $34,368
Left heart catheterization (diagnostic): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $2,911.40
  • CIGNA_MEDICARE_ADV — 36676_1: $2,911.40
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $2,911.40
  • HUMANA_MEDICARE_SNF — 56581_1: $2,911.40
  • MEDICARE_A_&_B — 1251_1: $2,911.40
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $2,911.40
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $2,911.40
  • MEDICARE_PART_A_ONLY — 1254_1: $2,911.40
  • MEDICARE_PSYCH_PPS — 1273_1: $2,911.40
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $2,911.40
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: Electrophysiology evaluation $29,072 Not listed in the file $6,868.52 – $29,072
Heart rhythm study (electrophysiology evaluation): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $6,868.52
  • CIGNA_MEDICARE_ADV — 36676_1: $6,868.52
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $6,868.52
  • HUMANA_MEDICARE_SNF — 56581_1: $6,868.52
  • MEDICARE_A_&_B — 1251_1: $6,868.52
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $6,868.52
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $6,868.52
  • MEDICARE_PART_A_ONLY — 1254_1: $6,868.52
  • MEDICARE_PSYCH_PPS — 1273_1: $6,868.52
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $6,868.52
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: Eps rec $29,072 Not listed in the file $6,868.52 – $29,072
Heart rhythm study (electrophysiology evaluation): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $6,868.52
  • CIGNA_MEDICARE_ADV — 36676_1: $6,868.52
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $6,868.52
  • HUMANA_MEDICARE_SNF — 56581_1: $6,868.52
  • MEDICARE_A_&_B — 1251_1: $6,868.52
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $6,868.52
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $6,868.52
  • MEDICARE_PART_A_ONLY — 1254_1: $6,868.52
  • MEDICARE_PSYCH_PPS — 1273_1: $6,868.52
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $6,868.52
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: Tx atrial fib pulm vein isol $291,156.78 Not listed in the file $22,205.90 – $291,156.78
Heart rhythm study with ablation for atrial fibrillation: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $22,205.90
  • CIGNA_MEDICARE_ADV — 36676_1: $22,205.90
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $22,205.90
  • HUMANA_MEDICARE_SNF — 56581_1: $22,205.90
  • MEDICARE_A_&_B — 1251_1: $22,205.90
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $22,205.90
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $22,205.90
  • MEDICARE_PART_A_ONLY — 1254_1: $22,205.90
  • MEDICARE_PSYCH_PPS — 1273_1: $22,205.90
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $22,205.90
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: Polysom 6/> yrs 4/> param $2,800 Not listed in the file $920.91 – $2,800
Sleep study (overnight, in a sleep lab): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $920.91
  • CIGNA_MEDICARE_ADV — 36676_1: $920.91
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $920.91
  • HUMANA_MEDICARE_SNF — 56581_1: $920.91
  • MEDICARE_A_&_B — 1251_1: $920.91
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $920.91
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $920.91
  • MEDICARE_PART_A_ONLY — 1254_1: $920.91
  • MEDICARE_PSYCH_PPS — 1273_1: $920.91
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $920.91
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: Polysomnography >4 par $2,800 Not listed in the file $920.91 – $2,800
Sleep study (overnight, in a sleep lab): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $920.91
  • CIGNA_MEDICARE_ADV — 36676_1: $920.91
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $920.91
  • HUMANA_MEDICARE_SNF — 56581_1: $920.91
  • MEDICARE_A_&_B — 1251_1: $920.91
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $920.91
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $920.91
  • MEDICARE_PART_A_ONLY — 1254_1: $920.91
  • MEDICARE_PSYCH_PPS — 1273_1: $920.91
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $920.91

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: Ot therapeutic ex 15 #2 $200 Not listed in the file $26.69 – $200
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $26.69
  • CIGNA_MEDICARE_ADV — 36676_1: $26.69
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $26.69
  • HUMANA_MEDICARE_SNF — 56581_1: $26.69
  • MEDICARE_A_&_B — 1251_1: $26.69
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $26.69
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $26.69
  • MEDICARE_PART_A_ONLY — 1254_1: $26.69
  • MEDICARE_PSYCH_PPS — 1273_1: $26.69
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $26.69
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: Therapeutic exercises $200 Not listed in the file $26.69 – $200
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $26.69
  • CIGNA_MEDICARE_ADV — 36676_1: $26.69
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $26.69
  • HUMANA_MEDICARE_SNF — 56581_1: $26.69
  • MEDICARE_A_&_B — 1251_1: $26.69
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $26.69
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $26.69
  • MEDICARE_PART_A_ONLY — 1254_1: $26.69
  • MEDICARE_PSYCH_PPS — 1273_1: $26.69
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $26.69
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: Pt eval low complex $603 Not listed in the file $90.82 – $603
Physical therapy evaluation (low complexity): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $90.82
  • CIGNA_MEDICARE_ADV — 36676_1: $90.82
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $90.82
  • HUMANA_MEDICARE_SNF — 56581_1: $90.82
  • MEDICARE_A_&_B — 1251_1: $90.82
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $90.82
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $90.82
  • MEDICARE_PART_A_ONLY — 1254_1: $90.82
  • MEDICARE_PSYCH_PPS — 1273_1: $90.82
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $90.82
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: Pt eval low complex 20 min $603 Not listed in the file $90.82 – $603
Physical therapy evaluation (low complexity): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $90.82
  • CIGNA_MEDICARE_ADV — 36676_1: $90.82
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $90.82
  • HUMANA_MEDICARE_SNF — 56581_1: $90.82
  • MEDICARE_A_&_B — 1251_1: $90.82
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $90.82
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $90.82
  • MEDICARE_PART_A_ONLY — 1254_1: $90.82
  • MEDICARE_PSYCH_PPS — 1273_1: $90.82
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $90.82
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: Pt eval mod complex 30 min $1,096 Not listed in the file $90.82 – $1,096
Physical therapy evaluation (moderate complexity): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $90.82
  • CIGNA_MEDICARE_ADV — 36676_1: $90.82
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $90.82
  • HUMANA_MEDICARE_SNF — 56581_1: $90.82
  • MEDICARE_A_&_B — 1251_1: $90.82
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $90.82
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $90.82
  • MEDICARE_PART_A_ONLY — 1254_1: $90.82
  • MEDICARE_PSYCH_PPS — 1273_1: $90.82
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $90.82
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: Pt eval moderate complex $1,096 Not listed in the file $90.82 – $1,096
Physical therapy evaluation (moderate complexity): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $90.82
  • CIGNA_MEDICARE_ADV — 36676_1: $90.82
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $90.82
  • HUMANA_MEDICARE_SNF — 56581_1: $90.82
  • MEDICARE_A_&_B — 1251_1: $90.82
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $90.82
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $90.82
  • MEDICARE_PART_A_ONLY — 1254_1: $90.82
  • MEDICARE_PSYCH_PPS — 1273_1: $90.82
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $90.82
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: Pt eval high complex $1,410 Not listed in the file $90.82 – $1,410
Physical therapy evaluation (high complexity): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $90.82
  • CIGNA_MEDICARE_ADV — 36676_1: $90.82
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $90.82
  • HUMANA_MEDICARE_SNF — 56581_1: $90.82
  • MEDICARE_A_&_B — 1251_1: $90.82
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $90.82
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $90.82
  • MEDICARE_PART_A_ONLY — 1254_1: $90.82
  • MEDICARE_PSYCH_PPS — 1273_1: $90.82
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $90.82
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: Pt eval high complex 45 min $1,410 Not listed in the file $90.82 – $1,410
Physical therapy evaluation (high complexity): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $90.82
  • CIGNA_MEDICARE_ADV — 36676_1: $90.82
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $90.82
  • HUMANA_MEDICARE_SNF — 56581_1: $90.82
  • MEDICARE_A_&_B — 1251_1: $90.82
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $90.82
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $90.82
  • MEDICARE_PART_A_ONLY — 1254_1: $90.82
  • MEDICARE_PSYCH_PPS — 1273_1: $90.82
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $90.82
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: Psytx 30min pt/fam $194 Not listed in the file $129.76 – $517.73
Psychotherapy, 30 minutes: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: Psytx w pt 30 minutes $194 Not listed in the file $129.76 – $517.73
Psychotherapy, 30 minutes: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: Psytx 45min pt/fam $257 Not listed in the file $172.73 – $517.73
Psychotherapy, 45 minutes: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: Psytx w pt 45 minutes $257 Not listed in the file $172.73 – $517.73
Psychotherapy, 45 minutes: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: Psytx 60min pt/fam $333 Not listed in the file $258.64 – $517.73
Psychotherapy, 60 minutes: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: Psytx w pt 60 minutes $333 Not listed in the file $258.64 – $517.73
Psychotherapy, 60 minutes: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient In the file: Family psytx w/o pt 50 min $300 Not listed in the file $208.82 – $517.73
Family psychotherapy, without the patient: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient In the file: Psytx family wo patient $300 Not listed in the file $208.82 – $517.73
Family psychotherapy, without the patient: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: Family psytx w/pt 50 min $300 Not listed in the file $216.34 – $517.73
Family psychotherapy, with the patient: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: Psytx family w patient $300 Not listed in the file $216.34 – $517.73
Family psychotherapy, with the patient: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Group psychotherapy CPT 90853 · Inpatient or outpatient In the file: Group psychotherapy $128 Not listed in the file $122.24 – $517.73
Group psychotherapy: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81
Group psychotherapy CPT 90853 · Inpatient or outpatient In the file: Psytx group (not family) $128 Not listed in the file $122.24 – $517.73
Group psychotherapy: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $369.81
  • CIGNA_MEDICARE_ADV — 36676_1: $369.81
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $369.81
  • HUMANA_MEDICARE_SNF — 56581_1: $369.81
  • MEDICARE_A_&_B — 1251_1: $369.81
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $369.81
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $369.81
  • MEDICARE_PART_A_ONLY — 1254_1: $369.81
  • MEDICARE_PSYCH_PPS — 1273_1: $369.81
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $369.81

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: Removal of breast lesion $41,461.77 Not listed in the file $3,466.15 – $41,461.77
Removal of breast growth (open surgery): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $3,466.15
  • CIGNA_MEDICARE_ADV — 36676_1: $3,466.15
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $3,466.15
  • HUMANA_MEDICARE_SNF — 56581_1: $3,466.15
  • MEDICARE_A_&_B — 1251_1: $3,466.15
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $3,466.15
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $3,466.15
  • MEDICARE_PART_A_ONLY — 1254_1: $3,466.15
  • MEDICARE_PSYCH_PPS — 1273_1: $3,466.15
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $3,466.15
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · modifier LT In the file: Removal of breast lesion $47,277.84 Not listed in the file $3,466.15 – $47,277.84
Removal of breast growth (open surgery): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $3,466.15
  • CIGNA_MEDICARE_ADV — 36676_1: $3,466.15
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $3,466.15
  • HUMANA_MEDICARE_SNF — 56581_1: $3,466.15
  • MEDICARE_A_&_B — 1251_1: $3,466.15
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $3,466.15
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $3,466.15
  • MEDICARE_PART_A_ONLY — 1254_1: $3,466.15
  • MEDICARE_PSYCH_PPS — 1273_1: $3,466.15
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $3,466.15
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · modifier RT In the file: Removal of breast lesion $45,605.88 Not listed in the file $3,466.15 – $45,605.88
Removal of breast growth (open surgery): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $3,466.15
  • CIGNA_MEDICARE_ADV — 36676_1: $3,466.15
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $3,466.15
  • HUMANA_MEDICARE_SNF — 56581_1: $3,466.15
  • MEDICARE_A_&_B — 1251_1: $3,466.15
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $3,466.15
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $3,466.15
  • MEDICARE_PART_A_ONLY — 1254_1: $3,466.15
  • MEDICARE_PSYCH_PPS — 1273_1: $3,466.15
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $3,466.15
Total hip replacement CPT 27130 · Inpatient (hospital stay) In the file: Total hip arthroplasty $176,990.43 Not listed in the file $4,163 – $176,990.43
Total hip replacement: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $11,646.66
  • CIGNA_MEDICARE_ADV — 36676_1: $11,646.66
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $11,646.66
  • HUMANA_MEDICARE_SNF — 56581_1: $11,646.66
  • MEDICARE_A_&_B — 1251_1: $11,646.66
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $11,646.66
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $11,646.66
  • MEDICARE_PART_A_ONLY — 1254_1: $11,646.66
  • MEDICARE_PSYCH_PPS — 1273_1: $11,646.66
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $11,646.66
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Total hip arthroplasty $114,521.03 Not listed in the file $4,163 – $114,521.03
Total hip replacement: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $11,646.66
  • CIGNA_MEDICARE_ADV — 36676_1: $11,646.66
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $11,646.66
  • HUMANA_MEDICARE_SNF — 56581_1: $11,646.66
  • MEDICARE_A_&_B — 1251_1: $11,646.66
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $11,646.66
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $11,646.66
  • MEDICARE_PART_A_ONLY — 1254_1: $11,646.66
  • MEDICARE_PSYCH_PPS — 1273_1: $11,646.66
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $11,646.66
Total hip replacement CPT 27130 · Inpatient or outpatient · modifier LT In the file: Total hip arthroplasty $122,393.08 Not listed in the file $4,163 – $122,393.08
Total hip replacement: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $11,646.66
  • CIGNA_MEDICARE_ADV — 36676_1: $11,646.66
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $11,646.66
  • HUMANA_MEDICARE_SNF — 56581_1: $11,646.66
  • MEDICARE_A_&_B — 1251_1: $11,646.66
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $11,646.66
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $11,646.66
  • MEDICARE_PART_A_ONLY — 1254_1: $11,646.66
  • MEDICARE_PSYCH_PPS — 1273_1: $11,646.66
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $11,646.66
Total knee replacement CPT 27447 · Inpatient (hospital stay) In the file: Total knee arthroplasty $149,741.78 Not listed in the file $4,163 – $149,741.78
Total knee replacement: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $11,646.66
  • CIGNA_MEDICARE_ADV — 36676_1: $11,646.66
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $11,646.66
  • HUMANA_MEDICARE_SNF — 56581_1: $11,646.66
  • MEDICARE_A_&_B — 1251_1: $11,646.66
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $11,646.66
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $11,646.66
  • MEDICARE_PART_A_ONLY — 1254_1: $11,646.66
  • MEDICARE_PSYCH_PPS — 1273_1: $11,646.66
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $11,646.66
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Total knee arthroplasty $120,931.02 Not listed in the file $4,163 – $120,931.02
Total knee replacement: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $11,646.66
  • CIGNA_MEDICARE_ADV — 36676_1: $11,646.66
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $11,646.66
  • HUMANA_MEDICARE_SNF — 56581_1: $11,646.66
  • MEDICARE_A_&_B — 1251_1: $11,646.66
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $11,646.66
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $11,646.66
  • MEDICARE_PART_A_ONLY — 1254_1: $11,646.66
  • MEDICARE_PSYCH_PPS — 1273_1: $11,646.66
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $11,646.66
Total knee replacement CPT 27447 · Inpatient or outpatient · modifier 50 In the file: Total knee arthroplasty $142,856.28 Not listed in the file $4,163 – $142,856.28
Total knee replacement: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $11,646.66
  • CIGNA_MEDICARE_ADV — 36676_1: $11,646.66
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $11,646.66
  • HUMANA_MEDICARE_SNF — 56581_1: $11,646.66
  • MEDICARE_A_&_B — 1251_1: $11,646.66
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $11,646.66
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $11,646.66
  • MEDICARE_PART_A_ONLY — 1254_1: $11,646.66
  • MEDICARE_PSYCH_PPS — 1273_1: $11,646.66
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $11,646.66
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: Shoulder arthroscopy/surgery $97,296.95 Not listed in the file $97,296.95
Shoulder arthroscopy: shaving of shoulder bone: 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier LT In the file: Shoulder arthroscopy/surgery $83,570.81 Not listed in the file $83,570.81
Shoulder arthroscopy: shaving of shoulder bone: 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier RT In the file: Shoulder arthroscopy/surgery $86,470.14 Not listed in the file $86,470.14
Shoulder arthroscopy: shaving of shoulder bone: 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: Knee arthroscopy/surgery $52,800.90 Not listed in the file $2,936.92 – $52,800.90
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $2,936.92
  • CIGNA_MEDICARE_ADV — 36676_1: $2,936.92
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $2,936.92
  • HUMANA_MEDICARE_SNF — 56581_1: $2,936.92
  • MEDICARE_A_&_B — 1251_1: $2,936.92
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $2,936.92
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $2,936.92
  • MEDICARE_PART_A_ONLY — 1254_1: $2,936.92
  • MEDICARE_PSYCH_PPS — 1273_1: $2,936.92
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $2,936.92
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · modifier LT In the file: Knee arthroscopy/surgery $52,391.77 Not listed in the file $2,936.92 – $52,391.77
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $2,936.92
  • CIGNA_MEDICARE_ADV — 36676_1: $2,936.92
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $2,936.92
  • HUMANA_MEDICARE_SNF — 56581_1: $2,936.92
  • MEDICARE_A_&_B — 1251_1: $2,936.92
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $2,936.92
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $2,936.92
  • MEDICARE_PART_A_ONLY — 1254_1: $2,936.92
  • MEDICARE_PSYCH_PPS — 1273_1: $2,936.92
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $2,936.92
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · modifier RT In the file: Knee arthroscopy/surgery $51,168.88 Not listed in the file $2,936.92 – $51,168.88
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $2,936.92
  • CIGNA_MEDICARE_ADV — 36676_1: $2,936.92
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $2,936.92
  • HUMANA_MEDICARE_SNF — 56581_1: $2,936.92
  • MEDICARE_A_&_B — 1251_1: $2,936.92
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $2,936.92
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $2,936.92
  • MEDICARE_PART_A_ONLY — 1254_1: $2,936.92
  • MEDICARE_PSYCH_PPS — 1273_1: $2,936.92
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $2,936.92
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient In the file: Remove tonsils and adenoids $31,504.01 Not listed in the file $2,884 – $31,504.01
Removal of tonsils and adenoids (under age 12): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $5,354.68
  • CIGNA_MEDICARE_ADV — 36676_1: $5,354.68
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $5,354.68
  • HUMANA_MEDICARE_SNF — 56581_1: $5,354.68
  • MEDICARE_A_&_B — 1251_1: $5,354.68
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $5,354.68
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $5,354.68
  • MEDICARE_PART_A_ONLY — 1254_1: $5,354.68
  • MEDICARE_PSYCH_PPS — 1273_1: $5,354.68
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $5,354.68
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · modifier 50 In the file: Remove tonsils and adenoids $35,548.75 Not listed in the file $2,884 – $35,548.75
Removal of tonsils and adenoids (under age 12): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $5,354.68
  • CIGNA_MEDICARE_ADV — 36676_1: $5,354.68
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $5,354.68
  • HUMANA_MEDICARE_SNF — 56581_1: $5,354.68
  • MEDICARE_A_&_B — 1251_1: $5,354.68
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $5,354.68
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $5,354.68
  • MEDICARE_PART_A_ONLY — 1254_1: $5,354.68
  • MEDICARE_PSYCH_PPS — 1273_1: $5,354.68
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $5,354.68
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: Egd diagnostic brush wash $160,392.31 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Not listed in the file $848.65 – $160,392.31 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Upper GI endoscopy (diagnostic): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $848.65
  • CIGNA_MEDICARE_ADV — 36676_1: $848.65
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $848.65
  • HUMANA_MEDICARE_SNF — 56581_1: $848.65
  • MEDICARE_A_&_B — 1251_1: $848.65
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $848.65
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $848.65
  • MEDICARE_PART_A_ONLY — 1254_1: $848.65
  • MEDICARE_PSYCH_PPS — 1273_1: $848.65
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $848.65
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Egd diagnostic brush wash $15,722.31 Not listed in the file $848.65 – $15,722.31
Upper GI endoscopy (diagnostic): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $848.65
  • CIGNA_MEDICARE_ADV — 36676_1: $848.65
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $848.65
  • HUMANA_MEDICARE_SNF — 56581_1: $848.65
  • MEDICARE_A_&_B — 1251_1: $848.65
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $848.65
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $848.65
  • MEDICARE_PART_A_ONLY — 1254_1: $848.65
  • MEDICARE_PSYCH_PPS — 1273_1: $848.65
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $848.65
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) In the file: Egd biopsy single/multiple $161,646.08 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Not listed in the file $848.65 – $161,646.08 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Upper GI endoscopy with biopsy: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $848.65
  • CIGNA_MEDICARE_ADV — 36676_1: $848.65
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $848.65
  • HUMANA_MEDICARE_SNF — 56581_1: $848.65
  • MEDICARE_A_&_B — 1251_1: $848.65
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $848.65
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $848.65
  • MEDICARE_PART_A_ONLY — 1254_1: $848.65
  • MEDICARE_PSYCH_PPS — 1273_1: $848.65
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $848.65
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd biopsy single/multiple $17,597.35 Not listed in the file $848.65 – $17,597.35
Upper GI endoscopy with biopsy: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $848.65
  • CIGNA_MEDICARE_ADV — 36676_1: $848.65
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $848.65
  • HUMANA_MEDICARE_SNF — 56581_1: $848.65
  • MEDICARE_A_&_B — 1251_1: $848.65
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $848.65
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $848.65
  • MEDICARE_PART_A_ONLY — 1254_1: $848.65
  • MEDICARE_PSYCH_PPS — 1273_1: $848.65
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $848.65
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) In the file: Diagnostic colonoscopy $140,669.91 Not listed in the file $825.25 – $140,669.91
Colonoscopy (diagnostic): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $825.25
  • CIGNA_MEDICARE_ADV — 36676_1: $825.25
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $825.25
  • HUMANA_MEDICARE_SNF — 56581_1: $825.25
  • MEDICARE_A_&_B — 1251_1: $825.25
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $825.25
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $825.25
  • MEDICARE_PART_A_ONLY — 1254_1: $825.25
  • MEDICARE_PSYCH_PPS — 1273_1: $825.25
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $825.25
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Diagnostic colonoscopy $16,136.43 Not listed in the file $825.25 – $16,136.43
Colonoscopy (diagnostic): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $825.25
  • CIGNA_MEDICARE_ADV — 36676_1: $825.25
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $825.25
  • HUMANA_MEDICARE_SNF — 56581_1: $825.25
  • MEDICARE_A_&_B — 1251_1: $825.25
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $825.25
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $825.25
  • MEDICARE_PART_A_ONLY — 1254_1: $825.25
  • MEDICARE_PSYCH_PPS — 1273_1: $825.25
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $825.25
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) In the file: Colonoscopy and biopsy $127,002.05 Not listed in the file $1,067.27 – $127,002.05
Colonoscopy with biopsy: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $1,067.27
  • CIGNA_MEDICARE_ADV — 36676_1: $1,067.27
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $1,067.27
  • HUMANA_MEDICARE_SNF — 56581_1: $1,067.27
  • MEDICARE_A_&_B — 1251_1: $1,067.27
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $1,067.27
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $1,067.27
  • MEDICARE_PART_A_ONLY — 1254_1: $1,067.27
  • MEDICARE_PSYCH_PPS — 1273_1: $1,067.27
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $1,067.27
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy and biopsy $18,675.04 Not listed in the file $1,067.27 – $18,675.04
Colonoscopy with biopsy: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $1,067.27
  • CIGNA_MEDICARE_ADV — 36676_1: $1,067.27
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $1,067.27
  • HUMANA_MEDICARE_SNF — 56581_1: $1,067.27
  • MEDICARE_A_&_B — 1251_1: $1,067.27
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $1,067.27
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $1,067.27
  • MEDICARE_PART_A_ONLY — 1254_1: $1,067.27
  • MEDICARE_PSYCH_PPS — 1273_1: $1,067.27
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $1,067.27
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) In the file: Colonoscopy w/lesion removal $94,462.63 Not listed in the file $1,067.27 – $94,462.63
Colonoscopy with removal of polyps (snare): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $1,067.27
  • CIGNA_MEDICARE_ADV — 36676_1: $1,067.27
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $1,067.27
  • HUMANA_MEDICARE_SNF — 56581_1: $1,067.27
  • MEDICARE_A_&_B — 1251_1: $1,067.27
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $1,067.27
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $1,067.27
  • MEDICARE_PART_A_ONLY — 1254_1: $1,067.27
  • MEDICARE_PSYCH_PPS — 1273_1: $1,067.27
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $1,067.27
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colonoscopy w/lesion removal $20,449.72 Not listed in the file $1,067.27 – $20,449.72
Colonoscopy with removal of polyps (snare): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $1,067.27
  • CIGNA_MEDICARE_ADV — 36676_1: $1,067.27
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $1,067.27
  • HUMANA_MEDICARE_SNF — 56581_1: $1,067.27
  • MEDICARE_A_&_B — 1251_1: $1,067.27
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $1,067.27
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $1,067.27
  • MEDICARE_PART_A_ONLY — 1254_1: $1,067.27
  • MEDICARE_PSYCH_PPS — 1273_1: $1,067.27
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $1,067.27
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) In the file: Colonoscopy w/endoscope us $140,669.91 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Not listed in the file $1,067.27 – $140,669.91 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Ultrasound of the lower bowel by endoscope: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $1,067.27
  • CIGNA_MEDICARE_ADV — 36676_1: $1,067.27
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $1,067.27
  • HUMANA_MEDICARE_SNF — 56581_1: $1,067.27
  • MEDICARE_A_&_B — 1251_1: $1,067.27
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $1,067.27
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $1,067.27
  • MEDICARE_PART_A_ONLY — 1254_1: $1,067.27
  • MEDICARE_PSYCH_PPS — 1273_1: $1,067.27
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $1,067.27
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: Colon ca scrn not hi rsk ind $15,568.98 Not listed in the file $825.25 – $15,568.98
Screening colonoscopy (not high risk): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $825.25
  • CIGNA_MEDICARE_ADV — 36676_1: $825.25
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $825.25
  • HUMANA_MEDICARE_SNF — 56581_1: $825.25
  • MEDICARE_A_&_B — 1251_1: $825.25
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $825.25
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $825.25
  • MEDICARE_PART_A_ONLY — 1254_1: $825.25
  • MEDICARE_PSYCH_PPS — 1273_1: $825.25
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $825.25
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) In the file: Laparoscopic cholecystectomy $158,527.83 Not listed in the file $4,483 – $158,527.83
Gallbladder removal by laparoscope: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $5,281.09
  • CIGNA_MEDICARE_ADV — 36676_1: $5,281.09
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $5,281.09
  • HUMANA_MEDICARE_SNF — 56581_1: $5,281.09
  • MEDICARE_A_&_B — 1251_1: $5,281.09
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $5,281.09
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $5,281.09
  • MEDICARE_PART_A_ONLY — 1254_1: $5,281.09
  • MEDICARE_PSYCH_PPS — 1273_1: $5,281.09
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $5,281.09
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopic cholecystectomy $64,454.24 Not listed in the file $4,483 – $64,454.24
Gallbladder removal by laparoscope: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $5,281.09
  • CIGNA_MEDICARE_ADV — 36676_1: $5,281.09
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $5,281.09
  • HUMANA_MEDICARE_SNF — 56581_1: $5,281.09
  • MEDICARE_A_&_B — 1251_1: $5,281.09
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $5,281.09
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $5,281.09
  • MEDICARE_PART_A_ONLY — 1254_1: $5,281.09
  • MEDICARE_PSYCH_PPS — 1273_1: $5,281.09
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $5,281.09
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) In the file: Prp i/hern init reduc >5 yr $104,559.76 Not listed in the file $3,194.40 – $104,559.76
Groin (inguinal) hernia repair, age 5 or older: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $3,194.40
  • CIGNA_MEDICARE_ADV — 36676_1: $3,194.40
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $3,194.40
  • HUMANA_MEDICARE_SNF — 56581_1: $3,194.40
  • MEDICARE_A_&_B — 1251_1: $3,194.40
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $3,194.40
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $3,194.40
  • MEDICARE_PART_A_ONLY — 1254_1: $3,194.40
  • MEDICARE_PSYCH_PPS — 1273_1: $3,194.40
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $3,194.40
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Prp i/hern init reduc >5 yr $59,082.72 Not listed in the file $3,194.40 – $59,082.72
Groin (inguinal) hernia repair, age 5 or older: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $3,194.40
  • CIGNA_MEDICARE_ADV — 36676_1: $3,194.40
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $3,194.40
  • HUMANA_MEDICARE_SNF — 56581_1: $3,194.40
  • MEDICARE_A_&_B — 1251_1: $3,194.40
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $3,194.40
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $3,194.40
  • MEDICARE_PART_A_ONLY — 1254_1: $3,194.40
  • MEDICARE_PSYCH_PPS — 1273_1: $3,194.40
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $3,194.40
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier 50 In the file: Prp i/hern init reduc >5 yr $71,384.02 Not listed in the file $3,194.40 – $71,384.02
Groin (inguinal) hernia repair, age 5 or older: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $3,194.40
  • CIGNA_MEDICARE_ADV — 36676_1: $3,194.40
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $3,194.40
  • HUMANA_MEDICARE_SNF — 56581_1: $3,194.40
  • MEDICARE_A_&_B — 1251_1: $3,194.40
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $3,194.40
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $3,194.40
  • MEDICARE_PART_A_ONLY — 1254_1: $3,194.40
  • MEDICARE_PSYCH_PPS — 1273_1: $3,194.40
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $3,194.40
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) In the file: Laparo radical prostatectomy $149,359.42 Not listed in the file $4,163 – $149,359.42
Prostate removal by laparoscope (radical prostatectomy): 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $9,423.92
  • CIGNA_MEDICARE_ADV — 36676_1: $9,423.92
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $9,423.92
  • HUMANA_MEDICARE_SNF — 56581_1: $9,423.92
  • MEDICARE_A_&_B — 1251_1: $9,423.92
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $9,423.92
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $9,423.92
  • MEDICARE_PART_A_ONLY — 1254_1: $9,423.92
  • MEDICARE_PSYCH_PPS — 1273_1: $9,423.92
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $9,423.92
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: Hysteroscopy biopsy $45,599.53 Not listed in the file $2,878.02 – $45,599.53
Hysteroscopy with biopsy of the uterus lining: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $2,878.02
  • CIGNA_MEDICARE_ADV — 36676_1: $2,878.02
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $2,878.02
  • HUMANA_MEDICARE_SNF — 56581_1: $2,878.02
  • MEDICARE_A_&_B — 1251_1: $2,878.02
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $2,878.02
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $2,878.02
  • MEDICARE_PART_A_ONLY — 1254_1: $2,878.02
  • MEDICARE_PSYCH_PPS — 1273_1: $2,878.02
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $2,878.02
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: Inj foramen epidural l/s $6,297.05 Not listed in the file $805.86 – $6,297.05
Nerve root injection, lower back, with imaging guidance: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $805.86
  • CIGNA_MEDICARE_ADV — 36676_1: $805.86
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $805.86
  • HUMANA_MEDICARE_SNF — 56581_1: $805.86
  • MEDICARE_A_&_B — 1251_1: $805.86
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $805.86
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $805.86
  • MEDICARE_PART_A_ONLY — 1254_1: $805.86
  • MEDICARE_PSYCH_PPS — 1273_1: $805.86
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $805.86
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: Carpal tunnel surgery $43,775.10 Not listed in the file $1,767.59 – $43,775.10
Carpal tunnel release: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $1,767.59
  • CIGNA_MEDICARE_ADV — 36676_1: $1,767.59
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $1,767.59
  • HUMANA_MEDICARE_SNF — 56581_1: $1,767.59
  • MEDICARE_A_&_B — 1251_1: $1,767.59
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $1,767.59
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $1,767.59
  • MEDICARE_PART_A_ONLY — 1254_1: $1,767.59
  • MEDICARE_PSYCH_PPS — 1273_1: $1,767.59
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $1,767.59
Carpal tunnel release CPT 64721 · Inpatient or outpatient · modifier 50 In the file: Carpal tunnel surgery $52,651.52 Not listed in the file $1,767.59 – $52,651.52
Carpal tunnel release: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $1,767.59
  • CIGNA_MEDICARE_ADV — 36676_1: $1,767.59
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $1,767.59
  • HUMANA_MEDICARE_SNF — 56581_1: $1,767.59
  • MEDICARE_A_&_B — 1251_1: $1,767.59
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $1,767.59
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $1,767.59
  • MEDICARE_PART_A_ONLY — 1254_1: $1,767.59
  • MEDICARE_PSYCH_PPS — 1273_1: $1,767.59
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $1,767.59
Carpal tunnel release CPT 64721 · Inpatient or outpatient · modifier LT In the file: Carpal tunnel surgery $44,049.65 Not listed in the file $1,767.59 – $44,049.65
Carpal tunnel release: 10 of 42 insurance plan rates
  • AETNA_MCARE_PPO_OR_HMO — 20676_1: $1,767.59
  • CIGNA_MEDICARE_ADV — 36676_1: $1,767.59
  • HUMANA_CHOICE_PPO_MCR — 56576_1: $1,767.59
  • HUMANA_MEDICARE_SNF — 56581_1: $1,767.59
  • MEDICARE_A_&_B — 1251_1: $1,767.59
  • MEDICARE_IP_PT_B_MED_NEC — 1288_1: $1,767.59
  • MEDICARE_IP_PT_B_ONLY — 1253_1: $1,767.59
  • MEDICARE_PART_A_ONLY — 1254_1: $1,767.59
  • MEDICARE_PSYCH_PPS — 1273_1: $1,767.59
  • MEDICARE_PSYCH_PT_A_ONLY — 1281_1: $1,767.59

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) In the file: Obstetrical care $47,517.39 Not listed in the file $47,517.39
Vaginal delivery, with care before and after: 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) In the file: Cesarean delivery $76,745.26 Not listed in the file $76,745.26
Cesarean delivery (C-section), with care before and after: 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) In the file: Vbac delivery $47,504.91 Not listed in the file $47,504.91
Vaginal delivery after a previous C-section, with care before and after: 10 of 21 insurance plan rates
  • GEHA_UHC — 51501_1: 100% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN — 69601_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_CINERGY_HEALTH — 69603_1: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604: 55% (a percentage in the contract, not a dollar amount)
  • MULTIPLAN_LIMITED_BENEFIT — 69604_1: 55% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_HMO — 83401_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_IQ_HIX — 83669_1: 100% (a percentage in the contract, not a dollar amount)
  • QUALCHOICE_SIGNATURE_NTWK — 83403_1: 100% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with mcc $394,157.81 Not listed in the file $72,559.03 – $131,294.96
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 17 insurance plan rates
  • GEHA_UHC — 51501: $114,850.07
  • NOVASYS_HLTH_INS_EXCHANGE — 74669: $72,559.03
  • NOVASYS_PREFERRED — 75701: $72,559.03
  • QUALCHOICE_HMO — 83401: $131,294.96
  • QUALCHOICE_IQ_HIX — 83669: $131,294.96
  • QUALCHOICE_SIGNATURE_NTWK — 83403: $131,294.96
  • TC_UHC_COMMUNITY_PLAN — 92350: $114,850.07
  • UHC_COMPASS_HIX — 93269: $114,850.07
  • UHC_DEFINITY_HEALTH — 92316: $114,850.07
  • UHC_FISERV_HEALTH — 92317: $114,850.07
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: Major hip and knee joint replacement or reattachment of lower extremity without mcc $141,991.97 Not listed in the file $14,306.65 – $25,887.77
Hip or knee replacement (major joint of the leg), without major complications: 10 of 17 insurance plan rates
  • GEHA_UHC — 51501: $22,645.29
  • NOVASYS_HLTH_INS_EXCHANGE — 74669: $14,306.65
  • NOVASYS_PREFERRED — 75701: $14,306.65
  • QUALCHOICE_HMO — 83401: $25,887.77
  • QUALCHOICE_IQ_HIX — 83669: $25,887.77
  • QUALCHOICE_SIGNATURE_NTWK — 83403: $25,887.77
  • TC_UHC_COMMUNITY_PLAN — 92350: $22,645.29
  • UHC_COMPASS_HIX — 93269: $22,645.29
  • UHC_DEFINITY_HEALTH — 92316: $22,645.29
  • UHC_FISERV_HEALTH — 92317: $22,645.29
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: Cervical spinal fusion without cc/mcc $152,616.37 Not listed in the file $18,107.12 – $32,764.69
Neck (cervical) spinal fusion, without complications: 10 of 17 insurance plan rates
  • GEHA_UHC — 51501: $28,660.86
  • NOVASYS_HLTH_INS_EXCHANGE — 74669: $18,107.12
  • NOVASYS_PREFERRED — 75701: $18,107.12
  • QUALCHOICE_HMO — 83401: $32,764.69
  • QUALCHOICE_IQ_HIX — 83669: $32,764.69
  • QUALCHOICE_SIGNATURE_NTWK — 83403: $32,764.69
  • TC_UHC_COMMUNITY_PLAN — 92350: $28,660.86
  • UHC_COMPASS_HIX — 93269: $28,660.86
  • UHC_DEFINITY_HEALTH — 92316: $28,660.86
  • UHC_FISERV_HEALTH — 92317: $28,660.86
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: Uterine and adnexa procedures for non-malignancy without cc/mcc $80,326.26 Not listed in the file $9,202.27 – $16,651.43
Uterus and ovary surgery (not for cancer), without complications: 10 of 17 insurance plan rates
  • GEHA_UHC — 51501: $14,565.82
  • NOVASYS_HLTH_INS_EXCHANGE — 74669: $9,202.27
  • NOVASYS_PREFERRED — 75701: $9,202.27
  • QUALCHOICE_HMO — 83401: $16,651.43
  • QUALCHOICE_IQ_HIX — 83669: $16,651.43
  • QUALCHOICE_SIGNATURE_NTWK — 83403: $16,651.43
  • TC_UHC_COMMUNITY_PLAN — 92350: $14,565.82
  • UHC_COMPASS_HIX — 93269: $14,565.82
  • UHC_DEFINITY_HEALTH — 92316: $14,565.82
  • UHC_FISERV_HEALTH — 92317: $14,565.82

Source: National Park Medical Center’s standard charges file (nationalparkmedical.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on July 17, 2026; retrieved November 5, 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 typeAcute Care Hospital
Address1910 Malvern Avenue, Hot Springs, AR 71901
CountyGarland County
StateArkansas
Phone(501) 321‑1000
Emergency servicesYes
OwnershipProprietary
Medicare overall rating2 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number040078
Name in Medicare recordsNATIONAL PARK MEDICAL CENTER
Profile levelMedicare data + hospital website
Official websitenationalparkmedical.com
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-11-02.

  1. National Park Medical Center | Hot Springs, AR Hospital — nationalparkmedical.com
  2. Hot Springs, AR - Capella Health — capellahealth.com