Does Nationwide Children's Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Nationwide Children's Hospital. In a medical emergency, call 911.

Where is Nationwide Children's Hospital?

700 Children's Drive, Columbus, OH 43205, in Franklin County, Ohio.

What is the phone number of Nationwide Children's Hospital?

(614) 722-2000, as listed by Medicare (CMS).

What is the Medicare star rating of Nationwide Children's Hospital?

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

Nationwide Children's Hospital — Columbus, OH

Quick answers

Does Nationwide Children's Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Nationwide Children's Hospital. In a medical emergency, call 911.
Where is Nationwide Children's Hospital?: 700 Children's Drive, Columbus, OH 43205, in Franklin County, Ohio.
What is the phone number of Nationwide Children's Hospital?: (614) 722-2000, as listed by Medicare (CMS).
What is the Medicare star rating of Nationwide Children's Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^{[6][7][8][11][12][15][16]}

Conditions treated^{[6][8][9][10][12][13][15]}

Congenital heart disease
Hypoplastic left heart syndrome
Single ventricle heart defect
Atrial septal defect
Patent ductus arteriosus
Tetralogy of Fallot
Transposition of the great vessels
Kawasaki disease
Pulmonary hypertension
Aneurysmal bone cyst
Dermoid cyst
Lymphatic malformation
Ranula
Sialorrhea (drooling)
Ear infections (otitis media)
Hearing loss
Sleep apnea
Croup
Tonsillitis
Sinusitis
Tongue tie
Recurrent respiratory papillomatosis
Choanal atresia
Subglottic stenosis
Tracheomalacia
Laryngomalacia

Treatments^{[6][7][8][10][11][12][13]}

Heart transplant
Fontan procedure
Hybrid stage 1 procedure
Cardiac catheterization
Balloon dilation of valves or vessels
Coil embolization
Catheter ablation
Stenting of narrowed vessels
Transcatheter pulmonary valve implantation
Septal defect closure
Patent ductus arteriosus closure
Ventricular assist device support
Sclerotherapy
Salivary gland ablation
Electrophysiology and pacing
Echocardiography

Procedures^[8][12][16]

Heart and chest surgery
Dermoid cyst ablation
Orbital sclerotherapy
Surgical treatment for excessive drooling

Programs and centers^{[6][8][13][15][16]}

Adolescent & Adult Congenital Heart Disease (ACHD) Program
Fetal Cardiac Program
Single Ventricle Program
Heart Transplant Program
Lung & Heart-Lung Transplant Program
Mechanical Cardiopulmonary Assist Program
Kawasaki Disease Program
Pulmonary Hypertension Program
Cardiac Neurodevelopmental Outcomes Program
Hearing Program
Aerodigestive Disorders Clinic
Rhinology Clinic
Salivary Gland Disorders Clinic
Voice and Swallowing Disorder Clinic
Pediatric Fontan Clinic

Emergency care (hospital website)^[4]

Emergency room	Yes

Visiting and practical information

Interpreters and languages	Language services for limited-English and deaf/hard-of-hearing families are offered at no cost, via staff and contracted interpreters, phone and video^[14]
Patient portal	MyChart

Recognition^[6]

Five-year accreditation from the Adult Congenital Heart Association (ACHD program)

Doctors and clinicians (215)

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

Main specialties

And 191 more: the button below opens the full list.

Other emergency rooms nearby

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

Grant Medical Center0.9 mi · Columbus, OH · Acute Care Hospital
Ohio State University State Health System3.5 mi · Columbus, OH · Acute Care Hospital
Twin Valley Behavioral Healthcare4.2 mi · Columbus, OH · Psychiatric Hospital
Riverside Methodist Hospital6.1 mi · Columbus, OH · Acute Care Hospital
Mount Carmel East & West7.4 mi · Columbus, OH · Acute Care Hospital

Other hospitals nearby

Select Specialty Hospital Columbus1.6 mi · Columbus, OH · Long-Term Acute Care Hospital
River Vista Health and Wellness LLC2.2 mi · Columbus, OH · Psychiatric Hospital
Ohio Hospital for Psychiatry2.3 mi · Columbus, OH · Psychiatric Hospital
OhioHealth Rehabilitation Hospital2.7 mi · Columbus, OH · Inpatient Rehabilitation Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Bella Terrace Rehabilitation and Nursing Center1.6 mi · Columbus, OH · 2 of 5 stars
Scioto Pointe2.3 mi · Columbus, OH · 3 of 5 stars
Ohio Living Westminster-Thurber2.3 mi · Columbus, OH · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Nationwide Children's Hospital Homecare2.0 mi · Columbus, OH
Zusman Community Hospice2.7 mi · Columbus, OH · 3 of 5 stars
Mount Carmel Hospice3.0 mi · Columbus, OH · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Matrix Home Care LLC1.0 mi · Columbus, OH
Raamis Community Home Health Care, Inc1.0 mi · Columbus, OH
River's Crossing Home Health1.0 mi · Columbus, OH

All home health agencies in the state →

Dialysis facilities

NATIONWIDE CHILDRENS HOSPITAL - Dialysis1.0 mi · Columbus, OH
DaVita Columbus Downtown Dialysis2.0 mi · Columbus, OH · 2 of 5 stars
FMC - Grant Park2.0 mi · Columbus, OH · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Downtown Endoscopy Center2.0 mi · Columbus, OH
Eye Center of Columbus, LLC2.0 mi · Columbus, OH
Vacco Ambulatory Surgery Center3.0 mi · Columbus, OH

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

FOH Men's Shelter- Dental Site0.5 mi · Columbus, OH · Community health center
PrimaryOne Health 240 Parsons Avenue, Suite 2330.5 mi · Columbus, OH · Community health center
PrimaryOne Health 1180 East Main Street0.7 mi · Columbus, OH · Community health center

Clinics and urgent care

Arlington Urgent Care Inc2.7 mi · Bexley, OH · Urgent care center
Southside Health Urgent Care, Inc4.0 mi · Columbus, OH · Urgent care center
Carbon Health Medical Group of Florida PA4.9 mi · Columbus, OH · Urgent care center

Pharmacies

Kessco Inc0.7 mi · Columbus, OH · Pharmacy
DBA East Main Street Pharmacy1.0 mi · Columbus, OH · Community/retail pharmacy
Global RX Pharmacy1.0 mi · Columbus, OH · Pharmacy

Assisted living nearby

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

Ohio Living Westminster-Thurber2.0 mi · Columbus, OH
Bickford of Bexley2.7 mi · Bexley, OH
Creekside at the Village2.7 mi · Columbus, OH
The Cottage at Wexner Heritage Village2.7 mi · Columbus, OH

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

What patients said (patient survey)

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

Not reported to Medicare

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

Infections caught in the hospital

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

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

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

Complications and deaths

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

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

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

Return visits to the hospital (readmissions)

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

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

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026.

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.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	Not reported to Medicare
Patients who left the emergency room before being seen (OP-22)	Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Columbus Best hospitals in Columbus

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Nationwide Children's Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99203-OFF VISIT NEW LVL 3	$296	$266.40	$192.40 – $290.08
New patient office visit (about 30–44 minutes): 10 of 26 insurance plan rates Aetna — All Products: $266.40 Aetna — Coventry Cares WV: $281.20 AHPO — All Products: $278.24 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $269.36 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $61.10 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $278.24
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$337	$303.30	$242.64 – $252.75
New patient office visit (about 30–44 minutes): 10 of 22 insurance plan rates Aetna — All Products: $201.13 Aetna — Coventry Cares WV: $252.75 Amerihealth — Managed Medicaid - Non-Cap: $64.28 Anthem — All Products: $229.49 Anthem — Managed Medicaid: $64.28 BCHP — Managed Medicaid - Non-Cap: $64.28 Caresource — Just4Me/Marketplace: $168.75 Caresource — Managed Medicaid - Non-Cap: $64.28 Cigna — All Products: $252.75 Front Path Health Coalition — All Products: $252.75
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99203-OFF VISIT NEW LVL 3	$296	$266.40	$192.40 – $290.08
New patient office visit (about 30–44 minutes): rates for 6 insurance plans Aetna — All Products: $281.20 Anthem BCBS — All Products: $278.24 Humana — All Products: $281.20 Ohio PPO Connect — All Products: $275.28 OSU — All Products: $275.28 UHC — All Products: $281.20
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99204-OFF VISIT NEW LVL 4	$382	$343.80	$248.30 – $374.36
New patient office visit (about 45–59 minutes): 10 of 26 insurance plan rates Aetna — All Products: $343.80 Aetna — Coventry Cares WV: $362.90 AHPO — All Products: $359.08 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $347.62 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $70.50 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $359.08
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$548	$493.20	$394.56 – $411
New patient office visit (about 45–59 minutes): 10 of 22 insurance plan rates Aetna — All Products: $335.76 Aetna — Coventry Cares WV: $411 Amerihealth — Managed Medicaid - Non-Cap: $98.03 Anthem — All Products: $324.35 Anthem — Managed Medicaid: $98.03 BCHP — Managed Medicaid - Non-Cap: $98.03 Caresource — Just4Me/Marketplace: $255.37 Caresource — Managed Medicaid - Non-Cap: $98.03 Cigna — All Products: $411 Front Path Health Coalition — All Products: $411
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99204-OFF VISIT NEW LVL 4	$382	$343.80	$248.30 – $374.36
New patient office visit (about 45–59 minutes): rates for 6 insurance plans Aetna — All Products: $362.90 Anthem BCBS — All Products: $359.08 Humana — All Products: $362.90 Ohio PPO Connect — All Products: $355.26 OSU — All Products: $355.26 UHC — All Products: $362.90
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99205-OFF VISIT NEW LVL 5	$493	$443.70	$320.45 – $483.14
New patient office visit (about 60–74 minutes): 10 of 26 insurance plan rates Aetna — All Products: $443.70 Aetna — Coventry Cares WV: $468.35 AHPO — All Products: $463.42 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $448.63 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $79.90 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $463.42
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$746	$671.40	$537.12 – $559.50
New patient office visit (about 60–74 minutes): 10 of 22 insurance plan rates Aetna — All Products: $436.54 Aetna — Coventry Cares WV: $559.50 Amerihealth — Managed Medicaid - Non-Cap: $123.18 Anthem — All Products: $422.59 Anthem — Managed Medicaid: $123.18 BCHP — Managed Medicaid - Non-Cap: $123.18 Caresource — Just4Me/Marketplace: $341.28 Caresource — Managed Medicaid - Non-Cap: $123.18 Cigna — All Products: $559.50 Front Path Health Coalition — All Products: $559.50
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99205-OFF VISIT NEW LVL 5	$493	$443.70	$320.45 – $483.14
New patient office visit (about 60–74 minutes): rates for 6 insurance plans Aetna — All Products: $468.35 Anthem BCBS — All Products: $463.42 Humana — All Products: $468.35 Ohio PPO Connect — All Products: $458.49 OSU — All Products: $458.49 UHC — All Products: $468.35
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99213-OFF VISIT EST LVL 3	$209	$188.10	$135.85 – $204.82
Established patient office visit (about 20–29 minutes): 10 of 26 insurance plan rates Aetna — All Products: $188.10 Aetna — Coventry Cares WV: $198.55 AHPO — All Products: $196.46 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $190.19 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $56.40 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $196.46
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PBSC DONOR INFO. SESSION - US	$1,300	$1,170	$611 – $1,274
Established patient office visit (about 20–29 minutes): 10 of 26 insurance plan rates Aetna — All Products: $1,170 Aetna — Coventry Cares WV: $1,235 AHPO — All Products: $1,222 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $271.67 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $611 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $105
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BM DONOR INFO. SESSION - US	$1,340	$1,206	$871 – $1,313.20
Established patient office visit (about 20–29 minutes): 10 of 25 insurance plan rates Aetna — All Products: $1,206 Aetna — Coventry Cares WV: $1,273 AHPO — All Products: $1,259.60 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $1,219.40 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $1,259.60 Emerald Health — All Products: $1,313.20
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99214-OFF VISIT EST LVL 4	$271	$243.90	$176.15 – $265.58
Established patient office visit (about 30–39 minutes): 10 of 26 insurance plan rates Aetna — All Products: $243.90 Aetna — Coventry Cares WV: $257.45 AHPO — All Products: $254.74 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $246.61 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $65.80 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $254.74
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$398	$358.20	$286.56 – $298.50
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates Aetna — All Products: $203.42 Aetna — Coventry Cares WV: $298.50 Amerihealth — Managed Medicaid - Non-Cap: $73.62 Anthem — All Products: $178.08 Anthem — Managed Medicaid: $73.62 BCHP — Managed Medicaid - Non-Cap: $73.62 Caresource — Just4Me/Marketplace: $194.75 Caresource — Managed Medicaid - Non-Cap: $73.62 Cigna — All Products: $298.50 Front Path Health Coalition — All Products: $298.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99214-OFF VISIT EST LVL 4	$271	$243.90	$176.15 – $265.58
Established patient office visit (about 30–39 minutes): rates for 6 insurance plans Aetna — All Products: $257.45 Anthem BCBS — All Products: $254.74 Humana — All Products: $257.45 Ohio PPO Connect — All Products: $252.03 OSU — All Products: $252.03 UHC — All Products: $257.45
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$381	$342.90	$63.78 – $287.10
Office consultation with a specialist (moderate): 10 of 19 insurance plan rates Aetna — All Products: $287.10 Aetna — Coventry Cares WV: $285.75 Amerihealth — Managed Medicaid - Non-Cap: $63.78 Anthem — All Products: $219.60 Anthem — Managed Medicaid: $63.78 BCHP — Managed Medicaid - Non-Cap: $63.78 Caresource — Managed Medicaid - Non-Cap: $63.78 Cigna — All Products: $285.75 Front Path Health Coalition — All Products: $285.75 Humana — All Products: $211.37
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Off/op cnsltj new/est low 30	Not listed in the file	Not listed in the file	$105.58
Office consultation with a specialist (moderate): rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Managed Medicaid - Non-Cap: $105.58 Humana — Managed Medicaid - Non-Cap: $105.58 Molina — Managed Medicaid - Non-Cap: $105.58 UHC — Managed Medicaid - Non-Cap: $105.58
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$318.55
Office consultation with a specialist (moderate): rates for 1 insurance plan Anthem BCBS — All Products: $318.55
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$614	$552.60	$399.10 – $460.50
Office consultation with a specialist (moderate to high): 10 of 19 insurance plan rates Aetna — All Products: $452.91 Aetna — Coventry Cares WV: $460.50 Amerihealth — Managed Medicaid - Non-Cap: $95.03 Anthem — All Products: $324.35 Anthem — Managed Medicaid: $95.03 BCHP — Managed Medicaid - Non-Cap: $95.03 Caresource — Managed Medicaid - Non-Cap: $95.03 Cigna — All Products: $460.50 Front Path Health Coalition — All Products: $460.50 Humana — All Products: $340.29
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Off/op cnsltj new/est mod 40	Not listed in the file	Not listed in the file	$105.58
Office consultation with a specialist (moderate to high): rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Managed Medicaid - Non-Cap: $105.58 Humana — Managed Medicaid - Non-Cap: $105.58 Molina — Managed Medicaid - Non-Cap: $105.58 UHC — Managed Medicaid - Non-Cap: $105.58
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$436.56
Office consultation with a specialist (moderate to high): rates for 1 insurance plan Anthem BCBS — All Products: $436.56
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99385-PREV VISIT NEW 18-39YR	$200	$180	$94 – $196
Preventive checkup, new patient, age 18–39: 10 of 26 insurance plan rates Aetna — All Products: $180 Aetna — Coventry Cares WV: $190 AHPO — All Products: $188 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $200 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $94 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $105
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$491	$441.90	$75.11 – $327.88
Preventive checkup, new patient, age 18–39: 10 of 19 insurance plan rates Aetna — All Products: $75.11 Aetna — Coventry Cares WV: $368.25 Amerihealth — Managed Medicaid - Non-Cap: $82.01 Anthem — All Products: $327.88 Anthem — Managed Medicaid: $82.01 BCHP — Managed Medicaid - Non-Cap: $82.01 Caresource — Managed Medicaid - Non-Cap: $82.01 Cigna — All Products: $368.25 Front Path Health Coalition — All Products: $368.25 Humana — All Products: $216.68
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99385-PREV VISIT NEW 18-39YR	$200	$180	$94 – $196
Preventive checkup, new patient, age 18–39: rates for 6 insurance plans Aetna — All Products: $190 Anthem BCBS — All Products: $188 Humana — All Products: $190 Ohio PPO Connect — All Products: $186 OSU — All Products: $186 UHC — All Products: $190
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99386-PREV VISIT NEW 40-64YR	$200	$180	$94 – $196
Preventive checkup, new patient, age 40–64: 10 of 26 insurance plan rates Aetna — All Products: $180 Aetna — Coventry Cares WV: $190 AHPO — All Products: $188 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $200 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $94 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $105
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$625	$562.50	$406.25 – $468.75
Preventive checkup, new patient, age 40–64: 10 of 19 insurance plan rates Aetna — All Products: $91.44 Aetna — Coventry Cares WV: $468.75 Amerihealth — Managed Medicaid - Non-Cap: $100.02 Anthem — All Products: $346.51 Anthem — Managed Medicaid: $100.02 BCHP — Managed Medicaid - Non-Cap: $100.02 Caresource — Managed Medicaid - Non-Cap: $100.02 Cigna — All Products: $468.75 Front Path Health Coalition — All Products: $468.75 Humana — All Products: $263.77
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99386-PREV VISIT NEW 40-64YR	$200	$180	$94 – $196
Preventive checkup, new patient, age 40–64: rates for 6 insurance plans Aetna — All Products: $190 Anthem BCBS — All Products: $188 Humana — All Products: $190 Ohio PPO Connect — All Products: $186 OSU — All Products: $186 UHC — All Products: $190
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99283-LEVEL 3	$930	$837	$604.50 – $911.40
Emergency room visit (moderate): 10 of 27 insurance plan rates Aetna — All Products: $837 Aetna — Coventry Cares WV: $883.50 AHPO — All Products: $874.20 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $846.30 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $418.34 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $874.20
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT LOW MDM	$293	$263.70	$64.04 – $202.23
Emergency room visit (moderate): 10 of 15 insurance plan rates Aetna — All Products: $182.27 Aetna — Coventry Cares WV: $219.75 Anthem — All Products: $201.64 Caresource — Just4Me/Marketplace: $103.07 Cigna — All Products: $219.75 Front Path Health Coalition — All Products: $219.75 Humana — All Products: $163.01 MMO — All Products: $210.96 OHC — All Products: $219.75 OHG — All Products: $219.75
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99283-LEVEL 3	$930	$837	$604.50 – $911.40
Emergency room visit (moderate): rates for 6 insurance plans Aetna — All Products: $883.50 Anthem BCBS — All Products: $874.20 Humana — All Products: $883.50 Ohio PPO Connect — All Products: $864.90 OSU — All Products: $864.90 UHC — All Products: $883.50
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99284-LEVEL 4	$1,350	$1,215	$877.50 – $1,323
Emergency room visit (moderately high): 10 of 27 insurance plan rates Aetna — All Products: $1,215 Aetna — Coventry Cares WV: $1,282.50 AHPO — All Products: $1,269 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $1,228.50 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $639.45 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $1,269
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$501	$450.90	$109.36 – $347.63
Emergency room visit (moderately high): 10 of 15 insurance plan rates Aetna — All Products: $339.44 Aetna — Coventry Cares WV: $375.75 Anthem — All Products: $314.75 Caresource — Just4Me/Marketplace: $175.54 Cigna — All Products: $375.75 Front Path Health Coalition — All Products: $375.75 Humana — All Products: $277.02 MMO — All Products: $360.72 OHC — All Products: $375.75 OHG — All Products: $375.75
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99284-LEVEL 4	$1,350	$1,215	$877.50 – $1,323
Emergency room visit (moderately high): rates for 6 insurance plans Aetna — All Products: $1,282.50 Anthem BCBS — All Products: $1,269 Humana — All Products: $1,282.50 Ohio PPO Connect — All Products: $1,255.50 OSU — All Products: $1,255.50 UHC — All Products: $1,282.50
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99285-LEVEL 5	$2,700	$2,430	$1,755 – $2,646
Emergency room visit (high): 10 of 27 insurance plan rates Aetna — All Products: $2,430 Aetna — Coventry Cares WV: $2,565 AHPO — All Products: $2,538 Amerihealth — Managed Medicaid - Non-Cap: $105.58 Anthem — Managed Medicaid - Non-Cap: $105.58 Anthem BCBS — All Products: $2,457 BCHP — Managed Medicaid - Non-Cap: $105.58 Caresource — Just4Me/Marketplace: $912.65 Caresource — Managed Medicaid - Non-Cap: $105.58 Cigna — All Products: $2,538
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$727	$654.30	$158.68 – $505.99
Emergency room visit (high): 10 of 15 insurance plan rates Aetna — All Products: $505.99 Aetna — Coventry Cares WV: $545.25 Anthem — All Products: $493.04 Caresource — Just4Me/Marketplace: $254.38 Cigna — All Products: $545.25 Front Path Health Coalition — All Products: $545.25 Humana — All Products: $404.73 MMO — All Products: $523.44 OHC — All Products: $545.25 OHG — All Products: $545.25
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99285-LEVEL 5	$2,700	$2,430	$1,755 – $2,646
Emergency room visit (high): rates for 6 insurance plans Aetna — All Products: $2,565 Anthem BCBS — All Products: $2,538 Humana — All Products: $2,565 Ohio PPO Connect — All Products: $2,511 OSU — All Products: $2,511 UHC — All Products: $2,565

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL CALCIUM TOTAL	$140	$126	$65.80 – $137.20
Basic metabolic panel (blood test): 10 of 26 insurance plan rates Aetna — All Products: $126 Aetna — Coventry Cares WV: $133 AHPO — All Products: $131.60 Amerihealth — Managed Medicaid - Non-Cap: $30.22 Anthem — Managed Medicaid - Non-Cap: $30.22 Anthem BCBS — All Products: $25.27 BCHP — Managed Medicaid - Non-Cap: $30.22 Caresource — Just4Me/Marketplace: $65.80 Caresource — Managed Medicaid - Non-Cap: $30.22 Cigna — All Products: $131.60
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$104	$93.60	$48.88 – $101.92
Basic metabolic panel (blood test): 10 of 26 insurance plan rates Aetna — All Products: $93.60 Aetna — Coventry Cares WV: $98.80 AHPO — All Products: $97.76 Amerihealth — Managed Medicaid - Non-Cap: $30.22 Anthem — Managed Medicaid - Non-Cap: $30.22 Anthem BCBS — All Products: $25.27 BCHP — Managed Medicaid - Non-Cap: $30.22 Caresource — Just4Me/Marketplace: $48.88 Caresource — Managed Medicaid - Non-Cap: $30.22 Cigna — All Products: $97.76
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL CALCIUM TOTAL	$140	$126	$65.80 – $137.20
Basic metabolic panel (blood test): rates for 6 insurance plans Aetna — All Products: $133 Anthem BCBS — All Products: $131.60 Humana — All Products: $133 Ohio PPO Connect — All Products: $130.20 OSU — All Products: $130.20 UHC — All Products: $133
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL	$165	$148.50	$77.55 – $161.70
Comprehensive metabolic panel (blood test): 10 of 26 insurance plan rates Aetna — All Products: $148.50 Aetna — Coventry Cares WV: $156.75 AHPO — All Products: $155.10 Amerihealth — Managed Medicaid - Non-Cap: $30.22 Anthem — Managed Medicaid - Non-Cap: $30.22 Anthem BCBS — All Products: $43.62 BCHP — Managed Medicaid - Non-Cap: $30.22 Caresource — Just4Me/Marketplace: $77.55 Caresource — Managed Medicaid - Non-Cap: $30.22 Cigna — All Products: $155.10
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMP METABOLIC PANEL	$159	$143.10	$74.73 – $155.82
Comprehensive metabolic panel (blood test): 10 of 26 insurance plan rates Aetna — All Products: $143.10 Aetna — Coventry Cares WV: $151.05 AHPO — All Products: $149.46 Amerihealth — Managed Medicaid - Non-Cap: $30.22 Anthem — Managed Medicaid - Non-Cap: $30.22 Anthem BCBS — All Products: $43.62 BCHP — Managed Medicaid - Non-Cap: $30.22 Caresource — Just4Me/Marketplace: $74.73 Caresource — Managed Medicaid - Non-Cap: $30.22 Cigna — All Products: $149.46
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL	$165	$148.50	$77.55 – $161.70
Comprehensive metabolic panel (blood test): rates for 6 insurance plans Aetna — All Products: $156.75 Anthem BCBS — All Products: $155.10 Humana — All Products: $156.75 Ohio PPO Connect — All Products: $153.45 OSU — All Products: $153.45 UHC — All Products: $156.75
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel	Not listed in the file	Not listed in the file	$30.22
Obstetric blood test panel: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $30.22 Anthem — Managed Medicaid - Non-Cap: $30.22 BCHP — Managed Medicaid - Non-Cap: $30.22 Caresource — Managed Medicaid - Non-Cap: $30.22 Humana — Managed Medicaid - Non-Cap: $30.22 Molina — Managed Medicaid - Non-Cap: $30.22 UHC — Managed Medicaid - Non-Cap: $30.22
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$171.95
Obstetric blood test panel: rates for 2 insurance plans Anthem BCBS — All Products: $171.95 Caresource — Just4Me/Marketplace: $71.72
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$149	$134.10	$70.03 – $146.02
Cholesterol panel (lipid panel): 10 of 26 insurance plan rates Aetna — All Products: $134.10 Aetna — Coventry Cares WV: $141.55 AHPO — All Products: $140.06 Amerihealth — Managed Medicaid - Non-Cap: $30.22 Anthem — Managed Medicaid - Non-Cap: $30.22 Anthem BCBS — All Products: $43.84 BCHP — Managed Medicaid - Non-Cap: $30.22 Caresource — Just4Me/Marketplace: $70.03 Caresource — Managed Medicaid - Non-Cap: $30.22 Cigna — All Products: $140.06
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIPID PANEL	$149	$134.10	$70.03 – $146.02
Cholesterol panel (lipid panel): rates for 6 insurance plans Aetna — All Products: $141.55 Anthem BCBS — All Products: $140.06 Humana — All Products: $141.55 Ohio PPO Connect — All Products: $138.57 OSU — All Products: $138.57 UHC — All Products: $141.55
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$130	$117	$61.10 – $127.40
Kidney function panel: 10 of 26 insurance plan rates Aetna — All Products: $117 Aetna — Coventry Cares WV: $123.50 AHPO — All Products: $122.20 Amerihealth — Managed Medicaid - Non-Cap: $30.22 Anthem — Managed Medicaid - Non-Cap: $30.22 Anthem BCBS — All Products: $29.93 BCHP — Managed Medicaid - Non-Cap: $30.22 Caresource — Just4Me/Marketplace: $61.10 Caresource — Managed Medicaid - Non-Cap: $30.22 Cigna — All Products: $122.20
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$130	$117	$61.10 – $127.40
Kidney function panel: rates for 6 insurance plans Aetna — All Products: $123.50 Anthem BCBS — All Products: $122.20 Humana — All Products: $123.50 Ohio PPO Connect — All Products: $120.90 OSU — All Products: $120.90 UHC — All Products: $123.50
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$398	$358.20	$187.06 – $390.04
Liver function panel: 10 of 26 insurance plan rates Aetna — All Products: $358.20 Aetna — Coventry Cares WV: $378.10 AHPO — All Products: $374.12 Amerihealth — Managed Medicaid - Non-Cap: $30.22 Anthem — Managed Medicaid - Non-Cap: $30.22 Anthem BCBS — All Products: $29.42 BCHP — Managed Medicaid - Non-Cap: $30.22 Caresource — Just4Me/Marketplace: $187.06 Caresource — Managed Medicaid - Non-Cap: $30.22 Cigna — All Products: $374.12
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$398	$358.20	$187.06 – $390.04
Liver function panel: rates for 6 insurance plans Aetna — All Products: $378.10 Anthem BCBS — All Products: $374.12 Humana — All Products: $378.10 Ohio PPO Connect — All Products: $370.14 OSU — All Products: $370.14 UHC — All Products: $378.10
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS, AUTO WITH SCOPE	$40	$36	$18.80 – $39.20
Urine test (automated, with microscope): 10 of 26 insurance plan rates Aetna — All Products: $36 Aetna — Coventry Cares WV: $38 AHPO — All Products: $37.60 Amerihealth — Managed Medicaid - Non-Cap: $9.80 Anthem — Managed Medicaid - Non-Cap: $9.80 Anthem BCBS — All Products: $28.40 BCHP — Managed Medicaid - Non-Cap: $9.80 Caresource — Just4Me/Marketplace: $18.80 Caresource — Managed Medicaid - Non-Cap: $9.80 Cigna — All Products: $37.60
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS, AUTO WITH SCOPE	$40	$36	$18.80 – $39.20
Urine test (automated, with microscope): rates for 6 insurance plans Aetna — All Products: $38 Anthem BCBS — All Products: $37.60 Humana — All Products: $38 Ohio PPO Connect — All Products: $37.20 OSU — All Products: $37.20 UHC — All Products: $38
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE, NON-AUTO, NO MICRO	$26	$23.40	$12.22 – $25.48
Urine test (manual, without microscope): 10 of 26 insurance plan rates Aetna — All Products: $23.40 Aetna — Coventry Cares WV: $24.70 AHPO — All Products: $24.44 Amerihealth — Managed Medicaid - Non-Cap: $9.80 Anthem — Managed Medicaid - Non-Cap: $9.80 Anthem BCBS — All Products: $20.17 BCHP — Managed Medicaid - Non-Cap: $9.80 Caresource — Just4Me/Marketplace: $12.22 Caresource — Managed Medicaid - Non-Cap: $9.80 Cigna — All Products: $24.44
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$26	$23.40	$16.90 – $19.50
Urine test (manual, without microscope): 10 of 12 insurance plan rates Aetna — All Products: $2.78 Aetna — Coventry Cares WV: $19.50 Anthem — All Products: $8.08 Cigna — All Products: $19.50 Front Path Health Coalition — All Products: $19.50 Humana — All Products: $7.83 MMO — All Products: $18.72 OHC — All Products: $19.50 OHG — All Products: $19.50 The Health Plan — All Products: $19.50
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINE, NON-AUTO, NO MICRO	$26	$23.40	$12.22 – $25.48
Urine test (manual, without microscope): rates for 6 insurance plans Aetna — All Products: $24.70 Anthem BCBS — All Products: $24.44 Humana — All Products: $24.70 Ohio PPO Connect — All Products: $24.18 OSU — All Products: $24.18 UHC — All Products: $24.70
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE ANALYSIS DIPSTICK AUTOMATED	$26	$23.40	$12.22 – $25.48
Urine test (automated, without microscope): 10 of 26 insurance plan rates Aetna — All Products: $23.40 Aetna — Coventry Cares WV: $24.70 AHPO — All Products: $24.44 Amerihealth — Managed Medicaid - Non-Cap: $9.80 Anthem — Managed Medicaid - Non-Cap: $9.80 Anthem BCBS — All Products: $7.72 BCHP — Managed Medicaid - Non-Cap: $9.80 Caresource — Just4Me/Marketplace: $12.22 Caresource — Managed Medicaid - Non-Cap: $9.80 Cigna — All Products: $24.44
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$26	$23.40	$16.90 – $19.50
Urine test (automated, without microscope): 10 of 12 insurance plan rates Aetna — All Products: $1.80 Aetna — Coventry Cares WV: $19.50 Anthem — All Products: $3.09 Cigna — All Products: $19.50 Front Path Health Coalition — All Products: $19.50 Humana — All Products: $5.06 MMO — All Products: $18.72 OHC — All Products: $19.50 OHG — All Products: $19.50 The Health Plan — All Products: $19.50
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINE ANALYSIS DIPSTICK AUTOMATED	$26	$23.40	$12.22 – $25.48
Urine test (automated, without microscope): rates for 6 insurance plans Aetna — All Products: $24.70 Anthem BCBS — All Products: $24.44 Humana — All Products: $24.70 Ohio PPO Connect — All Products: $24.18 OSU — All Products: $24.18 UHC — All Products: $24.70
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA	$22	$19.80	$10.34 – $21.56
PSA (prostate specific antigen) blood test: 10 of 26 insurance plan rates Aetna — All Products: $19.80 Aetna — Coventry Cares WV: $20.90 AHPO — All Products: $20.68 Amerihealth — Managed Medicaid - Non-Cap: $27.88 Anthem — Managed Medicaid - Non-Cap: $27.88 Anthem BCBS — All Products: $22 BCHP — Managed Medicaid - Non-Cap: $27.88 Caresource — Just4Me/Marketplace: $10.34 Caresource — Managed Medicaid - Non-Cap: $27.88 Cigna — All Products: $20.68
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA	$22	$19.80	$10.34 – $21.56
PSA (prostate specific antigen) blood test: rates for 6 insurance plans Aetna — All Products: $20.90 Anthem BCBS — All Products: $20.68 Humana — All Products: $20.90 Ohio PPO Connect — All Products: $20.46 OSU — All Products: $20.46 UHC — All Products: $20.90
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE	$124	$111.60	$58.28 – $121.52
Thyroid stimulating hormone (TSH) test: 10 of 26 insurance plan rates Aetna — All Products: $111.60 Aetna — Coventry Cares WV: $117.80 AHPO — All Products: $116.56 Amerihealth — Managed Medicaid - Non-Cap: $33.80 Anthem — Managed Medicaid - Non-Cap: $33.80 Anthem BCBS — All Products: $57.90 BCHP — Managed Medicaid - Non-Cap: $33.80 Caresource — Just4Me/Marketplace: $58.28 Caresource — Managed Medicaid - Non-Cap: $33.80 Cigna — All Products: $116.56
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE	$30	$27	$14.10 – $29.40
Thyroid stimulating hormone (TSH) test: 10 of 26 insurance plan rates Aetna — All Products: $27 Aetna — Coventry Cares WV: $28.50 AHPO — All Products: $28.20 Amerihealth — Managed Medicaid - Non-Cap: $33.80 Anthem — Managed Medicaid - Non-Cap: $33.80 Anthem BCBS — All Products: $30 BCHP — Managed Medicaid - Non-Cap: $33.80 Caresource — Just4Me/Marketplace: $14.10 Caresource — Managed Medicaid - Non-Cap: $33.80 Cigna — All Products: $28.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE	$124	$111.60	$58.28 – $121.52
Thyroid stimulating hormone (TSH) test: rates for 6 insurance plans Aetna — All Products: $117.80 Anthem BCBS — All Products: $116.56 Humana — All Products: $117.80 Ohio PPO Connect — All Products: $115.32 OSU — All Products: $115.32 UHC — All Products: $117.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W AUTO DIFF	$48	$43.20	$22.56 – $47.04
Complete blood count (CBC) with differential: 10 of 26 insurance plan rates Aetna — All Products: $43.20 Aetna — Coventry Cares WV: $45.60 AHPO — All Products: $45.12 Amerihealth — Managed Medicaid - Non-Cap: $13.04 Anthem — Managed Medicaid - Non-Cap: $13.04 Anthem BCBS — All Products: $26.80 BCHP — Managed Medicaid - Non-Cap: $13.04 Caresource — Just4Me/Marketplace: $22.56 Caresource — Managed Medicaid - Non-Cap: $13.04 Cigna — All Products: $45.12
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC W AUTO DIFF	$48	$43.20	$22.56 – $47.04
Complete blood count (CBC) with differential: rates for 6 insurance plans Aetna — All Products: $45.60 Anthem BCBS — All Products: $45.12 Humana — All Products: $45.60 Ohio PPO Connect — All Products: $44.64 OSU — All Products: $44.64 UHC — All Products: $45.60
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC WITHOUT DIFF	$31	$27.90	$14.57 – $30.38
Complete blood count (CBC), automated: 10 of 26 insurance plan rates Aetna — All Products: $27.90 Aetna — Coventry Cares WV: $29.45 AHPO — All Products: $29.14 Amerihealth — Managed Medicaid - Non-Cap: $13.04 Anthem — Managed Medicaid - Non-Cap: $13.04 Anthem BCBS — All Products: $22.29 BCHP — Managed Medicaid - Non-Cap: $13.04 Caresource — Just4Me/Marketplace: $14.57 Caresource — Managed Medicaid - Non-Cap: $13.04 Cigna — All Products: $29.14
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC WITHOUT DIFF	$31	$27.90	$14.57 – $30.38
Complete blood count (CBC), automated: rates for 6 insurance plans Aetna — All Products: $29.45 Anthem BCBS — All Products: $29.14 Humana — All Products: $29.45 Ohio PPO Connect — All Products: $28.83 OSU — All Products: $28.83 UHC — All Products: $29.45
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT/INR	$78	$70.20	$36.66 – $76.44
Blood clotting time test (prothrombin time, PT): 10 of 26 insurance plan rates Aetna — All Products: $70.20 Aetna — Coventry Cares WV: $74.10 AHPO — All Products: $73.32 Amerihealth — Managed Medicaid - Non-Cap: $14.92 Anthem — Managed Medicaid - Non-Cap: $14.92 Anthem BCBS — All Products: $37.36 BCHP — Managed Medicaid - Non-Cap: $14.92 Caresource — Just4Me/Marketplace: $36.66 Caresource — Managed Medicaid - Non-Cap: $14.92 Cigna — All Products: $73.32
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT/INR	$78	$70.20	$36.66 – $76.44
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans Aetna — All Products: $74.10 Anthem BCBS — All Products: $73.32 Humana — All Products: $74.10 Ohio PPO Connect — All Products: $72.54 OSU — All Products: $72.54 UHC — All Products: $74.10
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTT	$94	$84.60	$44.18 – $92.12
Blood clotting test (partial thromboplastin time, PTT): 10 of 26 insurance plan rates Aetna — All Products: $84.60 Aetna — Coventry Cares WV: $89.30 AHPO — All Products: $88.36 Amerihealth — Managed Medicaid - Non-Cap: $14.92 Anthem — Managed Medicaid - Non-Cap: $14.92 Anthem BCBS — All Products: $21.63 BCHP — Managed Medicaid - Non-Cap: $14.92 Caresource — Just4Me/Marketplace: $44.18 Caresource — Managed Medicaid - Non-Cap: $14.92 Cigna — All Products: $88.36
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PTT	$94	$84.60	$44.18 – $92.12
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans Aetna — All Products: $89.30 Anthem BCBS — All Products: $88.36 Humana — All Products: $89.30 Ohio PPO Connect — All Products: $87.42 OSU — All Products: $87.42 UHC — All Products: $89.30

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEAD/BRAIN W/O CONTRAST	$1,150	$1,035	$747.50 – $1,127
CT scan of the head or brain, without contrast: 10 of 26 insurance plan rates Aetna — All Products: $1,035 Aetna — Coventry Cares WV: $1,092.50 AHPO — All Products: $1,081 Amerihealth — Managed Medicaid - Non-Cap: $604.86 Anthem — Managed Medicaid - Non-Cap: $604.86 Anthem BCBS — All Products: $1,046.50 BCHP — Managed Medicaid - Non-Cap: $604.86 Caresource — Just4Me/Marketplace: $160.22 Caresource — Managed Medicaid - Non-Cap: $604.86 Cigna — All Products: $1,081
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEAD/BRAIN W/O CONTRAST	$1,150	$1,035	$747.50 – $1,127
CT scan of the head or brain, without contrast: rates for 6 insurance plans Aetna — All Products: $1,092.50 Anthem BCBS — All Products: $1,081 Humana — All Products: $1,092.50 Ohio PPO Connect — All Products: $1,069.50 OSU — All Products: $1,069.50 UHC — All Products: $1,092.50
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL	$201	$180.90	$140.70 – $150.75
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates Aetna — All Products: $45.72 Aetna — Coventry Cares WV: $150.75 Anthem — All Products: $124.63 Caresource — Just4Me/Marketplace: $57.83 Cigna — All Products: $150.75 Front Path Health Coalition — All Products: $150.75 Humana — All Products: $92.39 MMO — All Products: $144.72 OHC — All Products: $150.75 OHG — All Products: $150.75
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BRAIN (INCL BRAIN STEM), W/ & W/O CONTRAST	$3,870	$3,483	$2,515.50 – $3,792.60
MRI of the brain, before and after contrast: 10 of 26 insurance plan rates Aetna — All Products: $3,483 Aetna — Coventry Cares WV: $3,676.50 AHPO — All Products: $3,637.80 Amerihealth — Managed Medicaid - Non-Cap: $593.09 Anthem — Managed Medicaid - Non-Cap: $593.09 Anthem BCBS — All Products: $3,521.70 BCHP — Managed Medicaid - Non-Cap: $593.09 Caresource — Just4Me/Marketplace: $534.65 Caresource — Managed Medicaid - Non-Cap: $593.09 Cigna — All Products: $3,637.80
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BRAIN (INCL BRAIN STEM), W/ & W/O CONTRAST	$3,870	$3,483	$2,515.50 – $3,792.60
MRI of the brain, before and after contrast: rates for 6 insurance plans Aetna — All Products: $3,676.50 Anthem BCBS — All Products: $3,637.80 Humana — All Products: $3,676.50 Ohio PPO Connect — All Products: $3,599.10 OSU — All Products: $3,599.10 UHC — All Products: $3,676.50
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$544	$489.60	$380.80 – $408
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates Aetna — All Products: $125.77 Aetna — Coventry Cares WV: $408 Anthem — All Products: $345.95 Caresource — Just4Me/Marketplace: $154.43 Cigna — All Products: $408 Front Path Health Coalition — All Products: $408 Humana — All Products: $248.74 MMO — All Products: $391.68 OHC — All Products: $408 OHG — All Products: $408
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST, 2 VWS	$470	$423	$305.50 – $460.60
Chest X-ray, 2 views: 10 of 26 insurance plan rates Aetna — All Products: $423 Aetna — Coventry Cares WV: $446.50 AHPO — All Products: $441.80 Amerihealth — Managed Medicaid - Non-Cap: $87.22 Anthem — Managed Medicaid - Non-Cap: $87.22 Anthem BCBS — All Products: $427.70 BCHP — Managed Medicaid - Non-Cap: $87.22 Caresource — Just4Me/Marketplace: $133.37 Caresource — Managed Medicaid - Non-Cap: $87.22 Cigna — All Products: $441.80
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CHEST, 2 VWS	$470	$423	$305.50 – $460.60
Chest X-ray, 2 views: rates for 6 insurance plans Aetna — All Products: $446.50 Anthem BCBS — All Products: $441.80 Humana — All Products: $446.50 Ohio PPO Connect — All Products: $437.10 OSU — All Products: $437.10 UHC — All Products: $446.50
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG RADIOLOGIC EXAM CHEST 2 VIEWS	$52	$46.80	$36.40 – $39
Chest X-ray, 2 views: 10 of 15 insurance plan rates Aetna — All Products: $10.18 Aetna — Coventry Cares WV: $39 Anthem — All Products: $31.61 Caresource — Just4Me/Marketplace: $14.69 Cigna — All Products: $39 Front Path Health Coalition — All Products: $39 Humana — All Products: $23.87 MMO — All Products: $37.44 OHC — All Products: $39 OHG — All Products: $39
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPINE, LUMBOSACRAL, MIN 4 VW	$480	$432	$312 – $470.40
X-ray of the lower spine, at least 4 views: 10 of 26 insurance plan rates Aetna — All Products: $432 Aetna — Coventry Cares WV: $456 AHPO — All Products: $451.20 Amerihealth — Managed Medicaid - Non-Cap: $87.22 Anthem — Managed Medicaid - Non-Cap: $87.22 Anthem BCBS — All Products: $436.80 BCHP — Managed Medicaid - Non-Cap: $87.22 Caresource — Just4Me/Marketplace: $160.22 Caresource — Managed Medicaid - Non-Cap: $87.22 Cigna — All Products: $451.20
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINE, LUMBOSACRAL, MIN 4 VW	$480	$432	$312 – $470.40
X-ray of the lower spine, at least 4 views: rates for 6 insurance plans Aetna — All Products: $456 Anthem BCBS — All Products: $451.20 Humana — All Products: $456 Ohio PPO Connect — All Products: $446.40 OSU — All Products: $446.40 UHC — All Products: $456
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$64	$57.60	$44.80 – $48
X-ray of the lower spine, at least 4 views: 10 of 15 insurance plan rates Aetna — All Products: $16.22 Aetna — Coventry Cares WV: $48 Anthem — All Products: $48.26 Caresource — Just4Me/Marketplace: $18.57 Cigna — All Products: $48 Front Path Health Coalition — All Products: $48 Humana — All Products: $28.44 MMO — All Products: $46.08 OHC — All Products: $48 OHG — All Products: $48
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPINE, LUMBAR, W/O CONTRAST	$2,700	$2,430	$1,755 – $2,646
MRI of the lower back (lumbar spine), without contrast: 10 of 26 insurance plan rates Aetna — All Products: $2,430 Aetna — Coventry Cares WV: $2,565 AHPO — All Products: $2,538 Amerihealth — Managed Medicaid - Non-Cap: $392.46 Anthem — Managed Medicaid - Non-Cap: $392.46 Anthem BCBS — All Products: $2,457 BCHP — Managed Medicaid - Non-Cap: $392.46 Caresource — Just4Me/Marketplace: $365.66 Caresource — Managed Medicaid - Non-Cap: $392.46 Cigna — All Products: $2,538
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINE, LUMBAR, W/O CONTRAST	$2,700	$2,430	$1,755 – $2,646
MRI of the lower back (lumbar spine), without contrast: rates for 6 insurance plans Aetna — All Products: $2,565 Anthem BCBS — All Products: $2,538 Humana — All Products: $2,565 Ohio PPO Connect — All Products: $2,511 OSU — All Products: $2,511 UHC — All Products: $2,565
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$350	$315	$79.01 – $218.90
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates Aetna — All Products: $79.01 Aetna — Coventry Cares WV: $262.50 Anthem — All Products: $218.90 Caresource — Just4Me/Marketplace: $100.43 Cigna — All Products: $262.50 Front Path Health Coalition — All Products: $262.50 Humana — All Products: $160.07 MMO — All Products: $252 OHC — All Products: $262.50 OHG — All Products: $262.50
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PELVIS, W/ CONTRAST	$1,660	$1,494	$1,079 – $1,626.80
CT scan of the pelvis, with contrast: 10 of 26 insurance plan rates Aetna — All Products: $1,494 Aetna — Coventry Cares WV: $1,577 AHPO — All Products: $1,560.40 Amerihealth — Managed Medicaid - Non-Cap: $604.86 Anthem — Managed Medicaid - Non-Cap: $604.86 Anthem BCBS — All Products: $1,510.60 BCHP — Managed Medicaid - Non-Cap: $604.86 Caresource — Just4Me/Marketplace: $268.80 Caresource — Managed Medicaid - Non-Cap: $604.86 Cigna — All Products: $1,560.40
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PELVIS, W/ CONTRAST	$1,660	$1,494	$1,079 – $1,626.80
CT scan of the pelvis, with contrast: rates for 6 insurance plans Aetna — All Products: $1,577 Anthem BCBS — All Products: $1,560.40 Humana — All Products: $1,577 Ohio PPO Connect — All Products: $1,543.80 OSU — All Products: $1,543.80 UHC — All Products: $1,577
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG CT PELVIS W/CONTRAST MATERIAL	$273	$245.70	$61.95 – $170.06
CT scan of the pelvis, with contrast: 10 of 15 insurance plan rates Aetna — All Products: $61.95 Aetna — Coventry Cares WV: $204.75 Anthem — All Products: $170.06 Caresource — Just4Me/Marketplace: $78.45 Cigna — All Products: $204.75 Front Path Health Coalition — All Products: $204.75 Humana — All Products: $125.46 MMO — All Products: $196.56 OHC — All Products: $204.75 OHG — All Products: $204.75
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXTREMITY, LOWER, JOINT, W/O CONTRAST	$2,630	$2,367	$1,709.50 – $2,577.40
MRI of a leg joint (such as the knee), without contrast: 10 of 26 insurance plan rates Aetna — All Products: $2,367 Aetna — Coventry Cares WV: $2,498.50 AHPO — All Products: $2,472.20 Amerihealth — Managed Medicaid - Non-Cap: $392.46 Anthem — Managed Medicaid - Non-Cap: $392.46 Anthem BCBS — All Products: $2,393.30 BCHP — Managed Medicaid - Non-Cap: $392.46 Caresource — Just4Me/Marketplace: $365.66 Caresource — Managed Medicaid - Non-Cap: $392.46 Cigna — All Products: $2,472.20
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EXTREMITY, LOWER, JOINT, W/O CONTRAST	$2,630	$2,367	$1,709.50 – $2,577.40
MRI of a leg joint (such as the knee), without contrast: rates for 6 insurance plans Aetna — All Products: $2,498.50 Anthem BCBS — All Products: $2,472.20 Humana — All Products: $2,498.50 Ohio PPO Connect — All Products: $2,445.90 OSU — All Products: $2,445.90 UHC — All Products: $2,498.50
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$320	$288	$71.80 – $198
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates Aetna — All Products: $71.80 Aetna — Coventry Cares WV: $240 Anthem — All Products: $198 Caresource — Just4Me/Marketplace: $92.08 Cigna — All Products: $240 Front Path Health Coalition — All Products: $240 Humana — All Products: $146.97 MMO — All Products: $230.40 OHC — All Products: $240 OHG — All Products: $240
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ABDOMEN & PELIVS, W/ CONTRAST	$2,690	$2,421	$1,748.50 – $2,636.20
CT scan of the abdomen and pelvis, with contrast: 10 of 26 insurance plan rates Aetna — All Products: $2,421 Aetna — Coventry Cares WV: $2,555.50 AHPO — All Products: $2,528.60 Amerihealth — Managed Medicaid - Non-Cap: $604.86 Anthem — Managed Medicaid - Non-Cap: $604.86 Anthem BCBS — All Products: $2,447.90 BCHP — Managed Medicaid - Non-Cap: $604.86 Caresource — Just4Me/Marketplace: $534.65 Caresource — Managed Medicaid - Non-Cap: $604.86 Cigna — All Products: $2,528.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ABDOMEN & PELIVS, W/ CONTRAST	$2,690	$2,421	$1,748.50 – $2,636.20
CT scan of the abdomen and pelvis, with contrast: rates for 6 insurance plans Aetna — All Products: $2,555.50 Anthem BCBS — All Products: $2,528.60 Humana — All Products: $2,555.50 Ohio PPO Connect — All Products: $2,501.70 OSU — All Products: $2,501.70 UHC — All Products: $2,555.50
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$433	$389.70	$87.97 – $299.94
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates Aetna — All Products: $87.97 Aetna — Coventry Cares WV: $324.75 Anthem — All Products: $299.94 Caresource — Just4Me/Marketplace: $123.05 Cigna — All Products: $324.75 Front Path Health Coalition — All Products: $324.75 Humana — All Products: $197.93 MMO — All Products: $311.76 OHC — All Products: $324.75 OHG — All Products: $324.75
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ABDOMEN, COMPLETE	$860	$774	$559 – $842.80
Ultrasound of the abdomen, complete: 10 of 26 insurance plan rates Aetna — All Products: $774 Aetna — Coventry Cares WV: $817 AHPO — All Products: $808.40 Amerihealth — Managed Medicaid - Non-Cap: $230.84 Anthem — Managed Medicaid - Non-Cap: $230.84 Anthem BCBS — All Products: $782.60 BCHP — Managed Medicaid - Non-Cap: $230.84 Caresource — Just4Me/Marketplace: $160.22 Caresource — Managed Medicaid - Non-Cap: $230.84 Cigna — All Products: $808.40
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ABDOMEN, COMPLETE	$860	$774	$559 – $842.80
Ultrasound of the abdomen, complete: rates for 6 insurance plans Aetna — All Products: $817 Anthem BCBS — All Products: $808.40 Humana — All Products: $817 Ohio PPO Connect — All Products: $799.80 OSU — All Products: $799.80 UHC — All Products: $817
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$191	$171.90	$133.70 – $143.25
Ultrasound of the abdomen, complete: 10 of 15 insurance plan rates Aetna — All Products: $43.13 Aetna — Coventry Cares WV: $143.25 Anthem — All Products: $127.40 Caresource — Just4Me/Marketplace: $54.87 Cigna — All Products: $143.25 Front Path Health Coalition — All Products: $143.25 Humana — All Products: $87.82 MMO — All Products: $137.52 OHC — All Products: $143.25 OHG — All Products: $143.25
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB FETAL & MATRNL EVAL, POST 1ST TRI	$990	$891	$643.50 – $970.20
Pregnancy ultrasound (after the first trimester): 10 of 27 insurance plan rates Aetna — All Products: $891 Aetna — Coventry Cares WV: $940.50 AHPO — All Products: $930.60 Amerihealth — Managed Medicaid - Non-Cap: $179.56 Anthem — Managed Medicaid - Non-Cap: $179.56 Anthem BCBS — All Products: $900.90 BCHP — Managed Medicaid - Non-Cap: $179.56 Caresource — Just4Me/Marketplace: $160.22 Caresource — Managed Medicaid - Non-Cap: $179.56 Cigna — All Products: $930.60
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB FETAL & MATRNL EVAL, POST 1ST TRI	$990	$891	$643.50 – $970.20
Pregnancy ultrasound (after the first trimester): rates for 6 insurance plans Aetna — All Products: $940.50 Anthem BCBS — All Products: $930.60 Humana — All Products: $940.50 Ohio PPO Connect — All Products: $920.70 OSU — All Products: $920.70 UHC — All Products: $940.50
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$236	$212.40	$165.20 – $177
Pregnancy ultrasound (after the first trimester): 10 of 15 insurance plan rates Aetna — All Products: $51.78 Aetna — Coventry Cares WV: $177 Anthem — All Products: $155.80 Caresource — Just4Me/Marketplace: $68.96 Cigna — All Products: $177 Front Path Health Coalition — All Products: $177 Humana — All Products: $107.69 MMO — All Products: $169.92 OHC — All Products: $177 OHG — All Products: $177
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL, NON-OB	$720	$648	$468 – $705.60
Transvaginal ultrasound: 10 of 27 insurance plan rates Aetna — All Products: $648 Aetna — Coventry Cares WV: $684 AHPO — All Products: $676.80 Amerihealth — Managed Medicaid - Non-Cap: $150.10 Anthem — Managed Medicaid - Non-Cap: $150.10 Anthem BCBS — All Products: $655.20 BCHP — Managed Medicaid - Non-Cap: $150.10 Caresource — Just4Me/Marketplace: $160.22 Caresource — Managed Medicaid - Non-Cap: $150.10 Cigna — All Products: $676.80
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TRANSVAGINAL, NON-OB	$720	$648	$468 – $705.60
Transvaginal ultrasound: rates for 6 insurance plans Aetna — All Products: $684 Anthem BCBS — All Products: $676.80 Humana — All Products: $684 Ohio PPO Connect — All Products: $669.60 OSU — All Products: $669.60 UHC — All Products: $684
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG US TRANSVAGINAL	$164	$147.60	$36.29 – $107.63
Transvaginal ultrasound: 10 of 15 insurance plan rates Aetna — All Products: $36.29 Aetna — Coventry Cares WV: $123 Anthem — All Products: $107.63 Caresource — Just4Me/Marketplace: $47.48 Cigna — All Products: $123 Front Path Health Coalition — All Products: $123 Humana — All Products: $75.53 MMO — All Products: $118.08 OHC — All Products: $123 OHG — All Products: $123
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$79.63
Diagnostic mammogram, one breast: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $79.63 Anthem — Managed Medicaid - Non-Cap: $79.63 BCHP — Managed Medicaid - Non-Cap: $79.63 Caresource — Managed Medicaid - Non-Cap: $79.63 Humana — Managed Medicaid - Non-Cap: $79.63 Molina — Managed Medicaid - Non-Cap: $79.63 UHC — Managed Medicaid - Non-Cap: $79.63
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$849.32
Diagnostic mammogram, one breast: rates for 2 insurance plans Anthem BCBS — All Products: $849.32 Caresource — Just4Me/Marketplace: $252.17
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$270.41
Diagnostic mammogram, one breast: rates for 1 insurance plan Anthem BCBS — All Products: $270.41
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi	Not listed in the file	Not listed in the file	$79.63
Diagnostic mammogram, both breasts: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $79.63 Anthem — Managed Medicaid - Non-Cap: $79.63 BCHP — Managed Medicaid - Non-Cap: $79.63 Caresource — Managed Medicaid - Non-Cap: $79.63 Humana — Managed Medicaid - Non-Cap: $79.63 Molina — Managed Medicaid - Non-Cap: $79.63 UHC — Managed Medicaid - Non-Cap: $79.63
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$1,074.87
Diagnostic mammogram, both breasts: rates for 2 insurance plans Anthem BCBS — All Products: $1,074.87 Caresource — Just4Me/Marketplace: $319.62
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$332.24
Diagnostic mammogram, both breasts: rates for 1 insurance plan Anthem BCBS — All Products: $332.24
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad	Not listed in the file	Not listed in the file	$79.63
Screening mammogram, both breasts: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $79.63 Anthem — Managed Medicaid - Non-Cap: $79.63 BCHP — Managed Medicaid - Non-Cap: $79.63 Caresource — Managed Medicaid - Non-Cap: $79.63 Humana — Managed Medicaid - Non-Cap: $79.63 Molina — Managed Medicaid - Non-Cap: $79.63 UHC — Managed Medicaid - Non-Cap: $79.63
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD	Not listed in the file	Not listed in the file	$865.92
Screening mammogram, both breasts: rates for 2 insurance plans Anthem BCBS — All Products: $865.92 Caresource — Just4Me/Marketplace: $258.51
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: SCR MAMMO BI INCL CAD	Not listed in the file	Not listed in the file	$253.88
Screening mammogram, both breasts: rates for 1 insurance plan Anthem BCBS — All Products: $253.88

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ECG	$280	$252	$182 – $274.40
Electrocardiogram (ECG/EKG) with reading: 10 of 25 insurance plan rates Aetna — All Products: $252 Aetna — Coventry Cares WV: $266 AHPO — All Products: $263.20 Amerihealth — Managed Medicaid - Non-Cap: $36.11 Anthem — Managed Medicaid - Non-Cap: $36.11 Anthem BCBS — All Products: $254.80 BCHP — Managed Medicaid - Non-Cap: $36.11 Caresource — Managed Medicaid - Non-Cap: $36.11 Cigna — All Products: $263.20 Emerald Health — All Products: $274.40
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$70	$63	$50.40 – $52.50
Electrocardiogram (ECG/EKG) with reading: 10 of 15 insurance plan rates Aetna — All Products: $59.91 Aetna — Coventry Cares WV: $52.50 Anthem — All Products: $67.27 Caresource — Just4Me/Marketplace: $21.88 Cigna — All Products: $52.50 Front Path Health Coalition — All Products: $52.50 Humana — All Products: $32.27 MMO — All Products: $50.40 OHC — All Products: $52.50 OHG — All Products: $52.50
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ECG	$280	$252	$182 – $274.40
Electrocardiogram (ECG/EKG) with reading: rates for 6 insurance plans Aetna — All Products: $266 Anthem BCBS — All Products: $263.20 Humana — All Products: $266 Ohio PPO Connect — All Products: $260.40 OSU — All Products: $260.40 UHC — All Products: $266
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LHC, INC LEFT VENTRICULOGRAPHY WHEN PERF	$8,080	$7,272	$5,252 – $7,918.40
Left heart catheterization (diagnostic): 10 of 27 insurance plan rates Aetna — All Products: $7,272 Aetna — Coventry Cares WV: $7,676 AHPO — All Products: $7,595.20 Amerihealth — Managed Medicaid - Non-Cap: $2,992.21 Anthem — Managed Medicaid - Non-Cap: $2,992.21 Anthem BCBS — All Products: $7,352.80 BCHP — Managed Medicaid - Non-Cap: $2,992.21 Caresource — Just4Me/Marketplace: $4,968.23 Caresource — Managed Medicaid - Non-Cap: $2,992.21 Cigna — All Products: $7,595.20
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LHC, INC LEFT VENTRICULOGRAPHY WHEN PERF	$8,080	$7,272	$5,252 – $7,918.40
Left heart catheterization (diagnostic): rates for 6 insurance plans Aetna — All Products: $7,676 Anthem BCBS — All Products: $7,595.20 Humana — All Products: $7,676 Ohio PPO Connect — All Products: $7,514.40 OSU — All Products: $7,514.40 UHC — All Products: $7,676
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$1,162	$1,045.80	$813.40 – $871.50
Left heart catheterization (diagnostic): 10 of 15 insurance plan rates Aetna — All Products: $249.79 Aetna — Coventry Cares WV: $871.50 Anthem — All Products: $947.32 Caresource — Just4Me/Marketplace: $339.72 Cigna — All Products: $871.50 Front Path Health Coalition — All Products: $871.50 Humana — All Products: $535.25 MMO — All Products: $836.64 OHC — All Products: $871.50 OHG — All Products: $871.50
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVAL W/O INDUCTION OR ATTEMPT INDUCTION OF ARRY	$12,660	$11,394	$8,229 – $12,406.80
Heart rhythm study (electrophysiology evaluation): 10 of 27 insurance plan rates Aetna — All Products: $11,394 Aetna — Coventry Cares WV: $12,027 AHPO — All Products: $11,900.40 Amerihealth — Managed Medicaid - Non-Cap: $2,396.53 Anthem — Managed Medicaid - Non-Cap: $2,396.53 Anthem BCBS — All Products: $11,520.60 BCHP — Managed Medicaid - Non-Cap: $2,396.53 Caresource — Just4Me/Marketplace: $11,952.90 Caresource — Managed Medicaid - Non-Cap: $2,396.53 Cigna — All Products: $11,900.40
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVAL W/O INDUCTION OR ATTEMPT INDUCTION OF ARRY	$12,660	$11,394	$8,229 – $12,406.80
Heart rhythm study (electrophysiology evaluation): rates for 6 insurance plans Aetna — All Products: $12,027 Anthem BCBS — All Products: $11,900.40 Humana — All Products: $12,027 Ohio PPO Connect — All Products: $11,773.80 OSU — All Products: $11,773.80 UHC — All Products: $12,027
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$1,881	$1,692.90	$1,316.70 – $1,410.75
Heart rhythm study (electrophysiology evaluation): 10 of 15 insurance plan rates Aetna — All Products: $1,222.90 Aetna — Coventry Cares WV: $1,410.75 Anthem — All Products: $1,235.16 Caresource — Just4Me/Marketplace: $550.92 Cigna — All Products: $1,410.75 Front Path Health Coalition — All Products: $1,410.75 Humana — All Products: $886.57 MMO — All Products: $1,354.32 OHC — All Products: $1,410.75 OHG — All Products: $1,410.75
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Compre ep eval abltj atr fib	Not listed in the file	Not listed in the file	$18,622.09
Heart rhythm study with ablation for atrial fibrillation: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $18,622.09 Anthem — Managed Medicaid - Non-Cap: $18,622.09 BCHP — Managed Medicaid - Non-Cap: $18,622.09 Caresource — Managed Medicaid - Non-Cap: $18,622.09 Humana — Managed Medicaid - Non-Cap: $18,622.09 Molina — Managed Medicaid - Non-Cap: $18,622.09 UHC — Managed Medicaid - Non-Cap: $18,622.09
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$2,827.12
Heart rhythm study with ablation for atrial fibrillation: rates for 3 insurance plans Anthem BCBS — All Products: $2,827.12 Caresource — Just4Me/Marketplace: $40,055.99 Tricare CHAMPUS — All Products: $23,305.69
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPHY, 6 YRS+, 4 OR MORE ADDL PARAM, W/ TECH	$10,100	$9,090	$6,565 – $9,898
Sleep study (overnight, in a sleep lab): 10 of 27 insurance plan rates Aetna — All Products: $9,090 Aetna — Coventry Cares WV: $9,595 AHPO — All Products: $9,494 Amerihealth — Managed Medicaid - Non-Cap: $1,082.40 Anthem — Managed Medicaid - Non-Cap: $1,082.40 Anthem BCBS — All Products: $9,191 BCHP — Managed Medicaid - Non-Cap: $1,082.40 Caresource — Just4Me/Marketplace: $1,316.01 Caresource — Managed Medicaid - Non-Cap: $1,082.40 Cigna — All Products: $9,494
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPHY, 6 YRS+, 4 OR MORE ADDL PARAM, W/ TECH	$10,100	$9,090	$6,565 – $9,898
Sleep study (overnight, in a sleep lab): rates for 6 insurance plans Aetna — All Products: $9,595 Anthem BCBS — All Products: $9,494 Humana — All Products: $9,595 Ohio PPO Connect — All Products: $9,393 OSU — All Products: $9,393 UHC — All Products: $9,595
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$582	$523.80	$174.92 – $498.87
Sleep study (overnight, in a sleep lab): 10 of 15 insurance plan rates Aetna — All Products: $498.87 Aetna — Coventry Cares WV: $436.50 Anthem — All Products: $363.65 Caresource — Just4Me/Marketplace: $174.92 Cigna — All Products: $436.50 Front Path Health Coalition — All Products: $436.50 Humana — All Products: $267.80 MMO — All Products: $419.04 OHC — All Products: $436.50 OHG — All Products: $436.50

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISE(S), EA 15 MIN	$93	$83.70	$60.45 – $91.14
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 26 insurance plan rates Aetna — All Products: $83.70 Aetna — Coventry Cares WV: $88.35 AHPO — All Products: $87.42 Amerihealth — Managed Medicaid - Non-Cap: $130.69 Anthem — Managed Medicaid - Non-Cap: $130.69 Anthem BCBS — All Products: $84.63 BCHP — Managed Medicaid - Non-Cap: $130.69 Caresource — Just4Me/Marketplace: $55.97 Caresource — Managed Medicaid - Non-Cap: $130.69 Cigna — All Products: $87.42
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$93	$83.70	$66.96 – $69.75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 15 insurance plan rates Aetna — All Products: $81.63 Aetna — Coventry Cares WV: $69.75 Anthem — All Products: $57.10 Caresource — Just4Me/Marketplace: $41.81 Cigna — All Products: $69.75 Front Path Health Coalition — All Products: $69.75 Humana — All Products: $65.72 MMO — All Products: $66.96 OHC — All Products: $69.75 OHG — All Products: $69.75
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISE(S), EA 15 MIN	$93	$83.70	$60.45 – $91.14
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans Aetna — All Products: $88.35 Anthem BCBS — All Products: $87.42 Humana — All Products: $88.35 Ohio PPO Connect — All Products: $86.49 OSU — All Products: $86.49 UHC — All Products: $88.35
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL, LOW COMPLEXITY	$290	$261	$188.50 – $284.20
Physical therapy evaluation (low complexity): 10 of 26 insurance plan rates Aetna — All Products: $261 Aetna — Coventry Cares WV: $275.50 AHPO — All Products: $272.60 Amerihealth — Managed Medicaid - Non-Cap: $143.16 Anthem — Managed Medicaid - Non-Cap: $143.16 Anthem BCBS — All Products: $263.90 BCHP — Managed Medicaid - Non-Cap: $143.16 Caresource — Just4Me/Marketplace: $189.65 Caresource — Managed Medicaid - Non-Cap: $143.16 Cigna — All Products: $272.60
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$290	$261	$57.83 – $233.10
Physical therapy evaluation (low complexity): 10 of 15 insurance plan rates Aetna — All Products: $57.83 Aetna — Coventry Cares WV: $217.50 Anthem — All Products: $230.19 Caresource — Just4Me/Marketplace: $140.79 Cigna — All Products: $217.50 Front Path Health Coalition — All Products: $217.50 Humana — All Products: $220.52 MMO — All Products: $208.80 OHC — All Products: $217.50 OHG — All Products: $217.50
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVAL, LOW COMPLEXITY	$290	$261	$188.50 – $284.20
Physical therapy evaluation (low complexity): rates for 6 insurance plans Aetna — All Products: $275.50 Anthem BCBS — All Products: $272.60 Humana — All Products: $275.50 Ohio PPO Connect — All Products: $269.70 OSU — All Products: $269.70 UHC — All Products: $275.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL, MOD COMPLEXITY	$450	$405	$292.50 – $441
Physical therapy evaluation (moderate complexity): 10 of 26 insurance plan rates Aetna — All Products: $405 Aetna — Coventry Cares WV: $427.50 AHPO — All Products: $423 Amerihealth — Managed Medicaid - Non-Cap: $143.16 Anthem — Managed Medicaid - Non-Cap: $143.16 Anthem BCBS — All Products: $409.50 BCHP — Managed Medicaid - Non-Cap: $143.16 Caresource — Just4Me/Marketplace: $189.65 Caresource — Managed Medicaid - Non-Cap: $143.16 Cigna — All Products: $423
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$450	$405	$57.83 – $281.64
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates Aetna — All Products: $57.83 Aetna — Coventry Cares WV: $337.50 Anthem — All Products: $230.19 Caresource — Just4Me/Marketplace: $140.79 Cigna — All Products: $337.50 Front Path Health Coalition — All Products: $337.50 Humana — All Products: $220.52 MMO — All Products: $324 OHC — All Products: $337.50 OHG — All Products: $337.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVAL, MOD COMPLEXITY	$450	$405	$292.50 – $441
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans Aetna — All Products: $427.50 Anthem BCBS — All Products: $423 Humana — All Products: $427.50 Ohio PPO Connect — All Products: $418.50 OSU — All Products: $418.50 UHC — All Products: $427.50
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL, HIGH COMPLEXITY	$550	$495	$357.50 – $539
Physical therapy evaluation (high complexity): 10 of 26 insurance plan rates Aetna — All Products: $495 Aetna — Coventry Cares WV: $522.50 AHPO — All Products: $517 Amerihealth — Managed Medicaid - Non-Cap: $143.16 Anthem — Managed Medicaid - Non-Cap: $143.16 Anthem BCBS — All Products: $500.50 BCHP — Managed Medicaid - Non-Cap: $143.16 Caresource — Just4Me/Marketplace: $189.65 Caresource — Managed Medicaid - Non-Cap: $143.16 Cigna — All Products: $517
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$550	$495	$57.83 – $281.64
Physical therapy evaluation (high complexity): 10 of 15 insurance plan rates Aetna — All Products: $57.83 Aetna — Coventry Cares WV: $412.50 Anthem — All Products: $230.19 Caresource — Just4Me/Marketplace: $140.79 Cigna — All Products: $412.50 Front Path Health Coalition — All Products: $412.50 Humana — All Products: $220.52 MMO — All Products: $396 OHC — All Products: $412.50 OHG — All Products: $412.50
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVAL, HIGH COMPLEXITY	$550	$495	$357.50 – $539
Physical therapy evaluation (high complexity): rates for 6 insurance plans Aetna — All Products: $522.50 Anthem BCBS — All Products: $517 Humana — All Products: $522.50 Ohio PPO Connect — All Products: $511.50 OSU — All Products: $511.50 UHC — All Products: $522.50
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY 16-37 MIN W/PATIENT (90832)	$119	$107.10	$77.35 – $116.62
Psychotherapy, 30 minutes: 10 of 26 insurance plan rates Aetna — All Products: $107.10 Aetna — Coventry Cares WV: $113.05 AHPO — All Products: $111.86 Amerihealth — Managed Medicaid - Non-Cap: $128.11 Anthem — Managed Medicaid - Non-Cap: $128.11 Anthem BCBS — All Products: $108.29 BCHP — Managed Medicaid - Non-Cap: $128.11 Caresource — Just4Me/Marketplace: $119 Caresource — Managed Medicaid - Non-Cap: $128.11 Cigna — All Products: $111.86
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY, 16-37 MIN W/ PATIENT	$200	$180	$130 – $196
Psychotherapy, 30 minutes: 10 of 26 insurance plan rates Aetna — All Products: $180 Aetna — Coventry Cares WV: $190 AHPO — All Products: $188 Amerihealth — Managed Medicaid - Non-Cap: $128.11 Anthem — Managed Medicaid - Non-Cap: $128.11 Anthem BCBS — All Products: $182 BCHP — Managed Medicaid - Non-Cap: $128.11 Caresource — Just4Me/Marketplace: $200 Caresource — Managed Medicaid - Non-Cap: $128.11 Cigna — All Products: $188
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$362	$325.80	$260.64 – $271.50
Psychotherapy, 30 minutes: 10 of 22 insurance plan rates Aetna — All Products: $69.46 Aetna — Coventry Cares WV: $271.50 Amerihealth — Managed Medicaid - Non-Cap: $59.78 Anthem — All Products: $180.68 Anthem — Managed Medicaid: $59.78 BCHP — Managed Medicaid - Non-Cap: $59.78 Caresource — Just4Me/Marketplace: $126.06 Caresource — Managed Medicaid - Non-Cap: $59.78 Cigna — All Products: $271.50 Front Path Health Coalition — All Products: $271.50
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY 38-52 MIN, W/PATIENT (90834)	$171	$153.90	$111.15 – $167.58
Psychotherapy, 45 minutes: 10 of 26 insurance plan rates Aetna — All Products: $153.90 Aetna — Coventry Cares WV: $162.45 AHPO — All Products: $160.74 Amerihealth — Managed Medicaid - Non-Cap: $160.26 Anthem — Managed Medicaid - Non-Cap: $160.26 Anthem BCBS — All Products: $155.61 BCHP — Managed Medicaid - Non-Cap: $160.26 Caresource — Just4Me/Marketplace: $171 Caresource — Managed Medicaid - Non-Cap: $160.26 Cigna — All Products: $160.74
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY, 38-52 MIN W/ PATIENT	$370	$333	$240.50 – $362.60
Psychotherapy, 45 minutes: 10 of 26 insurance plan rates Aetna — All Products: $333 Aetna — Coventry Cares WV: $351.50 AHPO — All Products: $347.80 Amerihealth — Managed Medicaid - Non-Cap: $160.26 Anthem — Managed Medicaid - Non-Cap: $160.26 Anthem BCBS — All Products: $336.70 BCHP — Managed Medicaid - Non-Cap: $160.26 Caresource — Just4Me/Marketplace: $272.01 Caresource — Managed Medicaid - Non-Cap: $160.26 Cigna — All Products: $347.80
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$477	$429.30	$343.44 – $357.75
Psychotherapy, 45 minutes: 10 of 22 insurance plan rates Aetna — All Products: $92.70 Aetna — Coventry Cares WV: $357.75 Amerihealth — Managed Medicaid - Non-Cap: $77.71 Anthem — All Products: $271.80 Anthem — Managed Medicaid: $77.71 BCHP — Managed Medicaid - Non-Cap: $77.71 Caresource — Just4Me/Marketplace: $167.24 Caresource — Managed Medicaid - Non-Cap: $77.71 Cigna — All Products: $357.75 Front Path Health Coalition — All Products: $357.75
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY 53+ MIN, W/PATIENT (90837)	$223	$200.70	$144.95 – $218.54
Psychotherapy, 60 minutes: 10 of 26 insurance plan rates Aetna — All Products: $200.70 Aetna — Coventry Cares WV: $211.85 AHPO — All Products: $209.62 Amerihealth — Managed Medicaid - Non-Cap: $160.26 Anthem — Managed Medicaid - Non-Cap: $160.26 Anthem BCBS — All Products: $202.93 BCHP — Managed Medicaid - Non-Cap: $160.26 Caresource — Just4Me/Marketplace: $223 Caresource — Managed Medicaid - Non-Cap: $160.26 Cigna — All Products: $209.62
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY, 53+ MIN W/ PATIENT	$510	$459	$331.50 – $499.80
Psychotherapy, 60 minutes: 10 of 26 insurance plan rates Aetna — All Products: $459 Aetna — Coventry Cares WV: $484.50 AHPO — All Products: $479.40 Amerihealth — Managed Medicaid - Non-Cap: $160.26 Anthem — Managed Medicaid - Non-Cap: $160.26 Anthem BCBS — All Products: $464.10 BCHP — Managed Medicaid - Non-Cap: $160.26 Caresource — Just4Me/Marketplace: $272.01 Caresource — Managed Medicaid - Non-Cap: $160.26 Cigna — All Products: $479.40
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$707	$636.30	$509.04 – $530.25
Psychotherapy, 60 minutes: 10 of 22 insurance plan rates Aetna — All Products: $138.95 Aetna — Coventry Cares WV: $530.25 Amerihealth — Managed Medicaid - Non-Cap: $114 Anthem — All Products: $405.73 Anthem — Managed Medicaid: $114 BCHP — Managed Medicaid - Non-Cap: $114 Caresource — Just4Me/Marketplace: $245.28 Caresource — Managed Medicaid - Non-Cap: $114 Cigna — All Products: $530.25 Front Path Health Coalition — All Products: $530.25
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THERAPY W/O PATIENT, 26+ MIN (90846)	$285	$256.50	$185.25 – $279.30
Family psychotherapy, without the patient: 10 of 26 insurance plan rates Aetna — All Products: $256.50 Aetna — Coventry Cares WV: $270.75 AHPO — All Products: $267.90 Amerihealth — Managed Medicaid - Non-Cap: $213.92 Anthem — Managed Medicaid - Non-Cap: $213.92 Anthem BCBS — All Products: $259.35 BCHP — Managed Medicaid - Non-Cap: $213.92 Caresource — Just4Me/Marketplace: $272.01 Caresource — Managed Medicaid - Non-Cap: $213.92 Cigna — All Products: $267.90
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAM THPY W/O PATIENT PER VISIT, 26+ MIN	$420	$378	$273 – $411.60
Family psychotherapy, without the patient: 10 of 26 insurance plan rates Aetna — All Products: $378 Aetna — Coventry Cares WV: $399 AHPO — All Products: $394.80 Amerihealth — Managed Medicaid - Non-Cap: $213.92 Anthem — Managed Medicaid - Non-Cap: $213.92 Anthem BCBS — All Products: $382.20 BCHP — Managed Medicaid - Non-Cap: $213.92 Caresource — Just4Me/Marketplace: $272.01 Caresource — Managed Medicaid - Non-Cap: $213.92 Cigna — All Products: $394.80
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$516	$464.40	$92.81 – $293.04
Family psychotherapy, without the patient: 10 of 22 insurance plan rates Aetna — All Products: $250 Aetna — Coventry Cares WV: $387 Amerihealth — Managed Medicaid - Non-Cap: $96.87 Anthem — All Products: $263.64 Anthem — Managed Medicaid: $96.87 BCHP — Managed Medicaid - Non-Cap: $96.87 Caresource — Just4Me/Marketplace: $157.09 Caresource — Managed Medicaid - Non-Cap: $96.87 Cigna — All Products: $387 Front Path Health Coalition — All Products: $387
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY THERAPY W/PATIENT, 26+ MIN (90847)	$285	$256.50	$185.25 – $279.30
Family psychotherapy, with the patient: 10 of 26 insurance plan rates Aetna — All Products: $256.50 Aetna — Coventry Cares WV: $270.75 AHPO — All Products: $267.90 Amerihealth — Managed Medicaid - Non-Cap: $213.92 Anthem — Managed Medicaid - Non-Cap: $213.92 Anthem BCBS — All Products: $259.35 BCHP — Managed Medicaid - Non-Cap: $213.92 Caresource — Just4Me/Marketplace: $272.01 Caresource — Managed Medicaid - Non-Cap: $213.92 Cigna — All Products: $267.90
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAM THRPY W/PATIENT PER VISIT, 26+ MIN	$310	$279	$201.50 – $303.80
Family psychotherapy, with the patient: 10 of 26 insurance plan rates Aetna — All Products: $279 Aetna — Coventry Cares WV: $294.50 AHPO — All Products: $291.40 Amerihealth — Managed Medicaid - Non-Cap: $213.92 Anthem — Managed Medicaid - Non-Cap: $213.92 Anthem BCBS — All Products: $282.10 BCHP — Managed Medicaid - Non-Cap: $213.92 Caresource — Just4Me/Marketplace: $272.01 Caresource — Managed Medicaid - Non-Cap: $213.92 Cigna — All Products: $291.40
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$538	$484.20	$95.39 – $316.09
Family psychotherapy, with the patient: 10 of 22 insurance plan rates Aetna — All Products: $299.99 Aetna — Coventry Cares WV: $403.50 Amerihealth — Managed Medicaid - Non-Cap: $95.39 Anthem — All Products: $316.09 Anthem — Managed Medicaid: $95.39 BCHP — Managed Medicaid - Non-Cap: $95.39 Caresource — Just4Me/Marketplace: $162.60 Caresource — Managed Medicaid - Non-Cap: $95.39 Cigna — All Products: $403.50 Front Path Health Coalition — All Products: $403.50
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP THERAPY (PATIENT GROUPS) (90853)	$119	$107.10	$77.35 – $116.62
Group psychotherapy: 10 of 26 insurance plan rates Aetna — All Products: $107.10 Aetna — Coventry Cares WV: $113.05 AHPO — All Products: $111.86 Amerihealth — Managed Medicaid - Non-Cap: $177.48 Anthem — Managed Medicaid - Non-Cap: $177.48 Anthem BCBS — All Products: $108.29 BCHP — Managed Medicaid - Non-Cap: $177.48 Caresource — Just4Me/Marketplace: $119 Caresource — Managed Medicaid - Non-Cap: $177.48 Cigna — All Products: $111.86
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP PSYCHOTHERAPY, NOT MULTI FAMILY	$180	$162	$117 – $176.40
Group psychotherapy: 10 of 26 insurance plan rates Aetna — All Products: $162 Aetna — Coventry Cares WV: $171 AHPO — All Products: $169.20 Amerihealth — Managed Medicaid - Non-Cap: $177.48 Anthem — Managed Medicaid - Non-Cap: $177.48 Anthem BCBS — All Products: $163.80 BCHP — Managed Medicaid - Non-Cap: $177.48 Caresource — Just4Me/Marketplace: $155.69 Caresource — Managed Medicaid - Non-Cap: $177.48 Cigna — All Products: $169.20
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR GROUP PSYCHOTHERAPY	$127	$114.30	$26.21 – $86.72
Group psychotherapy: 10 of 15 insurance plan rates Aetna — All Products: $85.37 Aetna — Coventry Cares WV: $95.25 Anthem — All Products: $86.72 Caresource — Just4Me/Marketplace: $44.59 Cigna — All Products: $95.25 Front Path Health Coalition — All Products: $95.25 Humana — All Products: $53.78 MMO — All Products: $91.44 OHC — All Products: $95.25 OHG — All Products: $95.25

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OPEN EXCISION OF BREAST MASS, MALE OR FEMALE, 1 OR MORE LESIONS	$2,860	$2,574	$1,344.20 – $2,802.80
Removal of breast growth (open surgery): 10 of 27 insurance plan rates Aetna — All Products: $2,574 Aetna — Coventry Cares WV: $2,717 AHPO — All Products: $2,688.40 Amerihealth — Managed Medicaid - Non-Cap: $1,585.03 Anthem — Managed Medicaid - Non-Cap: $1,585.03 Anthem BCBS — All Products: $1,562.22 BCHP — Managed Medicaid - Non-Cap: $1,585.03 Caresource — Just4Me/Marketplace: $1,344.20 Caresource — Managed Medicaid - Non-Cap: $1,585.03 Cigna — All Products: $105
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$2,114	$1,902.60	$1,522.08 – $1,585.50
Removal of breast growth (open surgery): 10 of 22 insurance plan rates Aetna — All Products: $1,054.74 Aetna — Coventry Cares WV: $1,585.50 Amerihealth — Managed Medicaid - Non-Cap: $282.33 Anthem — All Products: $1,004.59 Anthem — Managed Medicaid: $282.33 BCHP — Managed Medicaid - Non-Cap: $282.33 Caresource — Just4Me/Marketplace: $816.99 Caresource — Managed Medicaid - Non-Cap: $282.33 Cigna — All Products: $1,585.50 Front Path Health Coalition — All Products: $1,585.50
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OPEN EXCISION OF BREAST MASS, MALE OR FEMALE, 1 OR MORE LESIONS	$2,860	$2,574	$1,344.20 – $2,802.80
Removal of breast growth (open surgery): rates for 6 insurance plans Aetna — All Products: $2,717 Anthem BCBS — All Products: $2,688.40 Humana — All Products: $2,717 Ohio PPO Connect — All Products: $2,659.80 OSU — All Products: $2,659.80 UHC — All Products: $2,717
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$6,463	$5,816.70	$4,653.36 – $4,847.25
Total hip replacement: 10 of 15 insurance plan rates Aetna — All Products: $4,027.88 Aetna — Coventry Cares WV: $4,847.25 Anthem — All Products: $4,006.26 Caresource — Just4Me/Marketplace: $1,693.96 Cigna — All Products: $4,847.25 Front Path Health Coalition — All Products: $4,847.25 Humana — All Products: $2,905.94 MMO — All Products: $4,653.36 OHC — All Products: $4,847.25 OHG — All Products: $4,847.25
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$12,108.46
Total hip replacement: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $12,108.46 Anthem — Managed Medicaid - Non-Cap: $12,108.46 BCHP — Managed Medicaid - Non-Cap: $12,108.46 Caresource — Managed Medicaid - Non-Cap: $12,108.46 Humana — Managed Medicaid - Non-Cap: $12,108.46 Molina — Managed Medicaid - Non-Cap: $12,108.46 UHC — Managed Medicaid - Non-Cap: $12,108.46
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$3,888.64
Total hip replacement: rates for 3 insurance plans Anthem BCBS — All Products: $3,888.64 Caresource — Just4Me/Marketplace: $19,675.14 Tricare CHAMPUS — All Products: $12,223.48
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$6,454	$5,808.60	$1,156.94 – $4,314.71
Total knee replacement: 10 of 15 insurance plan rates Aetna — All Products: $4,314.71 Aetna — Coventry Cares WV: $4,840.50 Anthem — All Products: $4,311.54 Caresource — Just4Me/Marketplace: $1,690.15 Cigna — All Products: $4,840.50 Front Path Health Coalition — All Products: $4,840.50 Humana — All Products: $2,902.07 MMO — All Products: $4,646.88 OHC — All Products: $4,840.50 OHG — All Products: $4,840.50
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$12,108.46
Total knee replacement: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $12,108.46 Anthem — Managed Medicaid - Non-Cap: $12,108.46 BCHP — Managed Medicaid - Non-Cap: $12,108.46 Caresource — Managed Medicaid - Non-Cap: $12,108.46 Humana — Managed Medicaid - Non-Cap: $12,108.46 Molina — Managed Medicaid - Non-Cap: $12,108.46 UHC — Managed Medicaid - Non-Cap: $12,108.46
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$3,882.71
Total knee replacement: rates for 3 insurance plans Anthem BCBS — All Products: $3,882.71 Caresource — Just4Me/Marketplace: $19,675.14 Tricare CHAMPUS — All Products: $12,223.48
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$862	$775.80	$154.58 – $862
Shoulder arthroscopy: shaving of shoulder bone: 10 of 15 insurance plan rates Aetna — All Products: $862 Aetna — Coventry Cares WV: $646.50 Anthem — All Products: $506.92 Caresource — Just4Me/Marketplace: $217.71 Cigna — All Products: $646.50 Front Path Health Coalition — All Products: $646.50 Humana — All Products: $395.15 MMO — All Products: $620.64 OHC — All Products: $646.50 OHG — All Products: $646.50
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sho arthrs srg decompression	Not listed in the file	Not listed in the file	$2,813.45
Shoulder arthroscopy: shaving of shoulder bone: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $2,813.45 Anthem — Managed Medicaid - Non-Cap: $2,813.45 BCHP — Managed Medicaid - Non-Cap: $2,813.45 Caresource — Managed Medicaid - Non-Cap: $2,813.45 Humana — Managed Medicaid - Non-Cap: $2,813.45 Molina — Managed Medicaid - Non-Cap: $2,813.45 UHC — Managed Medicaid - Non-Cap: $2,813.45
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$517.81
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan Anthem BCBS — All Products: $517.81
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ARTHRS KNEE SURG W/MENISCECTOMY MED/LAT W/SHVG	$2,735	$2,461.50	$1,969.20 – $2,051.25
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 15 insurance plan rates Aetna — All Products: $1,737.50 Aetna — Coventry Cares WV: $2,051.25 Anthem — All Products: $1,756.72 Caresource — Just4Me/Marketplace: $742.79 Cigna — All Products: $2,051.25 Front Path Health Coalition — All Products: $2,051.25 Humana — All Products: $1,217.50 MMO — All Products: $1,969.20 OHC — All Products: $2,051.25 OHG — All Products: $2,051.25
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrs kne srg mnisectmy m/l	Not listed in the file	Not listed in the file	$2,813.45
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $2,813.45 Anthem — Managed Medicaid - Non-Cap: $2,813.45 BCHP — Managed Medicaid - Non-Cap: $2,813.45 Caresource — Managed Medicaid - Non-Cap: $2,813.45 Humana — Managed Medicaid - Non-Cap: $2,813.45 Molina — Managed Medicaid - Non-Cap: $2,813.45 UHC — Managed Medicaid - Non-Cap: $2,813.45
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$1,644.47
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 3 insurance plans Anthem BCBS — All Products: $1,644.47 Caresource — Just4Me/Marketplace: $5,014.31 Tricare CHAMPUS — All Products: $3,082.38
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$1,466	$1,319.40	$1,055.52 – $1,099.50
Removal of tonsils and adenoids (under age 12): 10 of 15 insurance plan rates Aetna — All Products: $786.62 Aetna — Coventry Cares WV: $1,099.50 Anthem — All Products: $822.43 Caresource — Just4Me/Marketplace: $377.97 Cigna — All Products: $1,099.50 Front Path Health Coalition — All Products: $1,099.50 Humana — All Products: $642.17 MMO — All Products: $1,055.52 OHC — All Products: $1,099.50 OHG — All Products: $1,099.50
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$2,203.71
Removal of tonsils and adenoids (under age 12): rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $2,203.71 Anthem — Managed Medicaid - Non-Cap: $2,203.71 BCHP — Managed Medicaid - Non-Cap: $2,203.71 Caresource — Managed Medicaid - Non-Cap: $2,203.71 Humana — Managed Medicaid - Non-Cap: $2,203.71 Molina — Managed Medicaid - Non-Cap: $2,203.71 UHC — Managed Medicaid - Non-Cap: $2,203.71
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$884.39
Removal of tonsils and adenoids (under age 12): rates for 3 insurance plans Anthem BCBS — All Products: $884.39 Caresource — Just4Me/Marketplace: $9,072.08 Tricare CHAMPUS — All Products: $5,619.88
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$608	$547.20	$181.18 – $456
Upper GI endoscopy (diagnostic): 10 of 22 insurance plan rates Aetna — All Products: $410.26 Aetna — Coventry Cares WV: $456 Amerihealth — Managed Medicaid - Non-Cap: $181.18 Anthem — All Products: $398.56 Anthem — Managed Medicaid: $181.18 BCHP — Managed Medicaid - Non-Cap: $181.18 Caresource — Just4Me/Marketplace: $451.91 Caresource — Managed Medicaid - Non-Cap: $181.18 Cigna — All Products: $456 Front Path Health Coalition — All Products: $456
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash	Not listed in the file	Not listed in the file	$1,198.66
Upper GI endoscopy (diagnostic): rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $1,198.66 Anthem — Managed Medicaid - Non-Cap: $1,198.66 BCHP — Managed Medicaid - Non-Cap: $1,198.66 Caresource — Managed Medicaid - Non-Cap: $1,198.66 Humana — Managed Medicaid - Non-Cap: $1,198.66 Molina — Managed Medicaid - Non-Cap: $1,198.66 UHC — Managed Medicaid - Non-Cap: $1,198.66
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$839.45
Upper GI endoscopy (diagnostic): rates for 3 insurance plans Anthem BCBS — All Products: $839.45 Caresource — Just4Me/Marketplace: $1,389.95 Tricare CHAMPUS — All Products: $880.30
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$683	$614.70	$491.76 – $512.25
Upper GI endoscopy with biopsy: 10 of 22 insurance plan rates Aetna — All Products: $485.50 Aetna — Coventry Cares WV: $512.25 Amerihealth — Managed Medicaid - Non-Cap: $295.94 Anthem — All Products: $472.71 Anthem — Managed Medicaid: $295.94 BCHP — Managed Medicaid - Non-Cap: $295.94 Caresource — Just4Me/Marketplace: $585.05 Caresource — Managed Medicaid - Non-Cap: $295.94 Cigna — All Products: $512.25 Front Path Health Coalition — All Products: $512.25
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple	Not listed in the file	Not listed in the file	$1,198.66
Upper GI endoscopy with biopsy: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $1,198.66 Anthem — Managed Medicaid - Non-Cap: $1,198.66 BCHP — Managed Medicaid - Non-Cap: $1,198.66 Caresource — Managed Medicaid - Non-Cap: $1,198.66 Humana — Managed Medicaid - Non-Cap: $1,198.66 Molina — Managed Medicaid - Non-Cap: $1,198.66 UHC — Managed Medicaid - Non-Cap: $1,198.66
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$1,093.54
Upper GI endoscopy with biopsy: rates for 3 insurance plans Anthem BCBS — All Products: $1,093.54 Caresource — Just4Me/Marketplace: $1,389.95 Tricare CHAMPUS — All Products: $880.30
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$915	$823.50	$187.50 – $686.25
Colonoscopy (diagnostic): 10 of 22 insurance plan rates Aetna — All Products: $611.72 Aetna — Coventry Cares WV: $686.25 Amerihealth — Managed Medicaid - Non-Cap: $187.50 Anthem — All Products: $600.29 Anthem — Managed Medicaid: $187.50 BCHP — Managed Medicaid - Non-Cap: $187.50 Caresource — Just4Me/Marketplace: $533.62 Caresource — Managed Medicaid - Non-Cap: $187.50 Cigna — All Products: $686.25 Front Path Health Coalition — All Products: $686.25
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy	Not listed in the file	Not listed in the file	$1,367.54
Colonoscopy (diagnostic): rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $1,367.54 Anthem — Managed Medicaid - Non-Cap: $1,367.54 BCHP — Managed Medicaid - Non-Cap: $1,367.54 Caresource — Managed Medicaid - Non-Cap: $1,367.54 Humana — Managed Medicaid - Non-Cap: $1,367.54 Molina — Managed Medicaid - Non-Cap: $1,367.54 UHC — Managed Medicaid - Non-Cap: $1,367.54
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$999.94
Colonoscopy (diagnostic): rates for 3 insurance plans Anthem BCBS — All Products: $999.94 Caresource — Just4Me/Marketplace: $1,425.15 Tricare CHAMPUS — All Products: $902.60
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$995	$895.50	$312.01 – $746.25
Colonoscopy with biopsy: 10 of 22 insurance plan rates Aetna — All Products: $736.33 Aetna — Coventry Cares WV: $746.25 Amerihealth — Managed Medicaid - Non-Cap: $312.01 Anthem — All Products: $717.19 Anthem — Managed Medicaid: $312.01 BCHP — Managed Medicaid - Non-Cap: $312.01 Caresource — Just4Me/Marketplace: $674.44 Caresource — Managed Medicaid - Non-Cap: $312.01 Cigna — All Products: $746.25 Front Path Health Coalition — All Products: $746.25
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy	Not listed in the file	Not listed in the file	$1,367.54
Colonoscopy with biopsy: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $1,367.54 Anthem — Managed Medicaid - Non-Cap: $1,367.54 BCHP — Managed Medicaid - Non-Cap: $1,367.54 Caresource — Managed Medicaid - Non-Cap: $1,367.54 Humana — Managed Medicaid - Non-Cap: $1,367.54 Molina — Managed Medicaid - Non-Cap: $1,367.54 UHC — Managed Medicaid - Non-Cap: $1,367.54
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$1,267.99
Colonoscopy with biopsy: rates for 3 insurance plans Anthem BCBS — All Products: $1,267.99 Caresource — Just4Me/Marketplace: $1,833.84 Tricare CHAMPUS — All Products: $1,161.43
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$1,254	$1,128.60	$351.91 – $940.50
Colonoscopy with removal of polyps (snare): 10 of 22 insurance plan rates Aetna — All Products: $874.52 Aetna — Coventry Cares WV: $940.50 Amerihealth — Managed Medicaid - Non-Cap: $351.91 Anthem — All Products: $852.84 Anthem — Managed Medicaid: $351.91 BCHP — Managed Medicaid - Non-Cap: $351.91 Caresource — Just4Me/Marketplace: $706.63 Caresource — Managed Medicaid - Non-Cap: $351.91 Cigna — All Products: $940.50 Front Path Health Coalition — All Products: $940.50
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal	Not listed in the file	Not listed in the file	$1,367.54
Colonoscopy with removal of polyps (snare): rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $1,367.54 Anthem — Managed Medicaid - Non-Cap: $1,367.54 BCHP — Managed Medicaid - Non-Cap: $1,367.54 Caresource — Managed Medicaid - Non-Cap: $1,367.54 Humana — Managed Medicaid - Non-Cap: $1,367.54 Molina — Managed Medicaid - Non-Cap: $1,367.54 UHC — Managed Medicaid - Non-Cap: $1,367.54
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$1,336.59
Colonoscopy with removal of polyps (snare): rates for 3 insurance plans Anthem BCBS — All Products: $1,336.59 Caresource — Just4Me/Marketplace: $1,833.84 Tricare CHAMPUS — All Products: $1,161.43
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$1,271	$1,143.90	$915.12 – $953.25
Ultrasound of the lower bowel by endoscope: 10 of 15 insurance plan rates Aetna — All Products: $847.07 Aetna — Coventry Cares WV: $953.25 Anthem — All Products: $849.98 Caresource — Just4Me/Marketplace: $331.71 Cigna — All Products: $953.25 Front Path Health Coalition — All Products: $953.25 Humana — All Products: $574.67 MMO — All Products: $915.12 OHC — All Products: $953.25 OHG — All Products: $953.25
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us	Not listed in the file	Not listed in the file	$1,367.54
Ultrasound of the lower bowel by endoscope: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $1,367.54 Anthem — Managed Medicaid - Non-Cap: $1,367.54 BCHP — Managed Medicaid - Non-Cap: $1,367.54 Caresource — Managed Medicaid - Non-Cap: $1,367.54 Humana — Managed Medicaid - Non-Cap: $1,367.54 Molina — Managed Medicaid - Non-Cap: $1,367.54 UHC — Managed Medicaid - Non-Cap: $1,367.54
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$768.16
Ultrasound of the lower bowel by endoscope: rates for 3 insurance plans Anthem BCBS — All Products: $768.16 Caresource — Just4Me/Marketplace: $1,833.84 Tricare CHAMPUS — All Products: $1,161.43
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$1,367.54
Screening colonoscopy (not high risk): rates for 10 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $1,367.54 Anthem — Managed Medicaid - Non-Cap: $1,367.54 Anthem BCBS — All Products: $1,001.03 BCHP — Managed Medicaid - Non-Cap: $1,367.54 Caresource — Just4Me/Marketplace: $1,425.15 Caresource — Managed Medicaid - Non-Cap: $1,367.54 Humana — Managed Medicaid - Non-Cap: $1,367.54 Molina — Managed Medicaid - Non-Cap: $1,367.54 Tricare CHAMPUS — All Products: $866.12 UHC — Managed Medicaid - Non-Cap: $1,367.54
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$500.58
Screening colonoscopy (not high risk): rates for 1 insurance plan Anthem BCBS — All Products: $500.58
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR LAPAROSCOPY SURG CHOLECYSTECTOMY	$3,347	$3,012.30	$600.02 – $1,967.07
Gallbladder removal by laparoscope: 10 of 15 insurance plan rates Aetna — All Products: $1,967.07 Aetna — Coventry Cares WV: $2,510.25 Anthem — All Products: $1,962.26 Caresource — Just4Me/Marketplace: $922.66 Cigna — All Products: $2,510.25 Front Path Health Coalition — All Products: $2,510.25 Humana — All Products: $1,508.09 MMO — All Products: $2,409.84 OHC — All Products: $2,510.25 OHG — All Products: $2,510.25
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$4,643.87
Gallbladder removal by laparoscope: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $4,643.87 Anthem — Managed Medicaid - Non-Cap: $4,643.87 BCHP — Managed Medicaid - Non-Cap: $4,643.87 Caresource — Managed Medicaid - Non-Cap: $4,643.87 Humana — Managed Medicaid - Non-Cap: $4,643.87 Molina — Managed Medicaid - Non-Cap: $4,643.87 UHC — Managed Medicaid - Non-Cap: $4,643.87
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$2,015.70
Gallbladder removal by laparoscope: rates for 3 insurance plans Anthem BCBS — All Products: $2,015.70 Caresource — Just4Me/Marketplace: $9,264.71 Tricare CHAMPUS — All Products: $5,542.64
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$2,653	$2,387.70	$475.46 – $1,501.44
Groin (inguinal) hernia repair, age 5 or older: 10 of 15 insurance plan rates Aetna — All Products: $1,370.50 Aetna — Coventry Cares WV: $1,989.75 Anthem — All Products: $1,373.35 Caresource — Just4Me/Marketplace: $739.33 Cigna — All Products: $1,989.75 Front Path Health Coalition — All Products: $1,989.75 Humana — All Products: $1,191.24 MMO — All Products: $1,910.16 OHC — All Products: $1,989.75 OHG — All Products: $1,989.75
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$3,742.96
Groin (inguinal) hernia repair, age 5 or older: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $3,742.96 Anthem — Managed Medicaid - Non-Cap: $3,742.96 BCHP — Managed Medicaid - Non-Cap: $3,742.96 Caresource — Managed Medicaid - Non-Cap: $3,742.96 Humana — Managed Medicaid - Non-Cap: $3,742.96 Molina — Managed Medicaid - Non-Cap: $3,742.96 UHC — Managed Medicaid - Non-Cap: $3,742.96
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$1,596.46
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans Anthem BCBS — All Products: $1,596.46 Caresource — Just4Me/Marketplace: $5,486.93 Tricare CHAMPUS — All Products: $3,352.61
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PROSTATE NEEDLE BIOPSY ANY APPROACH	$647	$582.30	$131.18 – $485.25
Prostate biopsy: 10 of 21 insurance plan rates Aetna — All Products: $412.10 Aetna — Coventry Cares WV: $485.25 Amerihealth — Managed Medicaid - Non-Cap: $131.18 Anthem — All Products: $250.16 Anthem — Managed Medicaid: $131.18 BCHP — Managed Medicaid - Non-Cap: $131.18 Caresource — Managed Medicaid - Non-Cap: $131.18 Cigna — All Products: $485.25 Front Path Health Coalition — All Products: $485.25 Humana — All Products: $292.01
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$711.35
Prostate biopsy: rates for 1 insurance plan Anthem BCBS — All Products: $711.35
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR LAPS SURG PRST8ECT RPBIC RAD W/NERVE SPARING	$5,985	$5,386.50	$1,072.77 – $5,306.77
Prostate removal by laparoscope (radical prostatectomy): 10 of 15 insurance plan rates Aetna — All Products: $5,306.77 Aetna — Coventry Cares WV: $4,488.75 Anthem — All Products: $4,811.14 Caresource — Just4Me/Marketplace: $1,590.53 Cigna — All Products: $4,488.75 Front Path Health Coalition — All Products: $4,488.75 Humana — All Products: $3,234.04 MMO — All Products: $4,309.20 OHC — All Products: $4,488.75 OHG — All Products: $4,488.75
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps surg prst8ect rpbic rad	Not listed in the file	Not listed in the file	$5,045.91
Prostate removal by laparoscope (radical prostatectomy): rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $5,045.91 Anthem — Managed Medicaid - Non-Cap: $5,045.91 BCHP — Managed Medicaid - Non-Cap: $5,045.91 Caresource — Managed Medicaid - Non-Cap: $5,045.91 Humana — Managed Medicaid - Non-Cap: $5,045.91 Molina — Managed Medicaid - Non-Cap: $5,045.91 UHC — Managed Medicaid - Non-Cap: $5,045.91
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$3,605.33
Prostate removal by laparoscope (radical prostatectomy): rates for 3 insurance plans Anthem BCBS — All Products: $3,605.33 Caresource — Just4Me/Marketplace: $16,290.11 Tricare CHAMPUS — All Products: $9,890.66
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$1,162	$1,045.80	$836.64 – $871.50
Hysteroscopy with biopsy of the uterus lining: 10 of 22 insurance plan rates Aetna — All Products: $766.80 Aetna — Coventry Cares WV: $871.50 Amerihealth — Managed Medicaid - Non-Cap: $890.16 Anthem — All Products: $806.24 Anthem — Managed Medicaid: $890.16 BCHP — Managed Medicaid - Non-Cap: $890.16 Caresource — Just4Me/Marketplace: $1,162 Caresource — Managed Medicaid - Non-Cap: $890.16 Cigna — All Products: $871.50 Front Path Health Coalition — All Products: $871.50
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$2,617.48
Hysteroscopy with biopsy of the uterus lining: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $2,617.48 Anthem — Managed Medicaid - Non-Cap: $2,617.48 BCHP — Managed Medicaid - Non-Cap: $2,617.48 Caresource — Managed Medicaid - Non-Cap: $2,617.48 Humana — Managed Medicaid - Non-Cap: $2,617.48 Molina — Managed Medicaid - Non-Cap: $2,617.48 UHC — Managed Medicaid - Non-Cap: $2,617.48
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$3,790.98
Hysteroscopy with biopsy of the uterus lining: rates for 3 insurance plans Anthem BCBS — All Products: $3,790.98 Caresource — Just4Me/Marketplace: $4,960.86 Tricare CHAMPUS — All Products: $3,020.55
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION, NON-NEUROLYTIC, INTERL EPID/SUBARACH, LUMBAR OR SACRA	$2,030	$1,827	$1,319.50 – $1,989.40
Spinal injection, lower back (epidural), with imaging guidance: 10 of 27 insurance plan rates Aetna — All Products: $1,827 Aetna — Coventry Cares WV: $1,928.50 AHPO — All Products: $1,908.20 Amerihealth — Managed Medicaid - Non-Cap: $868.76 Anthem — Managed Medicaid - Non-Cap: $868.76 Anthem BCBS — All Products: $1,847.30 BCHP — Managed Medicaid - Non-Cap: $868.76 Caresource — Just4Me/Marketplace: $1,081.76 Caresource — Managed Medicaid - Non-Cap: $868.76 Cigna — All Products: $1,908.20
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$495	$445.50	$88.75 – $382.65
Spinal injection, lower back (epidural), with imaging guidance: 10 of 22 insurance plan rates Aetna — All Products: $88.75 Aetna — Coventry Cares WV: $371.25 Amerihealth — Managed Medicaid - Non-Cap: $206.56 Anthem — All Products: $294.78 Anthem — Managed Medicaid: $206.56 BCHP — Managed Medicaid - Non-Cap: $206.56 Caresource — Just4Me/Marketplace: $382.65 Caresource — Managed Medicaid - Non-Cap: $206.56 Cigna — All Products: $371.25 Front Path Health Coalition — All Products: $371.25
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJECTION, NON-NEUROLYTIC, INTERL EPID/SUBARACH, LUMBAR OR SACRA	$2,030	$1,827	$1,319.50 – $1,989.40
Spinal injection, lower back (epidural), with imaging guidance: rates for 6 insurance plans Aetna — All Products: $1,928.50 Anthem BCBS — All Products: $1,908.20 Humana — All Products: $1,928.50 Ohio PPO Connect — All Products: $1,887.90 OSU — All Products: $1,887.90 UHC — All Products: $1,928.50
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION; ANESTHETIC AGENT;TRANSFORAMINAL;LUMBAR OR SACRAL, SIN	$1,060	$954	$689 – $1,038.80
Nerve root injection, lower back, with imaging guidance: 10 of 27 insurance plan rates Aetna — All Products: $954 Aetna — Coventry Cares WV: $1,007 AHPO — All Products: $996.40 Amerihealth — Managed Medicaid - Non-Cap: $868.76 Anthem — Managed Medicaid - Non-Cap: $868.76 Anthem BCBS — All Products: $964.60 BCHP — Managed Medicaid - Non-Cap: $868.76 Caresource — Just4Me/Marketplace: $1,060 Caresource — Managed Medicaid - Non-Cap: $868.76 Cigna — All Products: $996.40
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$552	$496.80	$397.44 – $414
Nerve root injection, lower back, with imaging guidance: 10 of 22 insurance plan rates Aetna — All Products: $296.55 Aetna — Coventry Cares WV: $414 Amerihealth — Managed Medicaid - Non-Cap: $135.18 Anthem — All Products: $291.37 Anthem — Managed Medicaid: $135.18 BCHP — Managed Medicaid - Non-Cap: $135.18 Caresource — Just4Me/Marketplace: $371.61 Caresource — Managed Medicaid - Non-Cap: $135.18 Cigna — All Products: $414 Front Path Health Coalition — All Products: $414
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJECTION; ANESTHETIC AGENT;TRANSFORAMINAL;LUMBAR OR SACRAL, SIN	$1,060	$954	$689 – $1,038.80
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans Aetna — All Products: $1,007 Anthem BCBS — All Products: $996.40 Humana — All Products: $1,007 Ohio PPO Connect — All Products: $985.80 OSU — All Products: $985.80 UHC — All Products: $1,007
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$2,203	$1,982.70	$280.22 – $1,267.53
Carpal tunnel release: 10 of 22 insurance plan rates Aetna — All Products: $1,099.56 Aetna — Coventry Cares WV: $1,652.25 Amerihealth — Managed Medicaid - Non-Cap: $280.22 Anthem — All Products: $1,121.20 Anthem — Managed Medicaid: $280.22 BCHP — Managed Medicaid - Non-Cap: $280.22 Caresource — Just4Me/Marketplace: $686.83 Caresource — Managed Medicaid - Non-Cap: $280.22 Cigna — All Products: $1,652.25 Front Path Health Coalition — All Products: $1,652.25
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$1,674.73
Carpal tunnel release: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $1,674.73 Anthem — Managed Medicaid - Non-Cap: $1,674.73 BCHP — Managed Medicaid - Non-Cap: $1,674.73 Caresource — Managed Medicaid - Non-Cap: $1,674.73 Humana — Managed Medicaid - Non-Cap: $1,674.73 Molina — Managed Medicaid - Non-Cap: $1,674.73 UHC — Managed Medicaid - Non-Cap: $1,674.73
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$1,345.99
Carpal tunnel release: rates for 3 insurance plans Anthem BCBS — All Products: $1,345.99 Caresource — Just4Me/Marketplace: $2,992.53 Tricare CHAMPUS — All Products: $1,855.13
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POST CATARACT LASER SURGERY (YAG)	$750	$675	$352.50 – $735
Laser treatment of clouding after cataract surgery: 10 of 27 insurance plan rates Aetna — All Products: $675 Aetna — Coventry Cares WV: $712.50 AHPO — All Products: $705 Amerihealth — Managed Medicaid - Non-Cap: $489.07 Anthem — Managed Medicaid - Non-Cap: $489.07 Anthem BCBS — All Products: $750 BCHP — Managed Medicaid - Non-Cap: $489.07 Caresource — Just4Me/Marketplace: $352.50 Caresource — Managed Medicaid - Non-Cap: $489.07 Cigna — All Products: $105
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR POST-CATARACT LASER SURGERY	$1,500	$1,350	$177.15 – $906.81
Laser treatment of clouding after cataract surgery: 10 of 22 insurance plan rates Aetna — All Products: $721.77 Aetna — Coventry Cares WV: $1,125 Amerihealth — Managed Medicaid - Non-Cap: $177.15 Anthem — All Products: $795.83 Anthem — Managed Medicaid: $177.15 BCHP — Managed Medicaid - Non-Cap: $177.15 Caresource — Just4Me/Marketplace: $474.96 Caresource — Managed Medicaid - Non-Cap: $177.15 Cigna — All Products: $1,125 Front Path Health Coalition — All Products: $1,125
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POST CATARACT LASER SURGERY (YAG)	$750	$675	$352.50 – $735
Laser treatment of clouding after cataract surgery: rates for 6 insurance plans Aetna — All Products: $712.50 Anthem BCBS — All Products: $705 Humana — All Products: $712.50 Ohio PPO Connect — All Products: $697.50 OSU — All Products: $697.50 UHC — All Products: $712.50
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$2,643	$2,378.70	$1,902.96 – $1,982.25
Cataract removal with lens implant: 10 of 15 insurance plan rates Aetna — All Products: $1,852.64 Aetna — Coventry Cares WV: $1,982.25 Anthem — All Products: $1,931.12 Caresource — Just4Me/Marketplace: $667.36 Cigna — All Products: $1,982.25 Front Path Health Coalition — All Products: $1,982.25 Humana — All Products: $1,183.82 MMO — All Products: $1,902.96 OHC — All Products: $1,982.25 OHG — All Products: $1,982.25
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl ctrc rmvl w/o ecp	Not listed in the file	Not listed in the file	$2,027.89
Cataract removal with lens implant: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $2,027.89 Anthem — Managed Medicaid - Non-Cap: $2,027.89 BCHP — Managed Medicaid - Non-Cap: $2,027.89 Caresource — Managed Medicaid - Non-Cap: $2,027.89 Humana — Managed Medicaid - Non-Cap: $2,027.89 Molina — Managed Medicaid - Non-Cap: $2,027.89 UHC — Managed Medicaid - Non-Cap: $2,027.89
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$1,602.58
Cataract removal with lens implant: rates for 3 insurance plans Anthem BCBS — All Products: $1,602.58 Caresource — Just4Me/Marketplace: $3,536.72 Tricare CHAMPUS — All Products: $2,166.69

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$12,148	$10,933.20	$2,477.60 – $7,152.19
Vaginal delivery, with care before and after: 10 of 15 insurance plan rates Aetna — All Products: $5,058.11 Aetna — Coventry Cares WV: $9,111 Anthem — All Products: $7,152.19 Caresource — Just4Me/Marketplace: $3,244.17 Cigna — All Products: $9,111 Front Path Health Coalition — All Products: $9,111 Humana — All Products: $5,417.91 MMO — All Products: $8,746.56 OHC — All Products: $9,111 OHG — All Products: $9,111
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care	Not listed in the file	Not listed in the file	$2,376.34
Vaginal delivery, with care before and after: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $2,376.34 Anthem — Managed Medicaid - Non-Cap: $2,376.34 BCHP — Managed Medicaid - Non-Cap: $2,376.34 Caresource — Managed Medicaid - Non-Cap: $2,376.34 Humana — Managed Medicaid - Non-Cap: $2,376.34 Molina — Managed Medicaid - Non-Cap: $2,376.34 UHC — Managed Medicaid - Non-Cap: $2,376.34
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$7,380.89
Vaginal delivery, with care before and after: rates for 1 insurance plan Anthem BCBS — All Products: $7,380.89
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$13,517	$12,165.30	$2,422.84 – $7,651.05
Cesarean delivery (C-section), with care before and after: 10 of 15 insurance plan rates Aetna — All Products: $5,729.05 Aetna — Coventry Cares WV: $10,137.75 Anthem — All Products: $7,152.19 Caresource — Just4Me/Marketplace: $3,628.04 Cigna — All Products: $10,137.75 Front Path Health Coalition — All Products: $10,137.75 Humana — All Products: $5,996.21 MMO — All Products: $9,732.24 OHC — All Products: $10,137.75 OHG — All Products: $10,137.75
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery	Not listed in the file	Not listed in the file	$1,650.53
Cesarean delivery (C-section), with care before and after: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $1,650.53 Anthem — Managed Medicaid - Non-Cap: $1,650.53 BCHP — Managed Medicaid - Non-Cap: $1,650.53 Caresource — Managed Medicaid - Non-Cap: $1,650.53 Humana — Managed Medicaid - Non-Cap: $1,650.53 Molina — Managed Medicaid - Non-Cap: $1,650.53 UHC — Managed Medicaid - Non-Cap: $1,650.53
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$8,220.65
Cesarean delivery (C-section), with care before and after: rates for 1 insurance plan Anthem BCBS — All Products: $8,220.65
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$12,749	$11,474.10	$9,179.28 – $9,561.75
Vaginal delivery after a previous C-section, with care before and after: 10 of 15 insurance plan rates Aetna — All Products: $5,331.51 Aetna — Coventry Cares WV: $9,561.75 Anthem — All Products: $7,129.12 Caresource — Just4Me/Marketplace: $3,419.85 Cigna — All Products: $9,561.75 Front Path Health Coalition — All Products: $9,561.75 Humana — All Products: $5,677.43 MMO — All Products: $9,179.28 OHC — All Products: $9,561.75 OHG — All Products: $9,561.75
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery	Not listed in the file	Not listed in the file	$2,376.34
Vaginal delivery after a previous C-section, with care before and after: rates for 7 insurance plans Amerihealth — Managed Medicaid - Non-Cap: $2,376.34 Anthem — Managed Medicaid - Non-Cap: $2,376.34 BCHP — Managed Medicaid - Non-Cap: $2,376.34 Caresource — Managed Medicaid - Non-Cap: $2,376.34 Humana — Managed Medicaid - Non-Cap: $2,376.34 Molina — Managed Medicaid - Non-Cap: $2,376.34 UHC — Managed Medicaid - Non-Cap: $2,376.34
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$7,752.34
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan Anthem BCBS — All Products: $7,752.34

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$142,295.35
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 20 insurance plan rates Tricare CHAMPUS — All Products: $142,295.35 Aetna — All Products: 95% (a percentage in the contract, not a dollar amount) Aetna — Coventry Cares WV: 95% (a percentage in the contract, not a dollar amount) AHPO — All Products: 94% (a percentage in the contract, not a dollar amount) Anthem BCBS — All Products: 94% (a percentage in the contract, not a dollar amount) Caresource — Just4Me/Marketplace: 47% (a percentage in the contract, not a dollar amount) Cigna — All Products: 94% (a percentage in the contract, not a dollar amount) Emerald Health — All Products: 98% (a percentage in the contract, not a dollar amount) First Health — All Products: 98% (a percentage in the contract, not a dollar amount) Front Path Health Coalition — All Products: 92% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$26,713.64
Hip or knee replacement (major joint of the leg), without major complications: rates for 1 insurance plan Tricare CHAMPUS — All Products: $26,713.64
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major joint replacement or reattachment of lower extremity w/o MCC	Not listed in the file	Not listed in the file	Not listed in the file
Hip or knee replacement (major joint of the leg), without major complications: 10 of 19 insurance plan rates Aetna — All Products: 95% (a percentage in the contract, not a dollar amount) Aetna — Coventry Cares WV: 95% (a percentage in the contract, not a dollar amount) AHPO — All Products: 94% (a percentage in the contract, not a dollar amount) Anthem BCBS — All Products: 94% (a percentage in the contract, not a dollar amount) Caresource — Just4Me/Marketplace: 47% (a percentage in the contract, not a dollar amount) Cigna — All Products: 94% (a percentage in the contract, not a dollar amount) Emerald Health — All Products: 98% (a percentage in the contract, not a dollar amount) First Health — All Products: 98% (a percentage in the contract, not a dollar amount) Front Path Health Coalition — All Products: 94% (a percentage in the contract, not a dollar amount) Humana — All Products: 95% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$34,617.73
Neck (cervical) spinal fusion, without complications: 10 of 20 insurance plan rates Tricare CHAMPUS — All Products: $34,617.73 Aetna — All Products: 95% (a percentage in the contract, not a dollar amount) Aetna — Coventry Cares WV: 95% (a percentage in the contract, not a dollar amount) AHPO — All Products: 94% (a percentage in the contract, not a dollar amount) Anthem BCBS — All Products: 94% (a percentage in the contract, not a dollar amount) Caresource — Just4Me/Marketplace: 47% (a percentage in the contract, not a dollar amount) Cigna — All Products: 94% (a percentage in the contract, not a dollar amount) Emerald Health — All Products: 98% (a percentage in the contract, not a dollar amount) First Health — All Products: 98% (a percentage in the contract, not a dollar amount) Front Path Health Coalition — All Products: 94% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$19,721.30
Uterus and ovary surgery (not for cancer), without complications: 10 of 20 insurance plan rates Tricare CHAMPUS — All Products: $19,721.30 Aetna — All Products: 95% (a percentage in the contract, not a dollar amount) Aetna — Coventry Cares WV: 95% (a percentage in the contract, not a dollar amount) AHPO — All Products: 94% (a percentage in the contract, not a dollar amount) Anthem BCBS — All Products: 94% (a percentage in the contract, not a dollar amount) Caresource — Just4Me/Marketplace: 47% (a percentage in the contract, not a dollar amount) Cigna — All Products: 94% (a percentage in the contract, not a dollar amount) Emerald Health — All Products: 98% (a percentage in the contract, not a dollar amount) First Health — All Products: 98% (a percentage in the contract, not a dollar amount) Front Path Health Coalition — All Products: 94% (a percentage in the contract, not a dollar amount)

Source: Nationwide Children's Hospital’s standard charges file (nationwidechildrens.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Children's Hospital
Address	700 Children's Drive, Columbus, OH 43205
County	Franklin County
State	Ohio
Phone	(614) 722‑2000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	363305
Name in Medicare records	NATIONWIDE CHILDREN'S HOSPITAL
Profile level	Medicare data + hospital website
Official website	nationwidechildrens.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Main Campus, Nationwide Children's Hospital — nationwidechildrens.org
The Heart Center (Cardiology) | Nationwide Children's Hospital — nationwidechildrens.org
Interventional Cardiology — nationwidechildrens.org
The Heart Center Programs — nationwidechildrens.org
Services We Offer — nationwidechildrens.org
Animation Library — nationwidechildrens.org
Outcomes Data — nationwidechildrens.org
Interventional Radiology — nationwidechildrens.org
Pediatric Fontan Clinic at Nationwide Children’s Hospital — nationwidechildrens.org
Interpreter Services | Nationwide Children's Hospital — nationwidechildrens.org
ENT (Otolaryngology) Services | Nationwide Children’s Hospital — nationwidechildrens.org
Specialized Programs — nationwidechildrens.org

Nationwide Children's Hospital

Summary

Profile from official sources

At a glance