Does Navicent Health Baldwin have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Navicent Health Baldwin. In a medical emergency, call 911.

Where is Navicent Health Baldwin?

821 North Cobb Street, Milledgeville, GA 31061, in Baldwin County, Georgia.

What is the phone number of Navicent Health Baldwin?

(478) 454-3550, as listed by Medicare (CMS).

What is the Medicare star rating of Navicent Health Baldwin?

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

Navicent Health Baldwin — Milledgeville, GA

Quick answers

Does Navicent Health Baldwin have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Navicent Health Baldwin. In a medical emergency, call 911.
Where is Navicent Health Baldwin?: 821 North Cobb Street, Milledgeville, GA 31061, in Baldwin County, Georgia.
What is the phone number of Navicent Health Baldwin?: (478) 454-3550, as listed by Medicare (CMS).
What is the Medicare star rating of Navicent Health Baldwin?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5][9]

Emergency Room
Intensive Care Unit
Women's Care
Women's Imaging
Surgery
Radiology
Laboratory Services
Rehabilitation Services
Cardiopulmonary Services
Sleep Center
Gastroenterology
Urology
General medical and surgical services
Radiation oncology

Programs and centers^[4][5]

Cardiac and Pulmonary Rehabilitation
Sleep center
Intensive care unit

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Visiting	After 9 p.m. visitors use Park Tower entrance; ICU generally two visitors at a time; under-10s need nurse approval^[7]
Interpreters and languages	Free: in-house Spanish interpreters by appointment; phone and video interpreting for 200+ languages, 24/7^[6]

Recognition^[4]

Level III Emergency Cardiac Care Center (Georgia Office of Cardiac Care)
American Academy of Sleep Medicine accredited facility
Sleep center accreditation (American Academy of Sleep Medicine)

Doctors and clinicians (272)

272 doctors and other clinicians list Navicent Health Baldwin 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 248 more: the button below opens the full list.

Other emergency rooms nearby

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

Putnam General Hospital18 mi · Eatonton, GA · Critical Access Hospital
Washington County Regional Medical Center26 mi · Sandersville, GA · Acute Care Hospital
St Marys Good Samaritan Hospital27 mi · Greensboro, GA · Critical Access Hospital
Coliseum Medical Centers, LLC, dba27 mi · Macon, GA · Acute Care Hospital
Atrium Health Navicent the Medical Center29 mi · Macon, GA · Acute Care Hospital

Other hospitals nearby

Regency Hospital Company of Macon, LLC27 mi · Macon, GA · Long-Term Acute Care Hospital
Atrium Health Navicent Rehabilitation Hospital29 mi · Macon, GA · 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

Atrium Health Navicent Baldwin0.0 mi · Milledgeville, GA · 3 of 5 stars
Chaplinwood Nursing Home2.3 mi · Milledgeville, GA · 3 of 5 stars
Green Acres Health and Rehabilitation2.3 mi · Milledgeville, GA · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Primecare Hospice & Palliative, Inc2.3 mi · Milledgeville, GA
Peaceful Purpose Hospice of Georgia, LLC18 mi · Eatonton, GA
Affinis Hospice, LLC20 mi · Gray, GA

All hospice providers in the state →

Dialysis facilities

Baldwin Dialysis Center2.3 mi · Milledgeville, GA · 1 of 5 stars
DaVita Milledgeville Dialysis2.3 mi · Milledgeville, GA · 2 of 5 stars
Dialysis Center of Milledgeville2.3 mi · Milledgeville, GA · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Coliseum Same Day Surgery Center, LLC22 mi · Macon, GA

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

Oconee Valley Healthcare, Inc. Milledgeville0.3 mi · Milledgeville, GA · Community health center
CHCS, Inc-Baldwin School1.0 mi · Milledgeville, GA · Community health center
Oconee Valley Healthcare Inc2.3 mi · Milledgeville, GA · Community health center

Clinics and urgent care

Judah Health and Wellness Urgent Care2.3 mi · Milledgeville, GA · Urgent care center
Rural Urgent Care LLC2.3 mi · Milledgeville, GA · Urgent care center
O Akhras MD PC18 mi · Sparta, GA · Rural health clinic

Pharmacies

Georgia CVS Pharmacy LLC2.3 mi · Milledgeville, GA · Pharmacy
Oconee Community Service Board2.3 mi · Milledgeville, GA · Clinic pharmacy
Publix Super Markets, Inc.2.3 mi · Milledgeville, GA · Community/retail pharmacy

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	2 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	2 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	2 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	61%National average: 72%
Would definitely recommend the hospital	59%National average: 71%
Nurses “always” communicated well	75%National average: 80%
Doctors “always” communicated well	74%National average: 80%
Staff “always” explained medicines before giving them	56%National average: 62%
Were given information about recovery at home	81%National average: 86%
Room and bathroom “always” clean	66%National average: 74%
Area around the room “always” quiet at night	59%National average: 60%
Completed surveys	262Response rate: 13%

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	0.314No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	11.4%
Deaths within 30 days: pneumonia patients	16.3%
Deaths within 30 days: COPD patients	7.8%
Deaths within 30 days: stroke patients	12.9%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.16No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	19.3%
Readmitted within 30 days: pneumonia	17.2%
Readmitted within 30 days: COPD	18.4%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	203 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	44%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Georgia Best hospitals in Georgia

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 Navicent Health Baldwin 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 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30-44 MIN	Not listed in the file	Not listed in the file	$71.13 – $350
New patient office visit (about 30–44 minutes): 10 of 20 insurance plan rates Aetna — HMO/POS: $137.72 Aetna — Medicare Advantage: $71.13 Aetna — PPO: $143.51 Alliant — Solocare: $85.36 Ambetter — Managed Medicaid: $96.03 Anthem — HMO: $350 Anthem — Medicare Advantage: $71.13 Anthem — PPO: $350 Care Source — Medicare Advantage: $72.55 Cigna — Commercial: $138.60
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW LOW 30-44 MIN	Not listed in the file	Not listed in the file	$112.25 – $114.49
New patient office visit (about 30–44 minutes): rates for 9 insurance plans Aetna — Medicare Advantage: $113.37 Anthem — Medicare Advantage: $112.25 Care Source — Medicare Advantage: $114.49 Clover — Medicare Advantage: $114.49 Eon Health — Medicare Advantage: $114.49 Georgia Health Advantage — Medicare Advantage: $112.25 Humana — Medicare Advantage: $112.25 Pruitt Health — Medicare Advantage: $112.25 United Healthcare — Medicare Advantage: $112.25
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P NEW LOW 30-44 MIN	Not listed in the file	Not listed in the file	$137.72 – $143.51
New patient office visit (about 30–44 minutes): rates for 2 insurance plans Aetna — HMO/POS: $137.72 Aetna — PPO: $143.51
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45-59 MIN	Not listed in the file	Not listed in the file	$116.06 – $350
New patient office visit (about 45–59 minutes): 10 of 20 insurance plan rates Aetna — HMO/POS: $195.41 Aetna — Medicare Advantage: $116.06 Aetna — PPO: $203.62 Alliant — Solocare: $139.27 Ambetter — Managed Medicaid: $156.68 Anthem — HMO: $350 Anthem — Medicare Advantage: $116.06 Anthem — PPO: $350 Care Source — Medicare Advantage: $118.38 Cigna — Commercial: $214.19
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW MOD 45-59 MIN	Not listed in the file	Not listed in the file	$169.99 – $173.39
New patient office visit (about 45–59 minutes): rates for 9 insurance plans Aetna — Medicare Advantage: $171.69 Anthem — Medicare Advantage: $169.99 Care Source — Medicare Advantage: $173.39 Clover — Medicare Advantage: $173.39 Eon Health — Medicare Advantage: $173.39 Georgia Health Advantage — Medicare Advantage: $169.99 Humana — Medicare Advantage: $169.99 Pruitt Health — Medicare Advantage: $169.99 United Healthcare — Medicare Advantage: $169.99
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P NEW MOD 45-59 MIN	Not listed in the file	Not listed in the file	$195.41 – $203.62
New patient office visit (about 45–59 minutes): rates for 2 insurance plans Aetna — HMO/POS: $195.41 Aetna — PPO: $203.62
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60-74 MIN	Not listed in the file	Not listed in the file	$159.24 – $350
New patient office visit (about 60–74 minutes): 10 of 20 insurance plan rates Aetna — HMO/POS: $248.11 Aetna — Medicare Advantage: $159.24 Aetna — PPO: $258.54 Alliant — Solocare: $191.09 Ambetter — Managed Medicaid: $214.97 Anthem — HMO: $350 Anthem — Medicare Advantage: $159.24 Anthem — PPO: $350 Care Source — Medicare Advantage: $162.42 Cigna — Commercial: $267.49
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60-74 MIN	Not listed in the file	Not listed in the file	$227.47 – $232.02
New patient office visit (about 60–74 minutes): rates for 9 insurance plans Aetna — Medicare Advantage: $229.74 Anthem — Medicare Advantage: $227.47 Care Source — Medicare Advantage: $232.02 Clover — Medicare Advantage: $232.02 Eon Health — Medicare Advantage: $232.02 Georgia Health Advantage — Medicare Advantage: $227.47 Humana — Medicare Advantage: $227.47 Pruitt Health — Medicare Advantage: $227.47 United Healthcare — Medicare Advantage: $227.47
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P NEW HI 60-74 MIN	Not listed in the file	Not listed in the file	$248.11 – $258.54
New patient office visit (about 60–74 minutes): rates for 2 insurance plans Aetna — HMO/POS: $248.11 Aetna — PPO: $258.54
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P EST LOW 20-29 MIN	Not listed in the file	Not listed in the file	$56.84 – $350
Established patient office visit (about 20–29 minutes): 10 of 20 insurance plan rates Aetna — HMO/POS: $77.49 Aetna — Medicare Advantage: $56.84 Aetna — PPO: $85.04 Alliant — Solocare: $68.21 Ambetter — Managed Medicaid: $76.73 Anthem — HMO: $350 Anthem — Medicare Advantage: $56.84 Anthem — PPO: $350 Care Source — Medicare Advantage: $57.98 Cigna — Commercial: $93.67
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20-29 MIN	Not listed in the file	Not listed in the file	$90.50 – $92.31
Established patient office visit (about 20–29 minutes): rates for 9 insurance plans Aetna — Medicare Advantage: $91.41 Anthem — Medicare Advantage: $90.50 Care Source — Medicare Advantage: $92.31 Clover — Medicare Advantage: $92.31 Eon Health — Medicare Advantage: $92.31 Georgia Health Advantage — Medicare Advantage: $90.50 Humana — Medicare Advantage: $90.50 Pruitt Health — Medicare Advantage: $90.50 United Healthcare — Medicare Advantage: $90.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P EST MOD 30-39 MIN	Not listed in the file	Not listed in the file	$83.71 – $350
Established patient office visit (about 30–39 minutes): 10 of 20 insurance plan rates Aetna — HMO/POS: $120 Aetna — Medicare Advantage: $83.71 Aetna — PPO: $134 Alliant — Solocare: $100.45 Ambetter — Managed Medicaid: $113.01 Anthem — HMO: $350 Anthem — Medicare Advantage: $83.71 Anthem — PPO: $350 Care Source — Medicare Advantage: $85.38 Cigna — Commercial: $138.53
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30-39 MIN	Not listed in the file	Not listed in the file	$129.29 – $131.88
Established patient office visit (about 30–39 minutes): rates for 9 insurance plans Aetna — Medicare Advantage: $130.58 Anthem — Medicare Advantage: $129.29 Care Source — Medicare Advantage: $131.88 Clover — Medicare Advantage: $131.88 Eon Health — Medicare Advantage: $131.88 Georgia Health Advantage — Medicare Advantage: $129.29 Humana — Medicare Advantage: $129.29 Pruitt Health — Medicare Advantage: $129.29 United Healthcare — Medicare Advantage: $129.29
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$108 – $110.16
Office consultation with a specialist (moderate): rates for 9 insurance plans Aetna — Medicare Advantage: $109.08 Anthem — Medicare Advantage: $108 Care Source — Medicare Advantage: $110.16 Clover — Medicare Advantage: $110.16 Eon Health — Medicare Advantage: $110.16 Georgia Health Advantage — Medicare Advantage: $108 Humana — Medicare Advantage: $108 Pruitt Health — Medicare Advantage: $108 United Healthcare — Medicare Advantage: $108
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$171.16 – $238.08
Office consultation with a specialist (moderate): rates for 7 insurance plans Aetna — HMO/POS: $174.54 Aetna — PPO: $181.87 Cigna — Commercial: $171.16 Humana — HMO/POS: $208.61 Humana — PPO: $208.61 SecureHealth — Commercial: $238.08 United Healthcare — Commercial: $214.66
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$174.54 – $181.87
Office consultation with a specialist (moderate): rates for 2 insurance plans Aetna — HMO/POS: $174.54 Aetna — PPO: $181.87
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$155.01 – $158.11
Office consultation with a specialist (moderate to high): rates for 9 insurance plans Aetna — Medicare Advantage: $156.56 Anthem — Medicare Advantage: $155.01 Care Source — Medicare Advantage: $158.11 Clover — Medicare Advantage: $158.11 Eon Health — Medicare Advantage: $158.11 Georgia Health Advantage — Medicare Advantage: $155.01 Humana — Medicare Advantage: $155.01 Pruitt Health — Medicare Advantage: $155.01 United Healthcare — Medicare Advantage: $155.01
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$241.82 – $356.34
Office consultation with a specialist (moderate to high): rates for 7 insurance plans Aetna — HMO/POS: $246.60 Aetna — PPO: $256.97 Cigna — Commercial: $241.82 Humana — HMO/POS: $294.75 Humana — PPO: $294.75 SecureHealth — Commercial: $356.34 United Healthcare — Commercial: $301.51
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: OFFICE CONSULTATION	Not listed in the file	Not listed in the file	$246.60 – $256.97
Office consultation with a specialist (moderate to high): rates for 2 insurance plans Aetna — HMO/POS: $246.60 Aetna — PPO: $256.97
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$128.20 – $130.76
Preventive checkup, new patient, age 18–39: rates for 9 insurance plans Aetna — Medicare Advantage: $129.48 Anthem — Medicare Advantage: $128.20 Care Source — Medicare Advantage: $130.76 Clover — Medicare Advantage: $130.76 Eon Health — Medicare Advantage: $130.76 Georgia Health Advantage — Medicare Advantage: $128.20 Humana — Medicare Advantage: $128.20 Pruitt Health — Medicare Advantage: $128.20 United Healthcare — Medicare Advantage: $128.20
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$178.84 – $369.86
Preventive checkup, new patient, age 18–39: rates for 7 insurance plans Aetna — HMO/POS: $185.28 Aetna — PPO: $193.07 Cigna — Commercial: $178.84 Humana — HMO/POS: $218 Humana — PPO: $218 SecureHealth — Commercial: $332.68 United Healthcare — Commercial: $369.86
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$148.75 – $151.72
Preventive checkup, new patient, age 40–64: rates for 9 insurance plans Aetna — Medicare Advantage: $150.23 Anthem — Medicare Advantage: $148.75 Care Source — Medicare Advantage: $151.72 Clover — Medicare Advantage: $151.72 Eon Health — Medicare Advantage: $151.72 Georgia Health Advantage — Medicare Advantage: $148.75 Humana — Medicare Advantage: $148.75 Pruitt Health — Medicare Advantage: $148.75 United Healthcare — Medicare Advantage: $148.75
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$182.63 – $369.86
Preventive checkup, new patient, age 40–64: rates for 7 insurance plans Aetna — HMO/POS: $189.20 Aetna — PPO: $197.15 Cigna — Commercial: $182.63 Humana — HMO/POS: $222.60 Humana — PPO: $222.60 SecureHealth — Commercial: $332.68 United Healthcare — Commercial: $369.86
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER LEVEL 3 VISIT MODERATE SEVERITY	$726	$363	$217.80 – $3,355.02
Emergency room visit (moderate): 10 of 24 insurance plan rates Aetna — HMO/POS: $559.02 Aetna — Medicare Advantage: $271.30 Aetna — PPO: $602.58 Alliant — Solocare: $624.50 Ambetter — Managed Medicaid: $217.80 Anthem — HMO: $814.85 Anthem — Medicare Advantage: $268.62 Anthem — PPO: $3,355.02 Care Source — Medicare Advantage: $273.99 Cigna — Commercial: $559.02
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ER LEVEL 3 VISIT MODERATE SEVERITY	$726	$363	$370.26 – $617.10
Emergency room visit (moderate): rates for 10 insurance plans Aetna — HMO/POS: $559.02 Aetna — PPO: $602.58 Ambetter — Managed Medicaid: $370.26 Cigna — Commercial: $559.02 Humana — HMO/POS: $617.10 Humana — PPO: $617.10 Multiplan — PHO Agreement Complimentary Network: $580.80 Multiplan — PHO Agreement Primary Network: $471.90 Novanet — Commercial: $580.80 Three Rivers Provider Network — Commercial: $617.10
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$69.75 – $137.64
Emergency room visit (moderate): 10 of 18 insurance plan rates Aetna — HMO/POS: $103.52 Aetna — Medicare Advantage: $69.75 Aetna — PPO: $107.87 Alliant — Solocare: $83.70 Ambetter — Managed Medicaid: $94.16 Anthem — Medicare Advantage: $69.75 Care Source — Medicare Advantage: $71.15 Cigna — Commercial: $99.92 Clover — Medicare Advantage: $71.15 Eon Health — Medicare Advantage: $71.15
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER LEVEL 4 VISIT HIGH/URGENT SEVERITY	$1,061	$530.50	$318.30 – $4,744.44
Emergency room visit (moderately high): 10 of 24 insurance plan rates Aetna — HMO/POS: $816.97 Aetna — Medicare Advantage: $414.70 Aetna — PPO: $880.63 Alliant — Solocare: $1,149.88 Ambetter — Managed Medicaid: $318.30 Anthem — HMO: $1,500.37 Anthem — Medicare Advantage: $410.60 Anthem — PPO: $4,744.44 Care Source — Medicare Advantage: $418.81 Cigna — Commercial: $816.97
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ER LEVEL 4 VISIT HIGH/URGENT SEVERITY	$1,061	$530.50	$541.11 – $901.85
Emergency room visit (moderately high): rates for 10 insurance plans Aetna — HMO/POS: $816.97 Aetna — PPO: $880.63 Ambetter — Managed Medicaid: $541.11 Cigna — Commercial: $816.97 Humana — HMO/POS: $901.85 Humana — PPO: $901.85 Multiplan — PHO Agreement Complimentary Network: $848.80 Multiplan — PHO Agreement Primary Network: $689.65 Novanet — Commercial: $848.80 Three Rivers Provider Network — Commercial: $901.85
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$118.86 – $211.57
Emergency room visit (moderately high): 10 of 18 insurance plan rates Aetna — HMO/POS: $159.45 Aetna — Medicare Advantage: $118.86 Aetna — PPO: $166.15 Alliant — Solocare: $142.63 Ambetter — Managed Medicaid: $160.46 Anthem — Medicare Advantage: $118.86 Care Source — Medicare Advantage: $121.24 Cigna — Commercial: $153.92 Clover — Medicare Advantage: $121.24 Eon Health — Medicare Advantage: $121.24
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$1,591	$795.50	$477.30 – $4,744.44
Emergency room visit (high): 10 of 24 insurance plan rates Aetna — HMO/POS: $1,225.07 Aetna — Medicare Advantage: $591.88 Aetna — PPO: $1,320.53 Alliant — Solocare: $1,149.88 Ambetter — Managed Medicaid: $477.30 Anthem — HMO: $1,500.37 Anthem — Medicare Advantage: $586.02 Anthem — PPO: $4,744.44 Care Source — Medicare Advantage: $597.74 Cigna — Commercial: $1,225.07
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ER LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$1,591	$795.50	$811.41 – $1,352.35
Emergency room visit (high): rates for 10 insurance plans Aetna — HMO/POS: $1,225.07 Aetna — PPO: $1,320.53 Ambetter — Managed Medicaid: $811.41 Cigna — Commercial: $1,225.07 Humana — HMO/POS: $1,352.35 Humana — PPO: $1,352.35 Multiplan — PHO Agreement Complimentary Network: $1,272.80 Multiplan — PHO Agreement Primary Network: $1,034.15 Novanet — Commercial: $1,272.80 Three Rivers Provider Network — Commercial: $1,352.35
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT	Not listed in the file	Not listed in the file	$172.08 – $333.93
Emergency room visit (high): 10 of 18 insurance plan rates Aetna — HMO/POS: $249.89 Aetna — Medicare Advantage: $172.08 Aetna — PPO: $260.39 Alliant — Solocare: $206.50 Ambetter — Managed Medicaid: $232.31 Anthem — Medicare Advantage: $172.08 Care Source — Medicare Advantage: $175.52 Cigna — Commercial: $241.22 Clover — Medicare Advantage: $175.52 Eon Health — Medicare Advantage: $175.52

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: HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE	$111	$55.50	$8.46 – $94.35
Basic metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — HMO/POS: $85.47 Aetna — Medicare Advantage: $8.54 Aetna — PPO: $92.13 Alliant — Solocare: $8.46 Ambetter — Managed Medicaid: $33.30 Anthem — HMO: $83.25 Anthem — Medicare Advantage: $8.46 Anthem — PPO: $83.25 Care Source — Medicare Advantage: $8.63 Cigna — Commercial: $85.47
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE	$111	$55.50	$56.61 – $94.35
Basic metabolic panel (blood test): rates for 10 insurance plans Aetna — HMO/POS: $85.47 Aetna — PPO: $92.13 Ambetter — Managed Medicaid: $56.61 Cigna — Commercial: $85.47 Humana — HMO/POS: $94.35 Humana — PPO: $94.35 Multiplan — PHO Agreement Complimentary Network: $88.80 Multiplan — PHO Agreement Primary Network: $72.15 Novanet — Commercial: $88.80 Three Rivers Provider Network — Commercial: $94.35
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Doctor (professional) fee In the file: METABOLIC PANEL TOTAL CA	Not listed in the file	Not listed in the file	$17.67 – $22.46
Basic metabolic panel (blood test): rates for 6 insurance plans Aetna — HMO/POS: $21.55 Aetna — PPO: $22.46 Cigna — Commercial: $17.67 Humana — HMO/POS: $21.54 Humana — PPO: $21.54 SecureHealth — Commercial: $21.21
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE	$103	$51.50	$10.56 – $87.55
Comprehensive metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — HMO/POS: $79.31 Aetna — Medicare Advantage: $10.67 Aetna — PPO: $85.49 Alliant — Solocare: $10.56 Ambetter — Managed Medicaid: $30.90 Anthem — HMO: $77.25 Anthem — Medicare Advantage: $10.56 Anthem — PPO: $77.25 Care Source — Medicare Advantage: $10.77 Cigna — Commercial: $79.31
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE	$103	$51.50	$52.53 – $87.55
Comprehensive metabolic panel (blood test): rates for 10 insurance plans Aetna — HMO/POS: $79.31 Aetna — PPO: $85.49 Ambetter — Managed Medicaid: $52.53 Cigna — Commercial: $79.31 Humana — HMO/POS: $87.55 Humana — PPO: $87.55 Multiplan — PHO Agreement Complimentary Network: $82.40 Multiplan — PHO Agreement Primary Network: $66.95 Novanet — Commercial: $82.40 Three Rivers Provider Network — Commercial: $87.55
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPREHEN METABOLIC PANEL	Not listed in the file	Not listed in the file	$22.06 – $30.44
Comprehensive metabolic panel (blood test): rates for 6 insurance plans Aetna — HMO/POS: $29.21 Aetna — PPO: $30.44 Cigna — Commercial: $22.06 Humana — HMO/POS: $26.89 Humana — PPO: $26.89 SecureHealth — Commercial: $26.49
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	$47.81 – $48.77
Obstetric blood test panel: rates for 9 insurance plans Aetna — Medicare Advantage: $48.29 Anthem — Medicare Advantage: $47.81 Care Source — Medicare Advantage: $48.77 Clover — Medicare Advantage: $48.77 Eon Health — Medicare Advantage: $48.77 Georgia Health Advantage — Medicare Advantage: $47.81 Humana — Medicare Advantage: $47.81 Pruitt Health — Medicare Advantage: $47.81 United Healthcare — Medicare Advantage: $47.81
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$69.53 – $296.62
Obstetric blood test panel: rates for 7 insurance plans Aetna — HMO/POS: $69.53 Aetna — PPO: $72.45 Cigna — Commercial: $206.83 Humana — HMO/POS: $78.20 Humana — PPO: $78.20 SecureHealth — Commercial: $296.62 United Healthcare — Commercial: $93.97
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$78.20
Obstetric blood test panel: rates for 2 insurance plans Humana — HMO/POS: $78.20 Humana — PPO: $78.20
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL BUNDLED CHARGE	$131	$65.50	$13.39 – $111.35
Cholesterol panel (lipid panel): 10 of 24 insurance plan rates Aetna — HMO/POS: $100.87 Aetna — Medicare Advantage: $13.52 Aetna — PPO: $108.73 Alliant — Solocare: $13.39 Ambetter — Managed Medicaid: $39.30 Anthem — HMO: $98.25 Anthem — Medicare Advantage: $13.39 Anthem — PPO: $98.25 Care Source — Medicare Advantage: $13.66 Cigna — Commercial: $100.87
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LIPID PANEL BUNDLED CHARGE	$131	$65.50	$66.81 – $111.35
Cholesterol panel (lipid panel): rates for 10 insurance plans Aetna — HMO/POS: $100.87 Aetna — PPO: $108.73 Ambetter — Managed Medicaid: $66.81 Cigna — Commercial: $100.87 Humana — HMO/POS: $111.35 Humana — PPO: $111.35 Multiplan — PHO Agreement Complimentary Network: $104.80 Multiplan — PHO Agreement Primary Network: $85.15 Novanet — Commercial: $104.80 Three Rivers Provider Network — Commercial: $111.35
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Doctor (professional) fee In the file: LIPID PANEL	Not listed in the file	Not listed in the file	$27.96 – $72.91
Cholesterol panel (lipid panel): rates for 7 insurance plans Aetna — HMO/POS: $41.11 Aetna — PPO: $42.84 Cigna — Commercial: $27.96 Humana — HMO/POS: $34.08 Humana — PPO: $34.08 SecureHealth — Commercial: $33.57 United Healthcare — Commercial: $72.91
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL BUNDLED CHARGE	$106	$53	$8.68 – $90.10
Kidney function panel: 10 of 24 insurance plan rates Aetna — HMO/POS: $81.62 Aetna — Medicare Advantage: $8.77 Aetna — PPO: $87.98 Alliant — Solocare: $8.68 Ambetter — Managed Medicaid: $31.80 Anthem — HMO: $79.50 Anthem — Medicare Advantage: $8.68 Anthem — PPO: $79.50 Care Source — Medicare Advantage: $8.85 Cigna — Commercial: $81.62
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL BUNDLED CHARGE	$106	$53	$54.06 – $90.10
Kidney function panel: rates for 10 insurance plans Aetna — HMO/POS: $81.62 Aetna — PPO: $87.98 Ambetter — Managed Medicaid: $54.06 Cigna — Commercial: $81.62 Humana — HMO/POS: $90.10 Humana — PPO: $90.10 Multiplan — PHO Agreement Complimentary Network: $84.80 Multiplan — PHO Agreement Primary Network: $68.90 Novanet — Commercial: $84.80 Three Rivers Provider Network — Commercial: $90.10
Kidney function panel CPT 80069 · Inpatient or outpatient · Doctor (professional) fee In the file: RENAL FUNCTION PANEL	Not listed in the file	Not listed in the file	$18.11 – $24.01
Kidney function panel: rates for 6 insurance plans Aetna — HMO/POS: $23.04 Aetna — PPO: $24.01 Cigna — Commercial: $18.11 Humana — HMO/POS: $22.08 Humana — PPO: $22.08 SecureHealth — Commercial: $21.76
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL BUNDLED CHARGE	$106	$53	$8.17 – $90.10
Liver function panel: 10 of 24 insurance plan rates Aetna — HMO/POS: $81.62 Aetna — Medicare Advantage: $8.25 Aetna — PPO: $87.98 Alliant — Solocare: $8.17 Ambetter — Managed Medicaid: $31.80 Anthem — HMO: $79.50 Anthem — Medicare Advantage: $8.17 Anthem — PPO: $79.50 Care Source — Medicare Advantage: $8.33 Cigna — Commercial: $81.62
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL BUNDLED CHARGE	$106	$53	$54.06 – $90.10
Liver function panel: rates for 10 insurance plans Aetna — HMO/POS: $81.62 Aetna — PPO: $87.98 Ambetter — Managed Medicaid: $54.06 Cigna — Commercial: $81.62 Humana — HMO/POS: $90.10 Humana — PPO: $90.10 Multiplan — PHO Agreement Complimentary Network: $84.80 Multiplan — PHO Agreement Primary Network: $68.90 Novanet — Commercial: $84.80 Three Rivers Provider Network — Commercial: $90.10
Liver function panel CPT 80076 · Inpatient or outpatient · Doctor (professional) fee In the file: HEPATIC FUNCTION PANEL	Not listed in the file	Not listed in the file	$17.05 – $21.49
Liver function panel: rates for 6 insurance plans Aetna — HMO/POS: $20.62 Aetna — PPO: $21.49 Cigna — Commercial: $17.05 Humana — HMO/POS: $20.79 Humana — PPO: $20.79 SecureHealth — Commercial: $20.48
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/SCOPE MICRO	$62	$31	$3.17 – $76
Urine test (automated, with microscope): 10 of 24 insurance plan rates Aetna — HMO/POS: $47.74 Aetna — Medicare Advantage: $3.20 Aetna — PPO: $51.46 Alliant — Solocare: $3.17 Ambetter — Managed Medicaid: $18.60 Anthem — HMO: $46.50 Anthem — Medicare Advantage: $3.17 Anthem — PPO: $46.50 Care Source — Medicare Advantage: $3.23 Cigna — Commercial: $47.74
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/SCOPE MICRO	$62	$31	$31.62 – $52.70
Urine test (automated, with microscope): rates for 10 insurance plans Aetna — HMO/POS: $47.74 Aetna — PPO: $51.46 Ambetter — Managed Medicaid: $31.62 Cigna — Commercial: $47.74 Humana — HMO/POS: $52.70 Humana — PPO: $52.70 Multiplan — PHO Agreement Complimentary Network: $49.60 Multiplan — PHO Agreement Primary Network: $40.30 Novanet — Commercial: $49.60 Three Rivers Provider Network — Commercial: $52.70
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Doctor (professional) fee In the file: URINALYSIS AUTO W/SCOPE	Not listed in the file	Not listed in the file	$7.13 – $19.83
Urine test (automated, with microscope): rates for 6 insurance plans Aetna — HMO/POS: $19.03 Aetna — PPO: $19.83 Cigna — Commercial: $7.13 Humana — HMO/POS: $8.06 Humana — PPO: $8.06 SecureHealth — Commercial: $8.56
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS NONAUTO W/O MICRO	$33	$16.50	$3.48 – $76
Urine test (manual, without microscope): 10 of 24 insurance plan rates Aetna — HMO/POS: $25.41 Aetna — Medicare Advantage: $3.51 Aetna — PPO: $27.39 Alliant — Solocare: $3.48 Ambetter — Managed Medicaid: $9.90 Anthem — HMO: $24.75 Anthem — Medicare Advantage: $3.48 Anthem — PPO: $24.75 Care Source — Medicare Advantage: $3.55 Cigna — Commercial: $25.41
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS NONAUTO W/O MICRO	$33	$16.50	$16.83 – $28.05
Urine test (manual, without microscope): rates for 10 insurance plans Aetna — HMO/POS: $25.41 Aetna — PPO: $27.39 Ambetter — Managed Medicaid: $16.83 Cigna — Commercial: $25.41 Humana — HMO/POS: $28.05 Humana — PPO: $28.05 Multiplan — PHO Agreement Complimentary Network: $26.40 Multiplan — PHO Agreement Primary Network: $21.45 Novanet — Commercial: $26.40 Three Rivers Provider Network — Commercial: $28.05
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Doctor (professional) fee In the file: URINALYSIS NONAUTO W/O SCOPE	Not listed in the file	Not listed in the file	$5.74 – $24.32
Urine test (manual, without microscope): rates for 7 insurance plans Aetna — HMO/POS: $9.82 Aetna — PPO: $10.23 Cigna — Commercial: $5.74 Humana — HMO/POS: $6.50 Humana — PPO: $6.50 SecureHealth — Commercial: $6.90 United Healthcare — Commercial: $24.32
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/O SCOPE	$58	$29	$2.25 – $76
Urine test (automated, without microscope): 10 of 24 insurance plan rates Aetna — HMO/POS: $44.66 Aetna — Medicare Advantage: $2.27 Aetna — PPO: $48.14 Alliant — Solocare: $2.25 Ambetter — Managed Medicaid: $17.40 Anthem — HMO: $43.50 Anthem — Medicare Advantage: $2.25 Anthem — PPO: $43.50 Care Source — Medicare Advantage: $2.30 Cigna — Commercial: $44.66
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/O SCOPE	$58	$29	$29.58 – $49.30
Urine test (automated, without microscope): rates for 10 insurance plans Aetna — HMO/POS: $44.66 Aetna — PPO: $48.14 Ambetter — Managed Medicaid: $29.58 Cigna — Commercial: $44.66 Humana — HMO/POS: $49.30 Humana — PPO: $49.30 Multiplan — PHO Agreement Complimentary Network: $46.40 Multiplan — PHO Agreement Primary Network: $37.70 Novanet — Commercial: $46.40 Three Rivers Provider Network — Commercial: $49.30
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Doctor (professional) fee In the file: URINALYSIS AUTO W/O SCOPE	Not listed in the file	Not listed in the file	$5.05 – $25.91
Urine test (automated, without microscope): rates for 7 insurance plans Aetna — HMO/POS: $11.36 Aetna — PPO: $11.84 Cigna — Commercial: $5.05 Humana — HMO/POS: $5.72 Humana — PPO: $5.72 SecureHealth — Commercial: $6.07 United Healthcare — Commercial: $25.91
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROSTATE SPECIFIC ANTIGEN TOTAL	$146	$73	$18.39 – $124.10
PSA (prostate specific antigen) blood test: 10 of 24 insurance plan rates Aetna — HMO/POS: $112.42 Aetna — Medicare Advantage: $18.57 Aetna — PPO: $121.18 Alliant — Solocare: $18.39 Ambetter — Managed Medicaid: $43.80 Anthem — HMO: $109.50 Anthem — Medicare Advantage: $18.39 Anthem — PPO: $109.50 Care Source — Medicare Advantage: $18.76 Cigna — Commercial: $112.42
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PROSTATE SPECIFIC ANTIGEN TOTAL	$146	$73	$74.46 – $124.10
PSA (prostate specific antigen) blood test: rates for 10 insurance plans Aetna — HMO/POS: $112.42 Aetna — PPO: $121.18 Ambetter — Managed Medicaid: $74.46 Cigna — Commercial: $112.42 Humana — HMO/POS: $124.10 Humana — PPO: $124.10 Multiplan — PHO Agreement Complimentary Network: $116.80 Multiplan — PHO Agreement Primary Network: $94.90 Novanet — Commercial: $116.80 Three Rivers Provider Network — Commercial: $124.10
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Doctor (professional) fee In the file: ASSAY OF PSA TOTAL	Not listed in the file	Not listed in the file	$38.38 – $108.54
PSA (prostate specific antigen) blood test: rates for 7 insurance plans Aetna — HMO/POS: $63.43 Aetna — PPO: $66.09 Cigna — Commercial: $38.38 Humana — HMO/POS: $46.78 Humana — PPO: $46.78 SecureHealth — Commercial: $46.09 United Healthcare — Commercial: $108.54
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ASSAY THYROID STIMULATING HORMONE	$94	$47	$16.80 – $79.90
Thyroid stimulating hormone (TSH) test: 10 of 24 insurance plan rates Aetna — HMO/POS: $72.38 Aetna — Medicare Advantage: $16.97 Aetna — PPO: $78.02 Alliant — Solocare: $16.80 Ambetter — Managed Medicaid: $28.20 Anthem — HMO: $70.50 Anthem — Medicare Advantage: $16.80 Anthem — PPO: $70.50 Care Source — Medicare Advantage: $17.14 Cigna — Commercial: $72.38
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ASSAY THYROID STIMULATING HORMONE	$94	$47	$47.94 – $79.90
Thyroid stimulating hormone (TSH) test: rates for 10 insurance plans Aetna — HMO/POS: $72.38 Aetna — PPO: $78.02 Ambetter — Managed Medicaid: $47.94 Cigna — Commercial: $72.38 Humana — HMO/POS: $79.90 Humana — PPO: $79.90 Multiplan — PHO Agreement Complimentary Network: $75.20 Multiplan — PHO Agreement Primary Network: $61.10 Novanet — Commercial: $75.20 Three Rivers Provider Network — Commercial: $79.90
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Doctor (professional) fee In the file: ASSAY THYROID STIM HORMONE	Not listed in the file	Not listed in the file	$35.05 – $92.34
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans Aetna — HMO/POS: $53.01 Aetna — PPO: $55.24 Cigna — Commercial: $35.05 Humana — HMO/POS: $42.72 Humana — PPO: $42.72 SecureHealth — Commercial: $42.10 United Healthcare — Commercial: $92.34
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC AUTO DIFF WBC	$60	$30	$7.77 – $76
Complete blood count (CBC) with differential: 10 of 24 insurance plan rates Aetna — HMO/POS: $46.20 Aetna — Medicare Advantage: $7.85 Aetna — PPO: $49.80 Alliant — Solocare: $7.77 Ambetter — Managed Medicaid: $18 Anthem — HMO: $45 Anthem — Medicare Advantage: $7.77 Anthem — PPO: $45 Care Source — Medicare Advantage: $7.93 Cigna — Commercial: $46.20
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPLETE CBC AUTO DIFF WBC	$60	$30	$30.60 – $51
Complete blood count (CBC) with differential: rates for 10 insurance plans Aetna — HMO/POS: $46.20 Aetna — PPO: $49.80 Ambetter — Managed Medicaid: $30.60 Cigna — Commercial: $46.20 Humana — HMO/POS: $51 Humana — PPO: $51 Multiplan — PHO Agreement Complimentary Network: $48 Multiplan — PHO Agreement Primary Network: $39 Novanet — Commercial: $48 Three Rivers Provider Network — Commercial: $51
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPLETE CBC W/AUTO DIFF WBC	Not listed in the file	Not listed in the file	$17.47 – $27.54
Complete blood count (CBC) with differential: rates for 7 insurance plans Aetna — HMO/POS: $17.85 Aetna — PPO: $18.60 Cigna — Commercial: $17.47 Humana — HMO/POS: $19.77 Humana — PPO: $19.77 SecureHealth — Commercial: $19.70 United Healthcare — Commercial: $27.54
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC	$88	$44	$6.47 – $76
Complete blood count (CBC), automated: 10 of 24 insurance plan rates Aetna — HMO/POS: $67.76 Aetna — Medicare Advantage: $6.53 Aetna — PPO: $73.04 Alliant — Solocare: $6.47 Ambetter — Managed Medicaid: $26.40 Anthem — HMO: $66 Anthem — Medicare Advantage: $6.47 Anthem — PPO: $66 Care Source — Medicare Advantage: $6.60 Cigna — Commercial: $67.76
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPLETE CBC	$88	$44	$44.88 – $74.80
Complete blood count (CBC), automated: rates for 10 insurance plans Aetna — HMO/POS: $67.76 Aetna — PPO: $73.04 Ambetter — Managed Medicaid: $44.88 Cigna — Commercial: $67.76 Humana — HMO/POS: $74.80 Humana — PPO: $74.80 Multiplan — PHO Agreement Complimentary Network: $70.40 Multiplan — PHO Agreement Primary Network: $57.20 Novanet — Commercial: $70.40 Three Rivers Provider Network — Commercial: $74.80
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPLETE CBC AUTOMATED	Not listed in the file	Not listed in the file	$14.53 – $24.32
Complete blood count (CBC), automated: rates for 7 insurance plans Aetna — HMO/POS: $17.85 Aetna — PPO: $18.60 Cigna — Commercial: $14.53 Humana — HMO/POS: $16.46 Humana — PPO: $16.46 SecureHealth — Commercial: $17.45 United Healthcare — Commercial: $24.32
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$70	$35	$4.29 – $76
Blood clotting time test (prothrombin time, PT): 10 of 24 insurance plan rates Aetna — HMO/POS: $53.90 Aetna — Medicare Advantage: $4.33 Aetna — PPO: $58.10 Alliant — Solocare: $4.29 Ambetter — Managed Medicaid: $21 Anthem — HMO: $52.50 Anthem — Medicare Advantage: $4.29 Anthem — PPO: $52.50 Care Source — Medicare Advantage: $4.38 Cigna — Commercial: $53.90
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$70	$35	$35.70 – $59.50
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans Aetna — HMO/POS: $53.90 Aetna — PPO: $58.10 Ambetter — Managed Medicaid: $35.70 Cigna — Commercial: $53.90 Humana — HMO/POS: $59.50 Humana — PPO: $59.50 Multiplan — PHO Agreement Complimentary Network: $56 Multiplan — PHO Agreement Primary Network: $45.50 Novanet — Commercial: $56 Three Rivers Provider Network — Commercial: $59.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Doctor (professional) fee In the file: PROTHROMBIN TIME	Not listed in the file	Not listed in the file	$8.83 – $35.65
Blood clotting time test (prothrombin time, PT): rates for 7 insurance plans Aetna — HMO/POS: $17.31 Aetna — PPO: $18.04 Cigna — Commercial: $8.83 Humana — HMO/POS: $9.99 Humana — PPO: $9.99 SecureHealth — Commercial: $10.61 United Healthcare — Commercial: $35.65
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THROMBOPLAS TIME PARTIAL	$105	$52.50	$6.01 – $89.25
Blood clotting test (partial thromboplastin time, PTT): 10 of 24 insurance plan rates Aetna — HMO/POS: $80.85 Aetna — Medicare Advantage: $6.07 Aetna — PPO: $87.15 Alliant — Solocare: $6.01 Ambetter — Managed Medicaid: $31.50 Anthem — HMO: $78.75 Anthem — Medicare Advantage: $6.01 Anthem — PPO: $78.75 Care Source — Medicare Advantage: $6.13 Cigna — Commercial: $80.85
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THROMBOPLAS TIME PARTIAL	$105	$52.50	$53.55 – $89.25
Blood clotting test (partial thromboplastin time, PTT): rates for 10 insurance plans Aetna — HMO/POS: $80.85 Aetna — PPO: $87.15 Ambetter — Managed Medicaid: $53.55 Cigna — Commercial: $80.85 Humana — HMO/POS: $89.25 Humana — PPO: $89.25 Multiplan — PHO Agreement Complimentary Network: $84 Multiplan — PHO Agreement Primary Network: $68.25 Novanet — Commercial: $84 Three Rivers Provider Network — Commercial: $89.25
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Doctor (professional) fee In the file: THROMBOPLASTIN TIME PARTIAL	Not listed in the file	Not listed in the file	$13.47 – $22.67
Blood clotting test (partial thromboplastin time, PTT): rates for 7 insurance plans Aetna — HMO/POS: $17.08 Aetna — PPO: $17.79 Cigna — Commercial: $13.47 Humana — HMO/POS: $15.26 Humana — PPO: $15.26 SecureHealth — Commercial: $16.19 United Healthcare — Commercial: $22.67

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: HC CT HEAD/BRAIN W/O CONTRAST	$1,461	$730.50	$102.88 – $2,193
CT scan of the head or brain, without contrast: 10 of 24 insurance plan rates Aetna — HMO/POS: $1,124.97 Aetna — Medicare Advantage: $103.90 Aetna — PPO: $1,212.63 Alliant — Solocare: $811.50 Ambetter — Managed Medicaid: $438.30 Anthem — HMO: $661.05 Anthem — Medicare Advantage: $102.88 Anthem — PPO: $1,095.75 Care Source — Medicare Advantage: $104.93 Cigna — Commercial: $1,124.97
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT HEAD/BRAIN W/O CONTRAST	$1,461	$730.50	$745.11 – $1,241.85
CT scan of the head or brain, without contrast: rates for 10 insurance plans Aetna — HMO/POS: $1,124.97 Aetna — PPO: $1,212.63 Ambetter — Managed Medicaid: $745.11 Cigna — Commercial: $1,124.97 Humana — HMO/POS: $1,241.85 Humana — PPO: $1,241.85 Multiplan — PHO Agreement Complimentary Network: $1,168.80 Multiplan — PHO Agreement Primary Network: $949.65 Novanet — Commercial: $1,168.80 Three Rivers Provider Network — Commercial: $1,241.85
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee In the file: CT HEAD/BRAIN W/O DYE	Not listed in the file	Not listed in the file	$98.64 – $564.83
CT scan of the head or brain, without contrast: 10 of 18 insurance plan rates Aetna — HMO/POS: $499.69 Aetna — Medicare Advantage: $98.64 Aetna — PPO: $520.69 Alliant — Solocare: $118.37 Ambetter — Managed Medicaid: $133.16 Anthem — Medicare Advantage: $98.64 Care Source — Medicare Advantage: $100.61 Cigna — Commercial: $397.94 Clover — Medicare Advantage: $100.61 Eon Health — Medicare Advantage: $100.61
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN W & W/O CONTRAST	$3,495	$1,747.50	$343.30 – $3,284
MRI of the brain, before and after contrast: 10 of 24 insurance plan rates Aetna — HMO/POS: $2,691.15 Aetna — Medicare Advantage: $346.73 Aetna — PPO: $2,900.85 Alliant — Solocare: $579.63 Ambetter — Managed Medicaid: $1,048.50 Anthem — HMO: $1,978.17 Anthem — Medicare Advantage: $343.30 Anthem — PPO: $2,621.25 Care Source — Medicare Advantage: $350.17 Cigna — Commercial: $2,691.15
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI BRAIN W & W/O CONTRAST	$3,495	$1,747.50	$1,782.45 – $2,970.75
MRI of the brain, before and after contrast: rates for 10 insurance plans Aetna — HMO/POS: $2,691.15 Aetna — PPO: $2,900.85 Ambetter — Managed Medicaid: $1,782.45 Cigna — Commercial: $2,691.15 Humana — HMO/POS: $2,970.75 Humana — PPO: $2,970.75 Multiplan — PHO Agreement Complimentary Network: $2,796 Multiplan — PHO Agreement Primary Network: $2,271.75 Novanet — Commercial: $2,796 Three Rivers Provider Network — Commercial: $2,970.75
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI BRAIN STEM W/O & W/DYE	Not listed in the file	Not listed in the file	$292.39 – $2,661.91
MRI of the brain, before and after contrast: 10 of 18 insurance plan rates Aetna — HMO/POS: $2,377.92 Aetna — Medicare Advantage: $292.39 Aetna — PPO: $2,477.83 Alliant — Solocare: $350.87 Ambetter — Managed Medicaid: $394.73 Anthem — Medicare Advantage: $292.39 Care Source — Medicare Advantage: $298.24 Cigna — Commercial: $1,893.67 Clover — Medicare Advantage: $298.24 Eon Health — Medicare Advantage: $298.24
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX EXAM CHEST 2 VIEWS	$340	$170	$64.65 – $289
Chest X-ray, 2 views: 10 of 24 insurance plan rates Aetna — HMO/POS: $261.80 Aetna — Medicare Advantage: $86.49 Aetna — PPO: $282.20 Alliant — Solocare: $128.45 Ambetter — Managed Medicaid: $102 Anthem — HMO: $64.65 Anthem — Medicare Advantage: $85.63 Anthem — PPO: $255 Care Source — Medicare Advantage: $87.35 Cigna — Commercial: $261.80
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX EXAM CHEST 2 VIEWS	$340	$170	$173.40 – $289
Chest X-ray, 2 views: rates for 10 insurance plans Aetna — HMO/POS: $261.80 Aetna — PPO: $282.20 Ambetter — Managed Medicaid: $173.40 Cigna — Commercial: $261.80 Humana — HMO/POS: $289 Humana — PPO: $289 Multiplan — PHO Agreement Complimentary Network: $272 Multiplan — PHO Agreement Primary Network: $221 Novanet — Commercial: $272 Three Rivers Provider Network — Commercial: $289
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: X-RAY EXAM CHEST 2 VIEWS	Not listed in the file	Not listed in the file	$30.45 – $76.32
Chest X-ray, 2 views: 10 of 17 insurance plan rates Aetna — HMO/POS: $73.24 Aetna — Medicare Advantage: $30.45 Aetna — PPO: $76.32 Alliant — Solocare: $36.54 Ambetter — Managed Medicaid: $41.11 Anthem — HMO: $60.15 Anthem — Medicare Advantage: $30.45 Anthem — PPO: $60.15 Care Source — Medicare Advantage: $31.06 Clover — Medicare Advantage: $31.06
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX SPINE LUMBAR MIN 4 VIEWS	$376	$188	$102.88 – $319.60
X-ray of the lower spine, at least 4 views: 10 of 24 insurance plan rates Aetna — HMO/POS: $289.52 Aetna — Medicare Advantage: $103.90 Aetna — PPO: $312.08 Alliant — Solocare: $154.31 Ambetter — Managed Medicaid: $112.80 Anthem — HMO: $116.43 Anthem — Medicare Advantage: $102.88 Anthem — PPO: $282 Care Source — Medicare Advantage: $104.93 Cigna — Commercial: $289.52
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX SPINE LUMBAR MIN 4 VIEWS	$376	$188	$191.76 – $319.60
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans Aetna — HMO/POS: $289.52 Aetna — PPO: $312.08 Ambetter — Managed Medicaid: $191.76 Cigna — Commercial: $289.52 Humana — HMO/POS: $319.60 Humana — PPO: $319.60 Multiplan — PHO Agreement Complimentary Network: $300.80 Multiplan — PHO Agreement Primary Network: $244.40 Novanet — Commercial: $300.80 Three Rivers Provider Network — Commercial: $319.60
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	Not listed in the file	$48.87 – $130.34
X-ray of the lower spine, at least 4 views: 10 of 18 insurance plan rates Aetna — HMO/POS: $114.41 Aetna — Medicare Advantage: $48.87 Aetna — PPO: $119.21 Alliant — Solocare: $58.64 Ambetter — Managed Medicaid: $65.97 Anthem — Medicare Advantage: $48.87 Care Source — Medicare Advantage: $49.85 Cigna — Commercial: $91.11 Clover — Medicare Advantage: $49.85 Eon Health — Medicare Advantage: $49.85
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$2,353	$1,176.50	$234.79 – $3,284
MRI of the lower back (lumbar spine), without contrast: 10 of 24 insurance plan rates Aetna — HMO/POS: $1,811.81 Aetna — Medicare Advantage: $237.14 Aetna — PPO: $1,952.99 Alliant — Solocare: $579.63 Ambetter — Managed Medicaid: $705.90 Anthem — HMO: $1,256.67 Anthem — Medicare Advantage: $234.79 Anthem — PPO: $1,764.75 Care Source — Medicare Advantage: $239.49 Cigna — Commercial: $1,811.81
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$2,353	$1,176.50	$1,200.03 – $2,000.05
MRI of the lower back (lumbar spine), without contrast: rates for 10 insurance plans Aetna — HMO/POS: $1,811.81 Aetna — PPO: $1,952.99 Ambetter — Managed Medicaid: $1,200.03 Cigna — Commercial: $1,811.81 Humana — HMO/POS: $2,000.05 Humana — PPO: $2,000.05 Multiplan — PHO Agreement Complimentary Network: $1,882.40 Multiplan — PHO Agreement Primary Network: $1,529.45 Novanet — Commercial: $1,882.40 Three Rivers Provider Network — Commercial: $2,000.05
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	Not listed in the file	$177.21 – $1,372.99
MRI of the lower back (lumbar spine), without contrast: 10 of 18 insurance plan rates Aetna — HMO/POS: $1,127.26 Aetna — Medicare Advantage: $177.21 Aetna — PPO: $1,174.63 Alliant — Solocare: $212.65 Ambetter — Managed Medicaid: $239.23 Anthem — Medicare Advantage: $177.21 Care Source — Medicare Advantage: $180.75 Cigna — Commercial: $974.72 Clover — Medicare Advantage: $180.75 Eon Health — Medicare Advantage: $180.75
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT SCAN OF PELVIS CONTRAST	$1,695	$847.50	$172.60 – $2,193
CT scan of the pelvis, with contrast: 10 of 24 insurance plan rates Aetna — HMO/POS: $1,305.15 Aetna — Medicare Advantage: $174.32 Aetna — PPO: $1,406.85 Alliant — Solocare: $811.50 Ambetter — Managed Medicaid: $508.50 Anthem — HMO: $1,006.76 Anthem — Medicare Advantage: $172.60 Anthem — PPO: $1,271.25 Care Source — Medicare Advantage: $176.05 Cigna — Commercial: $1,305.15
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT SCAN OF PELVIS CONTRAST	$1,695	$847.50	$864.45 – $1,440.75
CT scan of the pelvis, with contrast: rates for 10 insurance plans Aetna — HMO/POS: $1,305.15 Aetna — PPO: $1,406.85 Ambetter — Managed Medicaid: $864.45 Cigna — Commercial: $1,305.15 Humana — HMO/POS: $1,440.75 Humana — PPO: $1,440.75 Multiplan — PHO Agreement Complimentary Network: $1,356 Multiplan — PHO Agreement Primary Network: $1,101.75 Novanet — Commercial: $1,356 Three Rivers Provider Network — Commercial: $1,440.75
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee In the file: CT PELVIS W/DYE	Not listed in the file	Not listed in the file	$206.38 – $805.23
CT scan of the pelvis, with contrast: 10 of 18 insurance plan rates Aetna — HMO/POS: $714.73 Aetna — Medicare Advantage: $206.38 Aetna — PPO: $744.76 Alliant — Solocare: $247.66 Ambetter — Managed Medicaid: $278.61 Anthem — Medicare Advantage: $206.38 Care Source — Medicare Advantage: $210.51 Cigna — Commercial: $569.17 Clover — Medicare Advantage: $210.51 Eon Health — Medicare Advantage: $210.51
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LOWER EXTREM JT W/O CONTRAST	$2,322	$1,161	$234.79 – $3,284
MRI of a leg joint (such as the knee), without contrast: 10 of 24 insurance plan rates Aetna — HMO/POS: $1,787.94 Aetna — Medicare Advantage: $237.14 Aetna — PPO: $1,927.26 Alliant — Solocare: $579.63 Ambetter — Managed Medicaid: $696.60 Anthem — HMO: $1,350.98 Anthem — Medicare Advantage: $234.79 Anthem — PPO: $1,741.50 Care Source — Medicare Advantage: $239.49 Cigna — Commercial: $1,787.94
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI LOWER EXTREM JT W/O CONTRAST	$2,322	$1,161	$1,184.22 – $1,973.70
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans Aetna — HMO/POS: $1,787.94 Aetna — PPO: $1,927.26 Ambetter — Managed Medicaid: $1,184.22 Cigna — Commercial: $1,787.94 Humana — HMO/POS: $1,973.70 Humana — PPO: $1,973.70 Multiplan — PHO Agreement Complimentary Network: $1,857.60 Multiplan — PHO Agreement Primary Network: $1,509.30 Novanet — Commercial: $1,857.60 Three Rivers Provider Network — Commercial: $1,973.70
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	Not listed in the file	Not listed in the file	$188 – $1,181.79
MRI of a leg joint (such as the knee), without contrast: 10 of 18 insurance plan rates Aetna — HMO/POS: $970.64 Aetna — Medicare Advantage: $188 Aetna — PPO: $1,011.42 Alliant — Solocare: $225.60 Ambetter — Managed Medicaid: $253.80 Anthem — Medicare Advantage: $188 Care Source — Medicare Advantage: $191.76 Cigna — Commercial: $865.61 Clover — Medicare Advantage: $191.76 Eon Health — Medicare Advantage: $191.76
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT SCAN ABDOMEN AND PELVIS W CONTRAST	$3,556	$1,778	$343.30 – $3,022.60
CT scan of the abdomen and pelvis, with contrast: 10 of 24 insurance plan rates Aetna — HMO/POS: $2,738.12 Aetna — Medicare Advantage: $346.73 Aetna — PPO: $2,951.48 Alliant — Solocare: $811.50 Ambetter — Managed Medicaid: $1,066.80 Anthem — HMO: $1,185.35 Anthem — Medicare Advantage: $343.30 Anthem — PPO: $2,667 Care Source — Medicare Advantage: $350.17 Cigna — Commercial: $2,738.12
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT SCAN ABDOMEN AND PELVIS W CONTRAST	$3,556	$1,778	$1,813.56 – $3,022.60
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans Aetna — HMO/POS: $2,738.12 Aetna — PPO: $2,951.48 Ambetter — Managed Medicaid: $1,813.56 Cigna — Commercial: $2,738.12 Humana — HMO/POS: $3,022.60 Humana — PPO: $3,022.60 Multiplan — PHO Agreement Complimentary Network: $2,844.80 Multiplan — PHO Agreement Primary Network: $2,311.40 Novanet — Commercial: $2,844.80 Three Rivers Provider Network — Commercial: $3,022.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: CT ABD & PELV W/CONTRAST	Not listed in the file	Not listed in the file	$275.53 – $1,026.08
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $275.53 Alliant — Solocare: $330.64 Ambetter — Managed Medicaid: $371.97 Anthem — Medicare Advantage: $275.53 Care Source — Medicare Advantage: $281.04 Cigna — Commercial: $688.08 Clover — Medicare Advantage: $281.04 Eon Health — Medicare Advantage: $281.04 Georgia Health Advantage — Medicare Advantage: $275.53 Humana — HMO/POS: $976.96
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE	$818	$409	$102.88 – $844
Ultrasound of the abdomen, complete: 10 of 24 insurance plan rates Aetna — HMO/POS: $629.86 Aetna — Medicare Advantage: $103.90 Aetna — PPO: $678.94 Alliant — Solocare: $400.82 Ambetter — Managed Medicaid: $245.40 Anthem — HMO: $294.05 Anthem — Medicare Advantage: $102.88 Anthem — PPO: $613.50 Care Source — Medicare Advantage: $104.93 Cigna — Commercial: $629.86
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE	$818	$409	$417.18 – $695.30
Ultrasound of the abdomen, complete: rates for 10 insurance plans Aetna — HMO/POS: $629.86 Aetna — PPO: $678.94 Ambetter — Managed Medicaid: $417.18 Cigna — Commercial: $629.86 Humana — HMO/POS: $695.30 Humana — PPO: $695.30 Multiplan — PHO Agreement Complimentary Network: $654.40 Multiplan — PHO Agreement Primary Network: $531.70 Novanet — Commercial: $654.40 Three Rivers Provider Network — Commercial: $695.30
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: US EXAM ABDOM COMPLETE	Not listed in the file	Not listed in the file	$105.35 – $301.24
Ultrasound of the abdomen, complete: 10 of 18 insurance plan rates Aetna — HMO/POS: $246.39 Aetna — Medicare Advantage: $105.35 Aetna — PPO: $256.74 Alliant — Solocare: $126.42 Ambetter — Managed Medicaid: $142.22 Anthem — Medicare Advantage: $105.35 Care Source — Medicare Advantage: $107.46 Cigna — Commercial: $210.49 Clover — Medicare Advantage: $107.46 Eon Health — Medicare Advantage: $107.46
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US OB >/= 14 WKS SNGL FETUS	$549	$274.50	$102.88 – $844
Pregnancy ultrasound (after the first trimester): 10 of 24 insurance plan rates Aetna — HMO/POS: $422.73 Aetna — Medicare Advantage: $103.90 Aetna — PPO: $455.67 Alliant — Solocare: $269.01 Ambetter — Managed Medicaid: $164.70 Anthem — HMO: $294.05 Anthem — Medicare Advantage: $102.88 Anthem — PPO: $411.75 Care Source — Medicare Advantage: $104.93 Cigna — Commercial: $422.73
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US OB >/= 14 WKS SNGL FETUS	$549	$274.50	$279.99 – $466.65
Pregnancy ultrasound (after the first trimester): rates for 10 insurance plans Aetna — HMO/POS: $422.73 Aetna — PPO: $455.67 Ambetter — Managed Medicaid: $279.99 Cigna — Commercial: $422.73 Humana — HMO/POS: $466.65 Humana — PPO: $466.65 Multiplan — PHO Agreement Complimentary Network: $439.20 Multiplan — PHO Agreement Primary Network: $356.85 Novanet — Commercial: $439.20 Three Rivers Provider Network — Commercial: $466.65
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: OB US >/= 14 WKS SNGL FETUS	Not listed in the file	Not listed in the file	$125.46 – $341.77
Pregnancy ultrasound (after the first trimester): 10 of 18 insurance plan rates Aetna — HMO/POS: $245.79 Aetna — Medicare Advantage: $125.46 Aetna — PPO: $256.12 Alliant — Solocare: $150.55 Ambetter — Managed Medicaid: $169.37 Anthem — Medicare Advantage: $125.46 Care Source — Medicare Advantage: $127.97 Cigna — Commercial: $236.80 Clover — Medicare Advantage: $127.97 Eon Health — Medicare Advantage: $127.97
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC TRANSVAGINAL ULTRASOUND	$560	$280	$102.88 – $844
Transvaginal ultrasound: 10 of 24 insurance plan rates Aetna — HMO/POS: $431.20 Aetna — Medicare Advantage: $103.90 Aetna — PPO: $464.80 Alliant — Solocare: $274.40 Ambetter — Managed Medicaid: $168 Anthem — HMO: $264.06 Anthem — Medicare Advantage: $102.88 Anthem — PPO: $420 Care Source — Medicare Advantage: $104.93 Cigna — Commercial: $431.20
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC TRANSVAGINAL ULTRASOUND	$560	$280	$285.60 – $476
Transvaginal ultrasound: rates for 10 insurance plans Aetna — HMO/POS: $431.20 Aetna — PPO: $464.80 Ambetter — Managed Medicaid: $285.60 Cigna — Commercial: $431.20 Humana — HMO/POS: $476 Humana — PPO: $476 Multiplan — PHO Agreement Complimentary Network: $448 Multiplan — PHO Agreement Primary Network: $364 Novanet — Commercial: $448 Three Rivers Provider Network — Commercial: $476
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: TRANSVAGINAL US NON-OB	Not listed in the file	Not listed in the file	$107.89 – $216.99
Transvaginal ultrasound: 10 of 18 insurance plan rates Aetna — HMO/POS: $182.22 Aetna — Medicare Advantage: $107.89 Aetna — PPO: $189.88 Alliant — Solocare: $129.47 Ambetter — Managed Medicaid: $145.65 Anthem — Medicare Advantage: $107.89 Care Source — Medicare Advantage: $110.05 Cigna — Commercial: $169.45 Clover — Medicare Advantage: $110.05 Eon Health — Medicare Advantage: $110.05
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$351	$175.50	$105.30 – $309.62
Diagnostic mammogram, one breast: 10 of 24 insurance plan rates Aetna — HMO/POS: $270.27 Aetna — Medicare Advantage: $115.13 Aetna — PPO: $291.33 Alliant — Solocare: $171.99 Ambetter — Managed Medicaid: $105.30 Anthem — HMO: $309.62 Anthem — Medicare Advantage: $113.99 Anthem — PPO: $263.25 Care Source — Medicare Advantage: $116.26 Cigna — Commercial: $270.27
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$351	$175.50	$179.01 – $298.35
Diagnostic mammogram, one breast: rates for 10 insurance plans Aetna — HMO/POS: $270.27 Aetna — PPO: $291.33 Ambetter — Managed Medicaid: $179.01 Cigna — Commercial: $270.27 Humana — HMO/POS: $298.35 Humana — PPO: $298.35 Multiplan — PHO Agreement Complimentary Network: $280.80 Multiplan — PHO Agreement Primary Network: $228.15 Novanet — Commercial: $280.80 Three Rivers Provider Network — Commercial: $298.35
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$113.99 – $287.51
Diagnostic mammogram, one breast: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $113.99 Alliant — Solocare: $136.79 Ambetter — Managed Medicaid: $153.89 Anthem — HMO: $223.48 Anthem — Medicare Advantage: $113.99 Anthem — PPO: $223.48 Care Source — Medicare Advantage: $116.27 Clover — Medicare Advantage: $116.27 Eon Health — Medicare Advantage: $116.27 Georgia Health Advantage — Medicare Advantage: $113.99
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$405	$202.50	$121.50 – $396.06
Diagnostic mammogram, both breasts: 10 of 24 insurance plan rates Aetna — HMO/POS: $311.85 Aetna — Medicare Advantage: $145.81 Aetna — PPO: $336.15 Alliant — Solocare: $198.45 Ambetter — Managed Medicaid: $121.50 Anthem — HMO: $396.06 Anthem — Medicare Advantage: $144.37 Anthem — PPO: $303.75 Care Source — Medicare Advantage: $147.25 Cigna — Commercial: $311.85
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$405	$202.50	$206.55 – $344.25
Diagnostic mammogram, both breasts: rates for 10 insurance plans Aetna — HMO/POS: $311.85 Aetna — PPO: $336.15 Ambetter — Managed Medicaid: $206.55 Cigna — Commercial: $311.85 Humana — HMO/POS: $344.25 Humana — PPO: $344.25 Multiplan — PHO Agreement Complimentary Network: $324 Multiplan — PHO Agreement Primary Network: $263.25 Novanet — Commercial: $324 Three Rivers Provider Network — Commercial: $344.25
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$144.37 – $364.47
Diagnostic mammogram, both breasts: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $144.37 Alliant — Solocare: $173.24 Ambetter — Managed Medicaid: $194.90 Anthem — HMO: $282.82 Anthem — Medicare Advantage: $144.37 Anthem — PPO: $282.82 Care Source — Medicare Advantage: $147.26 Clover — Medicare Advantage: $147.26 Eon Health — Medicare Advantage: $147.26 Georgia Health Advantage — Medicare Advantage: $144.37
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$386	$193	$115.79 – $328.10
Screening mammogram, both breasts: 10 of 24 insurance plan rates Aetna — HMO/POS: $297.22 Aetna — Medicare Advantage: $116.95 Aetna — PPO: $320.38 Alliant — Solocare: $189.14 Ambetter — Managed Medicaid: $115.80 Anthem — HMO: $327.14 Anthem — Medicare Advantage: $115.79 Anthem — PPO: $289.50 Care Source — Medicare Advantage: $118.11 Cigna — Commercial: $297.22
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$386	$193	$196.86 – $328.10
Screening mammogram, both breasts: rates for 10 insurance plans Aetna — HMO/POS: $297.22 Aetna — PPO: $320.38 Ambetter — Managed Medicaid: $196.86 Cigna — Commercial: $297.22 Humana — HMO/POS: $328.10 Humana — PPO: $328.10 Multiplan — PHO Agreement Complimentary Network: $308.80 Multiplan — PHO Agreement Primary Network: $250.90 Novanet — Commercial: $308.80 Three Rivers Provider Network — Commercial: $328.10
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: SCR MAMMO BI INCL CAD	Not listed in the file	Not listed in the file	$115.79 – $293.72
Screening mammogram, both breasts: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $115.79 Alliant — Solocare: $138.95 Ambetter — Managed Medicaid: $156.32 Anthem — HMO: $227.70 Anthem — Medicare Advantage: $115.79 Anthem — PPO: $227.70 Care Source — Medicare Advantage: $118.11 Clover — Medicare Advantage: $118.11 Eon Health — Medicare Advantage: $118.11 Georgia Health Advantage — Medicare Advantage: $115.79

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$14.52 – $76.30
Electrocardiogram (ECG/EKG) with reading: 10 of 18 insurance plan rates Aetna — HMO/POS: $51.82 Aetna — Medicare Advantage: $14.52 Aetna — PPO: $54 Alliant — Solocare: $17.42 Ambetter — Managed Medicaid: $19.60 Anthem — Medicare Advantage: $14.52 Care Source — Medicare Advantage: $14.81 Cigna — Commercial: $50.02 Clover — Medicare Advantage: $14.81 Eon Health — Medicare Advantage: $14.81
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$14.52 – $14.81
Electrocardiogram (ECG/EKG) with reading: rates for 9 insurance plans Aetna — Medicare Advantage: $14.66 Anthem — Medicare Advantage: $14.52 Care Source — Medicare Advantage: $14.81 Clover — Medicare Advantage: $14.81 Eon Health — Medicare Advantage: $14.81 Georgia Health Advantage — Medicare Advantage: $14.52 Humana — Medicare Advantage: $14.52 Pruitt Health — Medicare Advantage: $14.52 United Healthcare — Medicare Advantage: $14.52
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$60.97
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans Humana — HMO/POS: $60.97 Humana — PPO: $60.97
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$806.34 – $12,578.95
Left heart catheterization (diagnostic): 10 of 15 insurance plan rates Aetna — Medicare Advantage: $806.34 Alliant — Solocare: $967.61 Ambetter — Managed Medicaid: $1,088.56 Anthem — Medicare Advantage: $806.34 Care Source — Medicare Advantage: $822.47 Cigna — Commercial: $2,331.48 Clover — Medicare Advantage: $822.47 Eon Health — Medicare Advantage: $822.47 Georgia Health Advantage — Medicare Advantage: $806.34 Humana — HMO/POS: $2,355.52
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$3,190.13 – $10,955
Left heart catheterization (diagnostic): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $3,222.03 Anthem — HMO: $4,144.37 Anthem — Medicare Advantage: $3,190.13 Care Source — Medicare Advantage: $3,253.93 Clover — Medicare Advantage: $3,253.93 Eon Health — Medicare Advantage: $3,253.93 Georgia Health Advantage — Medicare Advantage: $3,190.13 Humana — Medicare Advantage: $3,190.13 Pruitt Health — Medicare Advantage: $3,190.13 United Healthcare — Commercial: $10,955
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$575.82 – $2,355.52
Left heart catheterization (diagnostic): 10 of 13 insurance plan rates Aetna — Medicare Advantage: $575.82 Alliant — Solocare: $690.98 Ambetter — Managed Medicaid: $777.36 Anthem — Medicare Advantage: $575.82 Care Source — Medicare Advantage: $587.34 Clover — Medicare Advantage: $587.34 Eon Health — Medicare Advantage: $587.34 Georgia Health Advantage — Medicare Advantage: $575.82 Humana — HMO/POS: $2,355.52 Humana — Medicare Advantage: $575.82
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee In the file: ELECTROPHYSIOLOGY EVALUATION	Not listed in the file	Not listed in the file	$648.90 – $2,159.42
Heart rhythm study (electrophysiology evaluation): 10 of 18 insurance plan rates Aetna — HMO/POS: $1,606.55 Aetna — Medicare Advantage: $648.90 Aetna — PPO: $1,674.05 Alliant — Solocare: $778.68 Ambetter — Managed Medicaid: $876.02 Anthem — Medicare Advantage: $648.90 Care Source — Medicare Advantage: $661.88 Cigna — Commercial: $1,550.77 Clover — Medicare Advantage: $661.88 Eon Health — Medicare Advantage: $661.88
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROPHYSIOLOGY EVALUATION	Not listed in the file	Not listed in the file	$7,675.04 – $10,955
Heart rhythm study (electrophysiology evaluation): rates for 10 insurance plans Aetna — Medicare Advantage: $7,751.79 Anthem — Medicare Advantage: $7,675.04 Care Source — Medicare Advantage: $7,828.54 Clover — Medicare Advantage: $7,828.54 Eon Health — Medicare Advantage: $7,828.54 Georgia Health Advantage — Medicare Advantage: $7,675.04 Humana — Medicare Advantage: $7,675.04 Pruitt Health — Medicare Advantage: $7,675.04 United Healthcare — Commercial: $10,955 United Healthcare — Medicare Advantage: $7,675.04
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: ELECTROPHYSIOLOGY EVALUATION	Not listed in the file	Not listed in the file	$373.32 – $1,079.81
Heart rhythm study (electrophysiology evaluation): 10 of 17 insurance plan rates Aetna — HMO/POS: $912.75 Aetna — Medicare Advantage: $373.32 Aetna — PPO: $951.10 Alliant — Solocare: $447.98 Ambetter — Managed Medicaid: $503.98 Anthem — Medicare Advantage: $373.32 Care Source — Medicare Advantage: $380.79 Cigna — Commercial: $881.07 Clover — Medicare Advantage: $380.79 Eon Health — Medicare Advantage: $380.79
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$818.50 – $3,235.31
Heart rhythm study with ablation for atrial fibrillation: 10 of 14 insurance plan rates Aetna — Medicare Advantage: $818.50 Alliant — Solocare: $982.20 Ambetter — Managed Medicaid: $1,104.98 Anthem — Medicare Advantage: $818.50 Care Source — Medicare Advantage: $834.87 Cigna — Commercial: $3,181.46 Clover — Medicare Advantage: $834.87 Eon Health — Medicare Advantage: $834.87 Georgia Health Advantage — Medicare Advantage: $818.50 Humana — HMO/POS: $3,235.31
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	$6,575 – $26,234.62
Heart rhythm study with ablation for atrial fibrillation: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $25,977.42 Anthem — HMO: $8,741.66 Anthem — Medicare Advantage: $25,720.22 Care Source — Medicare Advantage: $26,234.62 Clover — Medicare Advantage: $26,234.62 Eon Health — Medicare Advantage: $26,234.62 Georgia Health Advantage — Medicare Advantage: $25,720.22 Humana — Medicare Advantage: $25,720.22 Pruitt Health — Medicare Advantage: $25,720.22 United Healthcare — Commercial: $6,575
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$3,337	$1,668.50	$845.02 – $2,836.45
Sleep study (overnight, in a sleep lab): 10 of 24 insurance plan rates Aetna — HMO/POS: $2,569.49 Aetna — Medicare Advantage: $853.47 Aetna — PPO: $2,769.71 Alliant — Solocare: $1,635.13 Ambetter — Managed Medicaid: $1,001.10 Anthem — HMO: $2,502.75 Anthem — Medicare Advantage: $845.02 Anthem — PPO: $2,502.75 Care Source — Medicare Advantage: $861.92 Cigna — Commercial: $2,569.49
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$3,337	$1,668.50	$1,701.87 – $2,836.45
Sleep study (overnight, in a sleep lab): rates for 10 insurance plans Aetna — HMO/POS: $2,569.49 Aetna — PPO: $2,769.71 Ambetter — Managed Medicaid: $1,701.87 Cigna — Commercial: $2,569.49 Humana — HMO/POS: $2,836.45 Humana — PPO: $2,836.45 Multiplan — PHO Agreement Complimentary Network: $2,669.60 Multiplan — PHO Agreement Primary Network: $2,169.05 Novanet — Commercial: $2,669.60 Three Rivers Provider Network — Commercial: $2,836.45
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$612.34 – $1,647.43
Sleep study (overnight, in a sleep lab): 10 of 18 insurance plan rates Aetna — HMO/POS: $1,050.18 Aetna — Medicare Advantage: $612.34 Aetna — PPO: $1,094.30 Alliant — Solocare: $734.81 Ambetter — Managed Medicaid: $826.66 Anthem — Medicare Advantage: $612.34 Care Source — Medicare Advantage: $624.59 Cigna — Commercial: $1,013.71 Clover — Medicare Advantage: $624.59 Eon Health — Medicare Advantage: $624.59

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: HC THERAPEUTIC RECREATION IND TIMED	$196	$98	$27.64 – $166.60
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 24 insurance plan rates Aetna — HMO/POS: $150.92 Aetna — Medicare Advantage: $27.92 Aetna — PPO: $162.68 Alliant — Solocare: $96.04 Ambetter — Managed Medicaid: $58.80 Anthem — HMO: $147 Anthem — Medicare Advantage: $27.64 Anthem — PPO: $147 Care Source — Medicare Advantage: $28.20 Cigna — Commercial: $150.92
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT THERAPEUTIC EXERCISES	$119	$59.50	$27.64 – $171.38
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates Aetna — HMO/POS: $91.63 Aetna — Medicare Advantage: $27.92 Aetna — PPO: $98.77 Alliant — Solocare: $131.35 Ambetter — Managed Medicaid: $35.70 Anthem — HMO: $171.38 Anthem — Medicare Advantage: $27.64 Anthem — PPO: $89.25 Care Source — Medicare Advantage: $28.20 Cigna — Commercial: $91.63
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OT THERAPEUTIC EXERCISES	$119	$59.50	$27.64 – $171.38
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates Aetna — HMO/POS: $91.63 Aetna — Medicare Advantage: $27.92 Aetna — PPO: $98.77 Alliant — Solocare: $131.35 Ambetter — Managed Medicaid: $35.70 Anthem — HMO: $171.38 Anthem — Medicare Advantage: $27.64 Anthem — PPO: $89.25 Care Source — Medicare Advantage: $28.20 Cigna — Commercial: $91.63
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$168	$84	$50.40 – $171.38
Physical therapy evaluation (low complexity): 10 of 23 insurance plan rates Aetna — HMO/POS: $129.36 Aetna — Medicare Advantage: $93.88 Aetna — PPO: $139.44 Alliant — Solocare: $131.35 Ambetter — Managed Medicaid: $50.40 Anthem — HMO: $171.38 Anthem — Medicare Advantage: $92.95 Anthem — PPO: $126 Care Source — Medicare Advantage: $94.81 Cigna — Commercial: $129.36
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$168	$84	$85.68 – $142.80
Physical therapy evaluation (low complexity): rates for 10 insurance plans Aetna — HMO/POS: $129.36 Aetna — PPO: $139.44 Ambetter — Managed Medicaid: $85.68 Cigna — Commercial: $129.36 Humana — HMO/POS: $142.80 Humana — PPO: $142.80 Multiplan — PHO Agreement Complimentary Network: $134.40 Multiplan — PHO Agreement Primary Network: $109.20 Novanet — Commercial: $134.40 Three Rivers Provider Network — Commercial: $142.80
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL LOW COMPLEX 20 MIN	Not listed in the file	Not listed in the file	$92.95 – $125.48
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $92.95 Alliant — Solocare: $111.54 Ambetter — Managed Medicaid: $125.48 Anthem — Medicare Advantage: $92.95 Care Source — Medicare Advantage: $94.81 Clover — Medicare Advantage: $94.81 Eon Health — Medicare Advantage: $94.81 Georgia Health Advantage — Medicare Advantage: $92.95 Humana — Medicare Advantage: $92.95 Pruitt Health — Medicare Advantage: $97.60
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$282	$141	$84.60 – $239.70
Physical therapy evaluation (moderate complexity): 10 of 23 insurance plan rates Aetna — HMO/POS: $217.14 Aetna — Medicare Advantage: $93.88 Aetna — PPO: $234.06 Alliant — Solocare: $131.35 Ambetter — Managed Medicaid: $84.60 Anthem — HMO: $171.38 Anthem — Medicare Advantage: $92.95 Anthem — PPO: $211.50 Care Source — Medicare Advantage: $94.81 Cigna — Commercial: $217.14
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$282	$141	$143.82 – $239.70
Physical therapy evaluation (moderate complexity): rates for 10 insurance plans Aetna — HMO/POS: $217.14 Aetna — PPO: $234.06 Ambetter — Managed Medicaid: $143.82 Cigna — Commercial: $217.14 Humana — HMO/POS: $239.70 Humana — PPO: $239.70 Multiplan — PHO Agreement Complimentary Network: $225.60 Multiplan — PHO Agreement Primary Network: $183.30 Novanet — Commercial: $225.60 Three Rivers Provider Network — Commercial: $239.70
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL MOD COMPLEX 30 MIN	Not listed in the file	Not listed in the file	$92.95 – $125.48
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $92.95 Alliant — Solocare: $111.54 Ambetter — Managed Medicaid: $125.48 Anthem — Medicare Advantage: $92.95 Care Source — Medicare Advantage: $94.81 Clover — Medicare Advantage: $94.81 Eon Health — Medicare Advantage: $94.81 Georgia Health Advantage — Medicare Advantage: $92.95 Humana — Medicare Advantage: $92.95 Pruitt Health — Medicare Advantage: $97.60
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$412	$206	$92.95 – $350.20
Physical therapy evaluation (high complexity): 10 of 23 insurance plan rates Aetna — HMO/POS: $317.24 Aetna — Medicare Advantage: $93.88 Aetna — PPO: $341.96 Alliant — Solocare: $131.35 Ambetter — Managed Medicaid: $123.60 Anthem — HMO: $171.38 Anthem — Medicare Advantage: $92.95 Anthem — PPO: $309 Care Source — Medicare Advantage: $94.81 Cigna — Commercial: $317.24
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$412	$206	$210.12 – $350.20
Physical therapy evaluation (high complexity): rates for 10 insurance plans Aetna — HMO/POS: $317.24 Aetna — PPO: $341.96 Ambetter — Managed Medicaid: $210.12 Cigna — Commercial: $317.24 Humana — HMO/POS: $350.20 Humana — PPO: $350.20 Multiplan — PHO Agreement Complimentary Network: $329.60 Multiplan — PHO Agreement Primary Network: $267.80 Novanet — Commercial: $329.60 Three Rivers Provider Network — Commercial: $350.20
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	Not listed in the file	Not listed in the file	$92.95 – $125.48
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $92.95 Alliant — Solocare: $111.54 Ambetter — Managed Medicaid: $125.48 Anthem — Medicare Advantage: $92.95 Care Source — Medicare Advantage: $94.81 Clover — Medicare Advantage: $94.81 Eon Health — Medicare Advantage: $94.81 Georgia Health Advantage — Medicare Advantage: $92.95 Humana — Medicare Advantage: $92.95 Pruitt Health — Medicare Advantage: $97.60
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$69.07 – $99.60
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $69.07 Alliant — Solocare: $82.88 Ambetter — Managed Medicaid: $93.24 Anthem — Medicare Advantage: $69.07 Care Source — Medicare Advantage: $70.45 Cigna — Commercial: $92.94 Clover — Medicare Advantage: $70.45 Eon Health — Medicare Advantage: $70.45 Georgia Health Advantage — Medicare Advantage: $69.07 Humana — HMO/POS: $81.95
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$174.66 – $178.15
Psychotherapy, 30 minutes: rates for 9 insurance plans Aetna — Medicare Advantage: $176.41 Anthem — Medicare Advantage: $174.66 Care Source — Medicare Advantage: $178.15 Clover — Medicare Advantage: $178.15 Eon Health — Medicare Advantage: $178.15 Georgia Health Advantage — Medicare Advantage: $174.66 Humana — Medicare Advantage: $174.66 Pruitt Health — Medicare Advantage: $174.66 United Healthcare — Medicare Advantage: $174.66
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$91.37 – $137.99
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $91.37 Alliant — Solocare: $109.64 Ambetter — Managed Medicaid: $123.35 Anthem — Medicare Advantage: $91.37 Care Source — Medicare Advantage: $93.20 Cigna — Commercial: $123.31 Clover — Medicare Advantage: $93.20 Eon Health — Medicare Advantage: $93.20 Georgia Health Advantage — Medicare Advantage: $91.37 Humana — HMO/POS: $109.27
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$174.66 – $178.15
Psychotherapy, 45 minutes: rates for 9 insurance plans Aetna — Medicare Advantage: $176.41 Anthem — Medicare Advantage: $174.66 Care Source — Medicare Advantage: $178.15 Clover — Medicare Advantage: $178.15 Eon Health — Medicare Advantage: $178.15 Georgia Health Advantage — Medicare Advantage: $174.66 Humana — Medicare Advantage: $174.66 Pruitt Health — Medicare Advantage: $174.66 United Healthcare — Medicare Advantage: $174.66
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$134.50 – $204.70
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates Aetna — Medicare Advantage: $134.50 Alliant — Solocare: $161.40 Ambetter — Managed Medicaid: $181.58 Anthem — Medicare Advantage: $134.50 Care Source — Medicare Advantage: $137.19 Cigna — Commercial: $184.48 Clover — Medicare Advantage: $137.19 Eon Health — Medicare Advantage: $137.19 Georgia Health Advantage — Medicare Advantage: $134.50 Humana — HMO/POS: $164.32
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$174.66 – $178.15
Psychotherapy, 60 minutes: rates for 9 insurance plans Aetna — Medicare Advantage: $176.41 Anthem — Medicare Advantage: $174.66 Care Source — Medicare Advantage: $178.15 Clover — Medicare Advantage: $178.15 Eon Health — Medicare Advantage: $178.15 Georgia Health Advantage — Medicare Advantage: $174.66 Humana — Medicare Advantage: $174.66 Pruitt Health — Medicare Advantage: $174.66 United Healthcare — Medicare Advantage: $174.66
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$98.67 – $212.65
Family psychotherapy, without the patient: 10 of 18 insurance plan rates Aetna — HMO/POS: $158.27 Aetna — Medicare Advantage: $98.67 Aetna — PPO: $164.92 Alliant — Solocare: $118.40 Ambetter — Managed Medicaid: $133.20 Anthem — Medicare Advantage: $98.67 Care Source — Medicare Advantage: $100.64 Cigna — Commercial: $152.77 Clover — Medicare Advantage: $100.64 Eon Health — Medicare Advantage: $100.64
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$174.66 – $178.15
Family psychotherapy, without the patient: rates for 9 insurance plans Aetna — Medicare Advantage: $176.41 Anthem — Medicare Advantage: $174.66 Care Source — Medicare Advantage: $178.15 Clover — Medicare Advantage: $178.15 Eon Health — Medicare Advantage: $178.15 Georgia Health Advantage — Medicare Advantage: $174.66 Humana — Medicare Advantage: $174.66 Pruitt Health — Medicare Advantage: $174.66 United Healthcare — Medicare Advantage: $174.66
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$158.27 – $164.92
Family psychotherapy, without the patient: rates for 2 insurance plans Aetna — HMO/POS: $158.27 Aetna — PPO: $164.92
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$102.28 – $243.03
Family psychotherapy, with the patient: 10 of 18 insurance plan rates Aetna — HMO/POS: $180.88 Aetna — Medicare Advantage: $102.28 Aetna — PPO: $188.48 Alliant — Solocare: $122.74 Ambetter — Managed Medicaid: $138.08 Anthem — Medicare Advantage: $102.28 Care Source — Medicare Advantage: $104.33 Cigna — Commercial: $174.60 Clover — Medicare Advantage: $104.33 Eon Health — Medicare Advantage: $104.33
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$174.66 – $178.15
Family psychotherapy, with the patient: rates for 9 insurance plans Aetna — Medicare Advantage: $176.41 Anthem — Medicare Advantage: $174.66 Care Source — Medicare Advantage: $178.15 Clover — Medicare Advantage: $178.15 Eon Health — Medicare Advantage: $178.15 Georgia Health Advantage — Medicare Advantage: $174.66 Humana — Medicare Advantage: $174.66 Pruitt Health — Medicare Advantage: $174.66 United Healthcare — Medicare Advantage: $174.66
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$180.88 – $188.48
Family psychotherapy, with the patient: rates for 2 insurance plans Aetna — HMO/POS: $180.88 Aetna — PPO: $188.48
Group psychotherapy CPT 90853 · Inpatient or outpatient · Doctor (professional) fee In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$24.27 – $60.78
Group psychotherapy: 10 of 18 insurance plan rates Aetna — HMO/POS: $45.45 Aetna — Medicare Advantage: $24.27 Aetna — PPO: $47.36 Alliant — Solocare: $29.12 Ambetter — Managed Medicaid: $32.76 Anthem — Medicare Advantage: $24.27 Care Source — Medicare Advantage: $24.76 Cigna — Commercial: $43.86 Clover — Medicare Advantage: $24.76 Eon Health — Medicare Advantage: $24.76
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$99.97 – $101.97
Group psychotherapy: rates for 9 insurance plans Aetna — Medicare Advantage: $100.97 Anthem — Medicare Advantage: $99.97 Care Source — Medicare Advantage: $101.97 Clover — Medicare Advantage: $101.97 Eon Health — Medicare Advantage: $101.97 Georgia Health Advantage — Medicare Advantage: $99.97 Humana — Medicare Advantage: $99.97 Pruitt Health — Medicare Advantage: $99.97 United Healthcare — Medicare Advantage: $99.97
Group psychotherapy CPT 90853 · Inpatient or outpatient · Doctor (professional) fee · modifier 95 In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$45.45 – $47.36
Group psychotherapy: rates for 2 insurance plans Aetna — HMO/POS: $45.45 Aetna — PPO: $47.36

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$399.12 – $910.77
Removal of breast growth (open surgery): 10 of 18 insurance plan rates Aetna — HMO/POS: $774.09 Aetna — Medicare Advantage: $399.12 Aetna — PPO: $806.62 Alliant — Solocare: $478.94 Ambetter — Managed Medicaid: $538.81 Anthem — Medicare Advantage: $399.12 Care Source — Medicare Advantage: $407.10 Cigna — Commercial: $747.22 Clover — Medicare Advantage: $407.10 Eon Health — Medicare Advantage: $407.10
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$3,852.87 – $6,575
Removal of breast growth (open surgery): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $3,891.40 Alliant — Solocare: $4,020.37 Anthem — HMO: $4,144.37 Anthem — Medicare Advantage: $3,852.87 Care Source — Medicare Advantage: $3,929.93 Clover — Medicare Advantage: $3,929.93 Eon Health — Medicare Advantage: $3,929.93 Georgia Health Advantage — Medicare Advantage: $3,852.87 Humana — Medicare Advantage: $3,852.87 Pruitt Health — Medicare Advantage: $3,852.87
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,146.04 – $5,486.47
Total hip replacement: 10 of 18 insurance plan rates Aetna — HMO/POS: $4,363.23 Aetna — Medicare Advantage: $1,146.04 Aetna — PPO: $4,546.56 Alliant — Solocare: $1,375.25 Ambetter — Managed Medicaid: $1,547.15 Anthem — Medicare Advantage: $1,146.04 Care Source — Medicare Advantage: $1,168.96 Cigna — Commercial: $4,211.75 Clover — Medicare Advantage: $1,168.96 Eon Health — Medicare Advantage: $1,168.96
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	$3,430.29 – $12,886.21
Total hip replacement: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $12,759.87 Alliant — Solocare: $3,430.29 Anthem — HMO: $3,534.91 Anthem — Medicare Advantage: $12,633.54 Care Source — Medicare Advantage: $12,886.21 Clover — Medicare Advantage: $12,886.21 Eon Health — Medicare Advantage: $12,886.21 Georgia Health Advantage — Medicare Advantage: $12,633.54 Humana — Medicare Advantage: $12,633.54 Pruitt Health — Medicare Advantage: $12,633.54
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,143.35 – $5,795.49
Total knee replacement: 10 of 18 insurance plan rates Aetna — HMO/POS: $4,287.50 Aetna — Medicare Advantage: $1,143.35 Aetna — PPO: $4,467.65 Alliant — Solocare: $1,372.02 Ambetter — Managed Medicaid: $1,543.52 Anthem — Medicare Advantage: $1,143.35 Care Source — Medicare Advantage: $1,166.22 Cigna — Commercial: $4,138.65 Clover — Medicare Advantage: $1,166.22 Eon Health — Medicare Advantage: $1,166.22
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	$2,223.96 – $12,886.21
Total knee replacement: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $12,759.87 Alliant — Solocare: $3,430.29 Anthem — HMO: $2,223.96 Anthem — Medicare Advantage: $12,633.54 Care Source — Medicare Advantage: $12,886.21 Clover — Medicare Advantage: $12,886.21 Eon Health — Medicare Advantage: $12,886.21 Georgia Health Advantage — Medicare Advantage: $12,633.54 Humana — Medicare Advantage: $12,633.54 Pruitt Health — Medicare Advantage: $12,633.54
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$148.07 – $2,575.09
Shoulder arthroscopy: shaving of shoulder bone: 10 of 18 insurance plan rates Aetna — HMO/POS: $2,144.38 Aetna — Medicare Advantage: $148.07 Aetna — PPO: $2,234.48 Alliant — Solocare: $177.68 Ambetter — Managed Medicaid: $199.89 Anthem — Medicare Advantage: $148.07 Care Source — Medicare Advantage: $151.03 Cigna — Commercial: $2,069.93 Clover — Medicare Advantage: $151.03 Eon Health — Medicare Advantage: $151.03
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	$148.07 – $5,479
Shoulder arthroscopy: shaving of shoulder bone: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $149.55 Alliant — Solocare: $4,421.47 Anthem — Medicare Advantage: $148.07 Care Source — Medicare Advantage: $151.03 Clover — Medicare Advantage: $151.03 Eon Health — Medicare Advantage: $151.03 Georgia Health Advantage — Medicare Advantage: $148.07 Humana — Medicare Advantage: $148.07 Pruitt Health — Medicare Advantage: $148.07 United Healthcare — Commercial: $5,479
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$498.75 – $2,187.28
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 18 insurance plan rates Aetna — HMO/POS: $1,714.06 Aetna — Medicare Advantage: $498.75 Aetna — PPO: $1,786.08 Alliant — Solocare: $598.50 Ambetter — Managed Medicaid: $673.31 Anthem — Medicare Advantage: $498.75 Care Source — Medicare Advantage: $508.73 Cigna — Commercial: $1,654.56 Clover — Medicare Advantage: $508.73 Eon Health — Medicare Advantage: $508.73
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$3,219.72 – $7,667
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $3,251.92 Alliant — Solocare: $4,421.47 Anthem — HMO: $4,144.37 Anthem — Medicare Advantage: $3,219.72 Care Source — Medicare Advantage: $3,284.11 Clover — Medicare Advantage: $3,284.11 Eon Health — Medicare Advantage: $3,284.11 Georgia Health Advantage — Medicare Advantage: $3,219.72 Humana — Medicare Advantage: $3,219.72 Pruitt Health — Medicare Advantage: $3,219.72
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$253.43 – $859.71
Removal of tonsils and adenoids (under age 12): 10 of 18 insurance plan rates Aetna — HMO/POS: $599.76 Aetna — Medicare Advantage: $253.43 Aetna — PPO: $624.96 Alliant — Solocare: $304.12 Ambetter — Managed Medicaid: $342.13 Anthem — Medicare Advantage: $253.43 Care Source — Medicare Advantage: $258.50 Cigna — Commercial: $578.94 Clover — Medicare Advantage: $258.50 Eon Health — Medicare Advantage: $258.50
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	$4,020.37 – $6,575
Removal of tonsils and adenoids (under age 12): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $5,883.49 Alliant — Solocare: $4,020.37 Anthem — HMO: $4,557.85 Anthem — Medicare Advantage: $5,825.24 Care Source — Medicare Advantage: $5,941.74 Clover — Medicare Advantage: $5,941.74 Eon Health — Medicare Advantage: $5,941.74 Georgia Health Advantage — Medicare Advantage: $5,825.24 Humana — Medicare Advantage: $5,825.24 Pruitt Health — Medicare Advantage: $5,825.24
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$108.38 – $574.75
Upper GI endoscopy (diagnostic): 10 of 18 insurance plan rates Aetna — HMO/POS: $464.10 Aetna — Medicare Advantage: $108.38 Aetna — PPO: $483.60 Alliant — Solocare: $130.06 Ambetter — Managed Medicaid: $146.31 Anthem — Medicare Advantage: $108.38 Care Source — Medicare Advantage: $110.55 Cigna — Commercial: $447.99 Clover — Medicare Advantage: $110.55 Eon Health — Medicare Advantage: $110.55
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	$892.49 – $5,479
Upper GI endoscopy (diagnostic): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $901.42 Alliant — Solocare: $2,283.77 Anthem — HMO: $2,247.86 Anthem — Medicare Advantage: $892.49 Care Source — Medicare Advantage: $910.34 Clover — Medicare Advantage: $910.34 Eon Health — Medicare Advantage: $910.34 Georgia Health Advantage — Medicare Advantage: $892.49 Humana — Medicare Advantage: $892.49 Pruitt Health — Medicare Advantage: $892.49
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$121.35 – $645.05
Upper GI endoscopy with biopsy: 10 of 18 insurance plan rates Aetna — HMO/POS: $535.50 Aetna — Medicare Advantage: $121.35 Aetna — PPO: $558 Alliant — Solocare: $145.62 Ambetter — Managed Medicaid: $163.82 Anthem — Medicare Advantage: $121.35 Care Source — Medicare Advantage: $123.78 Cigna — Commercial: $516.91 Clover — Medicare Advantage: $123.78 Eon Health — Medicare Advantage: $123.78
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	$892.49 – $5,479
Upper GI endoscopy with biopsy: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $901.42 Alliant — Solocare: $2,283.77 Anthem — HMO: $2,247.86 Anthem — Medicare Advantage: $892.49 Care Source — Medicare Advantage: $910.34 Clover — Medicare Advantage: $910.34 Eon Health — Medicare Advantage: $910.34 Georgia Health Advantage — Medicare Advantage: $892.49 Humana — Medicare Advantage: $892.49 Pruitt Health — Medicare Advantage: $892.49
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$162.46 – $822.38
Colonoscopy (diagnostic): 10 of 18 insurance plan rates Aetna — HMO/POS: $642.60 Aetna — Medicare Advantage: $162.46 Aetna — PPO: $669.60 Alliant — Solocare: $194.95 Ambetter — Managed Medicaid: $219.32 Anthem — Medicare Advantage: $162.46 Care Source — Medicare Advantage: $165.71 Cigna — Commercial: $620.29 Clover — Medicare Advantage: $165.71 Eon Health — Medicare Advantage: $165.71
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	$915.10 – $5,479
Colonoscopy (diagnostic): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $924.25 Alliant — Solocare: $2,283.77 Anthem — HMO: $2,247.86 Anthem — Medicare Advantage: $915.10 Care Source — Medicare Advantage: $933.40 Clover — Medicare Advantage: $933.40 Eon Health — Medicare Advantage: $933.40 Georgia Health Advantage — Medicare Advantage: $915.10 Humana — Medicare Advantage: $915.10 Pruitt Health — Medicare Advantage: $915.10
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$81.43 – $109.93
Colonoscopy (diagnostic): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $81.43 Alliant — Solocare: $97.72 Ambetter — Managed Medicaid: $109.93 Anthem — Medicare Advantage: $81.43 Care Source — Medicare Advantage: $83.06 Clover — Medicare Advantage: $83.06 Eon Health — Medicare Advantage: $83.06 Georgia Health Advantage — Medicare Advantage: $81.43 Humana — Medicare Advantage: $81.43 Pruitt Health — Medicare Advantage: $85.50
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$175.23 – $920.20
Colonoscopy with biopsy: 10 of 18 insurance plan rates Aetna — HMO/POS: $725.90 Aetna — Medicare Advantage: $175.23 Aetna — PPO: $756.40 Alliant — Solocare: $210.28 Ambetter — Managed Medicaid: $236.56 Anthem — Medicare Advantage: $175.23 Care Source — Medicare Advantage: $178.73 Cigna — Commercial: $700.70 Clover — Medicare Advantage: $178.73 Eon Health — Medicare Advantage: $178.73
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	$1,177.52 – $5,479
Colonoscopy with biopsy: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $1,189.30 Alliant — Solocare: $2,283.77 Anthem — HMO: $2,354.21 Anthem — Medicare Advantage: $1,177.52 Care Source — Medicare Advantage: $1,201.07 Clover — Medicare Advantage: $1,201.07 Eon Health — Medicare Advantage: $1,201.07 Georgia Health Advantage — Medicare Advantage: $1,177.52 Humana — Medicare Advantage: $1,177.52 Pruitt Health — Medicare Advantage: $1,177.52
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$220.52 – $1,253.46
Colonoscopy with removal of polyps (snare): 10 of 18 insurance plan rates Aetna — HMO/POS: $928.20 Aetna — Medicare Advantage: $220.52 Aetna — PPO: $967.20 Alliant — Solocare: $264.62 Ambetter — Managed Medicaid: $297.70 Anthem — Medicare Advantage: $220.52 Care Source — Medicare Advantage: $224.93 Cigna — Commercial: $895.97 Clover — Medicare Advantage: $224.93 Eon Health — Medicare Advantage: $224.93
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	$1,177.52 – $5,479
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $1,189.30 Alliant — Solocare: $2,283.77 Anthem — HMO: $2,354.21 Anthem — Medicare Advantage: $1,177.52 Care Source — Medicare Advantage: $1,201.07 Clover — Medicare Advantage: $1,201.07 Eon Health — Medicare Advantage: $1,201.07 Georgia Health Advantage — Medicare Advantage: $1,177.52 Humana — Medicare Advantage: $1,177.52 Pruitt Health — Medicare Advantage: $1,177.52
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$222.92 – $432.20
Ultrasound of the lower bowel by endoscope: 10 of 17 insurance plan rates Aetna — HMO/POS: $326.20 Aetna — Medicare Advantage: $222.92 Aetna — PPO: $339.91 Alliant — Solocare: $267.50 Ambetter — Managed Medicaid: $300.94 Anthem — Medicare Advantage: $222.92 Care Source — Medicare Advantage: $227.38 Cigna — Commercial: $314.88 Clover — Medicare Advantage: $227.38 Eon Health — Medicare Advantage: $227.38
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	$1,177.52 – $5,479
Ultrasound of the lower bowel by endoscope: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $1,189.30 Alliant — Solocare: $2,283.77 Anthem — HMO: $2,354.21 Anthem — Medicare Advantage: $1,177.52 Care Source — Medicare Advantage: $1,201.07 Clover — Medicare Advantage: $1,201.07 Eon Health — Medicare Advantage: $1,201.07 Georgia Health Advantage — Medicare Advantage: $1,177.52 Humana — Medicare Advantage: $1,177.52 Pruitt Health — Medicare Advantage: $1,177.52
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$162.86 – $259.69
Screening colonoscopy (not high risk): 10 of 13 insurance plan rates Aetna — Medicare Advantage: $162.86 Alliant — Solocare: $195.43 Ambetter — Managed Medicaid: $219.86 Anthem — Medicare Advantage: $162.86 Care Source — Medicare Advantage: $166.12 Clover — Medicare Advantage: $166.12 Eon Health — Medicare Advantage: $166.12 Georgia Health Advantage — Medicare Advantage: $162.86 Humana — HMO/POS: $259.69 Humana — Medicare Advantage: $162.86
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	$915.10 – $5,479
Screening colonoscopy (not high risk): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $924.25 Alliant — Solocare: $2,180.59 Anthem — HMO: $2,247.86 Anthem — Medicare Advantage: $915.10 Care Source — Medicare Advantage: $933.40 Clover — Medicare Advantage: $933.40 Eon Health — Medicare Advantage: $933.40 Georgia Health Advantage — Medicare Advantage: $915.10 Humana — Medicare Advantage: $915.10 Pruitt Health — Medicare Advantage: $915.10
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$81.43 – $109.93
Screening colonoscopy (not high risk): 10 of 11 insurance plan rates Aetna — Medicare Advantage: $81.43 Alliant — Solocare: $97.72 Ambetter — Managed Medicaid: $109.93 Anthem — Medicare Advantage: $81.43 Care Source — Medicare Advantage: $83.06 Clover — Medicare Advantage: $83.06 Eon Health — Medicare Advantage: $83.06 Georgia Health Advantage — Medicare Advantage: $81.43 Humana — Medicare Advantage: $81.43 Pruitt Health — Medicare Advantage: $85.50
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$627.28 – $1,480.31
Gallbladder removal by laparoscope: 10 of 17 insurance plan rates Aetna — HMO/POS: $1,258.18 Aetna — Medicare Advantage: $627.28 Aetna — PPO: $1,311.04 Alliant — Solocare: $752.74 Ambetter — Managed Medicaid: $846.83 Anthem — Medicare Advantage: $627.28 Care Source — Medicare Advantage: $639.83 Cigna — Commercial: $1,214.50 Clover — Medicare Advantage: $639.83 Eon Health — Medicare Advantage: $639.83
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	$2,191.03 – $10,955
Gallbladder removal by laparoscope: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $6,008.42 Alliant — Solocare: $2,191.03 Anthem — HMO: $6,505.75 Anthem — Medicare Advantage: $5,948.93 Care Source — Medicare Advantage: $6,067.91 Clover — Medicare Advantage: $6,067.91 Eon Health — Medicare Advantage: $6,067.91 Georgia Health Advantage — Medicare Advantage: $5,948.93 Humana — Medicare Advantage: $5,948.93 Pruitt Health — Medicare Advantage: $5,948.93
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$7,456	$3,728	$1,316 – $6,337.60
Groin (inguinal) hernia repair, age 5 or older: 10 of 21 insurance plan rates Aetna — HMO/POS: $5,741.12 Aetna — Medicare Advantage: $3,558.42 Aetna — PPO: $6,188.48 Ambetter — Managed Medicaid: $2,236.80 Anthem — Medicare Advantage: $3,523.19 Care Source — Medicare Advantage: $3,593.65 Cigna — Commercial: $5,741.12 Clover — Medicare Advantage: $3,593.65 Eon Health — Medicare Advantage: $3,593.65 Georgia Health Advantage — Medicare Advantage: $3,523.19
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ER RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$7,456	$3,728	$3,802.56 – $6,337.60
Groin (inguinal) hernia repair, age 5 or older: rates for 10 insurance plans Aetna — HMO/POS: $5,741.12 Aetna — PPO: $6,188.48 Ambetter — Managed Medicaid: $3,802.56 Cigna — Commercial: $5,741.12 Humana — HMO/POS: $6,337.60 Humana — PPO: $6,337.60 Multiplan — PHO Agreement Complimentary Network: $5,964.80 Multiplan — PHO Agreement Primary Network: $4,846.40 Novanet — Commercial: $5,964.80 Three Rivers Provider Network — Commercial: $6,337.60
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$501.69 – $1,197.87
Groin (inguinal) hernia repair, age 5 or older: 10 of 18 insurance plan rates Aetna — HMO/POS: $868.22 Aetna — Medicare Advantage: $501.69 Aetna — PPO: $904.70 Alliant — Solocare: $602.03 Ambetter — Managed Medicaid: $677.28 Anthem — Medicare Advantage: $501.69 Care Source — Medicare Advantage: $511.72 Cigna — Commercial: $838.08 Clover — Medicare Advantage: $511.72 Eon Health — Medicare Advantage: $511.72
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$315.89 – $385.03
Prostate biopsy: rates for 7 insurance plans Aetna — HMO/POS: $327.25 Aetna — PPO: $341 Cigna — Commercial: $315.89 Humana — HMO/POS: $385.03 Humana — PPO: $385.03 SecureHealth — Commercial: $379.39 United Healthcare — Commercial: $347.45
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	$2,283.77 – $5,479
Prostate biopsy: rates for 3 insurance plans Alliant — Solocare: $2,283.77 Anthem — HMO: $2,354.21 United Healthcare — Commercial: $5,479
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: LAPARO RADICAL PROSTATECTOMY	Not listed in the file	Not listed in the file	$1,072.37 – $4,206.68
Prostate removal by laparoscope (radical prostatectomy): 10 of 17 insurance plan rates Aetna — HMO/POS: $3,575.43 Aetna — Medicare Advantage: $1,072.37 Aetna — PPO: $3,725.65 Alliant — Solocare: $1,286.84 Ambetter — Managed Medicaid: $1,447.70 Anthem — Medicare Advantage: $1,072.37 Care Source — Medicare Advantage: $1,093.82 Cigna — Commercial: $3,451.30 Clover — Medicare Advantage: $1,093.82 Eon Health — Medicare Advantage: $1,093.82
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPARO RADICAL PROSTATECTOMY	Not listed in the file	Not listed in the file	$2,223.96 – $12,049
Prostate removal by laparoscope (radical prostatectomy): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $10,564.58 Alliant — Solocare: $3,430.29 Anthem — HMO: $2,223.96 Anthem — Medicare Advantage: $10,459.99 Care Source — Medicare Advantage: $10,669.18 Clover — Medicare Advantage: $10,669.18 Eon Health — Medicare Advantage: $10,669.18 Georgia Health Advantage — Medicare Advantage: $10,459.99 Humana — Medicare Advantage: $10,459.99 Pruitt Health — Medicare Advantage: $10,459.99
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$204.23 – $2,436.20
Hysteroscopy with biopsy of the uterus lining: 10 of 17 insurance plan rates Aetna — HMO/POS: $516.51 Aetna — Medicare Advantage: $204.23 Aetna — PPO: $538.21 Alliant — Solocare: $245.08 Ambetter — Managed Medicaid: $275.71 Anthem — Medicare Advantage: $204.23 Care Source — Medicare Advantage: $208.31 Cigna — Commercial: $498.58 Clover — Medicare Advantage: $208.31 Eon Health — Medicare Advantage: $208.31
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	$2,354.21 – $6,575
Hysteroscopy with biopsy of the uterus lining: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $3,217.26 Alliant — Solocare: $4,020.37 Anthem — HMO: $2,354.21 Anthem — Medicare Advantage: $3,185.40 Care Source — Medicare Advantage: $3,249.11 Clover — Medicare Advantage: $3,249.11 Eon Health — Medicare Advantage: $3,249.11 Georgia Health Advantage — Medicare Advantage: $3,185.40 Humana — Medicare Advantage: $3,185.40 Pruitt Health — Medicare Advantage: $3,185.40
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$694.60 – $5,479
Spinal injection, lower back (epidural), with imaging guidance: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $701.55 Alliant — Solocare: $4,405.24 Anthem — HMO: $2,247.86 Anthem — Medicare Advantage: $694.60 Care Source — Medicare Advantage: $708.49 Clover — Medicare Advantage: $708.49 Eon Health — Medicare Advantage: $708.49 Georgia Health Advantage — Medicare Advantage: $694.60 Humana — Medicare Advantage: $694.60 Pruitt Health — Medicare Advantage: $694.60
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$87.60 – $118.26
Spinal injection, lower back (epidural), with imaging guidance: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $87.60 Alliant — Solocare: $105.12 Ambetter — Managed Medicaid: $118.26 Anthem — Medicare Advantage: $87.60 Care Source — Medicare Advantage: $89.35 Clover — Medicare Advantage: $89.35 Eon Health — Medicare Advantage: $89.35 Georgia Health Advantage — Medicare Advantage: $87.60 Humana — Medicare Advantage: $87.60 Pruitt Health — Medicare Advantage: $91.98
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$97.16 – $560.11
Nerve root injection, lower back, with imaging guidance: 10 of 17 insurance plan rates Aetna — HMO/POS: $476.06 Aetna — Medicare Advantage: $97.16 Aetna — PPO: $496.06 Alliant — Solocare: $116.59 Ambetter — Managed Medicaid: $131.17 Anthem — Medicare Advantage: $97.16 Care Source — Medicare Advantage: $99.10 Cigna — Commercial: $459.53 Clover — Medicare Advantage: $99.10 Eon Health — Medicare Advantage: $99.10
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$870.34 – $5,479
Nerve root injection, lower back, with imaging guidance: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $879.04 Alliant — Solocare: $2,180.59 Anthem — HMO: $2,247.86 Anthem — Medicare Advantage: $870.34 Care Source — Medicare Advantage: $887.75 Clover — Medicare Advantage: $887.75 Eon Health — Medicare Advantage: $887.75 Georgia Health Advantage — Medicare Advantage: $870.34 Humana — Medicare Advantage: $870.34 Pruitt Health — Medicare Advantage: $870.34
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$404.90 – $1,736.26
Carpal tunnel release: 10 of 18 insurance plan rates Aetna — HMO/POS: $1,181.13 Aetna — Medicare Advantage: $404.90 Aetna — PPO: $1,230.76 Alliant — Solocare: $485.88 Ambetter — Managed Medicaid: $546.62 Anthem — Medicare Advantage: $404.90 Care Source — Medicare Advantage: $413 Cigna — Commercial: $1,140.13 Clover — Medicare Advantage: $413 Eon Health — Medicare Advantage: $413
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	$1,921.52 – $6,575
Carpal tunnel release: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $1,940.74 Alliant — Solocare: $4,020.37 Anthem — HMO: $2,354.21 Anthem — Medicare Advantage: $1,921.52 Care Source — Medicare Advantage: $1,959.95 Clover — Medicare Advantage: $1,959.95 Eon Health — Medicare Advantage: $1,959.95 Georgia Health Advantage — Medicare Advantage: $1,921.52 Humana — Medicare Advantage: $1,921.52 Pruitt Health — Medicare Advantage: $1,921.52
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$260.02 – $689.04
Laser treatment of clouding after cataract surgery: 10 of 18 insurance plan rates Aetna — HMO/POS: $437.98 Aetna — Medicare Advantage: $260.02 Aetna — PPO: $456.38 Alliant — Solocare: $312.02 Ambetter — Managed Medicaid: $351.03 Anthem — Medicare Advantage: $260.02 Care Source — Medicare Advantage: $265.22 Cigna — Commercial: $525.30 Clover — Medicare Advantage: $265.22 Eon Health — Medicare Advantage: $265.22
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$541.21 – $5,479
Laser treatment of clouding after cataract surgery: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $546.62 Alliant — Solocare: $2,180.59 Anthem — HMO: $2,247.86 Anthem — Medicare Advantage: $541.21 Care Source — Medicare Advantage: $552.03 Clover — Medicare Advantage: $552.03 Eon Health — Medicare Advantage: $552.03 Georgia Health Advantage — Medicare Advantage: $541.21 Humana — Medicare Advantage: $541.21 Pruitt Health — Medicare Advantage: $541.21
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$443.92 – $2,332.91
Cataract removal with lens implant: 10 of 18 insurance plan rates Aetna — HMO/POS: $1,608.70 Aetna — Medicare Advantage: $443.92 Aetna — PPO: $1,676.29 Alliant — Solocare: $532.70 Ambetter — Managed Medicaid: $599.29 Anthem — Medicare Advantage: $443.92 Care Source — Medicare Advantage: $452.80 Cigna — Commercial: $1,552.85 Clover — Medicare Advantage: $452.80 Eon Health — Medicare Advantage: $452.80
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	$2,270.95 – $6,575
Cataract removal with lens implant: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $2,293.66 Alliant — Solocare: $4,020.37 Anthem — HMO: $2,354.21 Anthem — Medicare Advantage: $2,270.95 Care Source — Medicare Advantage: $2,316.37 Clover — Medicare Advantage: $2,316.37 Eon Health — Medicare Advantage: $2,316.37 Georgia Health Advantage — Medicare Advantage: $2,270.95 Humana — Medicare Advantage: $2,270.95 Pruitt Health — Medicare Advantage: $2,270.95

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$2,214.40 – $3,949.86
Vaginal delivery, with care before and after: 10 of 18 insurance plan rates Aetna — HMO/POS: $3,114 Aetna — Medicare Advantage: $2,214.40 Aetna — PPO: $2,914 Alliant — Solocare: $2,657.28 Ambetter — Managed Medicaid: $2,989.44 Anthem — Medicare Advantage: $2,214.40 Care Source — Medicare Advantage: $2,258.69 Cigna — Commercial: $2,699.41 Clover — Medicare Advantage: $2,258.69 Eon Health — Medicare Advantage: $2,258.69
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	$2,214.40 – $4,405.24
Vaginal delivery, with care before and after: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $2,236.54 Alliant — Solocare: $4,405.24 Anthem — HMO: $4,144.37 Anthem — Medicare Advantage: $2,214.40 Care Source — Medicare Advantage: $2,258.69 Clover — Medicare Advantage: $2,258.69 Eon Health — Medicare Advantage: $2,258.69 Georgia Health Advantage — Medicare Advantage: $2,214.40 Humana — Medicare Advantage: $2,214.40 Pruitt Health — Medicare Advantage: $2,214.40
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$2,484.56 – $4,453.61
Cesarean delivery (C-section), with care before and after: 10 of 18 insurance plan rates Aetna — HMO/POS: $3,335 Aetna — Medicare Advantage: $2,484.56 Aetna — PPO: $3,142.78 Alliant — Solocare: $2,981.47 Ambetter — Managed Medicaid: $3,354.16 Anthem — Medicare Advantage: $2,484.56 Care Source — Medicare Advantage: $2,534.25 Cigna — Commercial: $2,911.34 Clover — Medicare Advantage: $2,534.25 Eon Health — Medicare Advantage: $2,534.25
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	$2,484.56 – $4,405.24
Cesarean delivery (C-section), with care before and after: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $2,509.40 Alliant — Solocare: $4,405.24 Anthem — HMO: $4,144.37 Anthem — Medicare Advantage: $2,484.56 Care Source — Medicare Advantage: $2,534.25 Clover — Medicare Advantage: $2,534.25 Eon Health — Medicare Advantage: $2,534.25 Georgia Health Advantage — Medicare Advantage: $2,484.56 Humana — Medicare Advantage: $2,484.56 Pruitt Health — Medicare Advantage: $2,484.56
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$2,343.29 – $5,420.48
Vaginal delivery after a previous C-section, with care before and after: 10 of 18 insurance plan rates Aetna — HMO/POS: $3,626 Aetna — Medicare Advantage: $2,343.29 Aetna — PPO: $3,441.62 Alliant — Solocare: $2,811.95 Ambetter — Managed Medicaid: $3,163.44 Anthem — Medicare Advantage: $2,343.29 Care Source — Medicare Advantage: $2,390.16 Cigna — Commercial: $3,188.18 Clover — Medicare Advantage: $2,390.16 Eon Health — Medicare Advantage: $2,390.16
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	$2,343.29 – $4,405.24
Vaginal delivery after a previous C-section, with care before and after: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $2,366.72 Alliant — Solocare: $4,405.24 Anthem — HMO: $4,144.37 Anthem — Medicare Advantage: $2,343.29 Care Source — Medicare Advantage: $2,390.15 Clover — Medicare Advantage: $2,390.15 Eon Health — Medicare Advantage: $2,390.15 Georgia Health Advantage — Medicare Advantage: $2,343.29 Humana — Medicare Advantage: $2,343.29 Pruitt Health — Medicare Advantage: $2,343.29

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	$76,656.16 – $171,463.14
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $77,422.72 Anthem — Medicare Advantage: $76,656.16 Care Source — Medicare Advantage: $78,189.28 Clover — Medicare Advantage: $78,189.28 Eon Health — Medicare Advantage: $78,189.28 Georgia Health Advantage — Medicare Advantage: $76,656.16 Humana — Medicare Advantage: $76,656.16 Pruitt Health — Medicare Advantage: $76,656.16 SecureHealth — Commercial: $136,098.31 United Healthcare — Commercial: $171,463.14
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	$17,362.93 – $33,807.83
Hip or knee replacement (major joint of the leg), without major complications: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $17,536.56 Anthem — Medicare Advantage: $17,362.93 Care Source — Medicare Advantage: $17,710.19 Clover — Medicare Advantage: $17,710.19 Eon Health — Medicare Advantage: $17,710.19 Georgia Health Advantage — Medicare Advantage: $17,362.93 Humana — Medicare Advantage: $17,362.93 Pruitt Health — Medicare Advantage: $17,362.93 SecureHealth — Commercial: $26,834.86 United Healthcare — Commercial: $33,807.83
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	$21,231.31 – $42,788.67
Neck (cervical) spinal fusion, without complications: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $21,443.62 Anthem — Medicare Advantage: $21,231.31 Care Source — Medicare Advantage: $21,655.94 Clover — Medicare Advantage: $21,655.94 Eon Health — Medicare Advantage: $21,655.94 Georgia Health Advantage — Medicare Advantage: $21,231.31 Humana — Medicare Advantage: $21,231.31 Pruitt Health — Medicare Advantage: $21,231.31 SecureHealth — Commercial: $33,963.37 United Healthcare — Commercial: $42,788.67
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	$12,167.34 – $21,745.75
Uterus and ovary surgery (not for cancer), without complications: 10 of 11 insurance plan rates Aetna — Medicare Advantage: $12,289.01 Anthem — Medicare Advantage: $12,167.34 Care Source — Medicare Advantage: $12,410.69 Clover — Medicare Advantage: $12,410.69 Eon Health — Medicare Advantage: $12,410.69 Georgia Health Advantage — Medicare Advantage: $12,167.34 Humana — Medicare Advantage: $12,167.34 Pruitt Health — Medicare Advantage: $12,167.34 SecureHealth — Commercial: $17,260.62 United Healthcare — Commercial: $21,745.75

Source: Navicent Health Baldwin’s standard charges file (sthpiprd.blob.core.windows.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on October 30, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	821 North Cobb Street, Milledgeville, GA 31061
County	Baldwin County
State	Georgia
Phone	(478) 454‑3550
Emergency services	Yes
Ownership	Proprietary
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	110150
Name in Medicare records	NAVICENT HEALTH BALDWIN
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(478) 776‑4000^[4]
Name on the hospital’s website	Atrium Health Navicent Baldwin
Official website	navicenthealth.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.

Atrium Health Navicent Baldwin — navicenthealth.org
Services - Atrium Health Navicent Baldwin — navicenthealth.org
Interpreting Services — navicenthealth.org
Visitor Information: Atrium Health Navicent Baldwin | Atrium Health Navicent — navicenthealth.org
Atrium Health Navicent Peyton Anderson Cancer Center | Macon, GA — navicenthealth.org

Navicent Health Baldwin

Summary

Profile from official sources

At a glance