Does Northwestern Memorial Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Northwestern Memorial Hospital. In a medical emergency, call 911.

Where is Northwestern Memorial Hospital?

251 E Huron St, Chicago, IL 60611, in Cook County, Illinois.

What is the phone number of Northwestern Memorial Hospital?

(312) 926-2000, as listed by Medicare (CMS).

What is the Medicare star rating of Northwestern Memorial Hospital?

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

Northwestern Memorial Hospital — Chicago, IL

Quick answers

Does Northwestern Memorial Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Northwestern Memorial Hospital. In a medical emergency, call 911.
Where is Northwestern Memorial Hospital?: 251 E Huron St, Chicago, IL 60611, in Cook County, Illinois.
What is the phone number of Northwestern Memorial Hospital?: (312) 926-2000, as listed by Medicare (CMS).
What is the Medicare star rating of Northwestern Memorial Hospital?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][6][7]

Allergy and Immunology
Behavioral Health
Cancer Care
Cardiovascular Care
Clinical Genetics
Dermatology
Diabetes
Ear, Nose and Throat
Emergency Medicine
Gastroenterology
Hematology
Imaging Services
Infectious Disease
Integrative Medicine
Nephrology
Neurosciences
Nutrition
Ophthalmology
Organ Transplantation
Orthopaedics
Pain Management
Pediatrics
Primary Care
Pulmonary
Rheumatology
Surgical Services
Travel Medicine
Urology
Weight Management
Women's Health
Wound Care
Cardiac Surgery
Geriatrics
Radiation Oncology

Conditions treated^[10][13]

Acute and chronic kidney failure
Electrolyte and acid base problems
Glomerular disease
Hypertension
Kidney disease
Proteinuria
Varicose veins
Spider veins
Deep vein thrombosis (DVT)
Vein related leg pain
Pelvic congestion syndrome
Vascular malformations

Treatments^[13]

Endovenous laser vein ablation
Microphlebectomy
Sclerotherapy

Programs and centers^{[7][8][9][10][13]}

Lou and Jean Malnati Brain Tumor Institute
Low Grade Glioma Program
Von Hippel-Lindau Program
Sleep Laboratory
Vein Center
Lung Transplant Program
Mathews Center for Cellular Therapy
Nephrology and Hypertension Program
Norman and Ida Stone Institute of Psychiatry (inpatient)

Emergency care (hospital website)^[4][5]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level I
Stroke designation	Certified stroke center

Visiting and practical information

Visiting	Visiting hours 8 a.m.-8 p.m. daily^[4]
Parking	Discounted rates with validation: up to 7 hours $15, 7 to 24 hours $32^[4]
Interpreters and languages	Language interpreters are available through accessibility resources^[4]
Patient portal	MyNM Patient Portal

Recognition^[4][11]

U.S. News & World Report: No. 1 in Illinois for 15 straight years (2026-2027)
Magnet Recognition (ANCC)
U.S. News & World Report Best Hospitals Honor Roll; No. 1 in Illinois for 15 straight years 2026

Doctors and clinicians (3,399)

3,399 doctors and other clinicians list Northwestern Memorial Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Nurse Practitioner416
Physician Assistant382
Internal Medicine366
Diagnostic Radiology209
Hospitalist186
Family Practice156
Anesthesiology121
Obstetrics/Gynecology109
Certified Registered Nurse Anesthetist (CRNA)100
Cardiovascular Disease (Cardiology)97
Emergency Medicine91
Neurology85

Doctors with a page on this site (3,399)

A Charlotta Weaver, MDHospitalist
Aakar M. Shah, DOFamily Practice
Aamir Ahmed, MDCardiovascular Disease (Cardiology)
Aarati D. Didwania, MDInternal Medicine
Aaron A. Hart, MDInternal Medicine
Aaron C. DavisCertified Registered Nurse Anesthetist (CRNA)
Aaron Cohn, MDGastroenterology
Aaron D. ManshaemPhysician Assistant
Aaron Gilbert, MDPhysical Medicine and Rehabilitation
Aaron J. Clark, MDThoracic Surgery
Aaron M. Wibberley, MDEmergency Medicine
Aaron R. Landis, MDHospitalist
Aaron S. Epstein, MDEmergency Medicine
Aaron S. Reynolds, MDAnesthesiology
Aaron Smith, MDAnesthesiology
Aaron W. PoindexterCertified Registered Nurse Anesthetist (CRNA)
Aasheeta A. BawaPhysician Assistant
Aashish K. Didwania, MDInternal Medicine
Aashutos S. Patel, MDHospitalist
Abbas Al-Qamari, MDAnesthesiology
Abbas F. Alsaraf, MDFamily Practice
Abbi PlaczekNurse Practitioner
Abbie H. Roth, MDObstetrics/Gynecology
Abby N. Agulnek, MDHospitalist

And 3,375 more: the button below opens the full list.

Other emergency rooms nearby

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

Ann & Robert H Lurie Childrens Hospital of Chicago0.1 mi · Chicago, IL · Children's Hospital
Presence Saint Joseph Hospital - Chicago2.8 mi · Chicago, IL · Acute Care Hospital
John H Stroger Jr Hospital3.1 mi · Chicago, IL · Acute Care Hospital
University of Illinois Hospital and Clinics3.1 mi · Chicago, IL · Acute Care Hospital
Presence Saints Mary and Elizabeth Medical Center3.2 mi · Chicago, IL · Acute Care Hospital

Other hospitals nearby

Shirley Ryan Abilitylab0.1 mi · Chicago, IL · Inpatient Rehabilitation Hospital
Rush Specialty Hospital, LLC2.2 mi · Chicago, IL · Long-Term Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Terraces at the Clare0.3 mi · Chicago, IL · 5 of 5 stars
Warren Barr Gold Coast0.6 mi · Chicago, IL · 4 of 5 stars
Warren Barr South Loop2.5 mi · Chicago, IL · 1 of 5 stars

All nursing homes in the state →

Outpatient surgery centers nearby

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

River North Same Day Surgery LLC0.3 mi · Chicago, IL
Surgery Ctr at 900 N Michigan0.3 mi · Chicago, IL
Gold Coast Surgicenter, LLC0.7 mi · Chicago, IL

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

LCHC at Fourth Presbyterian - Chicago Lights0.3 mi · Chicago, IL · Community health center
Denny Community Health Center0.3 mi · Chicago, IL · Community health center
Winfield Moody Health Center1.3 mi · Chicago, IL · Community health center

Clinics and urgent care

Midwest Express Care 2, Inc0.8 mi · Chicago, IL · Urgent care center
Medin Medical Services PLLC1.2 mi · Chicago, IL · Urgent care center
Midwest Express Care 2, Inc1.4 mi · Chicago, IL · Urgent care center

Pharmacies

Blue Fig LLC0.3 mi · Chicago, IL · Community/retail pharmacy
Highland Park CVS LLC0.3 mi · Chicago, IL · Pharmacy
Northwestern Memorial Hospital0.3 mi · Chicago, IL · 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 Northwestern Memorial Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

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

Summary star rating (all survey topics)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	77%National average: 72%
Would definitely recommend the hospital	81%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	79%National average: 80%
Staff “always” explained medicines before giving them	60%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	66%National average: 74%
Area around the room “always” quiet at night	63%National average: 60%
Completed surveys	2,820Response rate: 23%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0.828No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.609Better than the national benchmark
Surgical site infections after colon surgery	0.897No different from the national benchmark
Surgical site infections after abdominal hysterectomy	0No different from the national benchmark
MRSA bloodstream infections	0.742No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.392Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	10.1%
Deaths within 30 days: heart failure patients	5.7%
Deaths within 30 days: pneumonia patients	7.9%
Deaths within 30 days: COPD patients	7.4%
Deaths within 30 days: stroke patients	8.5%
Deaths within 30 days: coronary bypass surgery (CABG)	2%
Serious complications (patient safety indicator PSI-90)	0.74Better than the national rate
Complications after hip or knee replacement	3.9%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.5%
Readmitted within 30 days: heart failure	19.6%
Readmitted within 30 days: pneumonia	17.7%
Readmitted within 30 days: COPD	21.5%
Readmitted within 30 days: coronary bypass surgery	11%
Readmitted within 30 days: hip or knee replacement	5.6%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	350 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	10%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	50%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 Chicago Best hospitals in Chicago

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 77 common services exactly as Northwestern Memorial Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

$ 4 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: HB Office/Outpatient Visit New Level 3	$543	$380.10	$105.34 – $543
New patient office visit (about 30–44 minutes): 10 of 38 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $173.76 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $191.68 AETNA HEALTH PLAN [171] — NMH AETNA BP: $162.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $105.34 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $146.61 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $543 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $244.35 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $543 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $244.35 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $271.50
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: HB Office/Outpatient Visit New Level 4	$626	$438.20	$121.44 – $626
New patient office visit (about 45–59 minutes): 10 of 38 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $200.32 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $220.98 AETNA HEALTH PLAN [171] — NMH AETNA BP: $187.80 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $121.44 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $169.02 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $626 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $281.70 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $626 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $281.70 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $313
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: HB Office/Outpatient Visit New Level 5	$915	$640.50	$177.51 – $915
New patient office visit (about 60–74 minutes): 10 of 38 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $292.80 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $323 AETNA HEALTH PLAN [171] — NMH AETNA BP: $274.50 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $177.51 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $247.05 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $915 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $411.75 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $915 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $411.75 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $457.50
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: HB Office/Outpatient Visit Established Level 3	$416	$291.20	$80.70 – $416
Established patient office visit (about 20–29 minutes): 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $133.12 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $146.85 AETNA HEALTH PLAN [171] — NMH AETNA BP: $124.80 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $80.70 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $112.32 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $416 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $187.20 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $416 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $187.20 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $208
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Hcpf Established Patient Level 3 Bh	$216	$151.20	$41.90 – $216
Established patient office visit (about 20–29 minutes): 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $69.12 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $76.25 AETNA HEALTH PLAN [171] — NMH AETNA BP: $64.80 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $41.90 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $58.32 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $216 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $97.20 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $216 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $97.20 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $108
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: HB Office/Outpatient Visit Established Level 4	$569	$398.30	$110.39 – $569
Established patient office visit (about 30–39 minutes): 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $182.08 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $200.86 AETNA HEALTH PLAN [171] — NMH AETNA BP: $170.70 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $110.39 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $153.63 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $569 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $256.05 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $569 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $256.05 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $284.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Hcpf Established Patient Level 4 Bh	$235	$164.50	$45.59 – $235
Established patient office visit (about 30–39 minutes): 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $75.20 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $82.96 AETNA HEALTH PLAN [171] — NMH AETNA BP: $70.50 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $45.59 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $63.45 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $235 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $105.75 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $235 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $105.75 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $117.50
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HB ED Visit Level 3	$1,924	$1,346.80	$373.26 – $1,924
Emergency room visit (moderate): 10 of 36 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $615.68 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $679.17 AETNA HEALTH PLAN [171] — NMH AETNA BP: $577.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $373.26 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $519.48 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $1,924 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $865.80 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $1,924 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $865.80 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $962
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HB ED Visit Level 4	$5,784.50	$4,049.15	$796 – $3,026
Emergency room visit (moderately high): 10 of 38 insurance plan rates CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $796 UNITED HEALTHCARE [158] — NMH UHC: $3,026 UNITED HEALTHCARE [158] — NMH UHC CORE: $2,723 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HB ED Visit Level 5	$14,401.50	$10,081.05	$796 – $3,026
Emergency room visit (high): 10 of 38 insurance plan rates CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $796 UNITED HEALTHCARE [158] — NMH UHC: $3,026 UNITED HEALTHCARE [158] — NMH UHC CORE: $2,723 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount)

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: HB Bmp With Bun/Creat Ratio	$314	$219.80	$60.92 – $314
Basic metabolic panel (blood test): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $110.84 AETNA HEALTH PLAN [171] — NMH AETNA BP: $94.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $60.92 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $84.78 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $314 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $141.30 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $314 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $141.30 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $157 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $251.20
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: HB Basic Metabolic Panel	$314	$219.80	$60.92 – $314
Basic metabolic panel (blood test): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $110.84 AETNA HEALTH PLAN [171] — NMH AETNA BP: $94.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $60.92 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $84.78 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $314 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $141.30 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $314 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $141.30 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $157 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $251.20
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: HB Ref Cmp With Bun/Creat Ratio	$438	$306.60	$84.97 – $438
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $154.61 AETNA HEALTH PLAN [171] — NMH AETNA BP: $131.40 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $84.97 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $118.26 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $438 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $197.10 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $438 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $197.10 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $219 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $350.40
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: HB Comprehensive Metabolic Panel	$438	$306.60	$84.97 – $438
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $154.61 AETNA HEALTH PLAN [171] — NMH AETNA BP: $131.40 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $84.97 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $118.26 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $438 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $197.10 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $438 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $197.10 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $219 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $350.40
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: HB Ref Chem-12/Alt (Gva)	$438	$306.60	$84.97 – $438
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $154.61 AETNA HEALTH PLAN [171] — NMH AETNA BP: $131.40 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $84.97 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $118.26 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $438 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $197.10 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $438 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $197.10 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $219 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $350.40
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: HB Ref Lipid Panel (Lc)	$263	$184.10	$51.02 – $263
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $92.84 AETNA HEALTH PLAN [171] — NMH AETNA BP: $78.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $51.02 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $71.01 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $263 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $118.35 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $263 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $118.35 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $131.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $210.40
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: HB Lipid Panel	$263	$184.10	$51.02 – $263
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $92.84 AETNA HEALTH PLAN [171] — NMH AETNA BP: $78.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $51.02 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $71.01 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $263 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $118.35 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $263 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $118.35 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $131.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $210.40
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: HB Lipid Panel, Reflex Ldl-D	$263	$184.10	$51.02 – $263
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $92.84 AETNA HEALTH PLAN [171] — NMH AETNA BP: $78.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $51.02 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $71.01 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $263 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $118.35 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $263 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $118.35 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $131.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $210.40
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: HB Ref Renal Function Panel	$212	$148.40	$41.13 – $212
Kidney function panel: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $74.84 AETNA HEALTH PLAN [171] — NMH AETNA BP: $63.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $41.13 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $57.24 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $212 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $95.40 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $212 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $95.40 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $106 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $169.60
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: HB Renal Function Panel	$397	$277.90	$43.26 – $397
Kidney function panel: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $78.72 AETNA HEALTH PLAN [171] — NMH AETNA BP: $66.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $43.26 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $54.54 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $397 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $107.10 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $397 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $88.20 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $119 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $178.40
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HB Ref Liver Fibrosis Risk Profile, Hepatic Function Panel (Lc)	$172	$120.40	$33.37 – $172
Liver function panel: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $60.72 AETNA HEALTH PLAN [171] — NMH AETNA BP: $51.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $33.37 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $46.44 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $172 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $77.40 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $172 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $77.40 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $86 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $137.60
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HB Hepatic Function Panel	$388	$271.60	$18.72 – $395
Liver function panel: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $84.01 AETNA HEALTH PLAN [171] — NMH AETNA BP: $71.40 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $46.17 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $71.82 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $388 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $177.75 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $388 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $106.65 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $118.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $190.40
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HB Ref Liver Fibrosis, Hepatic Function Panel (Q)	$199	$139.30	$38.61 – $199
Liver function panel: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $70.25 AETNA HEALTH PLAN [171] — NMH AETNA BP: $59.70 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $38.61 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $53.73 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $199 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $89.55 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $199 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $89.55 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $99.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $159.20
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: HB Urinalysis W Microscopic	$132	$92.40	$19.42 – $180
Urine test (automated, with microscope): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $46.60 AETNA HEALTH PLAN [171] — NMH AETNA BP: $39.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $25.61 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $23.22 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $132 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $81 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $180 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $81 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $90 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $105.60
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: HB Ketone, Urine	$84	$58.80	$16.30 – $84
Urine test (automated, with microscope): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $29.65 AETNA HEALTH PLAN [171] — NMH AETNA BP: $25.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $16.30 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $22.68 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $84 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $37.80 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $84 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $37.80 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $42 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $67.20
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: HB Ref Urinalysis W Microscopic (Q)	$200	$140	$24.80 – $200
Urine test (automated, with microscope): 10 of 19 insurance plan rates AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $28.62 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $200 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $90 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $200 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $90 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $53 CIGNA HEALTH PLAN [178] — NMHC NON-CONTRACTED PAYORS: $200 CURAECHOICE [6100] — NMHC CURAECHOICE: $24.80 FIRST HEALTH PLAN [6034] — NMHC NON-CONTRACTED PAYORS: $200 GALAXY HEALTH NETWORK [220] — NMHC NON-CONTRACTED PAYORS: $200
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: HB Specific Gravity, Urine	$49	$34.30	$10.53 – $203
Urine test (manual, without microscope): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $71.66 AETNA HEALTH PLAN [171] — NMH AETNA BP: $60.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $39.38 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $13.23 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $53 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $23.85 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $158 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $23.85 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $26.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $162.40
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: HB Urinalysis Nonauto W/O Scope (POC)	$31	$21.70	$6.01 – $31
Urine test (manual, without microscope): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $10.94 AETNA HEALTH PLAN [171] — NMH AETNA BP: $9.30 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $6.01 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $8.37 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $31 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $13.95 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $31 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $13.95 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $15.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $24.80
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: HB Urine Analysis (POCT)	$31	$21.70	$6.01 – $31
Urine test (manual, without microscope): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $10.94 AETNA HEALTH PLAN [171] — NMH AETNA BP: $9.30 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $6.01 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $8.37 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $31 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $13.95 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $31 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $13.95 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $15.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $24.80
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HB Ref Urinalysis W/O Microscopic	$53	$37.10	$10.28 – $53
Urine test (automated, without microscope): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $18.71 AETNA HEALTH PLAN [171] — NMH AETNA BP: $15.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $10.28 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $14.31 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $53 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $23.85 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $53 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $23.85 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $26.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $42.40
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HB Ketone, Urine	$53	$37.10	$10.28 – $53
Urine test (automated, without microscope): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $18.71 AETNA HEALTH PLAN [171] — NMH AETNA BP: $15.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $10.28 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $14.31 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $53 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $23.85 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $53 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $23.85 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $26.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $42.40
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HB Urinalysis W/O Microscopic	$72	$50.40	$13.97 – $146
Urine test (automated, without microscope): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $25.42 AETNA HEALTH PLAN [171] — NMH AETNA BP: $21.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $13.97 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $19.44 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $146 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $65.70 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $122 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $36 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $40 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $57.60
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HB Prostate Specific Antigen, Diagnostic	$251	$175.70	$38.84 – $327
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $88.60 AETNA HEALTH PLAN [171] — NMH AETNA BP: $75.30 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $48.69 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $66.96 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $251 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $111.60 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $327 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $111.60 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $163.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $200.80
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HB Prostate Specific Antigen, Total	$251	$175.70	$36.97 – $327
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $88.60 AETNA HEALTH PLAN [171] — NMH AETNA BP: $75.30 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $48.69 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $66.96 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $251 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $111.60 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $327 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $111.60 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $98 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $200.80
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HB Ref Psa, Post Prostatectomy�With Hama�Treatment (Q)	$87	$60.90	$15.91 – $253
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $30.71 AETNA HEALTH PLAN [171] — NMH AETNA BP: $26.10 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $16.88 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $18.36 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $253 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $98.10 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $253 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $72.90 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $34 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $69.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HB Ref Newborn Metabolic Screen, Tsh/T4	$232	$162.40	$45.01 – $232
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $81.90 AETNA HEALTH PLAN [171] — NMH AETNA BP: $69.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $45.01 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $62.64 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $232 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $104.40 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $232 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $104.40 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $116 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $185.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HB Ref Thyroid-Stimulating Hormone (Tsh) (Lc)	$232	$162.40	$45.01 – $232
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $81.90 AETNA HEALTH PLAN [171] — NMH AETNA BP: $69.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $45.01 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $62.64 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $232 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $104.40 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $232 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $104.40 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $116 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $185.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HB Ref Tsh With Reflex to Free T4 (Q)	$232	$162.40	$45.01 – $232
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $81.90 AETNA HEALTH PLAN [171] — NMH AETNA BP: $69.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $45.01 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $62.64 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $232 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $104.40 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $232 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $104.40 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $116 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $185.60
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: HB Ref Liver Fibrosis Risk Profile, Cbc W/Diff (Lc)	$112	$78.40	$21.73 – $112
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $39.54 AETNA HEALTH PLAN [171] — NMH AETNA BP: $33.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $21.73 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $30.24 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $112 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $50.40 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $112 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $50.40 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $56 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $89.60
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: HB Ref Anemia Profile B, Cbc (Lc)	$112	$78.40	$21.73 – $112
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $39.54 AETNA HEALTH PLAN [171] — NMH AETNA BP: $33.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $21.73 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $30.24 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $112 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $50.40 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $112 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $50.40 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $56 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $89.60
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: HB Cbc With Differential	$162	$113.40	$22.46 – $197
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $57.19 AETNA HEALTH PLAN [171] — NMH AETNA BP: $48.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $31.43 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $34.83 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $197 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $88.65 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $174 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $78.30 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $98.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $129.60
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HB Cbc	$123	$86.10	$20.12 – $175
Complete blood count (CBC), automated: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $43.42 AETNA HEALTH PLAN [171] — NMH AETNA BP: $36.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $23.86 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $31.86 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $175 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $55.35 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $175 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $55.35 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $87.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $98.40
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HB Ref Cbc (Q)	$93	$65.10	$18.04 – $93
Complete blood count (CBC), automated: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $32.83 AETNA HEALTH PLAN [171] — NMH AETNA BP: $27.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $18.04 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $25.11 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $93 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $41.85 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $93 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $41.85 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $46.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $74.40
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HB Ref Hemoglobinopathy Fractionation Cascade, Cbc (Lc)	$97	$67.90	$18.82 – $97
Complete blood count (CBC), automated: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $34.24 AETNA HEALTH PLAN [171] — NMH AETNA BP: $29.10 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $18.82 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $26.19 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $97 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $43.65 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $97 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $43.65 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $48.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $77.60
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HB Prothrombin Time Mixing Study	$124	$86.80	$17.55 – $124
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $43.77 AETNA HEALTH PLAN [171] — NMH AETNA BP: $37.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $24.06 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $33.48 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $124 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $33.75 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $111 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $33.75 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $37.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $99.20
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HB Prothrombin Time-Inr, Hemochron (POCT)	$39	$27.30	$7.57 – $39
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $13.77 AETNA HEALTH PLAN [171] — NMH AETNA BP: $11.70 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $7.57 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $10.53 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $39 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $17.55 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $39 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $17.55 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $19.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $31.20
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HB Ref Disseminated Intravascular Coagulation (Dic) Profile, Pt (Lc)	$74	$51.80	$14.36 – $74
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $26.12 AETNA HEALTH PLAN [171] — NMH AETNA BP: $22.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $14.36 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $19.98 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $74 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $33.30 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $74 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $33.30 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $37 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $59.20
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HB Lupus Anticoagulant Evaluation Panel, Silica Clotting Time Screen	$161	$112.70	$21.76 – $161
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $56.83 AETNA HEALTH PLAN [171] — NMH AETNA BP: $48.30 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $31.23 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $25.11 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $161 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $49.50 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $110 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $67.95 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $63 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $128.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HB Ref Thrombophilia Profile, Thromboplastin Time Partial (Mayo)	$110	$77	$21.34 – $110
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $38.83 AETNA HEALTH PLAN [171] — NMH AETNA BP: $33 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $21.34 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $29.70 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $110 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $49.50 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $110 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $49.50 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $55 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $88
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HB Aptt Mixing Study	$179	$125.30	$23.17 – $190
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $63.19 AETNA HEALTH PLAN [171] — NMH AETNA BP: $53.70 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $34.73 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $51.30 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $190 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $49.50 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $190 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $49.50 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $55 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $143.20

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) In the file: HB CT Head/Brain W/O Dye	$3,535	$2,474.50	$685.79 – $3,535
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $1,247.86 AETNA HEALTH PLAN [171] — NMH AETNA BP: $1,060.50 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $685.79 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $954.45 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $3,535 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $1,590.75 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $3,535 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $1,590.75 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $1,767.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $2,828
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: HB MRI Brain Stem W/O & W/Dye	$7,693	$5,385.10	$1,492.44 – $7,693
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $2,715.63 AETNA HEALTH PLAN [171] — NMH AETNA BP: $2,307.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $1,492.44 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $2,077.11 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $7,693 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $3,461.85 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $7,693 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $3,461.85 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $3,846.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $6,154.40
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: HB-Xray Exam Chest 2 Views	$963	$674.10	$108.81 – $963
Chest X-ray, 2 views: 10 of 34 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $308.16 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $339.94 AETNA HEALTH PLAN [171] — NMH AETNA BP: $288.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $186.82 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $260.01 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $963 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $433.35 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $963 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $433.35 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $481.50
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: HB X-Ray Exam L-2 Spine 4/>Vws	$1,299	$909.30	$194.69 – $1,299
X-ray of the lower spine, at least 4 views: 10 of 34 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $415.68 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $458.55 AETNA HEALTH PLAN [171] — NMH AETNA BP: $389.70 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $252.01 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $350.73 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $1,299 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $584.55 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $1,299 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $584.55 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $649.50
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: HB MRI Lumbar Spine W/O Dye	$5,482	$3,837.40	$1,063.51 – $5,482
MRI of the lower back (lumbar spine), without contrast: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $1,935.15 AETNA HEALTH PLAN [171] — NMH AETNA BP: $1,644.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $1,063.51 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $1,480.14 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $5,482 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $2,466.90 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $5,482 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $2,466.90 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $2,741 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $4,385.60
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: HB CT Pelvis W/Dye	$4,154	$2,907.80	$805.88 – $4,154
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $1,466.36 AETNA HEALTH PLAN [171] — NMH AETNA BP: $1,246.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $805.88 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $1,121.58 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $4,154 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $1,869.30 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $4,154 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $1,869.30 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $2,077 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $3,323.20
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: HB MRI Jnt of Lwr Extre W/O Dye	$5,479	$3,835.30	$1,062.93 – $5,479
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $1,934.09 AETNA HEALTH PLAN [171] — NMH AETNA BP: $1,643.70 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $1,062.93 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $1,479.33 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $5,479 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $2,465.55 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $5,479 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $2,465.55 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $2,739.50 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $4,383.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: HB CT Abd & Pelv W/Contrast	$8,642	$6,049.40	$1,676.55 – $8,642
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA ASA: $3,050.63 AETNA HEALTH PLAN [171] — NMH AETNA BP: $2,592.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $1,676.55 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $2,333.34 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $8,642 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $3,888.90 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $8,642 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $3,888.90 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $4,321 CIGNA HEALTH PLAN [178] — NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH): $6,913.60
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: HB US Exam Abdom Complete	$2,532	$1,772.40	$491.21 – $2,532
Ultrasound of the abdomen, complete: 10 of 34 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $810.24 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $893.80 AETNA HEALTH PLAN [171] — NMH AETNA BP: $759.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $491.21 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $683.64 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $2,532 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $1,139.40 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $2,532 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $1,139.40 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $1,266
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: HB OB US >/= 14 Wks Sngl Fetus	$1,723	$1,206.10	$334.26 – $1,723
Pregnancy ultrasound (after the first trimester): 10 of 34 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $551.36 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $608.22 AETNA HEALTH PLAN [171] — NMH AETNA BP: $516.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $334.26 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $465.21 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $1,723 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $775.35 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $1,723 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $775.35 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $861.50
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: HB Transvaginal US Non-OB	$1,542	$1,079.40	$299.15 – $1,542
Transvaginal ultrasound: 10 of 34 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $493.44 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $544.33 AETNA HEALTH PLAN [171] — NMH AETNA BP: $462.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $299.15 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $416.34 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $1,542 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $693.90 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $1,542 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $693.90 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $771
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: HB Diagnostic Mammography Incl Cad Unilateral	$664	$464.80	$128.82 – $664
Diagnostic mammogram, one breast: 10 of 34 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $212.48 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $234.39 AETNA HEALTH PLAN [171] — NMH AETNA BP: $199.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $128.82 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $179.28 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $664 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $298.80 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $664 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $298.80 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $332
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: HB Diagnostic Mammography Incl Cad Bilateral	$734	$513.80	$142.40 – $734
Diagnostic mammogram, both breasts: 10 of 34 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $234.88 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $259.10 AETNA HEALTH PLAN [171] — NMH AETNA BP: $220.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $142.40 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $198.18 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $734 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $330.30 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $734 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $330.30 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $367
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: HB Screening Mammography Bilateral Incl Cad	$748	$523.60	$145.11 – $748
Screening mammogram, both breasts: 10 of 34 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $239.36 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $264.04 AETNA HEALTH PLAN [171] — NMH AETNA BP: $224.40 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $145.11 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $201.96 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $748 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $336.60 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $748 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $336.60 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $374

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: HB Left Hrt Cath W/Ventrclgrphy	$15,397	$10,777.90	$2,675.45 – $15,397
Left heart catheterization (diagnostic): 10 of 36 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $4,413.12 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $4,868.22 AETNA HEALTH PLAN [171] — NMH AETNA BP: $4,137.30 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $2,675.45 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $4,157.19 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $13,791 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $6,928.65 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $15,397 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $6,928.65 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $7,698.50
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: HB Ep Evaluation Without Induction	$12,822	$8,975.40	$2,487.47 – $12,822
Heart rhythm study (electrophysiology evaluation): 10 of 38 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $4,103.04 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $4,526.17 AETNA HEALTH PLAN [171] — NMH AETNA BP: $3,846.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $2,487.47 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $3,461.94 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $12,822 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $5,769.90 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $12,822 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $5,769.90 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $6,411
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: HB Electrophysiology Evaluation Without Induction	$18,842	$13,189.40	$2,487.47 – $18,842
Heart rhythm study (electrophysiology evaluation): 10 of 38 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $4,103.04 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $4,526.17 AETNA HEALTH PLAN [171] — NMH AETNA BP: $3,846.60 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $2,487.47 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $5,087.34 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $12,822 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $8,478.90 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $18,842 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $8,478.90 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $9,421
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: HB Compre Ep Eval Abltj Atr Fib Pulm Vein Isolation	$38,940	$27,258	$6,183.22 – $38,940
Heart rhythm study with ablation for atrial fibrillation: 10 of 36 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $12,460.80 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $13,745.82 AETNA HEALTH PLAN [171] — NMH AETNA BP: $11,682 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $7,554.36 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $10,513.80 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $30,293 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $11,890.80 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $30,293 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $13,631.85 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $13,212
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: HB Polysom 6/> Yrs 4/> Param	$5,700	$3,990	$1,105.80 – $6,546
Sleep study (overnight, in a sleep lab): 10 of 38 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $1,824 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $2,012.10 AETNA HEALTH PLAN [171] — NMH AETNA BP: $1,710 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $1,105.80 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $1,353.78 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $6,546 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $2,256.30 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $6,546 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $2,256.30 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $2,507

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) In the file: HB Therapeutic Exercises	$236	$165.20	$42.35 – $236
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 38 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $75.52 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $83.31 AETNA HEALTH PLAN [171] — NMH AETNA BP: $70.80 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $45.78 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $63.72 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $236 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $106.20 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $236 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $106.20 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $118
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HB Pt Eval Low Complex	$419	$293.30	$81.29 – $486.50
Physical therapy evaluation (low complexity): 10 of 38 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $134.08 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $147.91 AETNA HEALTH PLAN [171] — NMH AETNA BP: $125.70 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $81.29 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $113.13 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $419 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $188.55 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $419 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $188.55 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $209.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HB Pt Eval Mod Complex	$503	$352.10	$97.58 – $611.10
Physical therapy evaluation (moderate complexity): 10 of 38 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $160.96 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $177.56 AETNA HEALTH PLAN [171] — NMH AETNA BP: $150.90 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $97.58 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $135.81 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $503 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $226.35 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $503 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $226.35 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $251.50
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HB Pt Eval High Complex	$638	$446.60	$123.77 – $731.50
Physical therapy evaluation (high complexity): 10 of 38 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $204.16 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $225.21 AETNA HEALTH PLAN [171] — NMH AETNA BP: $191.40 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $123.77 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $172.26 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $638 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $287.10 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $638 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $287.10 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $319
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: HB Psychotherapy W/Patient 30 Minutes	$314	$219.80	$37.21 – $281
Psychotherapy, 30 minutes: 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $62.08 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $68.48 AETNA HEALTH PLAN [171] — NMH AETNA BP: $58.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $37.64 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $84.78 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $281 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $71.55 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $281 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $71.55 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $79.50
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: HB Psychotherapy W/Patient 45 Minutes	$191	$133.70	$44.69 – $392
Psychotherapy, 45 minutes: 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $99.20 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $109.43 AETNA HEALTH PLAN [171] — NMH AETNA BP: $93 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $60.14 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $51.57 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $191 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $176.40 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $191 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $176.40 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $196
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: HB Cdh M/H OP Counseling Ind- 45 Min	$194	$135.80	$37.64 – $205
Psychotherapy, 45 minutes: 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $62.08 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $68.48 AETNA HEALTH PLAN [171] — NMH AETNA BP: $58.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $37.64 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $52.38 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $205 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $92.25 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $205 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $92.25 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $102.50
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: HB Cdh C/D OP Counseling Ind- 45 Min	$205	$143.50	$47.97 – $205
Psychotherapy, 45 minutes: 10 of 19 insurance plan rates AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $55.35 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $205 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $92.25 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $205 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $92.25 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $102.50 CIGNA HEALTH PLAN [178] — NMHC NON-CONTRACTED PAYORS: $205 CURAECHOICE [6100] — NMHC CURAECHOICE: $47.97 FIRST HEALTH PLAN [6034] — NMHC NON-CONTRACTED PAYORS: $205 GALAXY HEALTH NETWORK [220] — NMHC NON-CONTRACTED PAYORS: $205
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: HB Psychotherapy W/Patient 60 Minutes	$794	$555.80	$53.59 – $794
Psychotherapy, 60 minutes: 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $108.80 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $120.02 AETNA HEALTH PLAN [171] — NMH AETNA BP: $102 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $65.96 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $214.38 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $794 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $103.05 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $229 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $103.05 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $114.50
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: HB Cdh C/D OP Counseling Ind- 60 Min	$256	$179.20	$59.90 – $256
Psychotherapy, 60 minutes: 10 of 19 insurance plan rates AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $69.12 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $256 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $115.20 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $256 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $115.20 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $128 CIGNA HEALTH PLAN [178] — NMHC NON-CONTRACTED PAYORS: $256 CURAECHOICE [6100] — NMHC CURAECHOICE: $59.90 FIRST HEALTH PLAN [6034] — NMHC NON-CONTRACTED PAYORS: $256 GALAXY HEALTH NETWORK [220] — NMHC NON-CONTRACTED PAYORS: $256
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: HB Cdh M/H OP Counseling Ind- 60 Min	$256	$179.20	$53.59 – $256
Psychotherapy, 60 minutes: 10 of 19 insurance plan rates AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $69.12 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $229 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $103.05 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $229 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $103.05 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $114.50 CIGNA HEALTH PLAN [178] — NMHC NON-CONTRACTED PAYORS: $256 CURAECHOICE [6100] — NMHC CURAECHOICE: $53.59 FIRST HEALTH PLAN [6034] — NMHC NON-CONTRACTED PAYORS: $229 GALAXY HEALTH NETWORK [220] — NMHC NON-CONTRACTED PAYORS: $256
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: HB Family Psychotherapy W/O Patient Present 50 Mins	$202	$141.40	$47.27 – $202
Family psychotherapy, without the patient: 10 of 19 insurance plan rates AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $54.54 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $202 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $90.90 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $202 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $90.90 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $101 CIGNA HEALTH PLAN [178] — NMHC NON-CONTRACTED PAYORS: $202 CURAECHOICE [6100] — NMHC CURAECHOICE: $101.56 FIRST HEALTH PLAN [6034] — NMHC NON-CONTRACTED PAYORS: $202 GALAXY HEALTH NETWORK [220] — NMHC NON-CONTRACTED PAYORS: $202
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: HB Family Psytx W/Patient	$456	$319.20	$53.59 – $456
Family psychotherapy, with the patient: 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $115.20 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $127.08 AETNA HEALTH PLAN [171] — NMH AETNA BP: $108 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $69.84 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $123.12 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $456 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $205.20 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $456 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $103.05 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $114.50
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: HB Cdh Family Psytx W/Patient	$229	$160.30	$50.25 – $259
Family psychotherapy, with the patient: 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $82.88 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $91.43 AETNA HEALTH PLAN [171] — NMH AETNA BP: $77.70 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $50.25 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $61.83 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $229 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $103.05 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $256 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $103.05 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $114.50
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: HB Continuing Care Group Psychotherapy	$118	$82.60	$22.89 – $118
Group psychotherapy: 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $37.76 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $41.65 AETNA HEALTH PLAN [171] — NMH AETNA BP: $35.40 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $22.89 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $31.86 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $118 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $53.10 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $118 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $53.10 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $59
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: HB M/H Group Therapy	$90	$63	$21.06 – $114
Group psychotherapy: 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $36.48 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $40.24 AETNA HEALTH PLAN [171] — NMH AETNA BP: $34.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $22.12 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $24.30 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $90 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $40.50 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $90 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $40.50 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $45
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: HB Group Psychotherapy	$457	$319.90	$42.10 – $457
Group psychotherapy: 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $69.44 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $76.60 AETNA HEALTH PLAN [171] — NMH AETNA BP: $65.10 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $42.10 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $123.39 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $457 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $130.95 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $457 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $130.95 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $228.50

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: HB Removal of Breast Lesion	$6,369	$4,458.30	$1,490.35 – $3,502.95
Removal of breast growth (open surgery): rates for 2 insurance plans CURAECHOICE [6100] — NMHC CURAECHOICE: $1,490.35 HEALTHLINK [125] — NMHC SEIU HEALTHLINK: $3,502.95
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: HB Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$49,437	$34,605.90	$11,568.26 – $27,190.35
Total hip replacement: rates for 2 insurance plans CURAECHOICE [6100] — NMHC CURAECHOICE: $11,568.26 HEALTHLINK [125] — NMHC SEIU HEALTHLINK: $27,190.35
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: HB Arthrp Kne Condyle&Platu Medial&Lat Compartments	$49,437	$34,605.90	$11,568.26 – $29,975
Total knee replacement: rates for 2 insurance plans CURAECHOICE [6100] — NMHC CURAECHOICE: $11,568.26 HEALTHLINK [125] — NMHC SEIU HEALTHLINK: $27,190.35
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: HB Arthro/Surg Shld Decompress	$77,518.51	$54,262.96	$486.50 – $540.50
Shoulder arthroscopy: shaving of shoulder bone: 10 of 40 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $540.50 UNITED HEALTHCARE [158] — NMH UHC CORE: $486.50 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: HB Arthroscop Knee Med and Lat	$36,662.84	$25,663.99	$5,944 – $6,604
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 39 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $6,604 UNITED HEALTHCARE [158] — NMH UHC CORE: $5,944 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: HB Tonsillectomy & Adenoidectomy <Age 12	$7,609	$5,326.30	$1,780.51 – $6,481.75
Removal of tonsils and adenoids (under age 12): 10 of 20 insurance plan rates CURAECHOICE [6100] — NMHC CURAECHOICE: $1,780.51 HEALTHLINK [125] — NMHC SEIU HEALTHLINK: $4,184.95 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: 50% (a percentage in the contract, not a dollar amount) CIGNA HEALTH PLAN [178] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) FIRST HEALTH PLAN [6034] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: HB Esophagogastroduodenoscopy Transoral Diagnostic	$6,339.79	$4,437.85	$3,132 – $3,480
Upper GI endoscopy (diagnostic): 10 of 39 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $3,480 UNITED HEALTHCARE [158] — NMH UHC CORE: $3,132 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: HB Egd Transoral Biopsy Single/Multiple	$14,764.47	$10,335.13	$3,132 – $7,500
Upper GI endoscopy with biopsy: 10 of 40 insurance plan rates MULTIPLAN/PHCS [142] — NMH PHCS PPO: $7,500 UNITED HEALTHCARE [158] — NMH UHC: $3,480 UNITED HEALTHCARE [158] — NMH UHC CORE: $3,132 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: HB Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$6,195.14	$4,336.60	$2,432 – $2,702
Colonoscopy (diagnostic): 10 of 39 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $2,702 UNITED HEALTHCARE [158] — NMH UHC CORE: $2,432 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: HB Colonoscopy W/Biopsy Single/Multiple	$5,849	$4,094.30	$931.09 – $5,849
Colonoscopy with biopsy: 10 of 40 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $1,871.68 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $2,064.70 AETNA HEALTH PLAN [171] — NMH AETNA BP: $1,754.70 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $1,134.71 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $1,579.23 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $5,849 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $2,632.05 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $5,849 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $2,632.05 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $2,924.50
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: HB Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$5,849	$4,094.30	$937.40 – $5,849
Colonoscopy with removal of polyps (snare): 10 of 39 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $1,871.68 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $2,064.70 AETNA HEALTH PLAN [171] — NMH AETNA BP: $1,754.70 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $1,134.71 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $1,579.23 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $5,849 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $2,632.05 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $5,849 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $2,632.05 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $2,924.50
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: HB Colonoscopy W/Endoscope US	$17,487.84	$12,241.49	$3,132 – $3,480
Ultrasound of the lower bowel by endoscope: 10 of 38 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $3,480 UNITED HEALTHCARE [158] — NMH UHC CORE: $3,132 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: HB Colon Ca Scrn Not Hi Rsk Ind	$4,569	$3,198.30	$468 – $4,112
Screening colonoscopy (not high risk): 10 of 36 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $1,077.44 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $1,188.55 AETNA HEALTH PLAN [171] — NMH AETNA BP: $1,010.10 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $653.20 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $1,233.63 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $4,112 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $1,850.40 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $4,112 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $1,272.60 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $1,414
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy Surg Cholecystectomy	$43,772.34	$30,640.64	$7,941 – $8,823
Gallbladder removal by laparoscope: 10 of 39 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $8,823 UNITED HEALTHCARE [158] — NMH UHC CORE: $7,941 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: HB Laparoscopy Surg Cholecystectomy	$22,604	$15,822.80	$2,663.39 – $22,604
Gallbladder removal by laparoscope: 10 of 37 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: $7,233.28 AETNA HEALTH PLAN [171] — NMH AETNA ASA: $7,979.21 AETNA HEALTH PLAN [171] — NMH AETNA BP: $6,781.20 AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: $4,385.18 AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: $6,103.08 AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: $22,604 BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: $10,171.80 BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: $22,604 BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: $10,171.80 BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: $11,302
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$28,006.99	$19,604.89	$5,944 – $6,604
Groin (inguinal) hernia repair, age 5 or older: 10 of 38 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $6,604 UNITED HEALTHCARE [158] — NMH UHC CORE: $5,944 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: HB Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$6,654	$4,657.80	$1,557.04 – $3,659.70
Groin (inguinal) hernia repair, age 5 or older: rates for 2 insurance plans CURAECHOICE [6100] — NMHC CURAECHOICE: $1,557.04 HEALTHLINK [125] — NMHC SEIU HEALTHLINK: $3,659.70
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: HB Biopsy of Prostate_Biopsy, Prostate; Needle or Punch, Single or Multiple, Any Approach	$7,184	$5,028.80	$7,184
Prostate biopsy: 10 of 40 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $3,480 UNITED HEALTHCARE [158] — NMH UHC CORE: $3,132 UNITED HEALTHCARE [158] — NMH UHC NON-CONTRACTED OON - ED ONLY: $7,184 UNITED HEALTHCARE [158] — NMHC UHC REF LAB JOHN DEERE: $7,184 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laps Surg Prst8ect Rpbic Rad W/Nrv Sparing Robot	$120,939.41	$84,657.59	$425 – $12,933
Prostate removal by laparoscope (radical prostatectomy): 10 of 39 insurance plan rates OPTUM/UNITED BEHAVIORAL HEALTH [157] — NMH Optum UBH: $425 UNITED HEALTHCARE [158] — NMH UHC: $12,933 UNITED HEALTHCARE [158] — NMH UHC CORE: $11,640 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$26,850.81	$18,795.57	$4,026 – $4,474
Hysteroscopy with biopsy of the uterus lining: 10 of 38 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $4,474 UNITED HEALTHCARE [158] — NMH UHC CORE: $4,026 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HB Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$5,528	$3,869.60	$1,293.55 – $7,772.05
Hysteroscopy with biopsy of the uterus lining: rates for 2 insurance plans CURAECHOICE [6100] — NMHC CURAECHOICE: $1,293.55 HEALTHLINK [125] — NMHC SEIU HEALTHLINK: $3,040.40
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: HB Injection Inclu Needle/Cath Plct Interlaminar Lmbr/Sac W/ Flouro	$3,973.74	$2,781.62	$16
Spinal injection, lower back (epidural), with imaging guidance: 10 of 39 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $16 UNITED HEALTHCARE [158] — NMH UHC CORE: $16 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: HB Inj Foramen Epidural L/S	$3,671.74	$2,570.22	$11.36 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Nerve root injection, lower back, with imaging guidance: 10 of 39 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $11.36 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) UNITED HEALTHCARE [158] — NMH UHC CORE: $11.36 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: HB Carpal Tunnel Surgery	$12,536.64	$8,775.65	$6,039 – $6,711
Carpal tunnel release: 10 of 39 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $6,711 UNITED HEALTHCARE [158] — NMH UHC CORE: $6,039 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: HB Post-Cataract Laser Surgery	$1,277	$893.90	$298.82 – $702.35
Laser treatment of clouding after cataract surgery: rates for 2 insurance plans CURAECHOICE [6100] — NMHC CURAECHOICE: $298.82 HEALTHLINK [125] — NMHC SEIU HEALTHLINK: $702.35
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: HB Extracapsular Catarct Removal W/O Ecp	$15,504.27	$10,852.99	$4,026 – $4,474
Cataract removal with lens implant: 10 of 39 insurance plan rates UNITED HEALTHCARE [158] — NMH UHC: $4,474 UNITED HEALTHCARE [158] — NMH UHC CORE: $4,026 AETNA HEALTH PLAN [171] — NMH AETNA: 32% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 35.3% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC IMAGINE HEALTH: 27% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)

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) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	$549,132.20	$384,392.53	Not listed in the file
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 33 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA: 33.9% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA ASA: 31.7% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: 50% (a percentage in the contract, not a dollar amount) CIGNA HEALTH PLAN [178] — NMH CIGNA ALTERNATIVE: 23.6% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	$116,614.17	$81,629.92	Not listed in the file
Hip or knee replacement (major joint of the leg), without major complications: 10 of 28 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: 50% (a percentage in the contract, not a dollar amount) CIGNA HEALTH PLAN [178] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) CURAECHOICE [6100] — NMHC CURAECHOICE: 39% (a percentage in the contract, not a dollar amount) FIRST HEALTH PLAN [6034] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	$169,494.73	$118,646.31	Not listed in the file
Neck (cervical) spinal fusion, without complications: 10 of 29 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: 50% (a percentage in the contract, not a dollar amount) CIGNA HEALTH PLAN [178] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) CURAECHOICE [6100] — NMHC CURAECHOICE: 39% (a percentage in the contract, not a dollar amount) FIRST HEALTH PLAN [6034] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	$104,586.07	$73,210.25	Not listed in the file
Uterus and ovary surgery (not for cancer), without complications: 10 of 29 insurance plan rates AETNA HEALTH PLAN [171] — NMH AETNA BP: 30% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMH AETNA NM EMPLOYEES: 19.4% (a percentage in the contract, not a dollar amount) AETNA HEALTH PLAN [171] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC CHWN IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC SCPP IPA: 45% (a percentage in the contract, not a dollar amount) BLUE CROSS BLUE SHIELD [1401] — NMHC UIC IPA: 50% (a percentage in the contract, not a dollar amount) CIGNA HEALTH PLAN [178] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount) CURAECHOICE [6100] — NMHC CURAECHOICE: 39% (a percentage in the contract, not a dollar amount) FIRST HEALTH PLAN [6034] — NMHC NON-CONTRACTED PAYORS: 100% (a percentage in the contract, not a dollar amount)

Source: Northwestern Memorial Hospital’s standard charges file (nm.org, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	251 E Huron St, Chicago, IL 60611
County	Cook County
State	Illinois
Phone	(312) 926‑2000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	5 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	140281
Name in Medicare records	NORTHWESTERN MEMORIAL HOSPITAL
Profile level	Medicare data + hospital website
Official website	nm.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.

Northwestern Memorial Hospital

Summary

Profile from official sources

At a glance