Does Ochsner LSU Health Monroe have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Ochsner LSU Health Monroe. In a medical emergency, call 911.

Where is Ochsner LSU Health Monroe?

4864 Jackson Street, Monroe, LA 71202, in Ouachita Parish, Louisiana.

What is the phone number of Ochsner LSU Health Monroe?

(318) 388-7000, as listed by Medicare (CMS).

What is the Medicare star rating of Ochsner LSU Health Monroe?

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

Ochsner LSU Health Monroe — Monroe, LA

Quick answers

Does Ochsner LSU Health Monroe have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Ochsner LSU Health Monroe. In a medical emergency, call 911.
Where is Ochsner LSU Health Monroe?: 4864 Jackson Street, Monroe, LA 71202, in Ouachita Parish, Louisiana.
What is the phone number of Ochsner LSU Health Monroe?: (318) 388-7000, as listed by Medicare (CMS).
What is the Medicare star rating of Ochsner LSU Health Monroe?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Anesthesiology
Cardiology
Emergency medicine
Cancer care
Obstetrics and gynecology
Ophthalmology
Oral and maxillofacial surgery
Orthopedic surgery
Pathology
Pediatrics
Primary care
Psychiatry and behavioral health
Radiology and imaging
Surgery
Vascular surgery
Nephrology
Mammography

Treatments^[4]

Inpatient dialysis (24/7)

Procedures^[4]

Mammography

Programs and centers^[4]

Hybrid operating room

Emergency care (hospital website)^[4][5][6]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level III
Stroke designation	Get With The Guidelines Stroke Gold Plus (2026)

Visiting and practical information

Patient portal	MyOchsner

Recognition^[4]

Get With The Guidelines Stroke Gold Plus (2026)
Leapfrog Hospital Safety Grade A (Spring 2026)
Get With The Guidelines Stroke Gold Plus (American Heart Association/American Stroke Association) 2026

Doctors and clinicians (224)

224 doctors and other clinicians list Ochsner LSU Health Monroe as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (224)

Aakshit Goyal, MDDiagnostic Radiology
Abbie KemperDiagnostic Radiology
Abdulrahman Hesham, DDSOral Surgery
Adrian Sequeira, MDNephrology
Adrienne M. Williams, MDObstetrics/Gynecology
Afsana Asharaf, MDPulmonary Disease
Ahmed Algohiny, MDInternal Medicine
Alaina C. EdwardsPhysician Assistant
Alberto Simoncini, MDDiagnostic Radiology
Alexis B. James, CNACertified Registered Nurse Anesthetist (CRNA)
Alfonso Jimenez, MDInternal Medicine
Allan S. Matriano-Lim, MDInternal Medicine
Amanda C. Rutherford, PAPhysician Assistant
Amanda HallNurse Practitioner
Amber L. Jeansonne, NPNurse Practitioner
Ammoura Ibrahim, MDPathology
Amy C. Rowell, MDDiagnostic Radiology
Amy D. Lewing, NPNurse Practitioner
Amy E. Taylor, CNACertified Registered Nurse Anesthetist (CRNA)
Amy G. Hale, NPNurse Practitioner
Amy M. Givler, MDFamily Practice
Andree Breaux, PAPhysician Assistant
Andrew Green, MDGynecological Oncology
Anita M. O Toole, CNACertified Registered Nurse Anesthetist (CRNA)

And 200 more: the button below opens the full list.

Other emergency rooms nearby

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

Fmol Health St Francis3.3 mi · Monroe, LA · Acute Care Hospital
Glenwood Regional Medical Center5.1 mi · West Monroe, LA · Acute Care Hospital
Richardson Medical Center21 mi · Rayville, LA · Acute Care Hospital
Freedom Behavioral Hospital of Bastrop25 mi · Bastrop, LA · Psychiatric Hospital
Morehouse General Hospital25 mi · Bastrop, LA · Acute Care Hospital

Other hospitals nearby

Riverbend Rehabilitation Hospital0.7 mi · Monroe, LA · Inpatient Rehabilitation Hospital
Specialty Hospital3.3 mi · Monroe, LA · Long-Term Acute Care Hospital
Monroe Surgical Hospital5.9 mi · Monroe, LA · Acute Care Hospital
Cornerstone Specialty Hospitals West Monroe7.1 mi · West Monroe, LA · 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

Delta Grande Skilled Nursing and Rehabilitation2.6 mi · Monroe, LA · 4 of 5 stars
Mary Goss Nursing Home4.8 mi · Monroe, LA · 2 of 5 stars
The Oaks5.0 mi · Monroe, LA · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Elara Caring6.1 mi · Monroe, LA · 4 of 5 stars
Heart of Hospice, LLC6.1 mi · Monroe, LA
Hospice Compassus -Monroe6.1 mi · Monroe, LA

All hospice providers in the state →

Home health agencies

Alphacare Home Health, Inc.6.1 mi · Monroe, LA
Elara Caring6.1 mi · Monroe, LA
St Francis Medical Center Home Health6.1 mi · Monroe, LA · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

Fmcna - South Monroe4.6 mi · Monroe, LA · 2 of 5 stars
Fmcna - Northeast Louisiana Dialysis Ctr6.1 mi · Monroe, LA · 2 of 5 stars
Fmcna - West Monroe7.4 mi · West Monroe, LA · 1 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Advanced Surgery Center of Northern Louisiana, LLC6.1 mi · Monroe, LA
Arklamiss Surgery Center, LLC6.1 mi · Monroe, LA
Endoscopy Center of Monroe Inc6.1 mi · Monroe, LA

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

PHSC S D Hill Clinic2.7 mi · Monroe, LA · Community health center
PHSC School-Based Health Center- Wossman High School2.9 mi · Monroe, LA · Community health center
CommuniHealth Services - West Monroe Community Health Center3.3 mi · West Monroe, LA · Community health center

Clinics and urgent care

South Ouachita Clinic4.6 mi · Monroe, LA · Rural health clinic
St. Francis Urgent Care LLC6.1 mi · Monroe, LA · Urgent care center
Hulin Urgent Care Services LLC10 mi · Monroe, LA · Urgent care center

Pharmacies

BRFHH Monroe LLC4.6 mi · Monroe, LA · Community/retail pharmacy
Gray Pharm Inc4.6 mi · Monroe, LA · Community/retail pharmacy
Monroe Pharmacy LLC4.6 mi · Monroe, LA · 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 Ochsner LSU Health Monroe 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	4 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	2 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	74%National average: 72%
Would definitely recommend the hospital	77%National average: 71%
Nurses “always” communicated well	81%National average: 80%
Doctors “always” communicated well	83%National average: 80%
Staff “always” explained medicines before giving them	63%National average: 62%
Were given information about recovery at home	81%National average: 86%
Room and bathroom “always” clean	67%National average: 74%
Area around the room “always” quiet at night	71%National average: 60%
Completed surveys	365Response rate: 12%

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)	0.506No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0No different from the national benchmark
Surgical site infections after colon surgery	0No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	1.944No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.351Better 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	Too few cases to report
Deaths within 30 days: heart failure patients	11.3%
Deaths within 30 days: pneumonia patients	Too few cases to report
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	12.9%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.93No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	21.8%
Readmitted within 30 days: pneumonia	17%
Readmitted within 30 days: COPD	19.3%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	152 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	6%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	68%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 Monroe Best hospitals in Louisiana

Prices

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

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: HC OFFICE/OUTPT VISIT, NEW, LEVL III, 30-44 MIN	$253.08	$58.21	$37.83 – $229.21
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $37.83 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $178.67 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $37.83 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $229.21 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $229.21 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $229.21 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $229.21 FIRST HEALTH NETWORK — ALL PAYOR: $178.67 HEALTHY BLUE (FORMERLY AMERIGROUP LOUISIANA INC.) — ALL PAYOR: $37.83 HUMANA � MANAGED MEDICAID (HEALTHY LOUISIANA) — ALL PAYOR: $37.83
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) In the file: HC OFFICE/OUTPT VISIT, NEW, LEVL III, 30-44 MIN	$253.08	$58.21	Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: HC OFFICE/OUTPT VISIT, NEW, LEVL IV, 45-59 MIN	$303.70	$69.85	$56.77 – $333.51
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $56.77 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $214.41 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $56.77 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $333.51 FIRST HEALTH NETWORK — ALL PAYOR: $214.41 HEALTHY BLUE (FORMERLY AMERIGROUP LOUISIANA INC.) — ALL PAYOR: $56.77 HUMANA � MANAGED MEDICAID (HEALTHY LOUISIANA) — ALL PAYOR: $56.77
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) In the file: HC OFFICE/OUTPT VISIT, NEW, LEVL IV, 45-59 MIN	$303.70	$69.85	Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: HC OFFICE/OUTPT VISIT, NEW, LEVL V, 60-74 MIN	$364.44	$83.82	$56.77 – $333.51
New patient office visit (about 60–74 minutes): 10 of 17 insurance plan rates AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $56.77 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $257.29 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $56.77 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $333.51 FIRST HEALTH NETWORK — ALL PAYOR: $257.29 HEALTHY BLUE (FORMERLY AMERIGROUP LOUISIANA INC.) — ALL PAYOR: $56.77 HUMANA � MANAGED MEDICAID (HEALTHY LOUISIANA) — ALL PAYOR: $56.77
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) In the file: HC OFFICE/OUTPT VISIT, NEW, LEVL V, 60-74 MIN	$364.44	$83.82	Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: HC OFFICE/OUTPT VISIT, EST, LEVL III, 20-29 MIN	$240.43	$55.30	$37.83 – $229.21
Established patient office visit (about 20–29 minutes): 10 of 17 insurance plan rates AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $37.83 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $169.74 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $37.83 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $229.21 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $229.21 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $229.21 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $229.21 FIRST HEALTH NETWORK — ALL PAYOR: $169.74 HEALTHY BLUE (FORMERLY AMERIGROUP LOUISIANA INC.) — ALL PAYOR: $37.83 HUMANA � MANAGED MEDICAID (HEALTHY LOUISIANA) — ALL PAYOR: $37.83
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) In the file: HC OFFICE/OUTPT VISIT, EST, LEVL III, 20-29 MIN	$240.43	$55.30	Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: HC OFFICE/OUTPT VISIT, EST, LEVL IV, 30-39 MIN	$288.51	$66.36	$56.77 – $333.51
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $56.77 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $203.69 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $56.77 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $333.51 FIRST HEALTH NETWORK — ALL PAYOR: $203.69 HEALTHY BLUE (FORMERLY AMERIGROUP LOUISIANA INC.) — ALL PAYOR: $56.77 HUMANA � MANAGED MEDICAID (HEALTHY LOUISIANA) — ALL PAYOR: $56.77
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) In the file: HC OFFICE/OUTPT VISIT, EST, LEVL IV, 30-39 MIN	$288.51	$66.36	Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR OFFICE/OUTPT VISIT, EST, LEVL IV, 30-39 MIN	$214	$49.22	$56.77 – $333.51
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $56.77 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $151.08 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $56.77 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $333.51 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $333.51 FIRST HEALTH NETWORK — ALL PAYOR: $151.08 HEALTHY BLUE (FORMERLY AMERIGROUP LOUISIANA INC.) — ALL PAYOR: $56.77 HUMANA � MANAGED MEDICAID (HEALTHY LOUISIANA) — ALL PAYOR: $56.77
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR PREVENTIVE VISIT,NEW,18-39	$131	$30.13	$55.02 – $195
Preventive checkup, new patient, age 18–39: 10 of 12 insurance plan rates AETNA HEALTH INC. PPO/POS — ALL PAYOR: $92.49 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $65.50 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $65.50 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $65.50 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $65.50 FIRST HEALTH NETWORK — ALL PAYOR: $92.49 HUMANA MILITARY � TRICARE — ALL PAYOR: $85.06 MULTIPLAN/PHCS/AMERICAN LIFECARE — ALL PAYOR: $91.70 UNITED HEALTHCARE - COMMERCIAL HERITAGE — ALL PAYOR: $158 UNITED HEALTHCARE - COMMERCIAL HMO PPO — ALL PAYOR: $195
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR PREVENTIVE VISIT,NEW,40-64	$131	$30.13	$55.02 – $195
Preventive checkup, new patient, age 40–64: 10 of 12 insurance plan rates AETNA HEALTH INC. PPO/POS — ALL PAYOR: $92.49 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $65.50 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $65.50 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $65.50 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $65.50 FIRST HEALTH NETWORK — ALL PAYOR: $92.49 HUMANA MILITARY � TRICARE — ALL PAYOR: $103.10 MULTIPLAN/PHCS/AMERICAN LIFECARE — ALL PAYOR: $91.70 UNITED HEALTHCARE - COMMERCIAL HERITAGE — ALL PAYOR: $158 UNITED HEALTHCARE - COMMERCIAL HMO PPO — ALL PAYOR: $195
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HC EMER ROOM LEVEL III	$528	$121.44	$84.43 – $827
Emergency room visit (moderate): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $251.67 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $84.43 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $251.67 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $569 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $251.67 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $84.43 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $491.42 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $491.42 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $251.67 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $491.42
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) In the file: HC EMER ROOM LEVEL III	$528	$121.44	Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HC EMER ROOM LEVEL IV	$874.50	$201.13	$139.83 – $1,520
Emergency room visit (moderately high): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $387.04 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $139.83 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $387.04 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $569 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $387.04 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $139.83 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $855.10 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $855.10 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $387.04 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $855.10
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) In the file: HC EMER ROOM LEVEL IV	$874.50	$201.13	Not listed in the file
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HC EMER ROOM LEVEL V	$1,529	$351.67	$244.49 – $1,852
Emergency room visit (high): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $557.26 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $244.49 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $557.26 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $569 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $557.26 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $244.49 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $855.10 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $855.10 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $557.26 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $855.10
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) In the file: HC EMER ROOM LEVEL V	$1,529	$351.67	Not listed in the file

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: HC BASIC METABOLIC PANEL(8 TESTS)	$127	$29.21	$4.23 – $95.25
Basic metabolic panel (blood test): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $8.46 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $8.46 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $8.46 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $20.64 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $8.46 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $8.46 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $20.39 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $20.39 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $4.23 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $20.39
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) In the file: HC BASIC METABOLIC PANEL(8 TESTS)	$127	$29.21	Not listed in the file
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR BASIC METABOLIC PANEL CALCIUM TOTAL	$62	$14.26	$4.23 – $46.50
Basic metabolic panel (blood test): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $8.46 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $8.46 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $8.46 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $20.64 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $8.46 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $8.46 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $20.39 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $20.39 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $4.23 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $20.39
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: HC COMPREHENSIVE METABOLIC PAN 14	$31.68	$7.29	$5.28 – $29.68
Comprehensive metabolic panel (blood test): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $10.56 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $10.56 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $10.56 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $25.76 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $10.56 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $10.56 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $22.22 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $22.22 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $5.28 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $22.22
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) In the file: HC COMPREHENSIVE METABOLIC PAN 14	$31.68	$7.29	Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR METABOLIC PANEL,COMPREHENSIVE	$68	$15.64	$5.28 – $51
Comprehensive metabolic panel (blood test): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $10.56 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $10.56 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $10.56 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $25.76 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $10.56 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $10.56 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $22.22 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $22.22 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $5.28 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $22.22
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: HC OBSTETRIC PANEL	$143.43	$32.99	$23.91 – $132.22
Obstetric blood test panel: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $47.81 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $24.01 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $47.81 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $116.66 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $47.81 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $24.01 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $77.09 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $77.09 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $23.91 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $77.09
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) In the file: HC OBSTETRIC PANEL	$143.43	$32.99	Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: HC LIPID PROFILE	$179	$41.17	$6.70 – $134.25
Cholesterol panel (lipid panel): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $13.39 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $13.39 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $13.39 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $32.68 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $13.39 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $13.39 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $22.64 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $22.64 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $6.70 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $22.64
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: HC LIPID PROFILE	$179	$41.17	Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR LIPID PANEL	$69	$15.87	$6.70 – $51.75
Cholesterol panel (lipid panel): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $13.39 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $13.39 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $13.39 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $32.68 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $13.39 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $13.39 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $22.64 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $22.64 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $6.70 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $22.64
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: HC RENAL FUNCTION PANEL	$130	$29.90	$4.34 – $97.50
Kidney function panel: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $8.68 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $8.68 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $8.68 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $21.18 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $8.68 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $8.68 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $19.43 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $19.43 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $4.34 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $19.43
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: HC RENAL FUNCTION PANEL	$130	$29.90	Not listed in the file
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR RENAL FUNCTION PANEL	$59	$13.57	$4.34 – $44.25
Kidney function panel: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $8.68 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $8.68 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $8.68 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $21.18 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $8.68 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $8.68 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $19.43 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $19.43 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $4.34 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $19.43
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HC HEPATIC FUNCTION PANEL,7 TESTS	$123	$28.29	$4.08 – $92.25
Liver function panel: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $8.17 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $8.17 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $8.17 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $19.94 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $8.17 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $8.17 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $14.15 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $14.15 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $4.08 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $14.15
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: HC HEPATIC FUNCTION PANEL,7 TESTS	$123	$28.29	Not listed in the file
Liver function panel CPT 80076 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR HEPATIC FUNCTION PANEL	$43	$9.89	$4.08 – $32.25
Liver function panel: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $8.17 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $8.17 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $8.17 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $19.94 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $8.17 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $8.17 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $14.15 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $14.15 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $4.08 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $14.15
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: HC URINALYSIS, AUTO W/MICRO	$47.50	$10.93	$1.58 – $35.62
Urine test (automated, with microscope): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $3.17 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $3.17 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $3.17 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $7.74 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $3.17 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $3.17 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $5.33 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $5.33 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1.58 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $5.33
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) In the file: HC URINALYSIS, AUTO W/MICRO	$47.50	$10.93	Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR URINALYSIS, AUTO, W/SCOPE	$17	$3.91	$1.58 – $12.75
Urine test (automated, with microscope): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $3.17 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $3.17 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $3.17 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $7.74 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $3.17 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $3.17 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $5.33 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $5.33 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1.58 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $5.33
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: HC URINALYSIS W/O MICRO NON-AUTO	$17.72	$4.08	$1.74 – $13.29
Urine test (manual, without microscope): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $3.48 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $3.28 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $3.48 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $8.50 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $3.48 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $3.28 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $3.77 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $3.77 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1.74 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $3.77
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) In the file: HC URINALYSIS W/O MICRO NON-AUTO	$17.72	$4.08	Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR URINALYSIS NONAUTO W/O SCOPE	$12	$2.76	$1.74 – $9.04
Urine test (manual, without microscope): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $3.48 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $3.28 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $3.48 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $8.50 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $3.48 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $3.28 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $3.77 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $3.77 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1.74 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $3.77
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HC URINE W/O MICRO, AUTO	$33.70	$7.75	$1.12 – $25.27
Urine test (automated, without microscope): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $2.25 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $2.25 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $2.25 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $5.50 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $2.25 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $2.25 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $4.42 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $4.42 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1.12 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $4.42
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HC POC URINE W/O MICRO, AUTO	$33.70	$7.75	$1.12 – $25.27
Urine test (automated, without microscope): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $2.25 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $2.25 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $2.25 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $5.50 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $2.25 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $2.25 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $4.42 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $4.42 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1.12 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $4.42
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) In the file: HC URINE W/O MICRO, AUTO	$33.70	$7.75	Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HC PSA, DIAGNOSTIC	$276	$63.48	$9.20 – $207
PSA (prostate specific antigen) blood test: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $18.39 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $18.39 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $18.39 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $44.88 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $18.39 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $18.39 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $36.10 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $36.10 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $9.20 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $36.10
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HC PSA, SCREENING	$276	$63.48	$9.20 – $207
PSA (prostate specific antigen) blood test: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $18.39 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $18.39 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $18.39 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $44.88 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $18.39 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $18.39 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $36.10 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $36.10 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $9.20 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $36.10
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HC PSA, TOTAL	$276	$63.48	$9.20 – $207
PSA (prostate specific antigen) blood test: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $18.39 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $18.39 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $18.39 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $44.88 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $18.39 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $18.39 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $36.10 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $36.10 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $9.20 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $36.10
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HC TSH	$252	$57.96	$8.40 – $189
Thyroid stimulating hormone (TSH) test: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $16.80 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $16.80 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $16.80 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $41 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $16.80 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $16.80 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $37.53 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $37.53 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $8.40 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $37.53
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HC CU INDEX-TSH ASSAY	$252	$57.96	$8.40 – $189
Thyroid stimulating hormone (TSH) test: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $16.80 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $16.80 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $16.80 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $41 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $16.80 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $16.80 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $37.53 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $37.53 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $8.40 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $37.53
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HC TSH - SENSITIVE, SERUM - RL	$50.40	$11.59	$8.40 – $46.78
Thyroid stimulating hormone (TSH) test: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $16.80 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $16.80 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $16.80 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $41 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $16.80 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $16.80 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $37.53 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $37.53 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $8.40 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $37.53
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: HC COMPL CBC W/PLT W/AUTOM DIFF	$117	$26.91	$3.88 – $87.75
Complete blood count (CBC) with differential: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $7.77 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $7.77 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $7.77 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $18.96 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $7.77 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $7.77 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $16.04 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $16.04 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $3.88 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $16.04
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) In the file: HC COMPL CBC W/PLT W/AUTOM DIFF	$117	$26.91	Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HC HEMATOLOGY PROFILE	$97.10	$22.33	$3.23 – $72.83
Complete blood count (CBC), automated: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $6.47 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $6.47 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $6.47 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $15.78 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $6.47 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $6.47 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $12.71 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $12.71 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $3.23 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $12.71
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) In the file: HC HEMATOLOGY PROFILE	$97.10	$22.33	Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR COMPLETE CBC	$39	$8.97	$3.23 – $29.25
Complete blood count (CBC), automated: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $6.47 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $6.47 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $6.47 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $15.78 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $6.47 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $6.47 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $12.71 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $12.71 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $3.23 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $12.71
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HC PROTHROMBIN TIME	$59.10	$13.59	$2.15 – $44.33
Blood clotting time test (prothrombin time, PT): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $4.29 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $4.29 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $4.29 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $10.46 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $4.29 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $4.29 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $7.71 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $7.71 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $2.15 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $7.71
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HC PROTHROMBIN TIME/INR	$59.10	$13.59	$2.15 – $44.33
Blood clotting time test (prothrombin time, PT): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $4.29 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $4.29 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $4.29 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $10.46 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $4.29 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $4.29 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $7.71 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $7.71 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $2.15 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $7.71
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) In the file: HC PROTHROMBIN TIME	$59.10	$13.59	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HC PARTIAL THROMBOPLASTIN TIME	$90.10	$20.72	$3 – $67.58
Blood clotting test (partial thromboplastin time, PTT): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $6.01 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $6.01 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $6.01 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $14.66 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $6.01 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $6.01 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $12.37 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $12.37 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $3 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $12.37
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) In the file: HC PARTIAL THROMBOPLASTIN TIME	$90.10	$20.72	Not listed in the file

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: HC CT HEAD W/O CONTRAST	$885	$203.55	$93.27 – $711
CT scan of the head or brain, without contrast: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $96.65 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $141.51 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $96.65 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $711 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $96.65 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $141.51 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $312.30 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $312.30 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $96.65 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $312.30
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) In the file: HC CT HEAD W/O CONTRAST	$885	$203.55	Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: HC MRI BRAIN W/WO CONTRAST	$3,450	$793.50	$313.24 – $2,587.50
MRI of the brain, before and after contrast: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $324.60 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $551.65 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $324.60 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,112 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $324.60 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $551.65 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,118.79 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,118.79 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $324.60 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,118.79
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) In the file: HC MRI BRAIN W/WO CONTRAST	$3,450	$793.50	Not listed in the file
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: HC XRAY, CHEST, 2 VIEWS	$401	$92.23	$39.95 – $415
Chest X-ray, 2 views: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $80.03 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $64.12 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $80.03 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $48.72 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $80.03 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $64.12 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $39.95 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $39.95 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $80.03 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $39.95
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) In the file: HC XRAY, CHEST, 2 VIEWS	$401	$92.23	Not listed in the file
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR XRAY, CHEST, 2 VIEWS	$427	$98.21	$39.95 – $415
Chest X-ray, 2 views: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $80.03 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $68.28 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $80.03 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $48.72 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $80.03 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $68.28 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $39.95 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $39.95 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $80.03 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $39.95
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: HC SPINE LUMBAR COMP 5 VIEW	$636	$146.28	$73.91 – $477
X-ray of the lower spine, at least 4 views: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $96.65 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $101.70 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $96.65 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $78.86 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $96.65 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $101.70 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $75.41 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $75.41 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $96.65 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $75.41
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) In the file: HC SPINE LUMBAR COMP 5 VIEW	$636	$146.28	Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR X-RAY LUMBAR SPINE 4 VW	$427	$98.21	$68.28 – $415
X-ray of the lower spine, at least 4 views: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $96.65 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $68.28 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $96.65 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $78.86 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $96.65 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $68.28 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $75.41 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $75.41 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $96.65 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $75.41
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: HC MRI SPINE LUMBAR WITHOUT CONTRAST	$2,063	$474.49	$212.01 – $1,547.25
MRI of the lower back (lumbar spine), without contrast: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $219.70 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $329.87 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $219.70 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,112 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $219.70 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $329.87 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $730.25 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $730.25 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $219.70 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $730.25
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) In the file: HC MRI SPINE LUMBAR WITHOUT CONTRAST	$2,063	$474.49	Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: HC CT PELVIS W CONTRAST	$1,743	$400.89	$156.14 – $1,307.25
CT scan of the pelvis, with contrast: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $161.81 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $278.71 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $161.81 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $711 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $161.81 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $278.71 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $476.01 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $476.01 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $161.81 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $476.01
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) In the file: HC CT PELVIS W CONTRAST	$1,743	$400.89	Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: HC MRI LOW EXT JT W/O CONTR	$2,063	$474.49	$212.01 – $1,547.25
MRI of a leg joint (such as the knee), without contrast: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $219.70 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $329.87 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $219.70 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,112 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $219.70 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $329.87 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $730.25 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $730.25 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $219.70 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $730.25
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) In the file: HC MRI LOW EXT JT W/O CONTR	$2,063	$474.49	Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier 50 In the file: HC MRI LOW EXT JT W/O CONTR	$4,126	$948.98	$318.01 – $3,094.50
MRI of a leg joint (such as the knee), without contrast: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $329.56 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $659.75 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $329.56 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,668 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $329.56 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $659.75 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,095.38 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,095.38 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $329.56 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,095.38
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: HC CT ABD PELVIS WITH CONTRAST	$2,731	$628.13	$313.24 – $2,048.25
CT scan of the abdomen and pelvis, with contrast: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $324.60 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $436.69 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $324.60 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $711 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $324.60 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $436.69 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $778.90 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $778.90 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $324.60 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $778.90
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) In the file: HC CT ABD PELVIS WITH CONTRAST	$2,731	$628.13	Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: HC US, ABD, B-SCAN, COMPLETE	$942	$216.66	$93.27 – $706.50
Ultrasound of the abdomen, complete: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $96.65 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $150.63 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $96.65 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $183.54 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $96.65 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $150.63 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $191.58 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $191.58 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $96.65 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $191.58
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) In the file: HC US, ABD, B-SCAN, COMPLETE	$942	$216.66	Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE	$387	$89.01	$61.88 – $290.25
Ultrasound of the abdomen, complete: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $96.65 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $61.88 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $96.65 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $183.54 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $96.65 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $61.88 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $191.58 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $191.58 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $96.65 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $191.58
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: HC US, OB 14+WKS, TRANSABD, SINGLE GESTATION	$538	$123.74	$86.03 – $403.50
Pregnancy ultrasound (after the first trimester): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $96.65 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $86.03 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $96.65 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $201.78 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $96.65 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $86.03 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $192.34 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $192.34 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $96.65 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $192.34
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) In the file: HC US, OB 14+WKS, TRANSABD, SINGLE GESTATION	$538	$123.74	Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR US, OB 14+WKS, TRANSABD, SINGLE GESTATION	$388	$89.24	$62.04 – $291
Pregnancy ultrasound (after the first trimester): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $96.65 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $62.04 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $96.65 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $201.78 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $96.65 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $62.04 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $192.34 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $192.34 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $96.65 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $192.34
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: HC US TRANSVAGINAL NON OB	$538	$123.74	$86.03 – $403.50
Transvaginal ultrasound: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $96.65 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $86.03 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $96.65 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $197.82 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $96.65 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $86.03 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $171.99 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $171.99 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $96.65 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $171.99
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) In the file: HC US TRANSVAGINAL NON OB	$538	$123.74	Not listed in the file
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR ECHOGRAPHY,TRANSVAGINAL	$347	$79.81	$55.49 – $260.25
Transvaginal ultrasound: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $96.65 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $55.49 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $96.65 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $197.82 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $96.65 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $55.49 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $171.99 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $171.99 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $96.65 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $171.99
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: HC MAMMO W/WO CAD, DIAGNOSTIC, UNILAT	$249.20	$57.32	$39.85 – $257
Diagnostic mammogram, one breast: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $75.01 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $39.85 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $75.01 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $208.12 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $75.01 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $39.85 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $115.35 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $115.35 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $75.01 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $115.35
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) In the file: HC MAMMO W/WO CAD, DIAGNOSTIC, UNILAT	$249.20	$57.32	Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR MAMMO, CAD, DIAGNOSTIC, UNILAT	$328	$75.44	$52.45 – $257
Diagnostic mammogram, one breast: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $75.01 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $52.45 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $75.01 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $208.12 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $75.01 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $52.45 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $115.35 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $115.35 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $75.01 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $115.35
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: HC MAMMO W/WO CAD, DIAGNOSTIC, BILAT	$744	$171.12	$95.53 – $558
Diagnostic mammogram, both breasts: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $95.53 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $118.97 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $95.53 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $265.22 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $95.53 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $118.97 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $144.78 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $144.78 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $95.53 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $144.78
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) In the file: HC MAMMO W/WO CAD, DIAGNOSTIC, BILAT	$744	$171.12	Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR MAMMO, CAD, DIAGNOSTIC, BILAT	$418	$96.14	$66.84 – $313.50
Diagnostic mammogram, both breasts: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $95.53 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $66.84 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $95.53 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $265.22 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $95.53 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $66.84 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $144.78 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $144.78 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $95.53 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $144.78
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: HC MAMMO W/WO CAD, SCREENING, BILAT	$533	$122.59	$78.97 – $399.75
Screening mammogram, both breasts: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $78.97 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $85.23 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $78.97 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $220.02 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $78.97 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $85.23 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $107.06 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $107.06 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $78.97 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $107.06
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) In the file: HC MAMMO W/WO CAD, SCREENING, BILAT	$533	$122.59	Not listed in the file
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR MAMMO, CAD, SCREENING, BILAT	$347	$79.81	$55.49 – $260.25
Screening mammogram, both breasts: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $78.97 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $55.49 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $78.97 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $220.02 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $78.97 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $55.49 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $107.06 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $107.06 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $78.97 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $107.06

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: HC INSERTION OF PARACHUTE DEVICE	$10,348	$2,380.04	$482 – $12,884.90
Left heart catheterization (diagnostic): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $2,923.46 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $1,654.65 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $2,923.46 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $5,776 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $2,923.46 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $1,654.65 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $12,884.90 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $12,884.90 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $2,923.46 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $12,884.90
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) In the file: HC INSERTION OF PARACHUTE DEVICE	$10,348	$2,380.04	Not listed in the file
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: HC COMP EPS W/O ATTEMPT INDUCT	$25,397	$5,841.31	$482 – $19,047.75
Heart rhythm study (electrophysiology evaluation): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $6,896.98 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $4,060.98 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $6,896.98 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $3,396 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $6,896.98 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $4,060.98 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $7,743.79 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $7,743.79 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $6,896.98 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $7,743.79
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) In the file: HC COMP EPS W/O ATTEMPT INDUCT	$25,397	$5,841.31	Not listed in the file
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: HC EP EVAL W/TRANSSEPTAL CATH, INS & REPS MULT ELECT CATHS, AND INTRACARD CATH ABLTJ OF ATR FIB INC 3D MAPPING, INTRACARD ECHO W/IMG SUP & I	$78,690	$18,098.70	$482 – $59,017.50
Heart rhythm study with ablation for atrial fibrillation: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $22,297.90 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $12,582.53 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $22,297.90 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $3,396 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $22,297.90 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $12,582.53 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $42,400.33 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $42,400.33 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $22,297.90 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $42,400.33
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) In the file: HC EP EVAL W/TRANSSEPTAL CATH, INS & REPS MULT ELECT CATHS, AND INTRACARD CATH ABLTJ OF ATR FIB INC 3D MAPPING, INTRACARD ECHO W/IMG SUP & I	$78,690	$18,098.70	Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: HC POLYSOMNOGRAPHY, 4 OR MORE	$3,450	$793.50	$483 – $2,587.50
Sleep study (overnight, in a sleep lab): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $924.73 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $551.65 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $924.73 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,440.12 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $924.73 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $551.65 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $2,206.76 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $2,206.76 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $924.73 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $2,206.76
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) In the file: HC POLYSOMNOGRAPHY, 4 OR MORE	$3,450	$793.50	Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR POLYSOMNOGRAPHY, 4 OR MORE	$4,759	$1,094.57	$483 – $3,569.25
Sleep study (overnight, in a sleep lab): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $924.73 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $760.96 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $924.73 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,440.12 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $924.73 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $760.96 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $2,206.76 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $2,206.76 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $924.73 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $2,206.76

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: HC PT THERAPEUTIC EX EA 15MIN	$121	$27.83	$10.96 – $156
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $27.13 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $10.96 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $27.13 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $62.94 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $27.13 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $10.96 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $55.54 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $55.54 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $27.13 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $55.54
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: HC OT THERAPEUTIC EX EA 15MIN	$121	$27.83	$10.96 – $124
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $27.13 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $10.96 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $27.13 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $62.94 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $27.13 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $10.96 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $55.54 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $55.54 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $27.13 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $55.54
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) In the file: HC PT THERAPEUTIC EX EA 15MIN	$121	$27.83	Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HC PT EVAL LOW COMPLEXITY 20 MINS	$183.77	$42.27	$74.48 – $231.01
Physical therapy evaluation (low complexity): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $92.41 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $74.48 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $92.41 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $175.11 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $92.41 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $74.48 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $138.09 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $138.09 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $92.41 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $138.09
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) In the file: HC PT EVAL LOW COMPLEXITY 20 MINS	$183.77	$42.27	Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HC PT EVAL, MOD COMPLEXITY 30 MINS	$183.77	$42.27	$74.48 – $231.01
Physical therapy evaluation (moderate complexity): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $92.41 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $74.48 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $92.41 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $175.11 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $92.41 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $74.48 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $138.09 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $138.09 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $92.41 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $138.09
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) In the file: HC PT EVAL, MOD COMPLEXITY 30 MINS	$183.77	$42.27	Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HC PT EVAL HIGH COMPLEXITY 45 MINS	$183.77	$42.27	$74.48 – $231.01
Physical therapy evaluation (high complexity): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $92.41 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $74.48 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $92.41 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $175.11 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $92.41 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $74.48 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $138.09 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $138.09 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $92.41 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $138.09
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) In the file: HC PT EVAL HIGH COMPLEXITY 45 MINS	$183.77	$42.27	Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: HC FAMILY PSYCHOTHERAPY W/PATIENT, 50 MIN	$462.95	$106.48	$140.92 – $365.09
Family psychotherapy, with the patient: 10 of 23 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $146.04 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $146.04 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $326.84 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $146.04 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $231.47 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $231.47 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $146.04 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $231.47 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $231.47 CIGNA HEALTHCARE — ALL PAYOR: $198.14
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) In the file: HC FAMILY PSYCHOTHERAPY W/PATIENT, 50 MIN	$462.95	$106.48	Not listed in the file

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier 50,PBBFAC In the file: PR EXCISE BREAST CYST	$17,680	$4,066.40	$825.48 – $13,260
Removal of breast growth (open surgery): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $5,220.76 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $825.48 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $5,220.76 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,614.50 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $5,220.76 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $825.48 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $8,197.75 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $8,197.75 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $5,220.76 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $8,197.75
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR EXCISE BREAST CYST	$8,840	$2,033.20	$550.32 – $8,701.27
Removal of breast growth (open surgery): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $3,480.51 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $3,480.51 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,743 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $3,480.51 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $5,465.17 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $5,465.17 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $3,480.51 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $5,465.17
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: TOTAL HIP ARTHROPLASTY	$78,885.75	$18,143.72	$1,684 – $29,237.28
Total hip replacement: 10 of 25 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $11,694.91 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $11,694.91 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,837 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $11,694.91 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $9,340.20 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $9,340.20 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $11,694.91 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $9,340.20 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $9,340.20 CIGNA HEALTHCARE — ALL PAYOR: $1,684
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: TOTAL KNEE ARTHROPLASTY	$69,133.91	$15,900.80	$1,684 – $29,237.28
Total knee replacement: 10 of 25 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $11,694.91 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $11,694.91 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,837 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $11,694.91 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $14,860.15 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $14,860.15 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $11,694.91 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $14,860.15 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $14,860.15 CIGNA HEALTHCARE — ALL PAYOR: $1,684
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	Not listed in the file	Not listed in the file	$416 – $3,838.02
Shoulder arthroscopy: shaving of shoulder bone: 10 of 18 insurance plan rates AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,743 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $3,838.02 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $3,838.02 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $3,838.02 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $3,838.02 CIGNA HEALTHCARE — ALL PAYOR: $1,328 FIRST HEALTH NETWORK — ALL PAYOR: $1,743 HEALTHY BLUE (FORMERLY AMERIGROUP LOUISIANA INC.) — ALL PAYOR: $550.32
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: KNEE ARTHROSCOPY/SURGERY	$94,330.46	$21,696.01	$679.83 – $7,372.73
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $2,949.09 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $679.83 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $2,949.09 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,151 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $2,949.09 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $679.83 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $3,838.02 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $3,838.02 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $2,949.09 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $3,838.02
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$550.32 – $13,442.15
Removal of tonsils and adenoids (under age 12): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $5,376.86 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $5,376.86 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,743 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $5,376.86 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $3,223.86 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $3,223.86 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $5,376.86 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $3,223.86
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: HC EGD DX (INCL BRUSH/WASH)	$955.73	$219.82	$359.35 – $2,130.42
Upper GI endoscopy (diagnostic): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $852.17 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $359.35 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $852.17 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,135 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $852.17 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $359.35 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,093.74 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,093.74 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $852.17 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,093.74
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: HC EGD DX (INCL BRUSH/WASH)	$955.73	$219.82	Not listed in the file
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: HC EGD W/BX SGL OR MULT (BITE/COL	$955.73	$219.82	$401.41 – $2,130.42
Upper GI endoscopy with biopsy: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $852.17 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $852.17 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,524 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $852.17 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,093.74 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,093.74 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $852.17 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,093.74
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) In the file: HC EGD W/BX SGL OR MULT (BITE/COL	$955.73	$219.82	Not listed in the file
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: HC COLON DX (INCL BRUSH/WASH)	$1,059.34	$243.65	$444.92 – $2,071.68
Colonoscopy (diagnostic): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $828.67 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $828.67 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,524 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $828.67 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,212.31 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,212.31 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $828.67 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,212.31
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) In the file: HC COLON DX (INCL BRUSH/WASH)	$1,059.34	$243.65	Not listed in the file
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: HC COLON W/BX SGL OR MLT-BITE/CLD	$1,059.34	$243.65	$444.92 – $2,679.22
Colonoscopy with biopsy: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $1,071.69 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $1,071.69 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,524 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $1,071.69 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,212.31 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,212.31 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1,071.69 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,212.31
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) In the file: HC COLON W/BX SGL OR MLT-BITE/CLD	$1,059.34	$243.65	Not listed in the file
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: HC COLON W/REMOVAL BY SNARE TECH	$1,059.34	$243.65	$444.92 – $2,679.22
Colonoscopy with removal of polyps (snare): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $1,071.69 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $1,071.69 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,524 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $1,071.69 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,212.31 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,212.31 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1,071.69 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,212.31
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) In the file: HC COLON W/REMOVAL BY SNARE TECH	$1,059.34	$243.65	Not listed in the file
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: HC COLONOSCOPY W/EUS	$1,059.34	$243.65	$444.92 – $2,679.22
Ultrasound of the lower bowel by endoscope: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $1,071.69 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $1,071.69 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,524 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $1,071.69 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,212.31 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,212.31 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1,071.69 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,212.31
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) In the file: HC COLONOSCOPY W/EUS	$1,059.34	$243.65	Not listed in the file
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: HC COLONOSCOPY - AVERAGE RISK	$1,494.90	$343.83	$481.27 – $2,071.68
Screening colonoscopy (not high risk): 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $828.67 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $828.67 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,524 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $828.67 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,710.20 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,710.20 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $828.67 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,710.20
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) In the file: HC COLONOSCOPY - AVERAGE RISK	$1,494.90	$343.83	Not listed in the file
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: HC CHOLECYSTECTOMY, LAPAROSCOPIC	$14,501	$3,335.23	$550.32 – $13,257.42
Gallbladder removal by laparoscope: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $5,302.97 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $5,302.97 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,447 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $5,302.97 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $6,212.91 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $6,212.91 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $5,302.97 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $6,212.91
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) In the file: HC CHOLECYSTECTOMY, LAPAROSCOPIC	$14,501	$3,335.23	Not listed in the file
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR LAP,CHOLECYSTECTOMY	$10,325	$2,374.75	$550.32 – $13,257.42
Gallbladder removal by laparoscope: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $5,302.97 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $5,302.97 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,447 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $5,302.97 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $6,212.91 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $6,212.91 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $5,302.97 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $6,212.91
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PRP I/HERN INIT REDUC >5 YR	$40,735.05	$9,369.06	$679.83 – $8,376.68
Groin (inguinal) hernia repair, age 5 or older: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $3,207.63 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $679.83 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $3,207.63 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,151 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $3,207.63 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $679.83 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $8,376.68 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $8,376.68 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $3,207.63 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $8,376.68
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR BIOPSY OF PROSTATE,NEEDLE/PUNCH	$2,102	$483.46	$481.27 – $4,654.83
Prostate biopsy: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $1,861.93 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $1,861.93 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,524 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $1,861.93 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,299.41 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,299.41 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1,861.93 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,299.41
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: LAPARO RADICAL PROSTATECTOMY	Not listed in the file	Not listed in the file	$1,684 – $23,657.42
Prostate removal by laparoscope (radical prostatectomy): 10 of 25 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $9,462.97 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $9,462.97 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,447 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $9,462.97 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $4,802.46 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $4,802.46 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $9,462.97 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $4,802.46 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $4,802.46 CIGNA HEALTHCARE — ALL PAYOR: $1,684
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR HYSTEROSCOPY,W/ENDO BX	$8,246	$1,896.58	$550.32 – $7,224.85
Hysteroscopy with biopsy of the uterus lining: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $2,889.94 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $2,889.94 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,743 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $2,889.94 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $550.32 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $6,117.98 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $6,117.98 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $2,889.94 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $6,117.98
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: HC INJ LUMBAR/SACRAL, W/IMAGING GUIDANCE	$2,303.58	$529.82	$359.35 – $2,396.57
Spinal injection, lower back (epidural), with imaging guidance: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $629.45 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $359.35 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $629.45 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,135 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $629.45 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $359.35 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $2,396.57 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $2,396.57 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $629.45 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $2,396.57
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) In the file: HC INJ LUMBAR/SACRAL, W/IMAGING GUIDANCE	$2,303.58	$529.82	Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR INJ LUMBAR/SACRAL, W/IMAGING GUIDANCE	$3,231	$743.13	$359.35 – $2,423.25
Spinal injection, lower back (epidural), with imaging guidance: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $629.45 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $359.35 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $629.45 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,135 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $629.45 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $359.35 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $2,396.57 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $2,396.57 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $629.45 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $2,396.57
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: HC EPIDURAL INJ, ANES/STEROID, TRANSFORAMINAL, LUMB/SACR, SNGL LEVL	$4,019	$924.37	$642.64 – $3,014.25
Nerve root injection, lower back, with imaging guidance: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $809.20 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $642.64 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $809.20 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,135 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $809.20 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $642.64 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $967.30 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $967.30 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $809.20 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $967.30
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) In the file: HC EPIDURAL INJ, ANES/STEROID, TRANSFORAMINAL, LUMB/SACR, SNGL LEVL	$4,019	$924.37	Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · modifier 50 In the file: HC EPIDURAL INJ, ANES/STEROID, TRANSFORAMINAL, LUMB/SACR, SNGL LEVL	$8,038	$1,848.74	$1,126.50 – $6,028.50
Nerve root injection, lower back, with imaging guidance: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $1,213.80 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $1,285.28 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $1,213.80 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,702.50 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $1,213.80 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $1,285.28 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,450.95 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,450.95 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1,213.80 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,450.95
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: PR REVISE MEDIAN N/CARPAL TUNNEL SURG	$2,318.09	$533.16	$481.27 – $4,437.28
Carpal tunnel release: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $1,774.91 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $1,774.91 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,524 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $1,774.91 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $2,443.87 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $2,443.87 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $1,774.91 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $2,443.87
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) In the file: PR REVISE MEDIAN N/CARPAL TUNNEL SURG	$2,318.09	$533.16	Not listed in the file
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 50,PBBFAC In the file: PR REVISE MEDIAN N/CARPAL TUNNEL SURG	$6,588	$1,515.24	$721.90 – $6,655.92
Carpal tunnel release: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $2,662.37 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $721.90 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $2,662.37 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,286 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $2,662.37 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $721.90 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $3,665.80 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $3,665.80 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $2,662.37 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $3,665.80
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · modifier 50,PBBFAC In the file: PR DISCISSION,2ND CATARACT,LASER	$1,888	$434.24	$721.77 – $2,286
Laser treatment of clouding after cataract surgery: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $747.95 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $721.90 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $747.95 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,286 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $747.95 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $721.90 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $1,050.38 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $1,050.38 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $747.95 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $1,050.38
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · modifier PBBFAC In the file: PR DISCISSION,2ND CATARACT,LASER	$944	$217.12	$396.48 – $1,524
Laser treatment of clouding after cataract surgery: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $498.63 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $498.63 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $1,524 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $498.63 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $481.27 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $700.25 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $700.25 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $498.63 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $700.25
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: CATARACT SURG W/IOL 1 STAGE	$15,431.68	$3,549.29	$888.07 – $5,182.50
Cataract removal with lens implant: 10 of 31 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $2,073 AETNA BETTER HEALTH (HEALTHY LOUISIANA) — ALL PAYOR: $888.07 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $2,073 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $2,447 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $2,073 AMERIHEALTH CARITAS LOUISIANA (HEALTHY LOUISIANA) — ALL PAYOR: $888.07 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $3,090.24 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $3,090.24 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $2,073 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $3,090.24

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	Not listed in the file	Not listed in the file	$9,700 – $118,134.01
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 21 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $71,596 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $71,596 AETNA HEALTH INC. PPO/POS — ALL PAYOR: $52,447 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $71,596 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $96,936 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $96,936 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $67,677 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $96,936 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $96,936 FIRST HEALTH NETWORK — ALL PAYOR: $52,447
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MS DRG -MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC;APR DRG -ELECTIVE HIP JOINT REPLACEMENT;SOI -Mod	$117,683.30	$27,067.16	$13,335 – $88,262.48
Hip or knee replacement (major joint of the leg), without major complications: 10 of 18 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $15,921 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $15,921 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $15,921 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $18,938 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $18,938 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $13,335 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $18,938 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $18,938 HEALTHCOMP PPO (FORMERLY GILSBAR 360 — ALL PAYOR: $72,963.65 HUMANA MILITARY � TRICARE — ALL PAYOR: $18,989
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$14,910 – $23,778
Neck (cervical) spinal fusion, without complications: 10 of 17 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $19,376 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $19,376 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $19,376 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $23,778 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $23,778 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $16,707 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $23,778 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $23,778 HUMANA � MEDICARE ADVANTAGE — ALL PAYOR: $19,376 MULTIPLAN/PHCS/AMERICAN LIFECARE — ALL PAYOR: $22,963.78
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: MS DRG -UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC;APR DRG -UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA;SOI -Minor	$45,636.84	$10,496.47	$6,772 – $34,227.63
Uterus and ovary surgery (not for cancer), without complications: 10 of 18 insurance plan rates (HEALTHY LOUISIANA) AND HEALTHY BLUE DUAL ADVANTAGE (HMO-D-S — ALL PAYOR: $10,997 AETNA HEALTH INC. - MEDICARE ADVANTAGE — ALL PAYOR: $10,997 AMERICAN HEALTH ADVANTAGE OF LOUISIANA (FORMERLY DIGNITY HEA — ALL PAYOR: $10,997 BLUE CROSS BLUE SHIELD OF LOUISIANA BLUE CONNECT — ALL PAYOR: $12,040 BLUE CROSS BLUE SHIELD OF LOUISIANA HMO — ALL PAYOR: $12,040 BLUE CROSS BLUE SHIELD OF LOUISIANA MEDICARE ADVANTAGE PRODU — ALL PAYOR: $8,529 BLUE CROSS BLUE SHIELD OF LOUISIANA PPO — ALL PAYOR: $12,040 BLUE CROSS BLUE SHIELD OF LOUISIANA- BLUE HIGH-PERFORMANCE N — ALL PAYOR: $12,040 HEALTHCOMP PPO (FORMERLY GILSBAR 360 — ALL PAYOR: $28,294.84 HUMANA MILITARY � TRICARE — ALL PAYOR: $11,552

Source: Ochsner LSU Health Monroe’s standard charges file (ochsner-craft.s3.amazonaws.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	4864 Jackson Street, Monroe, LA 71202
Parish	Ouachita Parish
State	Louisiana
Phone	(318) 388‑7000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	190011
Name in Medicare records	OCHSNER LSU HEALTH MONROE
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(318) 330‑7000^[4]
Name on the hospital’s website	Ochsner LSU Health - Monroe Medical Center
Official website	ochsnerlsuhs.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.

Ochsner LSU Health - Monroe Medical Center — ochsnerlsuhs.org
Emergency Medicine | Ochsner LSU Health — ochsnerlsuhs.org
Trauma Care | Ochsner LSU Health — ochsnerlsuhs.org

Ochsner LSU Health Monroe

Summary

Profile from official sources

At a glance