Does Palo Alto County Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Palo Alto County Hospital. In a medical emergency, call 911.

Where is Palo Alto County Hospital?

3201 1st Street, Emmetsburg, IA 50536, in Palo Alto County, Iowa.

What is the phone number of Palo Alto County Hospital?

(712) 852-5500, as listed by Medicare (CMS).

What is the Medicare star rating of Palo Alto County Hospital?

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

Palo Alto County Hospital — Emmetsburg, IA

Quick answers

Does Palo Alto County Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Palo Alto County Hospital. In a medical emergency, call 911.
Where is Palo Alto County Hospital?: 3201 1st Street, Emmetsburg, IA 50536, in Palo Alto County, Iowa.
What is the phone number of Palo Alto County Hospital?: (712) 852-5500, as listed by Medicare (CMS).
What is the Medicare star rating of Palo Alto County Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^{[4][6][7][8][10][14][15][16]}

Behavioral Health
Cardio-Pulmonary Services
Radiology
Rehabilitation
Surgery
Telemedicine
Emergency medicine
Obstetrics
Cardiology
Orthopedics
Otolaryngology (ENT)
Urology
Ophthalmology
Podiatry
Dermatology
Audiology
Laboratory
Nutrition and diabetes education

Conditions treated^{[8][9][10][11][12][13][14]}

Treatments^{[4][8][9][11][12][13][15]}

Diabetic Education
Nutrition Services
Sleep Studies
Exercise stress test
Echocardiogram
Holter and ZioPatch cardiac monitoring
EKG
Pulmonary function testing
Overnight oximetry
Sleep study
Chest physiotherapy
CT scan
MRI (mobile service, Sunday and Thursday mornings)
X-ray
3D mammography
Bone density scan
Nuclear medicine
Thyroid scan
Fluoroscopy
Ultrasound
Laboratory testing
Medication-assisted treatment
Physical therapy
Occupational therapy
Speech therapy
Lymphedema therapy
Dry needling
Aquatic therapy
Mental health screening
Heart and vascular screening

Procedures^[10]

Inspire therapy implant for sleep apnea
Laparoscopic surgery
Cataract and laser eye surgery
Endoscopy

Programs and centers^{[4][8][10][13][14][15][17]}

Birth Center
Business Health Services
Community Health Services
Cardiac rehabilitation (phase II and III)
Pulmonary rehabilitation
Diabetes education program
Emergency surgery, 24 hours a day
Hospice room (inpatient)
Direct access lab wellness testing

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

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Visiting	Medical/surgical visiting is open; obstetrical grandparents and family 10 a.m.-7 p.m., friends 11 a.m.-7 p.m^[5]
Parking	Central front parking lot is reserved for patients and visitors^[5]
Patient portal	Patient Portal

Doctors and clinicians (68)

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

Main specialties

Doctors with a page on this site (68)

Alicia HeutonNurse Practitioner
Alireza Yarahmadi, MDNeurology
Amanda E. Young, DOFamily Practice
Amanda J. KuchenreutherNurse Practitioner
Amanda M. RichardNurse Practitioner
Amber Houge, PAPhysician Assistant
Ami L. FrohlingNurse Practitioner
Andrew G. Pick, DOOrthopedic Surgery
Anna M. ZwiefelNurse Practitioner
Benjamin J. Armstrong, CNACertified Registered Nurse Anesthetist (CRNA)
Benjamin R. Branigan, MDGeneral Surgery
Blake E. PedersenNurse Practitioner
Bria SchoelermanPhysician Assistant
Brian P. Wilson, DOObstetrics/Gynecology
Bruce A. Feldmann, MDFamily Practice
Byron T. Beasley, MDInternal Medicine
Cameron L. Andela, CNACertified Registered Nurse Anesthetist (CRNA)
Chaitra Gopinath, MDEndocrinology
Craig G. Simons, DOHospitalist
Crystal E. MeyerNurse Practitioner
Dale H. Kroll, CNACertified Registered Nurse Anesthetist (CRNA)
Daniel J. McGuire, MDOrthopedic Surgery
Daunyale L. Sporaa, DOFamily Practice
David L. Ruzicka, DOFamily Practice

And 44 more: the button below opens the full list.

Other emergency rooms nearby

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

Avera Holy Family Hospital21 mi · Estherville, IA · Critical Access Hospital
Spencer Municipal Hospital23 mi · Spencer, IA · Acute Care Hospital
Kossuth Regional Health Center24 mi · Algona, IA · Critical Access Hospital
Pocahontas Community Hospital26 mi · Pocahontas, IA · Critical Access Hospital
Lakes Regional Healthcare30 mi · Spirit Lake, IA · Acute Care Hospital

Other hospitals nearby

Humboldt County Memorial Hospital35 mi · Humboldt, IA · Critical Access 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

Palo Alto County Hospital0.0 mi · Emmetsburg, IA · 5 of 5 stars
Lakeside Lutheran Home0.4 mi · Emmetsburg, IA · 4 of 5 stars
Emmetsburg Care Center1.3 mi · Emmetsburg, IA · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice of Palo Alto County0.3 mi · Emmetsburg, IA
Avera at Home20 mi · Estherville, IA
Avera @ Home of Spencer Hospital23 mi · Spencer, IA

All hospice providers in the state →

Home health agencies

Palo Alto Community Health0.3 mi · Emmetsburg, IA
Avera @ Home20 mi · Estherville, IA · 4 of 5 stars
Avera at Home of Spencer Hospital23 mi · Spencer, IA

All home health agencies in the state →

Dialysis facilities

Warner Dialysis Center Spencer23 mi · Spencer, IA · 3 of 5 stars
FMC - Algona24 mi · Algona, IA · 4 of 5 stars

All dialysis facilities 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

Community Health Center of Spencer23 mi · Spencer, IA · Community health center

Clinics and urgent care

Family Practice Clinic Emmetsburg0.3 mi · Emmetsburg, IA · Rural health clinic
Family Practice Clinic Graettinger9.2 mi · Graettinger, IA · Rural health clinic
Family Practice Clinic West Bend16 mi · West Bend, IA · Rural health clinic

Pharmacies

Hughes Pharmacy Services Inc.0.3 mi · Emmetsburg, IA · Community/retail pharmacy
Hy-Vee Inc0.3 mi · Emmetsburg, IA · Community/retail pharmacy

Assisted living nearby

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

Emerald Oaks0.3 mi · Emmetsburg, IA
Lakeside Assisted Living0.3 mi · Emmetsburg, IA
Ruthven Community Care Center10 mi · Ruthven, IA

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	89%National average: 72%
Would definitely recommend the hospital	84%National average: 71%
Nurses “always” communicated well	76%National average: 80%
Doctors “always” communicated well	78%National average: 80%
Staff “always” explained medicines before giving them	46%National average: 62%
Were given information about recovery at home	73%National average: 86%
Room and bathroom “always” clean	71%National average: 74%
Area around the room “always” quiet at night	72%National average: 60%
Completed surveys	26Response rate: 28%

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

Infections caught in the hospital

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

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

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	18.5%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; 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	Too few cases to report
Readmitted within 30 days: pneumonia	16.8%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; 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)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	103 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Too few cases to report

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 Iowa Best hospitals in Iowa

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 41 common services exactly as Palo Alto County Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Office or other outpatient visit for the evaluation and mana	$184	$138	$89 – $184
Established patient office visit (about 20–29 minutes): rates for 6 insurance plans Blue Cross — Medicare: $89.20 Corvel — Work Comp: $165.60 Humana — Medicare: $90.97 Molina — Medicaid: $184 Wellpoint — Medicaid: $184 Wellpoint — Medicare: $89.20
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management	$513	$384.75	$348 – $513
Emergency room visit (moderate): 10 of 13 insurance plan rates Blue Cross — HMO: $348.84 Blue Cross — Medicare: $513 Blue Cross — PPO: $348.84 Corvel — Work Comp: $461.70 Humana — Medicare: $513 Iowa Total Care — Medicaid: $513 Medigold — Medicare: $513 Midlands Choice — Commercial: $487.35 Molina — Medicaid: $513 UHC — Medicare: $513
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management	$513	$384.75	$119 – $487
Emergency room visit (moderate): rates for 9 insurance plans Blue Cross — Medicare: $119.38 Corvel — Work Comp: $461.70 Medigold — Medicare: $246.24 Midlands Choice — Commercial: $487.35 Molina — Medicaid: $334.37 UHC — Medicare: $246.24 United Behavioral Health — Medicare: $246.24 Wellpoint — Medicaid: $332.76 Wellpoint — Medicare: $119.38
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Emergency department visit for the evaluation and management	$309	$231.75	$149 – $309
Emergency room visit (moderate): rates for 5 insurance plans Blue Cross — Medicare: $149.80 Corvel — Work Comp: $278.10 Molina — Medicaid: $309 Wellpoint — Medicaid: $309 Wellpoint — Medicare: $149.80
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management	$750	$562.50	$510 – $750
Emergency room visit (moderately high): 10 of 13 insurance plan rates Blue Cross — HMO: $510 Blue Cross — Medicare: $750 Blue Cross — PPO: $510 Corvel — Work Comp: $675 Humana — Medicare: $750 Iowa Total Care — Medicaid: $750 Medigold — Medicare: $750 Midlands Choice — Commercial: $712.50 Molina — Medicaid: $750 UHC — Medicare: $750
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management	$750	$562.50	$174 – $712
Emergency room visit (moderately high): rates for 9 insurance plans Blue Cross — Medicare: $174.53 Corvel — Work Comp: $675 Medigold — Medicare: $360 Midlands Choice — Commercial: $712.50 Molina — Medicaid: $488.85 UHC — Medicare: $360 United Behavioral Health — Medicare: $360 Wellpoint — Medicaid: $486.49 Wellpoint — Medicare: $174.53
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Emergency department visit for the evaluation and management	$463	$347.25	$224 – $463
Emergency room visit (moderately high): rates for 5 insurance plans Blue Cross — Medicare: $224.46 Corvel — Work Comp: $416.70 Molina — Medicaid: $463 Wellpoint — Medicaid: $463 Wellpoint — Medicare: $224.46
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management	$902	$676.50	$613 – $902
Emergency room visit (high): 10 of 13 insurance plan rates Blue Cross — HMO: $613.36 Blue Cross — Medicare: $902 Blue Cross — PPO: $613.36 Corvel — Work Comp: $811.80 Humana — Medicare: $902 Iowa Total Care — Medicaid: $902 Medigold — Medicare: $902 Midlands Choice — Commercial: $856.90 Molina — Medicaid: $902 UHC — Medicare: $902
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management	$902	$676.50	$209 – $856
Emergency room visit (high): rates for 9 insurance plans Blue Cross — Medicare: $209.90 Corvel — Work Comp: $811.80 Medigold — Medicare: $432.96 Midlands Choice — Commercial: $856.90 Molina — Medicaid: $587.93 UHC — Medicare: $432.96 United Behavioral Health — Medicare: $432.96 Wellpoint — Medicaid: $585.08 Wellpoint — Medicare: $209.90
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Emergency department visit for the evaluation and management	$713	$534.75	$345 – $713
Emergency room visit (high): rates for 6 insurance plans Blue Cross — Medicare: $345.66 Corvel — Work Comp: $641.70 Humana — Medicare: $352.51 Molina — Medicaid: $713 Wellpoint — Medicaid: $713 Wellpoint — Medicare: $345.66

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch	$135	$101.25	$91 – $135
Basic metabolic panel (blood test): 10 of 13 insurance plan rates Blue Cross — HMO: $91.80 Blue Cross — Medicare: $135 Blue Cross — PPO: $91.80 Corvel — Work Comp: $121.50 Humana — Medicare: $135 Iowa Total Care — Medicaid: $135 Medigold — Medicare: $135 Midlands Choice — Commercial: $128.25 Molina — Medicaid: $135 UHC — Medicare: $135
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch	$135	$101.25	$31 – $128
Basic metabolic panel (blood test): rates for 9 insurance plans Blue Cross — Medicare: $31.42 Corvel — Work Comp: $121.50 Medigold — Medicare: $64.80 Midlands Choice — Commercial: $128.25 Molina — Medicaid: $87.99 UHC — Medicare: $64.80 United Behavioral Health — Medicare: $64.80 Wellpoint — Medicaid: $87.57 Wellpoint — Medicare: $31.42
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon	$156	$117	$106 – $156
Comprehensive metabolic panel (blood test): 10 of 13 insurance plan rates Blue Cross — HMO: $106.08 Blue Cross — Medicare: $156 Blue Cross — PPO: $106.08 Corvel — Work Comp: $140.40 Humana — Medicare: $156 Iowa Total Care — Medicaid: $156 Medigold — Medicare: $156 Midlands Choice — Commercial: $148.20 Molina — Medicaid: $156 UHC — Medicare: $156
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon	$156	$117	$36 – $148
Comprehensive metabolic panel (blood test): rates for 9 insurance plans Blue Cross — Medicare: $36.30 Corvel — Work Comp: $140.40 Medigold — Medicare: $74.88 Midlands Choice — Commercial: $148.20 Molina — Medicaid: $101.68 UHC — Medicare: $74.88 United Behavioral Health — Medicare: $74.88 Wellpoint — Medicaid: $101.19 Wellpoint — Medicare: $36.30
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or	$305	$228.75	$207 – $305
Obstetric blood test panel: 10 of 13 insurance plan rates Blue Cross — HMO: $207.40 Blue Cross — Medicare: $305 Blue Cross — PPO: $207.40 Corvel — Work Comp: $274.50 Humana — Medicare: $305 Iowa Total Care — Medicaid: $305 Medigold — Medicare: $305 Midlands Choice — Commercial: $289.75 Molina — Medicaid: $305 UHC — Medicare: $305
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or	$305	$228.75	$70 – $289
Obstetric blood test panel: 10 of 11 insurance plan rates Blue Cross — Medicare: $70.97 Corvel — Work Comp: $274.50 Humana — Medicare: $72.38 Iowa Total Care — Medicaid: $195.92 Medigold — Medicare: $146.40 Midlands Choice — Commercial: $289.75 Molina — Medicaid: $198.80 UHC — Medicare: $146.40 United Behavioral Health — Medicare: $146.40 Wellpoint — Medicaid: $197.84
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester	$132	$99	$89 – $132
Cholesterol panel (lipid panel): 10 of 13 insurance plan rates Blue Cross — HMO: $89.76 Blue Cross — Medicare: $132 Blue Cross — PPO: $89.76 Corvel — Work Comp: $118.80 Humana — Medicare: $132 Iowa Total Care — Medicaid: $132 Medigold — Medicare: $132 Midlands Choice — Commercial: $125.40 Molina — Medicaid: $132 UHC — Medicare: $132
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester	$132	$99	$30 – $125
Cholesterol panel (lipid panel): rates for 9 insurance plans Blue Cross — Medicare: $30.72 Corvel — Work Comp: $118.80 Medigold — Medicare: $63.36 Midlands Choice — Commercial: $125.40 Molina — Medicaid: $86.04 UHC — Medicare: $63.36 United Behavioral Health — Medicare: $63.36 Wellpoint — Medicaid: $85.62 Wellpoint — Medicare: $30.72
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo	$135	$101.25	$91 – $135
Kidney function panel: 10 of 13 insurance plan rates Blue Cross — HMO: $91.80 Blue Cross — Medicare: $135 Blue Cross — PPO: $91.80 Corvel — Work Comp: $121.50 Humana — Medicare: $135 Iowa Total Care — Medicaid: $135 Medigold — Medicare: $135 Midlands Choice — Commercial: $128.25 Molina — Medicaid: $135 UHC — Medicare: $135
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo	$135	$101.25	$31 – $128
Kidney function panel: 10 of 11 insurance plan rates Blue Cross — Medicare: $31.42 Corvel — Work Comp: $121.50 Humana — Medicare: $32.04 Iowa Total Care — Medicaid: $86.72 Medigold — Medicare: $64.80 Midlands Choice — Commercial: $128.25 Molina — Medicaid: $87.99 UHC — Medicare: $64.80 United Behavioral Health — Medicare: $64.80 Wellpoint — Medicaid: $87.57
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase	$153	$114.75	$104 – $153
Liver function panel: 10 of 13 insurance plan rates Blue Cross — HMO: $104.04 Blue Cross — Medicare: $153 Blue Cross — PPO: $104.04 Corvel — Work Comp: $137.70 Humana — Medicare: $153 Iowa Total Care — Medicaid: $153 Medigold — Medicare: $153 Midlands Choice — Commercial: $145.35 Molina — Medicaid: $153 UHC — Medicare: $153
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase	$153	$114.75	$35 – $145
Liver function panel: rates for 9 insurance plans Blue Cross — Medicare: $35.60 Corvel — Work Comp: $137.70 Medigold — Medicare: $73.44 Midlands Choice — Commercial: $145.35 Molina — Medicaid: $99.73 UHC — Medicare: $73.44 United Behavioral Health — Medicare: $73.44 Wellpoint — Medicaid: $99.24 Wellpoint — Medicare: $35.60
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$67	$50.25	$45 – $67
Urine test (automated, with microscope): 10 of 13 insurance plan rates Blue Cross — HMO: $45.56 Blue Cross — Medicare: $67 Blue Cross — PPO: $45.56 Corvel — Work Comp: $60.30 Humana — Medicare: $67 Iowa Total Care — Medicaid: $67 Medigold — Medicare: $67 Midlands Choice — Commercial: $63.65 Molina — Medicaid: $67 UHC — Medicare: $67
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, gl	$67	$50.25	$45 – $67
Urine test (automated, with microscope): 10 of 13 insurance plan rates Blue Cross — HMO: $45.56 Blue Cross — Medicare: $67 Blue Cross — PPO: $45.56 Corvel — Work Comp: $60.30 Humana — Medicare: $67 Iowa Total Care — Medicaid: $67 Medigold — Medicare: $67 Midlands Choice — Commercial: $63.65 Molina — Medicaid: $67 UHC — Medicare: $67
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$67	$50.25	$15 – $63
Urine test (automated, with microscope): rates for 9 insurance plans Blue Cross — Medicare: $15.59 Corvel — Work Comp: $60.30 Medigold — Medicare: $32.16 Midlands Choice — Commercial: $63.65 Molina — Medicaid: $43.67 UHC — Medicare: $32.16 United Behavioral Health — Medicare: $32.16 Wellpoint — Medicaid: $43.46 Wellpoint — Medicare: $15.59
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$38	$28.50	$25 – $38
Urine test (manual, without microscope): 10 of 13 insurance plan rates Blue Cross — HMO: $25.84 Blue Cross — Medicare: $38 Blue Cross — PPO: $25.84 Corvel — Work Comp: $34.20 Humana — Medicare: $38 Iowa Total Care — Medicaid: $38 Medigold — Medicare: $38 Midlands Choice — Commercial: $36.10 Molina — Medicaid: $38 UHC — Medicare: $38
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$38	$28.50	$8 – $36
Urine test (manual, without microscope): 10 of 11 insurance plan rates Blue Cross — Medicare: $8.84 Corvel — Work Comp: $34.20 Humana — Medicare: $9.02 Iowa Total Care — Medicaid: $24.41 Medigold — Medicare: $18.24 Midlands Choice — Commercial: $36.10 Molina — Medicaid: $24.77 UHC — Medicare: $18.24 United Behavioral Health — Medicare: $18.24 Wellpoint — Medicaid: $24.65
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$36	$27	$24 – $36
Urine test (automated, without microscope): 10 of 13 insurance plan rates Blue Cross — HMO: $24.48 Blue Cross — Medicare: $36 Blue Cross — PPO: $24.48 Corvel — Work Comp: $32.40 Humana — Medicare: $36 Iowa Total Care — Medicaid: $36 Medigold — Medicare: $36 Midlands Choice — Commercial: $34.20 Molina — Medicaid: $36 UHC — Medicare: $36
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$36	$27	$8 – $34
Urine test (automated, without microscope): rates for 9 insurance plans Blue Cross — Medicare: $8.38 Corvel — Work Comp: $32.40 Medigold — Medicare: $17.28 Midlands Choice — Commercial: $34.20 Molina — Medicaid: $23.46 UHC — Medicare: $17.28 United Behavioral Health — Medicare: $17.28 Wellpoint — Medicaid: $23.35 Wellpoint — Medicare: $8.38
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee · modifier QW In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$36	$27	$24 – $36
Urine test (automated, without microscope): 10 of 13 insurance plan rates Blue Cross — HMO: $24.48 Blue Cross — Medicare: $36 Blue Cross — PPO: $24.48 Corvel — Work Comp: $32.40 Humana — Medicare: $36 Iowa Total Care — Medicaid: $36 Medigold — Medicare: $36 Midlands Choice — Commercial: $34.20 Molina — Medicaid: $36 UHC — Medicare: $36
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Prostate specific antigen (PSA); total	$152	$114	$103 – $152
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates Blue Cross — HMO: $103.36 Blue Cross — Medicare: $152 Blue Cross — PPO: $103.36 Corvel — Work Comp: $136.80 Humana — Medicare: $152 Iowa Total Care — Medicaid: $152 Medigold — Medicare: $152 Midlands Choice — Commercial: $144.40 Molina — Medicaid: $152 UHC — Medicare: $152
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prostate specific antigen (PSA); total	$152	$114	$35 – $144
PSA (prostate specific antigen) blood test: rates for 9 insurance plans Blue Cross — Medicare: $35.37 Corvel — Work Comp: $136.80 Medigold — Medicare: $72.96 Midlands Choice — Commercial: $144.40 Molina — Medicaid: $99.07 UHC — Medicare: $72.96 United Behavioral Health — Medicare: $72.96 Wellpoint — Medicaid: $98.60 Wellpoint — Medicare: $35.37
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Thyroid stimulating hormone (TSH)	$137	$102.75	$93 – $137
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates Blue Cross — HMO: $93.16 Blue Cross — Medicare: $137 Blue Cross — PPO: $93.16 Corvel — Work Comp: $123.30 Humana — Medicare: $137 Iowa Total Care — Medicaid: $137 Medigold — Medicare: $137 Midlands Choice — Commercial: $130.15 Molina — Medicaid: $137 UHC — Medicare: $137
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Thyroid stimulating hormone (TSH) Newborn metabolic screening	$49	$36.75	$33 – $49
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates Blue Cross — HMO: $33.32 Blue Cross — Medicare: $49 Blue Cross — PPO: $33.32 Corvel — Work Comp: $44.10 Humana — Medicare: $49 Iowa Total Care — Medicaid: $49 Medigold — Medicare: $49 Midlands Choice — Commercial: $46.55 Molina — Medicaid: $49 UHC — Medicare: $49
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thyroid stimulating hormone (TSH)	$137	$102.75	$31 – $130
Thyroid stimulating hormone (TSH) test: rates for 9 insurance plans Blue Cross — Medicare: $31.88 Corvel — Work Comp: $123.30 Medigold — Medicare: $65.76 Midlands Choice — Commercial: $130.15 Molina — Medicaid: $89.30 UHC — Medicare: $65.76 United Behavioral Health — Medicare: $65.76 Wellpoint — Medicaid: $88.87 Wellpoint — Medicare: $31.88
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count	$108	$81	$73 – $108
Complete blood count (CBC) with differential: 10 of 13 insurance plan rates Blue Cross — HMO: $73.44 Blue Cross — Medicare: $108 Blue Cross — PPO: $73.44 Corvel — Work Comp: $97.20 Humana — Medicare: $108 Iowa Total Care — Medicaid: $108 Medigold — Medicare: $108 Midlands Choice — Commercial: $102.60 Molina — Medicaid: $108 UHC — Medicare: $108
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count	$108	$81	$25 – $102
Complete blood count (CBC) with differential: rates for 9 insurance plans Blue Cross — Medicare: $25.13 Corvel — Work Comp: $97.20 Medigold — Medicare: $51.84 Midlands Choice — Commercial: $102.60 Molina — Medicaid: $70.39 UHC — Medicare: $51.84 United Behavioral Health — Medicare: $51.84 Wellpoint — Medicaid: $70.05 Wellpoint — Medicare: $25.13
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)	$93	$69.75	$63 – $93
Complete blood count (CBC), automated: 10 of 13 insurance plan rates Blue Cross — HMO: $63.24 Blue Cross — Medicare: $93 Blue Cross — PPO: $63.24 Corvel — Work Comp: $83.70 Humana — Medicare: $93 Iowa Total Care — Medicaid: $93 Medigold — Medicare: $93 Midlands Choice — Commercial: $88.35 Molina — Medicaid: $93 UHC — Medicare: $93
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)	$93	$69.75	$21 – $88
Complete blood count (CBC), automated: rates for 9 insurance plans Blue Cross — Medicare: $21.64 Corvel — Work Comp: $83.70 Medigold — Medicare: $44.64 Midlands Choice — Commercial: $88.35 Molina — Medicaid: $60.62 UHC — Medicare: $44.64 United Behavioral Health — Medicare: $44.64 Wellpoint — Medicaid: $60.32 Wellpoint — Medicare: $21.64
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Prothrombin time;	$54	$40.50	$36 – $54
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates Blue Cross — HMO: $36.72 Blue Cross — Medicare: $54 Blue Cross — PPO: $36.72 Corvel — Work Comp: $48.60 Humana — Medicare: $54 Iowa Total Care — Medicaid: $54 Medigold — Medicare: $54 Midlands Choice — Commercial: $51.30 Molina — Medicaid: $54 UHC — Medicare: $54
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time;	$54	$40.50	$12 – $51
Blood clotting time test (prothrombin time, PT): rates for 9 insurance plans Blue Cross — Medicare: $12.57 Corvel — Work Comp: $48.60 Medigold — Medicare: $25.92 Midlands Choice — Commercial: $51.30 Molina — Medicaid: $35.20 UHC — Medicare: $25.92 United Behavioral Health — Medicare: $25.92 Wellpoint — Medicaid: $35.03 Wellpoint — Medicare: $12.57
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee · modifier QW In the file: Prothrombin time;	$32	$24	$21 – $32
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates Blue Cross — HMO: $21.76 Blue Cross — Medicare: $32 Blue Cross — PPO: $21.76 Corvel — Work Comp: $28.80 Humana — Medicare: $32 Iowa Total Care — Medicaid: $32 Medigold — Medicare: $32 Midlands Choice — Commercial: $30.40 Molina — Medicaid: $32 UHC — Medicare: $32
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Thromboplastin time, partial (PTT); plasma or whole blood	$74	$55.50	$50 – $74
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates Blue Cross — HMO: $50.32 Blue Cross — Medicare: $74 Blue Cross — PPO: $50.32 Corvel — Work Comp: $66.60 Humana — Medicare: $74 Iowa Total Care — Medicaid: $74 Medigold — Medicare: $74 Midlands Choice — Commercial: $70.30 Molina — Medicaid: $74 UHC — Medicare: $74
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time, partial (PTT); plasma or whole blood	$74	$55.50	$17 – $70
Blood clotting test (partial thromboplastin time, PTT): rates for 9 insurance plans Blue Cross — Medicare: $17.22 Corvel — Work Comp: $66.60 Medigold — Medicare: $35.52 Midlands Choice — Commercial: $70.30 Molina — Medicaid: $48.23 UHC — Medicare: $35.52 United Behavioral Health — Medicare: $35.52 Wellpoint — Medicaid: $48 Wellpoint — Medicare: $17.22

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 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Computed tomography, head or brain; without contrast material	$2,200	$1,650	$1,496 – $2,200
CT scan of the head or brain, without contrast: 10 of 13 insurance plan rates Blue Cross — HMO: $1,496 Blue Cross — Medicare: $2,200 Blue Cross — PPO: $1,496 Corvel — Work Comp: $1,980 Humana — Medicare: $2,200 Iowa Total Care — Medicaid: $2,200 Medigold — Medicare: $2,200 Midlands Choice — Commercial: $2,090 Molina — Medicaid: $2,200 UHC — Medicare: $2,200
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, head or brain; without contrast material	$2,200	$1,650	$511 – $2,090
CT scan of the head or brain, without contrast: rates for 9 insurance plans Blue Cross — Medicare: $511.95 Corvel — Work Comp: $1,980 Medigold — Medicare: $1,056 Midlands Choice — Commercial: $2,090 Molina — Medicaid: $1,433.96 UHC — Medicare: $1,056 United Behavioral Health — Medicare: $1,056 Wellpoint — Medicaid: $1,427.04 Wellpoint — Medicare: $511.95
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth	$5,800	$4,350	$3,460 – $5,800
MRI of the brain, before and after contrast: 10 of 13 insurance plan rates Blue Cross — HMO: $3,944 Blue Cross — Medicare: $3,494 Blue Cross — PPO: $3,944 Corvel — Work Comp: $5,220 Humana — Medicare: $3,563 Iowa Total Care — Medicaid: $5,800 Medigold — Medicare: $3,460 Midlands Choice — Commercial: $5,510 Molina — Medicaid: $5,800 UHC — Medicare: $3,460
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth	$5,800	$4,350	$1,349 – $5,510
MRI of the brain, before and after contrast: rates for 10 insurance plans Blue Cross — Medicare: $1,349.68 Corvel — Work Comp: $5,220 Humana — Medicare: $1,376.41 Medigold — Medicare: $2,784 Midlands Choice — Commercial: $5,510 Molina — Medicaid: $3,780.45 UHC — Medicare: $2,784 United Behavioral Health — Medicare: $2,784 Wellpoint — Medicaid: $3,762.19 Wellpoint — Medicare: $1,349.68
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Radiologic examination, chest; 2 views	$360	$270	$244 – $360
Chest X-ray, 2 views: 10 of 13 insurance plan rates Blue Cross — HMO: $244.80 Blue Cross — Medicare: $360 Blue Cross — PPO: $244.80 Corvel — Work Comp: $324 Humana — Medicare: $360 Iowa Total Care — Medicaid: $360 Medigold — Medicare: $360 Midlands Choice — Commercial: $342 Molina — Medicaid: $360 UHC — Medicare: $360
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Radiologic examination, chest; 2 views	$360	$270	$83 – $342
Chest X-ray, 2 views: rates for 9 insurance plans Blue Cross — Medicare: $83.77 Corvel — Work Comp: $324 Medigold — Medicare: $172.80 Midlands Choice — Commercial: $342 Molina — Medicaid: $234.65 UHC — Medicare: $172.80 United Behavioral Health — Medicare: $172.80 Wellpoint — Medicaid: $233.52 Wellpoint — Medicare: $83.77
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views	$530	$397.50	$360 – $530
X-ray of the lower spine, at least 4 views: 10 of 13 insurance plan rates Blue Cross — HMO: $360.40 Blue Cross — Medicare: $530 Blue Cross — PPO: $360.40 Corvel — Work Comp: $477 Humana — Medicare: $530 Iowa Total Care — Medicaid: $530 Medigold — Medicare: $530 Midlands Choice — Commercial: $503.50 Molina — Medicaid: $530 UHC — Medicare: $530
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views	$530	$397.50	$123 – $503
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans Blue Cross — Medicare: $123.33 Corvel — Work Comp: $477 Humana — Medicare: $125.78 Medigold — Medicare: $254.40 Midlands Choice — Commercial: $503.50 Molina — Medicaid: $345.45 UHC — Medicare: $254.40 United Behavioral Health — Medicare: $254.40 Wellpoint — Medicaid: $343.79 Wellpoint — Medicare: $123.33
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	$2,839	$2,129.25	$1,930 – $2,839
MRI of the lower back (lumbar spine), without contrast: 10 of 13 insurance plan rates Blue Cross — HMO: $1,930.52 Blue Cross — Medicare: $2,839 Blue Cross — PPO: $1,930.52 Corvel — Work Comp: $2,555.10 Humana — Medicare: $2,839 Iowa Total Care — Medicaid: $2,839 Medigold — Medicare: $2,839 Midlands Choice — Commercial: $2,697.05 Molina — Medicaid: $2,839 UHC — Medicare: $2,839
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	$2,839	$2,129.25	$660 – $2,697
MRI of the lower back (lumbar spine), without contrast: rates for 9 insurance plans Blue Cross — Medicare: $660.65 Corvel — Work Comp: $2,555.10 Medigold — Medicare: $1,362.72 Midlands Choice — Commercial: $2,697.05 Molina — Medicaid: $1,850.46 UHC — Medicare: $1,362.72 United Behavioral Health — Medicare: $1,362.72 Wellpoint — Medicaid: $1,841.53 Wellpoint — Medicare: $660.65
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Computed tomography, pelvis; with contrast material(s)	$2,613	$1,959.75	$1,776 – $2,613
CT scan of the pelvis, with contrast: 10 of 13 insurance plan rates Blue Cross — HMO: $1,776.84 Blue Cross — Medicare: $2,613 Blue Cross — PPO: $1,776.84 Corvel — Work Comp: $2,351.70 Humana — Medicare: $2,613 Iowa Total Care — Medicaid: $2,613 Medigold — Medicare: $2,613 Midlands Choice — Commercial: $2,482.35 Molina — Medicaid: $2,613 UHC — Medicare: $2,613
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, pelvis; with contrast material(s)	$2,613	$1,959.75	$608 – $2,482
CT scan of the pelvis, with contrast: 10 of 11 insurance plan rates Blue Cross — Medicare: $608.06 Corvel — Work Comp: $2,351.70 Humana — Medicare: $620.10 Iowa Total Care — Medicaid: $1,678.47 Medigold — Medicare: $1,254.24 Midlands Choice — Commercial: $2,482.35 Molina — Medicaid: $1,703.16 UHC — Medicare: $1,254.24 United Behavioral Health — Medicare: $1,254.24 Wellpoint — Medicaid: $1,694.93
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee · modifier LT In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material	$3,027	$2,270.25	$2,058 – $3,027
MRI of a leg joint (such as the knee), without contrast: 10 of 13 insurance plan rates Blue Cross — HMO: $2,058.36 Blue Cross — Medicare: $3,027 Blue Cross — PPO: $2,058.36 Corvel — Work Comp: $2,724.30 Humana — Medicare: $3,027 Iowa Total Care — Medicaid: $3,027 Medigold — Medicare: $3,027 Midlands Choice — Commercial: $2,875.65 Molina — Medicaid: $3,027 UHC — Medicare: $3,027
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee · modifier RT In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material	$3,027	$2,270.25	$2,058 – $3,027
MRI of a leg joint (such as the knee), without contrast: 10 of 13 insurance plan rates Blue Cross — HMO: $2,058.36 Blue Cross — Medicare: $3,027 Blue Cross — PPO: $2,058.36 Corvel — Work Comp: $2,724.30 Humana — Medicare: $3,027 Iowa Total Care — Medicaid: $3,027 Medigold — Medicare: $3,027 Midlands Choice — Commercial: $2,875.65 Molina — Medicaid: $3,027 UHC — Medicare: $3,027
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material	$3,027	$2,270.25	$704 – $2,875
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans Blue Cross — Medicare: $704.40 Corvel — Work Comp: $2,724.30 Humana — Medicare: $718.34 Medigold — Medicare: $1,452.96 Midlands Choice — Commercial: $2,875.65 Molina — Medicaid: $1,973 UHC — Medicare: $1,452.96 United Behavioral Health — Medicare: $1,452.96 Wellpoint — Medicaid: $1,963.47 Wellpoint — Medicare: $704.40
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Computed tomography, abdomen and pelvis; with contrast material(s)	$4,864	$3,648	$3,307 – $4,864
CT scan of the abdomen and pelvis, with contrast: 10 of 13 insurance plan rates Blue Cross — HMO: $3,307.52 Blue Cross — Medicare: $3,494 Blue Cross — PPO: $3,307.52 Corvel — Work Comp: $4,377.60 Humana — Medicare: $3,563 Iowa Total Care — Medicaid: $4,864 Medigold — Medicare: $3,460 Midlands Choice — Commercial: $4,620.80 Molina — Medicaid: $4,864 UHC — Medicare: $3,460
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, abdomen and pelvis; with contrast material(s)	$4,864	$3,648	$1,131 – $4,620
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans Blue Cross — Medicare: $1,131.87 Corvel — Work Comp: $4,377.60 Humana — Medicare: $1,154.29 Medigold — Medicare: $2,334.72 Midlands Choice — Commercial: $4,620.80 Molina — Medicaid: $3,170.36 UHC — Medicare: $2,334.72 United Behavioral Health — Medicare: $2,334.72 Wellpoint — Medicaid: $3,155.05 Wellpoint — Medicare: $1,131.87
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Ultrasound, abdominal, real time with image documentation; complete	$765	$573.75	$520 – $765
Ultrasound of the abdomen, complete: 10 of 13 insurance plan rates Blue Cross — HMO: $520.20 Blue Cross — Medicare: $765 Blue Cross — PPO: $520.20 Corvel — Work Comp: $688.50 Humana — Medicare: $765 Iowa Total Care — Medicaid: $765 Medigold — Medicare: $765 Midlands Choice — Commercial: $726.75 Molina — Medicaid: $765 UHC — Medicare: $765
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, abdominal, real time with image documentation; complete	$765	$573.75	$178 – $726
Ultrasound of the abdomen, complete: 10 of 11 insurance plan rates Blue Cross — Medicare: $178.02 Corvel — Work Comp: $688.50 Humana — Medicare: $181.54 Iowa Total Care — Medicaid: $491.40 Medigold — Medicare: $367.20 Midlands Choice — Commercial: $726.75 Molina — Medicaid: $498.63 UHC — Medicare: $367.20 United Behavioral Health — Medicare: $367.20 Wellpoint — Medicaid: $496.22
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day	$950	$712.50	$646 – $950
Pregnancy ultrasound (after the first trimester): 10 of 13 insurance plan rates Blue Cross — HMO: $646 Blue Cross — Medicare: $950 Blue Cross — PPO: $646 Corvel — Work Comp: $855 Humana — Medicare: $950 Iowa Total Care — Medicaid: $950 Medigold — Medicare: $950 Midlands Choice — Commercial: $902.50 Molina — Medicaid: $950 UHC — Medicare: $950
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day	$950	$712.50	$221 – $902
Pregnancy ultrasound (after the first trimester): rates for 10 insurance plans Blue Cross — Medicare: $221.07 Corvel — Work Comp: $855 Humana — Medicare: $225.45 Medigold — Medicare: $456 Midlands Choice — Commercial: $902.50 Molina — Medicaid: $619.21 UHC — Medicare: $456 United Behavioral Health — Medicare: $456 Wellpoint — Medicaid: $616.22 Wellpoint — Medicare: $221.07
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Ultrasound, transvaginal	$770	$577.50	$523 – $770
Transvaginal ultrasound: 10 of 13 insurance plan rates Blue Cross — HMO: $523.60 Blue Cross — Medicare: $770 Blue Cross — PPO: $523.60 Corvel — Work Comp: $693 Humana — Medicare: $770 Iowa Total Care — Medicaid: $770 Medigold — Medicare: $770 Midlands Choice — Commercial: $731.50 Molina — Medicaid: $770 UHC — Medicare: $770
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, transvaginal	$770	$577.50	$179 – $731
Transvaginal ultrasound: 10 of 11 insurance plan rates Blue Cross — Medicare: $179.18 Corvel — Work Comp: $693 Humana — Medicare: $182.73 Iowa Total Care — Medicaid: $494.61 Medigold — Medicare: $369.60 Midlands Choice — Commercial: $731.50 Molina — Medicaid: $501.89 UHC — Medicare: $369.60 United Behavioral Health — Medicare: $369.60 Wellpoint — Medicaid: $499.46
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee · modifier 59 In the file: Ultrasound, transvaginal	$585	$438.75	$397 – $585
Transvaginal ultrasound: 10 of 13 insurance plan rates Blue Cross — HMO: $397.80 Blue Cross — Medicare: $585 Blue Cross — PPO: $397.80 Corvel — Work Comp: $526.50 Humana — Medicare: $585 Iowa Total Care — Medicaid: $585 Medigold — Medicare: $585 Midlands Choice — Commercial: $555.75 Molina — Medicaid: $585 UHC — Medicare: $585
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee · modifier LT In the file: Diagnostic mammography, including computer-aided detection (	$480	$360	$326 – $480
Diagnostic mammogram, one breast: 10 of 13 insurance plan rates Blue Cross — HMO: $326.40 Blue Cross — Medicare: $480 Blue Cross — PPO: $326.40 Corvel — Work Comp: $432 Humana — Medicare: $480 Iowa Total Care — Medicaid: $480 Medigold — Medicare: $480 Midlands Choice — Commercial: $456 Molina — Medicaid: $480 UHC — Medicare: $480
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee · modifier RT In the file: Diagnostic mammography, including computer-aided detection (	$480	$360	$326 – $480
Diagnostic mammogram, one breast: 10 of 13 insurance plan rates Blue Cross — HMO: $326.40 Blue Cross — Medicare: $480 Blue Cross — PPO: $326.40 Corvel — Work Comp: $432 Humana — Medicare: $480 Iowa Total Care — Medicaid: $480 Medigold — Medicare: $480 Midlands Choice — Commercial: $456 Molina — Medicaid: $480 UHC — Medicare: $480
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee · modifier LT In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral	$464	$348	$315 – $464
Diagnostic mammogram, one breast: 10 of 13 insurance plan rates Blue Cross — HMO: $315.52 Blue Cross — Medicare: $464 Blue Cross — PPO: $315.52 Corvel — Work Comp: $417.60 Humana — Medicare: $464 Iowa Total Care — Medicaid: $464 Medigold — Medicare: $464 Midlands Choice — Commercial: $440.80 Molina — Medicaid: $464 UHC — Medicare: $464
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Diagnostic mammography, including computer-aided detection (	$583	$437.25	$396 – $583
Diagnostic mammogram, both breasts: 10 of 13 insurance plan rates Blue Cross — HMO: $396.44 Blue Cross — Medicare: $583 Blue Cross — PPO: $396.44 Corvel — Work Comp: $524.70 Humana — Medicare: $583 Iowa Total Care — Medicaid: $583 Medigold — Medicare: $583 Midlands Choice — Commercial: $553.85 Molina — Medicaid: $583 UHC — Medicare: $583
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	$583	$437.25	$396 – $583
Diagnostic mammogram, both breasts: 10 of 13 insurance plan rates Blue Cross — HMO: $396.44 Blue Cross — Medicare: $583 Blue Cross — PPO: $396.44 Corvel — Work Comp: $524.70 Humana — Medicare: $583 Iowa Total Care — Medicaid: $583 Medigold — Medicare: $583 Midlands Choice — Commercial: $553.85 Molina — Medicaid: $583 UHC — Medicare: $583
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic mammography, including computer-aided detection (	$583	$437.25	$135 – $553
Diagnostic mammogram, both breasts: rates for 10 insurance plans Blue Cross — Medicare: $135.67 Corvel — Work Comp: $524.70 Iowa Total Care — Medicaid: $374.49 Medigold — Medicare: $279.84 Midlands Choice — Commercial: $553.85 Molina — Medicaid: $380 UHC — Medicare: $279.84 United Behavioral Health — Medicare: $279.84 Wellpoint — Medicaid: $378.16 Wellpoint — Medicare: $135.67
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Screening mammography, bilateral (2-view study of each breas	$399	$299.25	$271 – $399
Screening mammogram, both breasts: 10 of 13 insurance plan rates Blue Cross — HMO: $271.32 Blue Cross — Medicare: $399 Blue Cross — PPO: $271.32 Corvel — Work Comp: $359.10 Humana — Medicare: $399 Iowa Total Care — Medicaid: $399 Medigold — Medicare: $399 Midlands Choice — Commercial: $379.05 Molina — Medicaid: $399 UHC — Medicare: $399
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed	$399	$299.25	$271 – $399
Screening mammogram, both breasts: 10 of 13 insurance plan rates Blue Cross — HMO: $271.32 Blue Cross — Medicare: $399 Blue Cross — PPO: $271.32 Corvel — Work Comp: $359.10 Humana — Medicare: $399 Iowa Total Care — Medicaid: $399 Medigold — Medicare: $399 Midlands Choice — Commercial: $379.05 Molina — Medicaid: $399 UHC — Medicare: $399
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Screening mammography, bilateral (2-view study of each breas	$399	$299.25	$92 – $379
Screening mammogram, both breasts: rates for 9 insurance plans Blue Cross — Medicare: $92.85 Corvel — Work Comp: $359.10 Medigold — Medicare: $191.52 Midlands Choice — Commercial: $379.05 Molina — Medicaid: $260.07 UHC — Medicare: $191.52 United Behavioral Health — Medicare: $191.52 Wellpoint — Medicaid: $258.81 Wellpoint — Medicare: $92.85

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist	$4,492	$3,369	$3,054 – $4,492
Sleep study (overnight, in a sleep lab): 10 of 13 insurance plan rates Blue Cross — HMO: $3,054.56 Blue Cross — Medicare: $3,494 Blue Cross — PPO: $3,054.56 Corvel — Work Comp: $4,042.80 Humana — Medicare: $3,563 Iowa Total Care — Medicaid: $4,492 Medigold — Medicare: $3,460 Midlands Choice — Commercial: $4,267.40 Molina — Medicaid: $4,492 UHC — Medicare: $3,460
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist	$4,492	$3,369	$1,045 – $4,267
Sleep study (overnight, in a sleep lab): 10 of 11 insurance plan rates Blue Cross — Medicare: $1,045.31 Corvel — Work Comp: $4,042.80 Humana — Medicare: $1,066.01 Iowa Total Care — Medicaid: $2,885.46 Medigold — Medicare: $2,156.16 Midlands Choice — Commercial: $4,267.40 Molina — Medicaid: $2,927.89 UHC — Medicare: $2,156.16 United Behavioral Health — Medicare: $2,156.16 Wellpoint — Medicaid: $2,913.75

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib	$120	$90	$81 – $120
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 13 insurance plan rates Blue Cross — HMO: $81.60 Blue Cross — Medicare: $120 Blue Cross — PPO: $81.60 Corvel — Work Comp: $108 Humana — Medicare: $120 Iowa Total Care — Medicaid: $120 Medigold — Medicare: $120 Midlands Choice — Commercial: $114 Molina — Medicaid: $120 UHC — Medicare: $120
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GO In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib	$120	$90	$81 – $120
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 13 insurance plan rates Blue Cross — HMO: $81.60 Blue Cross — Medicare: $120 Blue Cross — PPO: $81.60 Corvel — Work Comp: $108 Humana — Medicare: $120 Iowa Total Care — Medicaid: $120 Medigold — Medicare: $120 Midlands Choice — Commercial: $114 Molina — Medicaid: $120 UHC — Medicare: $120
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib	$120	$90	$27 – $114
Physical therapy: therapeutic exercise (each 15 minutes): rates for 9 insurance plans Blue Cross — Medicare: $27.92 Corvel — Work Comp: $108 Medigold — Medicare: $57.60 Midlands Choice — Commercial: $114 Molina — Medicaid: $78.22 UHC — Medicare: $57.60 United Behavioral Health — Medicare: $57.60 Wellpoint — Medicaid: $77.84 Wellpoint — Medicare: $27.92
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: Physical therapy evaluation: low complexity, requiring these	$191	$143.25	$129 – $191
Physical therapy evaluation (low complexity): 10 of 13 insurance plan rates Blue Cross — HMO: $129.88 Blue Cross — Medicare: $191 Blue Cross — PPO: $129.88 Corvel — Work Comp: $171.90 Humana — Medicare: $191 Iowa Total Care — Medicaid: $191 Medigold — Medicare: $191 Midlands Choice — Commercial: $181.45 Molina — Medicaid: $191 UHC — Medicare: $191
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Physical therapy evaluation: low complexity, requiring these	$191	$143.25	$44 – $181
Physical therapy evaluation (low complexity): rates for 9 insurance plans Blue Cross — Medicare: $44.45 Corvel — Work Comp: $171.90 Medigold — Medicare: $91.68 Midlands Choice — Commercial: $181.45 Molina — Medicaid: $124.49 UHC — Medicare: $91.68 United Behavioral Health — Medicare: $91.68 Wellpoint — Medicaid: $123.89 Wellpoint — Medicare: $44.45
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy, 30 minutes with patient	$202	$151.50	$47 – $191
Psychotherapy, 30 minutes: 10 of 13 insurance plan rates Blue Cross — HMO: $137.36 Blue Cross — Medicare: $47.01 Blue Cross — PPO: $137.36 Corvel — Work Comp: $181.80 Humana — Medicare: $47.94 Iowa Total Care — Medicaid: $129.76 Medigold — Medicare: $96.96 Midlands Choice — Commercial: $191.90 Molina — Medicaid: $131.66 UHC — Medicare: $96.96
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy, 45 minutes with patient	$313	$234.75	$72 – $297
Psychotherapy, 45 minutes: 10 of 12 insurance plan rates Blue Cross — HMO: $212.84 Blue Cross — Medicare: $72.84 Blue Cross — PPO: $212.84 Corvel — Work Comp: $281.70 Humana — Medicare: $74.28 Medigold — Medicare: $150.24 Midlands Choice — Commercial: $297.35 Molina — Medicaid: $204.01 UHC — Medicare: $150.24 United Behavioral Health — Medicare: $150.24
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy, 60 minutes with patient	$353	$264.75	$82 – $335
Psychotherapy, 60 minutes: 10 of 13 insurance plan rates Blue Cross — HMO: $240.04 Blue Cross — Medicare: $82.14 Blue Cross — PPO: $240.04 Corvel — Work Comp: $317.70 Humana — Medicare: $83.77 Iowa Total Care — Medicaid: $226.75 Medigold — Medicare: $169.44 Midlands Choice — Commercial: $335.35 Molina — Medicaid: $230.09 UHC — Medicare: $169.44

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg,	$1,892	$1,419	$1,286 – $1,892
Spinal injection, lower back (epidural), with imaging guidance: 10 of 13 insurance plan rates Blue Cross — HMO: $1,286.56 Blue Cross — Medicare: $1,892 Blue Cross — PPO: $1,286.56 Corvel — Work Comp: $1,702.80 Humana — Medicare: $1,892 Iowa Total Care — Medicaid: $1,892 Medigold — Medicare: $1,892 Midlands Choice — Commercial: $1,797.40 Molina — Medicaid: $1,892 UHC — Medicare: $1,892
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neur	$1,892	$1,419	$1,286 – $1,892
Spinal injection, lower back (epidural), with imaging guidance: 10 of 13 insurance plan rates Blue Cross — HMO: $1,286.56 Blue Cross — Medicare: $1,892 Blue Cross — PPO: $1,286.56 Corvel — Work Comp: $1,702.80 Humana — Medicare: $1,892 Iowa Total Care — Medicaid: $1,892 Medigold — Medicare: $1,892 Midlands Choice — Commercial: $1,797.40 Molina — Medicaid: $1,892 UHC — Medicare: $1,892
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg,	$1,892	$1,419	$440 – $1,797
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans Blue Cross — Medicare: $440.28 Corvel — Work Comp: $1,702.80 Iowa Total Care — Medicaid: $1,215.34 Medigold — Medicare: $908.16 Midlands Choice — Commercial: $1,797.40 Molina — Medicaid: $1,233.21 UHC — Medicare: $908.16 United Behavioral Health — Medicare: $908.16 Wellpoint — Medicaid: $1,227.25 Wellpoint — Medicare: $440.28
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee · modifier LT In the file: Injection(s), anesthetic agent(s) and/or steroid; transforam	$1,177	$882.75	$800 – $1,177
Nerve root injection, lower back, with imaging guidance: 10 of 13 insurance plan rates Blue Cross — HMO: $800.36 Blue Cross — Medicare: $1,177 Blue Cross — PPO: $800.36 Corvel — Work Comp: $1,059.30 Humana — Medicare: $1,177 Iowa Total Care — Medicaid: $1,177 Medigold — Medicare: $1,177 Midlands Choice — Commercial: $1,118.15 Molina — Medicaid: $1,177 UHC — Medicare: $1,177
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee · modifier RT In the file: Injection(s), anesthetic agent(s) and/or steroid; transforam	$1,177	$882.75	$800 – $1,177
Nerve root injection, lower back, with imaging guidance: 10 of 13 insurance plan rates Blue Cross — HMO: $800.36 Blue Cross — Medicare: $1,177 Blue Cross — PPO: $800.36 Corvel — Work Comp: $1,059.30 Humana — Medicare: $1,177 Iowa Total Care — Medicaid: $1,177 Medigold — Medicare: $1,177 Midlands Choice — Commercial: $1,118.15 Molina — Medicaid: $1,177 UHC — Medicare: $1,177
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: Injection(s), anesthetic agent(s) and/or steroid; transforam	$1,177	$882.75	$273 – $1,118
Nerve root injection, lower back, with imaging guidance: 10 of 11 insurance plan rates Blue Cross — Medicare: $273.89 Corvel — Work Comp: $1,059.30 Humana — Medicare: $279.32 Iowa Total Care — Medicaid: $756.05 Medigold — Medicare: $564.96 Midlands Choice — Commercial: $1,118.15 Molina — Medicaid: $767.17 UHC — Medicare: $564.96 United Behavioral Health — Medicare: $564.96 Wellpoint — Medicaid: $763.46

Source: Palo Alto County Hospital’s standard charges file (pachs.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 31, 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	Critical Access Hospital
Address	3201 1st Street, Emmetsburg, IA 50536
County	Palo Alto County
State	Iowa
Phone	(712) 852‑5500
Emergency services	Yes
Ownership	Government - Local
Medicare overall rating	Not rated by CMS
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	161357
Name in Medicare records	PALO ALTO COUNTY HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	Palo Alto County Health System
Official website	pachs.com
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.

Palo Alto County Health System — pachs.com
Patients & Visitors — pachs.com
Emergency Medical Center Serving West Bend, IA — pachs.com
Birth Center - PACHS — pachs.com
Cardio-Pulmonary Services - PACHS — pachs.com
Radiology - PACHS — pachs.com
Surgery - PACHS — pachs.com
Mental Health Screening - PACHS — pachs.com
Behavioral Health - PACHS — pachs.com
Rehabilitation - PACHS — pachs.com
Nutrition Services - PACHS — pachs.com
Laboratory - PACHS — pachs.com
Specialty Clinics - PACHS — pachs.com
Community Health Services - PACHS — pachs.com

Palo Alto County Hospital

Summary

Profile from official sources

At a glance