Does Pampa Regional Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Pampa Regional Medical Center. In a medical emergency, call 911.

Where is Pampa Regional Medical Center?

1 Medical Plaza, Pampa, TX 79065, in Gray County, Texas.

What is the phone number of Pampa Regional Medical Center?

(806) 665-3721, as listed by Medicare (CMS).

What is the Medicare star rating of Pampa Regional Medical Center?

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.

Pampa Regional Medical Center — Pampa, TX

Quick answers

Does Pampa Regional Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Pampa Regional Medical Center. In a medical emergency, call 911.
Where is Pampa Regional Medical Center?: 1 Medical Plaza, Pampa, TX 79065, in Gray County, Texas.
What is the phone number of Pampa Regional Medical Center?: (806) 665-3721, as listed by Medicare (CMS).
What is the Medicare star rating of Pampa Regional Medical Center?: 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][5][6][8][13][14]}

Conditions treated^[12][13][14]

Depression
Anxiety
Grief
Anger
Bipolar disorder
Dementia
Suicidal thoughts
Schizophrenia
Psychosis
Cardiac arrhythmias
Congestive heart failure
Hypertension
Ischemic heart disease
Peripheral arterial disease
Cardiomyopathy
Varicose veins

Treatments^{[4][5][8][9][11][12]}

Physical therapy
Allergy testing and treatment
Swing bed (transitional care)
Extended care
Cardiac catheterization
Coronary angioplasty
Stress testing
Echocardiography
Pacemaker interrogation and management
Peripheral angioplasty
LAP-BAND gastric banding
Lithotripsy
Laparoscopic surgery
Endoscopy
Major joint surgery
Digital mammography
CT scan
MRI
Ultrasound
Nuclear medicine
Bone density testing

Procedures^[4][8]

General surgery
Gynecologic surgery
Urologic surgery
Orthopaedic surgery
Cardiac catheterization
Inpatient surgery
Outpatient surgery
Colon and rectal endoscopy

Programs and centers^{[6][7][12][14]}

24/7 acute heart attack program
Behavioral Health Clinic
Inpatient behavioral health unit (voluntary and involuntary admissions)
FastTrackCare ER arrival reservation
Urgent care

Emergency care (hospital website)^[4][7]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV
Stroke designation	Stroke Ready Center (accredited by ACHC)

Visiting and practical information

Visiting	Visiting hours 9:00 a.m. to 9:00 p.m.; no more than two visitors at the bedside at one time^[15]
Patient portal	Patient Portal

Recognition^[4][6][7]

Accredited by The Accreditation Commission for Health Care
Geriatric-Accredited Emergency Department
Stroke Ready Center accredited by ACHC

Doctors and clinicians (83)

83 doctors and other clinicians list Pampa Regional Medical Center 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 (83)

Abid M. Farooq, DOInternal Medicine
Adan GonzalezNephrology
Agustin Cabrera Santamaria, MDCardiovascular Disease (Cardiology)
Ali Rasool, MDHospitalist
Amber J. White, PAPhysician Assistant
Angela HawkinsNurse Practitioner
Anna O. Isaacs, MDFamily Practice
Ashley N. Fulcher, NPNurse Practitioner
Austin R. Fultz, CNACertified Registered Nurse Anesthetist (CRNA)
Beau L. McCrory, MDFamily Practice
Belinda M. Diaz, NPNurse Practitioner
Blane C. Womack, MDEmergency Medicine
Bobby W. Smith, DOGeneral Surgery
Branch T. Archer Iii, MDDiagnostic Radiology
Brenda S. McCullough, NPNurse Practitioner
Callie A. Crouch, NPNurse Practitioner
Caron S. McMillian, NPNurse Practitioner
Chandana Yalamanchili, MDHospitalist
Darci Crawford, NPNurse Practitioner
David G. Brabham, DOCardiovascular Disease (Cardiology)
David M. Hampton, MDOrthopedic Surgery
Debra L. Krenek, CNACertified Registered Nurse Anesthetist (CRNA)
Dezirae R. Belcher, NPNurse Practitioner
Esther O. Iheukwumere, MDNephrology

And 59 more: the button below opens the full list.

Other emergency rooms nearby

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

Golden Plains Community Hospital30 mi · Borger, TX · Critical Access Hospital
Parkview Hospital36 mi · Wheeler, TX · Critical Access Hospital
Hemphill County Hospital39 mi · Canadian, TX · Critical Access Hospital
Shamrock General Hospital43 mi · Shamrock, TX · Critical Access Hospital
Hansford County Hospital49 mi · Spearman, TX · Critical Access Hospital

Other hospitals nearby

Ochiltree General Hospital59 mi · Perryton, TX · 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

Avir at Pampa5.0 mi · Pampa, TX · 5 of 5 stars
Pampa Nursing Center5.0 mi · Pampa, TX · 4 of 5 stars

All nursing homes in the state →

Dialysis facilities

Fresenius Medical Care Pampa0.0 mi · Pampa, TX · 2 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.

Clinics and urgent care

Harvester Family Medical Clinic0.0 mi · Pampa, TX · Rural health clinic
Pampa Medical Group0.0 mi · Pampa, TX · Rural health clinic

Pharmacies

Frogge Enterprises Inc0.0 mi · Pampa, TX · Community/retail pharmacy
Keyes Pharmacy LLC0.0 mi · Pampa, TX · Community/retail pharmacy
United Supermarkets LLC0.0 mi · Pampa, TX · Community/retail pharmacy

Assisted living nearby

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

Meredith Court0.0 mi · Pampa, TX

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

What patients said (patient survey)

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

Not reported to Medicare

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

Infections caught in the hospital

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

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

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

Complications and deaths

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

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

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

Return visits to the hospital (readmissions)

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

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

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	110 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)	Not reported to Medicare

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 Texas Best hospitals in Texas

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 62 common services exactly as Pampa Regional Medical Center 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)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ER ROOM - LEVEL 3	$2,200	$418	$19.50 – $1,760
Emergency room visit (moderate): 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $108.78 BCBS — BCBS HMO: $625.35 BCBS — BCBS HMO Advantage: $203.24 BCBS — BCBS PPO: $694.59 BCBS — BCBS Traditional: $694.59 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $166.50 Employer Direct Healthcare — Employer Direct Healthcare: $155.40 Imperial Insurance Companies — Imperial Insurance Companies: $117.66 Molina — Molina Insurance Exchange: $719.15 Molina — Molina Medicare Advantage: $116.55
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ER ROOM - LEVEL 4	$3,500	$665	$166.29 – $2,800
Emergency room visit (moderately high): 10 of 29 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $166.29 BCBS — BCBS HMO: $985.01 BCBS — BCBS HMO Advantage: $320.13 BCBS — BCBS PPO: $1,094.07 BCBS — BCBS Traditional: $1,094.07 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $254.52 Employer Direct Healthcare — Employer Direct Healthcare: $237.55 Imperial Insurance Companies — Imperial Insurance Companies: $179.86 Molina — Molina Insurance Exchange: $1,132.76 Molina — Molina Medicare Advantage: $178.16
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ER ROOM - LEVEL 5	$5,000	$950	$237.34 – $4,000
Emergency room visit (high): 10 of 28 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $237.34 BCBS — BCBS HMO: $1,412.63 BCBS — BCBS HMO Advantage: $459.10 BCBS — BCBS PPO: $1,569.03 BCBS — BCBS Traditional: $1,569.03 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $363.27 Employer Direct Healthcare — Employer Direct Healthcare: $339.05 Imperial Insurance Companies — Imperial Insurance Companies: $256.71 Molina — Molina Insurance Exchange: $1,624.54 Molina — Molina Medicare Advantage: $254.29

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: BASIC METABOLIC PANEL	$415.25	$78	$7.36 – $332.20
Basic metabolic panel (blood test): 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $8.29 Amerigroup — Amerigroup Medicaid: $11.94 BCBS — BCBS HMO: $34.18 BCBS — BCBS HMO Advantage: $7.36 BCBS — BCBS Medicaid: $11.94 BCBS — BCBS PPO: $37.99 BCBS — BCBS Traditional: $37.99 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $12.69 Employer Direct Healthcare — Employer Direct Healthcare: $11.84 Imperial Insurance Companies — Imperial Insurance Companies: $8.97
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL(ML)	$446.88	$84	$9.19 – $357.50
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $10.35 Amerigroup — Amerigroup Medicaid: $14.89 BCBS — BCBS HMO: $42.66 BCBS — BCBS HMO Advantage: $9.19 BCBS — BCBS Medicaid: $14.89 BCBS — BCBS PPO: $47.41 BCBS — BCBS Traditional: $47.41 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $15.84 Employer Direct Healthcare — Employer Direct Healthcare: $14.78 Imperial Insurance Companies — Imperial Insurance Companies: $11.19
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL	$361.63	$68	$11.65 – $289.30
Cholesterol panel (lipid panel): 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $13.12 Amerigroup — Amerigroup Medicaid: $18.90 BCBS — BCBS HMO: $54.10 BCBS — BCBS HMO Advantage: $11.65 BCBS — BCBS Medicaid: $18.90 BCBS — BCBS PPO: $60.12 BCBS — BCBS Traditional: $60.12 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $20.09 Employer Direct Healthcare — Employer Direct Healthcare: $18.75 Imperial Insurance Companies — Imperial Insurance Companies: $14.19
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL - 80069 - 800593	$270	$51	$7.55 – $231
Kidney function panel: 10 of 29 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $8.51 Amerigroup — Amerigroup Medicaid: $12.25 BCBS — BCBS HMO: $35.07 BCBS — BCBS HMO Advantage: $7.55 BCBS — BCBS Medicaid: $12.25 BCBS — BCBS PPO: $38.97 BCBS — BCBS Traditional: $38.97 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $13.02 Employer Direct Healthcare — Employer Direct Healthcare: $12.15 Imperial Insurance Companies — Imperial Insurance Companies: $9.20
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL - 80069 - 835409	$288.75	$51	$7.55 – $231
Kidney function panel: 10 of 29 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $8.51 Amerigroup — Amerigroup Medicaid: $12.25 BCBS — BCBS HMO: $35.07 BCBS — BCBS HMO Advantage: $7.55 BCBS — BCBS Medicaid: $12.25 BCBS — BCBS PPO: $38.97 BCBS — BCBS Traditional: $38.97 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $13.02 Employer Direct Healthcare — Employer Direct Healthcare: $12.15 Imperial Insurance Companies — Imperial Insurance Companies: $9.20
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: LIVER FIBROSIS RISK PROFILE	$39.05	$69	$5.86 – $292.60
Liver function panel: 10 of 29 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $8.01 Amerigroup — Amerigroup Medicaid: $11.53 BCBS — BCBS HMO: $33.01 BCBS — BCBS HMO Advantage: $7.11 BCBS — BCBS Medicaid: $11.53 BCBS — BCBS PPO: $36.68 BCBS — BCBS Traditional: $36.68 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $12.26 Employer Direct Healthcare — Employer Direct Healthcare: $11.44 Imperial Insurance Companies — Imperial Insurance Companies: $8.66
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL	$365.75	$69	$5.86 – $292.60
Liver function panel: 10 of 29 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $8.01 Amerigroup — Amerigroup Medicaid: $11.53 BCBS — BCBS HMO: $33.01 BCBS — BCBS HMO Advantage: $7.11 BCBS — BCBS Medicaid: $11.53 BCBS — BCBS PPO: $36.68 BCBS — BCBS Traditional: $36.68 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $12.26 Employer Direct Healthcare — Employer Direct Healthcare: $11.44 Imperial Insurance Companies — Imperial Insurance Companies: $8.66
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO	$106.25	$15	$2.76 – $85
Urine test (automated, with microscope): 10 of 31 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $3.11 Amerigroup — Amerigroup Medicaid: $4.47 BCBS — BCBS HMO: $12.81 BCBS — BCBS HMO Advantage: $2.76 BCBS — BCBS Medicaid: $4.47 BCBS — BCBS PPO: $14.23 BCBS — BCBS Traditional: $14.23 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $4.76 Employer Direct Healthcare — Employer Direct Healthcare: $4.44 Imperial Insurance Companies — Imperial Insurance Companies: $3.36
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: URINALYSIS AUTO W SCOPE	$83.88	$15	$2.76 – $85
Urine test (automated, with microscope): 10 of 31 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $3.11 Amerigroup — Amerigroup Medicaid: $4.47 BCBS — BCBS HMO: $12.81 BCBS — BCBS HMO Advantage: $2.76 BCBS — BCBS Medicaid: $4.47 BCBS — BCBS PPO: $14.23 BCBS — BCBS Traditional: $14.23 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $4.76 Employer Direct Healthcare — Employer Direct Healthcare: $4.44 Imperial Insurance Companies — Imperial Insurance Companies: $3.36
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: UA W O MICRO MANUAL	$10	$1	$1.50 – $37.21
Urine test (manual, without microscope): 10 of 25 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $3.41 Amerigroup — Amerigroup Medicaid: $4.91 BCBS — BCBS HMO: $10 BCBS — BCBS HMO Advantage: $3.03 BCBS — BCBS Medicaid: $4.91 BCBS — BCBS PPO: $10 BCBS — BCBS Traditional: $10 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $5.22 Employer Direct Healthcare — Employer Direct Healthcare: $4.87 Imperial Insurance Companies — Imperial Insurance Companies: $3.69
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: UA W O MICRO MANUAL(ML)	$46.51	$1	$1.50 – $37.21
Urine test (manual, without microscope): 10 of 25 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $3.41 Amerigroup — Amerigroup Medicaid: $4.91 BCBS — BCBS HMO: $14.06 BCBS — BCBS HMO Advantage: $3.03 BCBS — BCBS Medicaid: $4.91 BCBS — BCBS PPO: $15.63 BCBS — BCBS Traditional: $15.63 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $5.22 Employer Direct Healthcare — Employer Direct Healthcare: $4.87 Imperial Insurance Companies — Imperial Insurance Companies: $3.69
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: URINALYSIS AUTO W/O SCOPE	$12.38	$2	$1.86 – $10.10
Urine test (automated, without microscope): 10 of 32 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $2.21 Amerigroup — Amerigroup Medicaid: $3.17 BCBS — BCBS HMO: $9.09 BCBS — BCBS HMO Advantage: $1.96 BCBS — BCBS Medicaid: $3.17 BCBS — BCBS PPO: $10.10 BCBS — BCBS Traditional: $10.10 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $3.38 Employer Direct Healthcare — Employer Direct Healthcare: $3.15 Imperial Insurance Companies — Imperial Insurance Companies: $2.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA ULTRASENSITIVE WO SERIAL L	$123.64	$19	$15.17 – $187
PSA (prostate specific antigen) blood test: 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $18.02 Amerigroup — Amerigroup Medicaid: $25.95 BCBS — BCBS HMO: $74.30 BCBS — BCBS HMO Advantage: $16 BCBS — BCBS Medicaid: $25.95 BCBS — BCBS PPO: $82.57 BCBS — BCBS Traditional: $82.57 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $27.59 Employer Direct Healthcare — Employer Direct Healthcare: $25.75 Imperial Insurance Companies — Imperial Insurance Companies: $19.49
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA SCREEN - 84153 - 810187	$233.75	$19	$15.17 – $187
PSA (prostate specific antigen) blood test: 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $18.02 Amerigroup — Amerigroup Medicaid: $25.95 BCBS — BCBS HMO: $74.30 BCBS — BCBS HMO Advantage: $16 BCBS — BCBS Medicaid: $25.95 BCBS — BCBS PPO: $82.57 BCBS — BCBS Traditional: $82.57 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $27.59 Employer Direct Healthcare — Employer Direct Healthcare: $25.75 Imperial Insurance Companies — Imperial Insurance Companies: $19.49
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA SERIAL MONITOR(REF)	$101.15	$19	$15.17 – $187
PSA (prostate specific antigen) blood test: 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $18.02 Amerigroup — Amerigroup Medicaid: $25.95 BCBS — BCBS HMO: $74.30 BCBS — BCBS HMO Advantage: $16 BCBS — BCBS Medicaid: $25.95 BCBS — BCBS PPO: $82.57 BCBS — BCBS Traditional: $82.57 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $27.59 Employer Direct Healthcare — Employer Direct Healthcare: $25.75 Imperial Insurance Companies — Imperial Insurance Companies: $19.49
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: THYROID CASCADE PROFILE LC	$84	$66	$12.60 – $281.60
Thyroid stimulating hormone (TSH) test: 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $16.46 Amerigroup — Amerigroup Medicaid: $23.71 BCBS — BCBS HMO: $67.87 BCBS — BCBS HMO Advantage: $14.62 BCBS — BCBS Medicaid: $23.71 BCBS — BCBS PPO: $75.43 BCBS — BCBS Traditional: $75.43 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $25.20 Employer Direct Healthcare — Employer Direct Healthcare: $23.52 Imperial Insurance Companies — Imperial Insurance Companies: $17.81
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH	$352	$66	$12.60 – $281.60
Thyroid stimulating hormone (TSH) test: 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $16.46 Amerigroup — Amerigroup Medicaid: $23.71 BCBS — BCBS HMO: $67.87 BCBS — BCBS HMO Advantage: $14.62 BCBS — BCBS Medicaid: $23.71 BCBS — BCBS PPO: $75.43 BCBS — BCBS Traditional: $75.43 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $25.20 Employer Direct Healthcare — Employer Direct Healthcare: $23.52 Imperial Insurance Companies — Imperial Insurance Companies: $17.81
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: COMPL CBC W/AUTO DIFF WBC(ML)	$231	$43	$6.76 – $184.80
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $7.61 Amerigroup — Amerigroup Medicaid: $10.96 BCBS — BCBS HMO: $31.39 BCBS — BCBS HMO Advantage: $6.76 BCBS — BCBS Medicaid: $10.96 BCBS — BCBS PPO: $34.89 BCBS — BCBS Traditional: $34.89 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $11.66 Employer Direct Healthcare — Employer Direct Healthcare: $10.88 Imperial Insurance Companies — Imperial Insurance Companies: $8.24
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: COMPLETE CBC W/O DIFF(ML)	$154	$29	$5.63 – $123.20
Complete blood count (CBC), automated: 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $6.34 Amerigroup — Amerigroup Medicaid: $9.13 BCBS — BCBS HMO: $26.14 BCBS — BCBS HMO Advantage: $5.63 BCBS — BCBS Medicaid: $9.13 BCBS — BCBS PPO: $29.05 BCBS — BCBS Traditional: $29.05 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $9.71 Employer Direct Healthcare — Employer Direct Healthcare: $9.06 Imperial Insurance Companies — Imperial Insurance Companies: $6.86
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME	$123.75	$23	$3.73 – $99
Blood clotting time test (prothrombin time, PT): 10 of 32 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $4.20 Amerigroup — Amerigroup Medicaid: $6.06 BCBS — BCBS HMO: $17.33 BCBS — BCBS HMO Advantage: $3.73 BCBS — BCBS Medicaid: $6.06 BCBS — BCBS PPO: $19.26 BCBS — BCBS Traditional: $19.26 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $6.44 Employer Direct Healthcare — Employer Direct Healthcare: $6.01 Imperial Insurance Companies — Imperial Insurance Companies: $4.55
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT	$143.86	$27	$5.23 – $115.09
Blood clotting test (partial thromboplastin time, PTT): 10 of 32 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $5.89 Amerigroup — Amerigroup Medicaid: $8.48 BCBS — BCBS HMO: $24.28 BCBS — BCBS HMO Advantage: $5.23 BCBS — BCBS Medicaid: $8.48 BCBS — BCBS PPO: $26.98 BCBS — BCBS Traditional: $26.98 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $9.02 Employer Direct Healthcare — Employer Direct Healthcare: $8.41 Imperial Insurance Companies — Imperial Insurance Companies: $6.37

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: CT HEAD/BRAIN W/O CONT	$2,750	$522	$41.66 – $2,200
CT scan of the head or brain, without contrast: 10 of 31 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $41.66 Amerigroup — Amerigroup Medicaid: $135.95 BCBS — BCBS HMO: $452.80 BCBS — BCBS HMO Advantage: $97.51 BCBS — BCBS Medicaid: $135.95 BCBS — BCBS PPO: $503.24 BCBS — BCBS Traditional: $503.24 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $63.77 Employer Direct Healthcare — Employer Direct Healthcare: $59.51 Imperial Insurance Companies — Imperial Insurance Companies: $45.06
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W&WO CONT	$6,009.75	$1,141	$139.03 – $4,807.80
MRI of the brain, before and after contrast: 10 of 31 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $139.03 Amerigroup — Amerigroup Medicaid: $475.54 BCBS — BCBS HMO: $1,542.67 BCBS — BCBS HMO Advantage: $332.21 BCBS — BCBS Medicaid: $475.54 BCBS — BCBS PPO: $1,714.51 BCBS — BCBS Traditional: $1,714.51 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $212.81 Employer Direct Healthcare — Employer Direct Healthcare: $198.62 Imperial Insurance Companies — Imperial Insurance Companies: $150.38
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: XR CHEST 2 V	$514.25	$97	$34.68 – $411.40
Chest X-ray, 2 views: 10 of 32 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $34.68 Amerigroup — Amerigroup Medicaid: $112.36 BCBS — BCBS HMO: $322.43 BCBS — BCBS HMO Advantage: $69.43 BCBS — BCBS Medicaid: $112.36 BCBS — BCBS PPO: $358.35 BCBS — BCBS Traditional: $358.35 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $53.09 Employer Direct Healthcare — Employer Direct Healthcare: $49.55 Imperial Insurance Companies — Imperial Insurance Companies: $37.51
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR L-SPINE>4 V	$1,014.75	$192	$41.66 – $811.80
X-ray of the lower spine, at least 4 views: 10 of 29 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $41.66 Amerigroup — Amerigroup Medicaid: $135.95 BCBS — BCBS HMO: $452.80 BCBS — BCBS HMO Advantage: $97.51 BCBS — BCBS Medicaid: $135.95 BCBS — BCBS PPO: $503.24 BCBS — BCBS Traditional: $503.24 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $63.77 Employer Direct Healthcare — Employer Direct Healthcare: $59.51 Imperial Insurance Companies — Imperial Insurance Companies: $45.06
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI L-SPINE W/O CONT	$4,345.61	$825	$95.08 – $3,476.49
MRI of the lower back (lumbar spine), without contrast: 10 of 31 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $95.08 Amerigroup — Amerigroup Medicaid: $303 BCBS — BCBS HMO: $941.48 BCBS — BCBS HMO Advantage: $202.74 BCBS — BCBS Medicaid: $303 BCBS — BCBS PPO: $1,046.35 BCBS — BCBS Traditional: $1,046.35 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $145.53 Employer Direct Healthcare — Employer Direct Healthcare: $135.83 Imperial Insurance Companies — Imperial Insurance Companies: $102.84
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST	$3,150.08	$598	$69.89 – $2,520.06
CT scan of the pelvis, with contrast: 10 of 25 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $69.89 Amerigroup — Amerigroup Medicaid: $227.20 BCBS — BCBS HMO: $736.17 BCBS — BCBS HMO Advantage: $158.53 BCBS — BCBS Medicaid: $227.20 BCBS — BCBS PPO: $818.17 BCBS — BCBS Traditional: $818.17 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $106.98 Employer Direct Healthcare — Employer Direct Healthcare: $99.85 Imperial Insurance Companies — Imperial Insurance Companies: $75.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI LOWER EXT JOINT-LT	$3,199	$954	$95.08 – $4,020.20
MRI of a leg joint (such as the knee), without contrast: 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $95.08 Amerigroup — Amerigroup Medicaid: $303 BCBS — BCBS HMO: $941.48 BCBS — BCBS HMO Advantage: $202.74 BCBS — BCBS Medicaid: $303 BCBS — BCBS PPO: $1,046.35 BCBS — BCBS Traditional: $1,046.35 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $145.53 Employer Direct Healthcare — Employer Direct Healthcare: $135.83 Imperial Insurance Companies — Imperial Insurance Companies: $102.84
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI LOWER EXT JOINT-RT	$3,199	$954	$95.08 – $4,020.20
MRI of a leg joint (such as the knee), without contrast: 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $95.08 Amerigroup — Amerigroup Medicaid: $303 BCBS — BCBS HMO: $941.48 BCBS — BCBS HMO Advantage: $202.74 BCBS — BCBS Medicaid: $303 BCBS — BCBS PPO: $1,046.35 BCBS — BCBS Traditional: $1,046.35 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $145.53 Employer Direct Healthcare — Employer Direct Healthcare: $135.83 Imperial Insurance Companies — Imperial Insurance Companies: $102.84
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI BILAT LOWER EXT JOINT	$5,025.25	$954	$95.08 – $4,020.20
MRI of a leg joint (such as the knee), without contrast: 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $95.08 Amerigroup — Amerigroup Medicaid: $303 BCBS — BCBS HMO: $941.48 BCBS — BCBS HMO Advantage: $202.74 BCBS — BCBS Medicaid: $303 BCBS — BCBS PPO: $1,046.35 BCBS — BCBS Traditional: $1,046.35 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $145.53 Employer Direct Healthcare — Employer Direct Healthcare: $135.83 Imperial Insurance Companies — Imperial Insurance Companies: $102.84
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD/PELVIS W/CONTRAST	$7,121.13	$1,353	$139.03 – $5,696.90
CT scan of the abdomen and pelvis, with contrast: 10 of 31 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $139.03 Amerigroup — Amerigroup Medicaid: $475.54 BCBS — BCBS HMO: $1,542.67 BCBS — BCBS HMO Advantage: $332.21 BCBS — BCBS Medicaid: $475.54 BCBS — BCBS PPO: $1,714.51 BCBS — BCBS Traditional: $1,714.51 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $212.81 Employer Direct Healthcare — Employer Direct Healthcare: $198.62 Imperial Insurance Companies — Imperial Insurance Companies: $150.38
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE	$1,457.23	$276	$41.66 – $1,165.78
Ultrasound of the abdomen, complete: 10 of 30 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $41.66 Amerigroup — Amerigroup Medicaid: $135.95 BCBS — BCBS HMO: $452.80 BCBS — BCBS HMO Advantage: $97.51 BCBS — BCBS Medicaid: $135.95 BCBS — BCBS PPO: $503.24 BCBS — BCBS Traditional: $503.24 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $63.77 Employer Direct Healthcare — Employer Direct Healthcare: $59.51 Imperial Insurance Companies — Imperial Insurance Companies: $45.06
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREGNANCY AFTER 14 WKS	$1,094.63	$207	$41.66 – $875.70
Pregnancy ultrasound (after the first trimester): 10 of 25 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $41.66 Amerigroup — Amerigroup Medicaid: $135.95 BCBS — BCBS HMO: $369.82 BCBS — BCBS HMO Advantage: $79.64 BCBS — BCBS Medicaid: $135.95 BCBS — BCBS PPO: $411.01 BCBS — BCBS Traditional: $411.01 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $63.77 Employer Direct Healthcare — Employer Direct Healthcare: $59.51 Imperial Insurance Companies — Imperial Insurance Companies: $45.06
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TV-GYN	$1,031.25	$195	$41.66 – $825
Transvaginal ultrasound: 10 of 29 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $41.66 Amerigroup — Amerigroup Medicaid: $135.95 BCBS — BCBS HMO: $356.73 BCBS — BCBS HMO Advantage: $76.82 BCBS — BCBS Medicaid: $135.95 BCBS — BCBS PPO: $396.47 BCBS — BCBS Traditional: $396.47 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $63.77 Employer Direct Healthcare — Employer Direct Healthcare: $59.51 Imperial Insurance Companies — Imperial Insurance Companies: $45.06
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAM DIAGNOSTIC RT W/ICAD	$1,293.10	$62	$49.63 – $1,034.48
Diagnostic mammogram, one breast: 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $80.12 BCBS — BCBS HMO: $380 BCBS — BCBS HMO Advantage: $81.83 BCBS — BCBS PPO: $422.33 BCBS — BCBS Traditional: $422.33 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $122.64 Employer Direct Healthcare — Employer Direct Healthcare: $114.46 Imperial Insurance Companies — Imperial Insurance Companies: $86.67 Molina — Molina Insurance Exchange: $134.90 Molina — Molina Medicare Advantage: $85.85
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAMMOGM DIAG UNI	$330.84	$62	$49.63 – $1,034.48
Diagnostic mammogram, one breast: 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $80.12 BCBS — BCBS HMO: $330.84 BCBS — BCBS HMO Advantage: $81.83 BCBS — BCBS PPO: $330.84 BCBS — BCBS Traditional: $330.84 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $122.64 Employer Direct Healthcare — Employer Direct Healthcare: $114.46 Imperial Insurance Companies — Imperial Insurance Companies: $86.67 Molina — Molina Insurance Exchange: $134.90 Molina — Molina Medicare Advantage: $85.85
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: MAM DIAGNOSTIC LT W/ICAD	$1,293.10	$62	$49.63 – $1,034.48
Diagnostic mammogram, one breast: 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $80.12 BCBS — BCBS HMO: $380 BCBS — BCBS HMO Advantage: $81.83 BCBS — BCBS PPO: $422.33 BCBS — BCBS Traditional: $422.33 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $122.64 Employer Direct Healthcare — Employer Direct Healthcare: $114.46 Imperial Insurance Companies — Imperial Insurance Companies: $86.67 Molina — Molina Insurance Exchange: $134.90 Molina — Molina Medicare Advantage: $85.85
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: DX MAMMO INCL CAD BI	$120.23	$85	$18.03 – $451.93
Diagnostic mammogram, both breasts: 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $102.79 BCBS — BCBS HMO: $120.23 BCBS — BCBS HMO Advantage: $104.72 BCBS — BCBS PPO: $120.23 BCBS — BCBS Traditional: $120.23 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $120.23 Employer Direct Healthcare — Employer Direct Healthcare: $120.23 Imperial Insurance Companies — Imperial Insurance Companies: $111.18 Molina — Molina Insurance Exchange: $120.23 Molina — Molina Medicare Advantage: $110.13
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMMOGM DIAG BI	$451.93	$85	$18.03 – $451.93
Diagnostic mammogram, both breasts: 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $102.79 BCBS — BCBS HMO: $451.93 BCBS — BCBS HMO Advantage: $104.72 BCBS — BCBS PPO: $451.93 BCBS — BCBS Traditional: $451.93 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $157.34 Employer Direct Healthcare — Employer Direct Healthcare: $146.85 Imperial Insurance Companies — Imperial Insurance Companies: $111.18 Molina — Molina Insurance Exchange: $173.07 Molina — Molina Medicare Advantage: $110.13
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCREEN UNI W/ICAD	$176	$42	$26.40 – $352
Screening mammogram, both breasts: 10 of 26 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $84.79 BCBS — BCBS HMO: $176 BCBS — BCBS HMO Advantage: $86.54 BCBS — BCBS PPO: $176 BCBS — BCBS Traditional: $176 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $129.78 Employer Direct Healthcare — Employer Direct Healthcare: $121.13 Imperial Insurance Companies — Imperial Insurance Companies: $91.71 Managed Medicare - CAH — Managed Medicare - CAH: $86.52 Molina — Molina Insurance Exchange: $142.76
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMOGRAM SCREENING	$352	$42	$26.40 – $352
Screening mammogram, both breasts: 10 of 26 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $84.79 BCBS — BCBS HMO: $352 BCBS — BCBS HMO Advantage: $86.54 BCBS — BCBS PPO: $352 BCBS — BCBS Traditional: $352 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $129.78 Employer Direct Healthcare — Employer Direct Healthcare: $121.13 Imperial Insurance Companies — Imperial Insurance Companies: $91.71 Managed Medicare - CAH — Managed Medicare - CAH: $86.52 Molina — Molina Insurance Exchange: $142.76
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Screening w Icad	$225	$42	$26.40 – $352
Screening mammogram, both breasts: 10 of 26 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $84.79 BCBS — BCBS HMO: $225 BCBS — BCBS HMO Advantage: $86.54 BCBS — BCBS PPO: $225 BCBS — BCBS Traditional: $225 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $129.78 Employer Direct Healthcare — Employer Direct Healthcare: $121.13 Imperial Insurance Companies — Imperial Insurance Companies: $91.71 Managed Medicare - CAH — Managed Medicare - CAH: $86.52 Molina — Molina Insurance Exchange: $142.76

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAM	$5,667.53	$870	$342.23 – $4,534.02
Sleep study (overnight, in a sleep lab): 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $342.23 BCBS — BCBS HMO: $1,357.55 BCBS — BCBS HMO Advantage: $435.82 BCBS — BCBS PPO: $1,507.83 BCBS — BCBS Traditional: $1,507.83 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $523.82 Employer Direct Healthcare — Employer Direct Healthcare: $488.89 Imperial Insurance Companies — Imperial Insurance Companies: $370.16 Molina — Molina Insurance Exchange: $576.20 Molina — Molina Medicare Advantage: $366.67
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: DIAGNOSTIC POLYSOMNOGRAM	$4,582.55	$870	$342.23 – $4,534.02
Sleep study (overnight, in a sleep lab): 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $342.23 BCBS — BCBS HMO: $1,357.55 BCBS — BCBS HMO Advantage: $435.82 BCBS — BCBS PPO: $1,507.83 BCBS — BCBS Traditional: $1,507.83 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $523.82 Employer Direct Healthcare — Employer Direct Healthcare: $488.89 Imperial Insurance Companies — Imperial Insurance Companies: $370.16 Molina — Molina Insurance Exchange: $576.20 Molina — Molina Medicare Advantage: $366.67
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: SLEEP STUDY	$4,582.55	$870	$342.23 – $4,534.02
Sleep study (overnight, in a sleep lab): 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $342.23 BCBS — BCBS HMO: $1,357.55 BCBS — BCBS HMO Advantage: $435.82 BCBS — BCBS PPO: $1,507.83 BCBS — BCBS Traditional: $1,507.83 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $523.82 Employer Direct Healthcare — Employer Direct Healthcare: $488.89 Imperial Insurance Companies — Imperial Insurance Companies: $370.16 Molina — Molina Insurance Exchange: $576.20 Molina — Molina Medicare Advantage: $366.67

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: PT THERAPEUTIC EX 15 MIN	$178.75	$33	$26.81 – $143
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 24 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $27.76 BCBS — BCBS HMO: $84.96 BCBS — BCBS HMO Advantage: $27.27 BCBS — BCBS PPO: $94.36 BCBS — BCBS Traditional: $94.36 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $42.50 Employer Direct Healthcare — Employer Direct Healthcare: $39.66 Imperial Insurance Companies — Imperial Insurance Companies: $30.03 Molina — Molina Insurance Exchange: $46.74 Molina — Molina Medicare Advantage: $29.75
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: OT THERAPEUTIC EX 15 MIN	$178.75	$33	$26.81 – $143
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $27.76 BCBS — BCBS HMO: $84.96 BCBS — BCBS HMO Advantage: $27.27 BCBS — BCBS PPO: $94.36 BCBS — BCBS Traditional: $94.36 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $42.50 Employer Direct Healthcare — Employer Direct Healthcare: $39.66 Imperial Insurance Companies — Imperial Insurance Companies: $30.03 Molina — Molina Insurance Exchange: $46.74 Molina — Molina Medicare Advantage: $29.75
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT EVAL LOW COMPLEX 20 MIN	$424.63	$80	$46.34 – $339.70
Physical therapy evaluation (low complexity): 10 of 24 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $93.57 BCBS — BCBS HMO: $234.39 BCBS — BCBS HMO Advantage: $75.25 BCBS — BCBS PPO: $260.33 BCBS — BCBS Traditional: $260.33 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $143.22 Employer Direct Healthcare — Employer Direct Healthcare: $133.67 Imperial Insurance Companies — Imperial Insurance Companies: $101.21 Molina — Molina Insurance Exchange: $157.54 Molina — Molina Medicare Advantage: $100.25
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Wound Eval-Low Risk	$308.90	$80	$46.34 – $339.70
Physical therapy evaluation (low complexity): 10 of 24 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $93.57 BCBS — BCBS HMO: $234.39 BCBS — BCBS HMO Advantage: $75.25 BCBS — BCBS PPO: $260.33 BCBS — BCBS Traditional: $260.33 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $143.22 Employer Direct Healthcare — Employer Direct Healthcare: $133.67 Imperial Insurance Companies — Imperial Insurance Companies: $101.21 Molina — Molina Insurance Exchange: $157.54 Molina — Molina Medicare Advantage: $100.25
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Wound Eval-Mod Risk - 97162 - 487026	$324	$124	$48.60 – $522.70
Physical therapy evaluation (moderate complexity): 10 of 21 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $93.58 BCBS — BCBS HMO: $234.39 BCBS — BCBS HMO Advantage: $75.25 BCBS — BCBS PPO: $260.33 BCBS — BCBS Traditional: $260.33 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $143.24 Employer Direct Healthcare — Employer Direct Healthcare: $133.69 Imperial Insurance Companies — Imperial Insurance Companies: $101.22 Molina — Molina Insurance Exchange: $157.56 Molina — Molina Medicare Advantage: $100.26
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT EVAL MOD COMPLEX 30 MIN	$653.38	$124	$48.60 – $522.70
Physical therapy evaluation (moderate complexity): 10 of 21 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $93.58 BCBS — BCBS HMO: $234.39 BCBS — BCBS HMO Advantage: $75.25 BCBS — BCBS PPO: $260.33 BCBS — BCBS Traditional: $260.33 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $143.24 Employer Direct Healthcare — Employer Direct Healthcare: $133.69 Imperial Insurance Companies — Imperial Insurance Companies: $101.22 Molina — Molina Insurance Exchange: $157.56 Molina — Molina Medicare Advantage: $100.26
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVAL 45 MIN	$585	$137	$75.25 – $580.26
Physical therapy evaluation (high complexity): 10 of 18 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $93.59 BCBS — BCBS HMO: $234.39 BCBS — BCBS HMO Advantage: $75.25 BCBS — BCBS PPO: $260.33 BCBS — BCBS Traditional: $260.33 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $143.25 Employer Direct Healthcare — Employer Direct Healthcare: $133.70 Imperial Insurance Companies — Imperial Insurance Companies: $101.23 Molina — Molina Insurance Exchange: $157.58 Molina — Molina Medicare Advantage: $100.28
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVAL HIGH COMPLEX 45 MIN	$725.32	$137	$75.25 – $580.26
Physical therapy evaluation (high complexity): 10 of 18 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $93.59 BCBS — BCBS HMO: $234.39 BCBS — BCBS HMO Advantage: $75.25 BCBS — BCBS PPO: $260.33 BCBS — BCBS Traditional: $260.33 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $143.25 Employer Direct Healthcare — Employer Direct Healthcare: $133.70 Imperial Insurance Companies — Imperial Insurance Companies: $101.23 Molina — Molina Insurance Exchange: $157.58 Molina — Molina Medicare Advantage: $100.28
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Wound Eval-High to Severe Risk	$696.07	$137	$75.25 – $580.26
Physical therapy evaluation (high complexity): 10 of 18 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $93.59 BCBS — BCBS HMO: $234.39 BCBS — BCBS HMO Advantage: $75.25 BCBS — BCBS PPO: $260.33 BCBS — BCBS Traditional: $260.33 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $143.25 Employer Direct Healthcare — Employer Direct Healthcare: $133.70 Imperial Insurance Companies — Imperial Insurance Companies: $101.23 Molina — Molina Insurance Exchange: $157.58 Molina — Molina Medicare Advantage: $100.28
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: PSYTX OFF 20-30 MIN W/E&M(905)	$310.24	$58	$46.54 – $516.80
Psychotherapy, 30 minutes: 10 of 20 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $70.73 BCBS — BCBS HMO: $106 BCBS — BCBS HMO Advantage: $99 BCBS — BCBS PPO: $118 BCBS — BCBS Traditional: $118 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $108.26 Employer Direct Healthcare — Employer Direct Healthcare: $101.04 Imperial Insurance Companies — Imperial Insurance Companies: $76.50 Molina — Molina Insurance Exchange: $119.08 Molina — Molina Medicare Advantage: $75.78
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: PSYTX OFF 20-30 MIN W/E&M(900)	$310.24	$58	$46.54 – $516.80
Psychotherapy, 30 minutes: 10 of 13 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $70.73 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $108.26 Employer Direct Healthcare — Employer Direct Healthcare: $101.04 Imperial Insurance Companies — Imperial Insurance Companies: $76.50 Molina — Molina Insurance Exchange: $119.08 Molina — Molina Medicare Advantage: $75.78 PROVIDER PARTNERS HEALTH PLAN — Provider Partners Health Plan Medicare: $75.78 Texas Blue Bonnet Health Plan — Texas Blue Bonnet Health Plan Commercial: $119.08 Texas Blue Bonnet Health Plan — Texas Blue Bonnet Health Plan Medicare Advantage: $72.17 Tricare — Tricare: $72.17
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: INDIVIDUAL PS	$646	$58	$46.54 – $516.80
Psychotherapy, 30 minutes: 10 of 12 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $70.73 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $108.26 Employer Direct Healthcare — Employer Direct Healthcare: $101.04 Imperial Insurance Companies — Imperial Insurance Companies: $76.50 Molina — Molina Insurance Exchange: $119.08 Molina — Molina Medicare Advantage: $75.78 PROVIDER PARTNERS HEALTH PLAN — Provider Partners Health Plan Medicare: $75.78 Texas Blue Bonnet Health Plan — Texas Blue Bonnet Health Plan Commercial: $119.08 Texas Blue Bonnet Health Plan — Texas Blue Bonnet Health Plan Medicare Advantage: $72.17 Tricare — Tricare: $72.17
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: HLTH BEHAVR IVNTJ INDIV F2-905	$354	$153	$53.10 – $646
Psychotherapy, 45 minutes: 10 of 20 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $70.73 BCBS — BCBS HMO: $106 BCBS — BCBS HMO Advantage: $99 BCBS — BCBS PPO: $118 BCBS — BCBS Traditional: $118 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $108.26 Employer Direct Healthcare — Employer Direct Healthcare: $101.04 Imperial Insurance Companies — Imperial Insurance Companies: $76.50 Molina — Molina Insurance Exchange: $119.08 Molina — Molina Medicare Advantage: $75.78
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: PSYTX PT&/FAM 45 MIN(1:1(905))	$807.50	$153	$53.10 – $646
Psychotherapy, 45 minutes: 10 of 20 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $70.73 BCBS — BCBS HMO: $106 BCBS — BCBS HMO Advantage: $99 BCBS — BCBS PPO: $118 BCBS — BCBS Traditional: $118 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $108.26 Employer Direct Healthcare — Employer Direct Healthcare: $101.04 Imperial Insurance Companies — Imperial Insurance Companies: $76.50 Molina — Molina Insurance Exchange: $119.08 Molina — Molina Medicare Advantage: $75.78
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: HEALTH BEHAVIOR IVNTJ INDIV F2	$354	$153	$53.10 – $646
Psychotherapy, 45 minutes: 10 of 13 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $70.73 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $108.26 Employer Direct Healthcare — Employer Direct Healthcare: $101.04 Imperial Insurance Companies — Imperial Insurance Companies: $76.50 Molina — Molina Insurance Exchange: $119.08 Molina — Molina Medicare Advantage: $75.78 PROVIDER PARTNERS HEALTH PLAN — Provider Partners Health Plan Medicare: $75.78 Texas Blue Bonnet Health Plan — Texas Blue Bonnet Health Plan Commercial: $119.08 Texas Blue Bonnet Health Plan — Texas Blue Bonnet Health Plan Medicare Advantage: $72.17 Tricare — Tricare: $72.17
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: PSYTX W PT 60 MIN(905)	$750	$142	$70.73 – $600
Psychotherapy, 60 minutes: 10 of 20 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $70.73 BCBS — BCBS HMO: $106 BCBS — BCBS HMO Advantage: $99 BCBS — BCBS PPO: $118 BCBS — BCBS Traditional: $118 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $108.26 Employer Direct Healthcare — Employer Direct Healthcare: $101.04 Imperial Insurance Companies — Imperial Insurance Companies: $76.50 Molina — Molina Insurance Exchange: $119.08 Molina — Molina Medicare Advantage: $75.78
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: PSYTX W PT 60 MINUTES(900)	$750	$142	$70.73 – $600
Psychotherapy, 60 minutes: 10 of 13 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $70.73 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $108.26 Employer Direct Healthcare — Employer Direct Healthcare: $101.04 Imperial Insurance Companies — Imperial Insurance Companies: $76.50 Molina — Molina Insurance Exchange: $119.08 Molina — Molina Medicare Advantage: $75.78 PROVIDER PARTNERS HEALTH PLAN — Provider Partners Health Plan Medicare: $75.78 Texas Blue Bonnet Health Plan — Texas Blue Bonnet Health Plan Commercial: $119.08 Texas Blue Bonnet Health Plan — Texas Blue Bonnet Health Plan Medicare Advantage: $72.17 Tricare — Tricare: $72.17
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: GRP PSYCH SUB HR (905)	$318.30	$60	$40.48 – $254.64
Group psychotherapy: 10 of 20 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $40.48 BCBS — BCBS HMO: $106 BCBS — BCBS HMO Advantage: $99 BCBS — BCBS PPO: $118 BCBS — BCBS Traditional: $118 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $61.97 Employer Direct Healthcare — Employer Direct Healthcare: $57.83 Imperial Insurance Companies — Imperial Insurance Companies: $43.79 Molina — Molina Insurance Exchange: $68.16 Molina — Molina Medicare Advantage: $43.38
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: GRP PSYCHOTHERAPY INTL HR(905)	$318.30	$60	$40.48 – $254.64
Group psychotherapy: 10 of 20 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $40.48 BCBS — BCBS HMO: $106 BCBS — BCBS HMO Advantage: $99 BCBS — BCBS PPO: $118 BCBS — BCBS Traditional: $118 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $61.97 Employer Direct Healthcare — Employer Direct Healthcare: $57.83 Imperial Insurance Companies — Imperial Insurance Companies: $43.79 Molina — Molina Insurance Exchange: $68.16 Molina — Molina Medicare Advantage: $43.38
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: GRP PSYCH SUB HR(900)	$318.30	$60	$40.48 – $254.64
Group psychotherapy: 10 of 13 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $40.48 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $61.97 Employer Direct Healthcare — Employer Direct Healthcare: $57.83 Imperial Insurance Companies — Imperial Insurance Companies: $43.79 Molina — Molina Insurance Exchange: $68.16 Molina — Molina Medicare Advantage: $43.38 PROVIDER PARTNERS HEALTH PLAN — Provider Partners Health Plan Medicare: $43.38 Texas Blue Bonnet Health Plan — Texas Blue Bonnet Health Plan Commercial: $68.16 Texas Blue Bonnet Health Plan — Texas Blue Bonnet Health Plan Medicare Advantage: $41.31 Tricare — Tricare: $41.31

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Removal of breast lesion	$4,418.75	$839	$662.81 – $4,418.75
Removal of breast growth (open surgery): 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $1,560.41 BCBS — BCBS HMO: $4,029.30 BCBS — BCBS HMO Advantage: $2,150.98 BCBS — BCBS PPO: $4,418.75 BCBS — BCBS Traditional: $4,418.75 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $2,388.38 Employer Direct Healthcare — Employer Direct Healthcare: $2,229.15 Imperial Insurance Companies — Imperial Insurance Companies: $1,687.79 Molina — Molina Insurance Exchange: $2,627.21 Molina — Molina Medicare Advantage: $1,671.86
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Total hip arthroplasty	$11,875.20	$2,256	$1,781.28 – $11,875.20
Total hip replacement: 10 of 18 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $5,116.57 BCBS — BCBS HMO: $11,875.20 BCBS — BCBS HMO Advantage: $8,449.50 BCBS — BCBS PPO: $11,875.20 BCBS — BCBS Traditional: $11,875.20 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $7,831.49 Employer Direct Healthcare — Employer Direct Healthcare: $7,309.39 Imperial Insurance Companies — Imperial Insurance Companies: $5,534.25 Molina — Molina Insurance Exchange: $8,614.63 Molina — Molina Medicare Advantage: $5,482.04
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Total knee arthroplasty	$8,950.80	$1,700	$1,342.62 – $17,613.05
Total knee replacement: 10 of 20 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $5,116.57 BCBS — BCBS HMO: $8,950.80 BCBS — BCBS HMO Advantage: $8,449.50 BCBS — BCBS PPO: $8,950.80 BCBS — BCBS Traditional: $8,950.80 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $7,831.49 Employer Direct Healthcare — Employer Direct Healthcare: $7,309.39 Imperial Insurance Companies — Imperial Insurance Companies: $5,534.25 Molina — Molina Insurance Exchange: $8,614.63 Molina — Molina Medicare Advantage: $5,482.04
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: TOTAL KNEE	$21,462	$1,700	$1,342.62 – $17,613.05
Total knee replacement: 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $5,116.57 BCBS — BCBS HMO: $15,827.94 BCBS — BCBS HMO Advantage: $8,449.50 BCBS — BCBS PPO: $17,613.05 BCBS — BCBS Traditional: $17,613.05 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $7,831.49 Employer Direct Healthcare — Employer Direct Healthcare: $7,309.39 Imperial Insurance Companies — Imperial Insurance Companies: $5,534.25 Molina — Molina Insurance Exchange: $8,614.63 Molina — Molina Medicare Advantage: $5,482.04
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Knee arthroscopy/surgery - 29881 - OR36029881	$3,348.95	$2,844	$502.34 – $11,977.92
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $1,303.98 BCBS — BCBS HMO: $3,348.95 BCBS — BCBS HMO Advantage: $1,943.59 BCBS — BCBS PPO: $3,348.95 BCBS — BCBS Traditional: $3,348.95 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $1,995.89 Employer Direct Healthcare — Employer Direct Healthcare: $1,862.83 Imperial Insurance Companies — Imperial Insurance Companies: $1,410.43 Molina — Molina Insurance Exchange: $2,195.47 Molina — Molina Medicare Advantage: $1,397.12
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthroscopy w/meniscectomy	$14,972.40	$2,844	$502.34 – $11,977.92
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $1,303.98 BCBS — BCBS HMO: $3,640.81 BCBS — BCBS HMO Advantage: $1,943.59 BCBS — BCBS PPO: $4,051.43 BCBS — BCBS Traditional: $4,051.43 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $1,995.89 Employer Direct Healthcare — Employer Direct Healthcare: $1,862.83 Imperial Insurance Companies — Imperial Insurance Companies: $1,410.43 Molina — Molina Insurance Exchange: $2,195.47 Molina — Molina Medicare Advantage: $1,397.12
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Egd diagnostic brush wash	$4,418.75	$839	$361.45 – $3,535
Upper GI endoscopy (diagnostic): 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $361.45 BCBS — BCBS HMO: $1,045.27 BCBS — BCBS HMO Advantage: $558 BCBS — BCBS PPO: $1,163.16 BCBS — BCBS Traditional: $1,163.16 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $553.25 Employer Direct Healthcare — Employer Direct Healthcare: $516.36 Imperial Insurance Companies — Imperial Insurance Companies: $390.96 Molina — Molina Insurance Exchange: $608.57 Molina — Molina Medicare Advantage: $387.27
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: DIAGNOSTIC EGD	$3,223.78	$839	$361.45 – $3,535
Upper GI endoscopy (diagnostic): 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $361.45 BCBS — BCBS HMO: $1,045.27 BCBS — BCBS HMO Advantage: $558 BCBS — BCBS PPO: $1,163.16 BCBS — BCBS Traditional: $1,163.16 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $553.25 Employer Direct Healthcare — Employer Direct Healthcare: $516.36 Imperial Insurance Companies — Imperial Insurance Companies: $390.96 Molina — Molina Insurance Exchange: $608.57 Molina — Molina Medicare Advantage: $387.27
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd biopsy single/multiple - 43239 - OR36043239	$2,018.29	$628	$302.74 – $2,645.49
Upper GI endoscopy with biopsy: 10 of 22 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $361.45 BCBS — BCBS HMO: $1,045.27 BCBS — BCBS HMO Advantage: $558 BCBS — BCBS PPO: $1,163.16 BCBS — BCBS Traditional: $1,163.16 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $553.25 Employer Direct Healthcare — Employer Direct Healthcare: $516.36 Imperial Insurance Companies — Imperial Insurance Companies: $390.96 Molina — Molina Insurance Exchange: $608.57 Molina — Molina Medicare Advantage: $387.27
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: EGD BIOPSY SINGLE/MULTIPLE - 43239 - 007144	$3,306.86	$628	$302.74 – $2,645.49
Upper GI endoscopy with biopsy: 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $361.45 BCBS — BCBS HMO: $1,045.27 BCBS — BCBS HMO Advantage: $558 BCBS — BCBS PPO: $1,163.16 BCBS — BCBS Traditional: $1,163.16 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $553.25 Employer Direct Healthcare — Employer Direct Healthcare: $516.36 Imperial Insurance Companies — Imperial Insurance Companies: $390.96 Molina — Molina Insurance Exchange: $608.57 Molina — Molina Medicare Advantage: $387.27
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Diagnostic colonoscopy - 45378 - OR36045378	$2,422.28	$692	$363.34 – $2,915.67
Colonoscopy (diagnostic): 10 of 22 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $370.62 BCBS — BCBS HMO: $1,015.96 BCBS — BCBS HMO Advantage: $542.35 BCBS — BCBS PPO: $1,130.54 BCBS — BCBS Traditional: $1,130.54 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $567.27 Employer Direct Healthcare — Employer Direct Healthcare: $529.45 Imperial Insurance Companies — Imperial Insurance Companies: $400.87 Molina — Molina Insurance Exchange: $624 Molina — Molina Medicare Advantage: $397.09
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: DIAGNOSTIC COLONOSCOPY - 45378 - 007155	$3,644.59	$692	$363.34 – $2,915.67
Colonoscopy (diagnostic): 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $370.62 BCBS — BCBS HMO: $1,015.96 BCBS — BCBS HMO Advantage: $542.35 BCBS — BCBS PPO: $1,130.54 BCBS — BCBS Traditional: $1,130.54 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $567.27 Employer Direct Healthcare — Employer Direct Healthcare: $529.45 Imperial Insurance Companies — Imperial Insurance Companies: $400.87 Molina — Molina Insurance Exchange: $624 Molina — Molina Medicare Advantage: $397.09
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy and biopsy	$2,309.53	$733	$346.43 – $3,087.55
Colonoscopy with biopsy: 10 of 21 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $476.89 BCBS — BCBS HMO: $1,335.61 BCBS — BCBS HMO Advantage: $713 BCBS — BCBS PPO: $1,486.25 BCBS — BCBS Traditional: $1,486.25 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $729.93 Employer Direct Healthcare — Employer Direct Healthcare: $681.27 Imperial Insurance Companies — Imperial Insurance Companies: $515.82 Molina — Molina Insurance Exchange: $802.92 Molina — Molina Medicare Advantage: $510.95
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY AND BIOPSY-NONSNAR - 45380 - 409232	$3,859.44	$733	$346.43 – $3,087.55
Colonoscopy with biopsy: 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $476.89 BCBS — BCBS HMO: $1,335.61 BCBS — BCBS HMO Advantage: $713 BCBS — BCBS PPO: $1,486.25 BCBS — BCBS Traditional: $1,486.25 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $729.93 Employer Direct Healthcare — Employer Direct Healthcare: $681.27 Imperial Insurance Companies — Imperial Insurance Companies: $515.82 Molina — Molina Insurance Exchange: $802.92 Molina — Molina Medicare Advantage: $510.95
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colonoscopy w/lesion removal	$3,093.13	$587	$463.97 – $2,911.23
Colonoscopy with removal of polyps (snare): 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $476.89 BCBS — BCBS HMO: $1,335.61 BCBS — BCBS HMO Advantage: $713 BCBS — BCBS PPO: $1,486.25 BCBS — BCBS Traditional: $1,486.25 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $729.93 Employer Direct Healthcare — Employer Direct Healthcare: $681.27 Imperial Insurance Companies — Imperial Insurance Companies: $515.82 Molina — Molina Insurance Exchange: $802.92 Molina — Molina Medicare Advantage: $510.95
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/LES RMVL BYSNARE	$3,639.04	$587	$463.97 – $2,911.23
Colonoscopy with removal of polyps (snare): 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $476.89 BCBS — BCBS HMO: $1,335.61 BCBS — BCBS HMO Advantage: $713 BCBS — BCBS PPO: $1,486.25 BCBS — BCBS Traditional: $1,486.25 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $729.93 Employer Direct Healthcare — Employer Direct Healthcare: $681.27 Imperial Insurance Companies — Imperial Insurance Companies: $515.82 Molina — Molina Insurance Exchange: $802.92 Molina — Molina Medicare Advantage: $510.95
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/ BX THRU STOMA - G0121 - 007165	$2,993.50	Not listed in the file	$370.62 – $3,143.92
Screening colonoscopy (not high risk): 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $370.62 BCBS — BCBS HMO: $1,015.96 BCBS — BCBS HMO Advantage: $542.35 BCBS — BCBS PPO: $1,130.54 BCBS — BCBS Traditional: $1,130.54 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $567.27 Employer Direct Healthcare — Employer Direct Healthcare: $529.45 Imperial Insurance Companies — Imperial Insurance Companies: $400.87 Molina — Molina Insurance Exchange: $624 Molina — Molina Medicare Advantage: $397.09
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/FB REMOVAL - G0121 - 007226	$3,929.90	Not listed in the file	$370.62 – $3,143.92
Screening colonoscopy (not high risk): 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $370.62 BCBS — BCBS HMO: $1,015.96 BCBS — BCBS HMO Advantage: $542.35 BCBS — BCBS PPO: $1,130.54 BCBS — BCBS Traditional: $1,130.54 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $567.27 Employer Direct Healthcare — Employer Direct Healthcare: $529.45 Imperial Insurance Companies — Imperial Insurance Companies: $400.87 Molina — Molina Insurance Exchange: $624 Molina — Molina Medicare Advantage: $397.09
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/BALLOON DILAT-NR - G0121 - 007195	$2,817	Not listed in the file	$370.62 – $3,143.92
Screening colonoscopy (not high risk): 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $370.62 BCBS — BCBS HMO: $1,015.96 BCBS — BCBS HMO Advantage: $542.35 BCBS — BCBS PPO: $1,130.54 BCBS — BCBS Traditional: $1,130.54 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $567.27 Employer Direct Healthcare — Employer Direct Healthcare: $529.45 Imperial Insurance Companies — Imperial Insurance Companies: $400.87 Molina — Molina Insurance Exchange: $624 Molina — Molina Medicare Advantage: $397.09
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopic cholecystectomy	$6,295.23	$1,196	$944.28 – $6,295.23
Gallbladder removal by laparoscope: 10 of 18 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $2,409.30 BCBS — BCBS HMO: $6,295.23 BCBS — BCBS HMO Advantage: $3,431.93 BCBS — BCBS PPO: $6,295.23 BCBS — BCBS Traditional: $6,295.23 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $3,687.71 Employer Direct Healthcare — Employer Direct Healthcare: $3,441.86 Imperial Insurance Companies — Imperial Insurance Companies: $2,605.98 Molina — Molina Insurance Exchange: $4,056.48 Molina — Molina Medicare Advantage: $2,581.39
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Prp i/hern init reduc >5 yr	$5,744.38	$1,091	$861.66 – $4,601.82
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $1,426.89 BCBS — BCBS HMO: $4,135.42 BCBS — BCBS HMO Advantage: $2,207.63 BCBS — BCBS PPO: $4,601.82 BCBS — BCBS Traditional: $4,601.82 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $2,184.02 Employer Direct Healthcare — Employer Direct Healthcare: $2,038.41 Imperial Insurance Companies — Imperial Insurance Companies: $1,543.37 Molina — Molina Insurance Exchange: $2,402.42 Molina — Molina Medicare Advantage: $1,528.81
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY BX/WWO D&C	$8,583.34	$1,630	$1,287.50 – $6,866.67
Hysteroscopy with biopsy of the uterus lining: 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $1,290.08 BCBS — BCBS HMO: $3,322.47 BCBS — BCBS HMO Advantage: $1,773.65 BCBS — BCBS PPO: $3,697.19 BCBS — BCBS Traditional: $3,697.19 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $1,974.62 Employer Direct Healthcare — Employer Direct Healthcare: $1,842.97 Imperial Insurance Companies — Imperial Insurance Companies: $1,395.39 Molina — Molina Insurance Exchange: $2,172.08 Molina — Molina Medicare Advantage: $1,382.23
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Njx interlaminar lmbrsac	$5,334.38	$1,013	$281.31 – $4,267.50
Spinal injection, lower back (epidural), with imaging guidance: 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $281.31 BCBS — BCBS HMO: $831.32 BCBS — BCBS HMO Advantage: $443.79 BCBS — BCBS PPO: $925.07 BCBS — BCBS Traditional: $925.07 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $430.58 Employer Direct Healthcare — Employer Direct Healthcare: $401.87 Imperial Insurance Companies — Imperial Insurance Companies: $304.27 Molina — Molina Insurance Exchange: $473.63 Molina — Molina Medicare Advantage: $301.40
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Njx aa&strd tfrm epi ls 1	$11,250	$2,137	$352.49 – $9,000
Nerve root injection, lower back, with imaging guidance: 10 of 16 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $352.49 BCBS — BCBS HMO: $1,080.03 BCBS — BCBS HMO Advantage: $576.56 BCBS — BCBS PPO: $1,201.83 BCBS — BCBS Traditional: $1,201.83 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $539.52 Employer Direct Healthcare — Employer Direct Healthcare: $503.55 Imperial Insurance Companies — Imperial Insurance Companies: $381.26 Molina — Molina Insurance Exchange: $593.47 Molina — Molina Medicare Advantage: $377.66
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Carpal tunnel surgery	$2,540.78	$482	$381.12 – $2,540.78
Carpal tunnel release: 10 of 21 insurance plan rates Aetna — Coventry FKA Aetna Workers Compensation: $778.21 BCBS — BCBS HMO: $2,286.74 BCBS — BCBS HMO Advantage: $1,220.74 BCBS — BCBS PPO: $2,540.78 BCBS — BCBS Traditional: $2,540.78 Corporate Remedies (WC) — Corporate Remedies Workers Compensation: $1,191.14 Employer Direct Healthcare — Employer Direct Healthcare: $1,111.73 Imperial Insurance Companies — Imperial Insurance Companies: $841.74 Molina — Molina Insurance Exchange: $1,310.25 Molina — Molina Medicare Advantage: $833.79

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: VAGINAL DELIVERY	$3,057.50	$580	$313 – $3,057.50
Vaginal delivery, with care before and after: rates for 5 insurance plans BCBS — BCBS HMO: $2,896.53 BCBS — BCBS HMO Advantage: $1,546.27 BCBS — BCBS PPO: $3,057.50 BCBS — BCBS Traditional: $3,057.50 United Healthcare — UHC Commercial All Payor: $313
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: VAGINAL DELIVERY LEVEL 2	$3,669	$697	$550.35 – $3,382.16
Vaginal delivery after a previous C-section, with care before and after: rates for 4 insurance plans BCBS — BCBS HMO: $3,039.37 BCBS — BCBS HMO Advantage: $1,622.52 BCBS — BCBS PPO: $3,382.16 BCBS — BCBS Traditional: $3,382.16

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	$48,150 – $98,149.40
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 2 insurance plans Tricare — Tricare: $98,149.40 United Healthcare — UHC Commercial All Payor: $93,787.70
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$7,650 – $18,550.80
Hip or knee replacement (major joint of the leg), without major complications: rates for 2 insurance plans Tricare — Tricare: $18,550.80 United Healthcare — UHC Commercial All Payor: $18,492.36
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CCMCC	Not listed in the file	Not listed in the file	$7,200 – $23,547.65
Neck (cervical) spinal fusion, without complications: rates for 2 insurance plans Tricare — Tricare: $20,147.40 United Healthcare — UHC Commercial All Payor: $23,404.74
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CCMCC	Not listed in the file	Not listed in the file	$5,228.96 – $11,894.59
Uterus and ovary surgery (not for cancer), without complications: rates for 2 insurance plans Tricare — Tricare: $11,285.50 United Healthcare — UHC Commercial All Payor: $11,894.59

Source: Pampa Regional Medical Center’s standard charges file (prmctx.com, JSON, CMS template 3.0; it can be a very large file), last updated by the hospital on September 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	Critical Access Hospital
Address	1 Medical Plaza, Pampa, TX 79065
County	Gray County
State	Texas
Phone	(806) 665‑3721
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	451398
Name in Medicare records	PAMPA REGIONAL MEDICAL CENTER
Profile level	Medicare data + hospital website
Official website	prmctx.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 ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

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

Pampa Regional Medical Center — prmctx.com
Our Services — prmctx.com
Pampa Regional Medical Center | Prime Healthcare Services — prmctx.com
Emergency Care Services Open 24 Hour Trauma and ER Care Unit — prmctx.com
Advanced Surgical Services Inpatient and Outpatient Care Hub — prmctx.com
Radiology and Imaging Services Advanced Diagnostic Care — prmctx.com
Specialty Services Weight Loss LAP BAND System Treatment — prmctx.com
Cardiology Services Advanced Heart Care and Diagnostics Unit — prmctx.com
Outpatient Behavioral Health Therapy and Counseling Care Hub — prmctx.com
Inpatient Behavioral Health and Mental Treatmnt Care Unit ER — prmctx.com
Patients & Visitors - Pampa Regional Medical Center — prmctx.com

Pampa Regional Medical Center

Summary

Profile from official sources

At a glance