Does River Falls Area Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at River Falls Area Hospital. In a medical emergency, call 911.

Where is River Falls Area Hospital?

1629 E Division St, River Falls, WI 54022, in St. Croix County, Wisconsin.

What is the phone number of River Falls Area Hospital?

(715) 307-6000, as listed by Medicare (CMS).

What is the Medicare star rating of River Falls Area Hospital?

5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

River Falls Area Hospital — Phone, Address & ER

Quick answers

Does River Falls Area Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at River Falls Area Hospital. In a medical emergency, call 911.
Where is River Falls Area Hospital?: 1629 E Division St, River Falls, WI 54022, in St. Croix County, Wisconsin.
What is the phone number of River Falls Area Hospital?: (715) 307-6000, as listed by Medicare (CMS).
What is the Medicare star rating of River Falls Area Hospital?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Specialties and care areas^{[8][11][12][13][14]}

Conditions treated^[11][13]

Anterior cruciate ligament (ACL) tears
Rotator cuff tears
Labral tears
Meniscus tears
Shoulder instability
Shoulder arthritis
Severe chest pain
Breathing difficulty
Head or brain injury
Stroke
Seizure
Severe bleeding
Broken bones
Severe abdominal pain
Poisoning
Major burns
Mental health or substance abuse crisis

Treatments^[11][12][14]

TeleStroke
Tele-neurology consults
Remote cardiac telemetry monitoring
Mental health assessments
Physical therapy

Procedures^[13]

Hip replacement
Knee replacement
Shoulder replacement
Advanced arthroscopy
Foot and ankle surgery

Programs and centers^{[8][11][12][14]}

Emergency department
Medical and surgical care unit
Specialty care unit
Surgery Center
Allina Health Cancer Institute
Courage Kenny Sports & Physical Therapy
High-risk pregnancy and perinatal care

Emergency care (hospital website)^[6][11]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV

Visiting and practical information

Parking	Free parking in lots outside the main lobby entrance, with more around the hospital^[7]
Interpreters and languages	Interpreters and services for the hearing impaired are listed on the patient and visitor information page^[9]

Recognition^[10]

Accredited by The Joint Commission

Doctors and clinicians (178)

178 doctors and other clinicians list River Falls Area 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

And 154 more: the button below opens the full list.

Other emergency rooms nearby

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

Hudson Hospital8.6 mi · Hudson, WI · Critical Access Hospital
Western Wisconsin Health13 mi · Baldwin, WI · Critical Access Hospital
Lakeview Memorial Hospital16 mi · Stillwater, MN · Acute Care Hospital
Westfields Hospital and Clinic18 mi · New Richmond, WI · Critical Access Hospital
M Health Fairview Woodwinds Hospital19 mi · Woodbury, MN · Acute Care Hospital

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near River Falls

M Health Fairview St John's Hospital24 mi · Maplewood, MN · Acute Care Hospital

Hospitals in St. Croix County · Hospitals near me

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

Kinnic Health and Rehabilitation Center0.0 mi · River Falls, WI · 2 of 5 stars
Christian Community Home10 mi · Hudson, WI · 5 of 5 stars
Ellsworth Health Services10 mi · Ellsworth, WI · 5 of 5 stars

All nursing homes in the state →

Hospice providers

St Croix Hospice Hudson9.3 mi · Hudson, WI · 4 of 5 stars
Adoray Home Health and Hospice13 mi · Baldwin, WI · 5 of 5 stars
Hospice of the Midwest17 mi · Woodbury, MN · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Interim Healthcare of Western Wisconsin9.3 mi · Hudson, WI · 3 of 5 stars
Adoray Home Health and Hospice13 mi · Baldwin, WI · 4 of 5 stars
Careaparent17 mi · Woodbury, MN · 2.5 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Hudson Dialysis9.3 mi · Hudson, WI · 4 of 5 stars
DaVita Historical Hastings Dialysis16 mi · Hastings, MN · 3 of 5 stars
Fresenius Medical Care - Two Rivers Dialysis16 mi · Hastings, MN · 4 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Valley Surgery Center9.3 mi · Hudson, WI
High Pointe Surgery Center16 mi · Lake Elmo, MN
Health Partners Specialty Center Woodbury17 mi · Woodbury, MN

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

MN Community Care - Harding SBC22 mi · Saint Paul, MN · Community health center
Elders Lodge22 mi · Saint Paul, MN · Community health center
MN Community Care - East Side Clinic23 mi · Saint Paul, MN · Community health center

Clinics and urgent care

Western Wisconsin Health Roberts Clinic8.4 mi · Roberts, WI · Rural health clinic
Western Wisconsin Health13 mi · Baldwin, WI · Rural health clinic
Allina Health System16 mi · Hastings, MN · Urgent care center

Pharmacies

Ericksons Diversified LLC1.1 mi · River Falls, WI · Community/retail pharmacy
Freeman Drug, Inc1.1 mi · River Falls, WI · Pharmacy
Walgreen Co1.1 mi · River Falls, WI · Pharmacy

Assisted living nearby

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

Comforts of Home River Falls CBRF1.1 mi · River Falls, WI
Kinnic Falls Alcohol Drug Services Inc1.1 mi · River Falls, WI
Our House River Falls Memory Care1.1 mi · River Falls, WI
Ridgewood CBRF1.1 mi · River Falls, WI

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 River Falls Area 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)	5 of 5 stars
Overall rating of the hospital	5 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	5 of 5 stars
Doctors communicated well	4 of 5 stars
Patients got help quickly from staff	5 of 5 stars
Staff explained medicines	5 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	5 of 5 stars
Restfulness of Environment	5 of 5 stars
Care Coordination	5 of 5 stars
Symptoms After Stay	4 of 5 stars
Rated the hospital 9 or 10 out of 10	84%National average: 72%
Would definitely recommend the hospital	85%National average: 71%
Nurses “always” communicated well	92%National average: 80%
Doctors “always” communicated well	86%National average: 80%
“Always” got help as soon as they wanted	78%National average: 64%
Staff “always” explained medicines before giving them	70%National average: 62%
Were given information about recovery at home	88%National average: 86%
Room and bathroom “always” clean	78%National average: 73%
Completed surveys	139Response rate: 35%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Complications and deaths

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

Deaths within 30 days: heart failure patients	11.3%
Deaths within 30 days: pneumonia patients	14.6%
Deaths within 30 days: stroke patients	10.6%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG); Serious complications (patient safety indicator PSI-90); Complications after hip or knee replacement
Too few cases to report	Deaths within 30 days: heart attack patients; Deaths within 30 days: COPD patients

Source: Complications and Deaths - Hospital — CMS, released October 20, 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)	15.4%
Readmitted within 30 days: heart failure	21.3%
Readmitted within 30 days: pneumonia	16.6%
Readmitted within 30 days: COPD	19.6%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement
Too few cases to report	Readmitted within 30 days: heart attack

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 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)	93 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)	67%National average: 66%

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

Not reported to Medicare: infections caught in the hospital. For these topics Medicare shows no result for this hospital (not reported, or too few cases).

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 Wisconsin Best hospitals in Wisconsin

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 52 common services exactly as River Falls Area 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 →

$ 6 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Show the prices of 52 common services

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) · Hospital (facility) fee In the file: HCHG UC-EST PT FAC VISIT LEVEL III	$199.40	$111.66	$40.12 – $542.59
Established patient office visit (about 20–29 minutes): 10 of 23 insurance plan rates Aetna — Aetna Elevate (N R): $123.39 Aetna — Aetna Performance (N R): $133.30 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $170.35 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $199.40 All Other Medicaid — All Other Medicaid (R): $95.71 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $167.50 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $153.82 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $382.05 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $542.59 BCBS — BC AEHP (R): $505.47
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG E/M EST PT LEVEL III	$143.50	$80.36	$28.87 – $542.59
Established patient office visit (about 20–29 minutes): 10 of 23 insurance plan rates Aetna — Aetna Elevate (N R): $88.80 Aetna — Aetna Performance (N R): $95.93 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $122.59 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $143.50 All Other Medicaid — All Other Medicaid (R): $68.88 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $120.54 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $110.70 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $382.05 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $542.59 BCBS — BC AEHP (R): $505.47
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG EST PT FAC VISIT LEVEL III	$143	$80.08	$28.77 – $542.59
Established patient office visit (about 20–29 minutes): 10 of 22 insurance plan rates Aetna — Aetna Elevate (N R): $88.49 Aetna — Aetna Performance (N R): $95.60 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $122.16 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $143 All Other Medicaid — All Other Medicaid (R): $68.64 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $120.12 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $110.31 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $382.04 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $542.59 BCBS — BC AEHP (R): $505.47
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG UC-EST PT FAC VISIT LEVEL IV	$238.30	$133.45	$47.95 – $836.50
Established patient office visit (about 30–39 minutes): 10 of 23 insurance plan rates Aetna — Aetna Elevate (N R): $147.46 Aetna — Aetna Performance (N R): $159.30 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $203.58 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $238.30 All Other Medicaid — All Other Medicaid (R): $114.38 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $200.17 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $183.82 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $588.98 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $836.50 BCBS — BC AEHP (R): $779.26
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG E/M EST PT LEVEL IV	$171.50	$96.04	$34.51 – $836.50
Established patient office visit (about 30–39 minutes): 10 of 23 insurance plan rates Aetna — Aetna Elevate (N R): $106.12 Aetna — Aetna Performance (N R): $114.65 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $146.51 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $171.50 All Other Medicaid — All Other Medicaid (R): $82.32 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $144.06 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $132.30 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $588.98 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $836.50 BCBS — BC AEHP (R): $779.26
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG EST PT FAC VISIT LEVEL IV	$170.50	$95.48	$34.30 – $836.50
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates Aetna — Aetna Elevate (N R): $105.51 Aetna — Aetna Performance (N R): $113.98 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $145.66 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $170.50 All Other Medicaid — All Other Medicaid (R): $81.84 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $143.22 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $131.52 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $588.98 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $836.50 BCBS — BC AEHP (R): $779.26
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LVL 3 HCHG	$801.80	$449.01	$161.32 – $1,576.33
Emergency room visit (moderate): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $496.15 Aetna — Aetna Performance (N R): $536 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $684.98 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $801.80 All Other Medicaid — All Other Medicaid (R): $384.86 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $267.26 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $673.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $618.51 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $1,110.18 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,576.33
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED LVL 3 HCHG	$801.80	$449.01	$491.26 – $801.80
Emergency room visit (moderate): rates for 7 insurance plans Aetna — Aetna Elevate (N R): $491.26 Aetna — Aetna Performance (N R): $530.71 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $678.16 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $801.80 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $673.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $618.51 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $673.51
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LVL 4 HCHG	$1,315.80	$736.85	$264.74 – $1,576.33
Emergency room visit (moderately high): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $814.22 Aetna — Aetna Performance (N R): $879.61 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,124.09 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,315.80 All Other Medicaid — All Other Medicaid (R): $631.58 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $408.53 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,105.27 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,015.01 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $1,110.17 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,576.33
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED LVL 4 HCHG	$1,315.80	$736.85	$806.19 – $1,315.80
Emergency room visit (moderately high): rates for 7 insurance plans Aetna — Aetna Elevate (N R): $806.19 Aetna — Aetna Performance (N R): $870.93 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,112.90 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,315.80 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,105.27 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,015.01 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $1,105.27
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LVL 5 HCHG	$1,818.50	$1,018.36	$331.10 – $1,818.50
Emergency room visit (high): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,125.29 Aetna — Aetna Performance (N R): $1,215.67 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,553.54 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,818.50 All Other Medicaid — All Other Medicaid (R): $872.88 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $583.06 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,527.54 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,402.79 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $1,110.17 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,576.33
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED LVL 5 HCHG	$1,818.50	$1,018.36	$1,114.19 – $1,818.50
Emergency room visit (high): rates for 7 insurance plans Aetna — Aetna Elevate (N R): $1,114.19 Aetna — Aetna Performance (N R): $1,203.67 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,538.09 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,818.50 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,527.54 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,402.79 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $1,527.54

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG BASIC METABOLIC PANEL	$199.30	$111.61	$7.88 – $199.30
Basic metabolic panel (blood test): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $123.33 Aetna — Aetna Performance (N R): $133.23 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $170.26 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $199.30 All Other Medicaid — All Other Medicaid (R): $95.66 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $7.88 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $167.41 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $153.74 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG BASIC METABOLIC PANEL QUEST	$30	$16.80	$6.04 – $102.36
Basic metabolic panel (blood test): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $18.56 Aetna — Aetna Performance (N R): $20.05 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $25.63 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $30 All Other Medicaid — All Other Medicaid (R): $14.40 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $7.88 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $25.20 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $23.14 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.08 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG BASIC METABOLIC RTR	$199.30	$111.61	$7.88 – $199.30
Basic metabolic panel (blood test): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $123.33 Aetna — Aetna Performance (N R): $133.23 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $170.26 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $199.30 All Other Medicaid — All Other Medicaid (R): $95.66 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $7.88 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $167.41 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $153.74 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG COMPREHENSIVE METABOLIC PANE	$362.80	$203.17	$9.83 – $362.80
Comprehensive metabolic panel (blood test): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $224.50 Aetna — Aetna Performance (N R): $242.53 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $309.94 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $362.80 All Other Medicaid — All Other Medicaid (R): $174.14 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $9.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $304.75 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $279.86 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG COMPREHENSIVE METABOLIC PANEL QUEST	$31.20	$17.47	$6.28 – $102.36
Comprehensive metabolic panel (blood test): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $19.31 Aetna — Aetna Performance (N R): $20.86 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $26.65 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $31.20 All Other Medicaid — All Other Medicaid (R): $14.98 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $9.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $26.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $24.07 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG COMP METABOLIC RTR	$362.80	$203.17	$9.83 – $362.80
Comprehensive metabolic panel (blood test): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $224.50 Aetna — Aetna Performance (N R): $242.53 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $309.94 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $362.80 All Other Medicaid — All Other Medicaid (R): $174.14 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $9.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $304.75 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $279.86 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG OBSTETRIC PANEL	$501.50	$280.84	$20.68 – $501.50
Obstetric blood test panel: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $310.33 Aetna — Aetna Performance (N R): $335.25 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $428.43 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $501.50 All Other Medicaid — All Other Medicaid (R): $240.72 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $44.51 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $421.26 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $386.86 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG OBSTETRIC PANEL	$501.50	$280.84	$307.27 – $501.50
Obstetric blood test panel: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $307.27 Aetna — Aetna Performance (N R): $331.94 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $424.17 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $501.50 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $421.26 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $386.86 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $421.26
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LIPID PANEL	$55.20	$30.91	$11.11 – $102.36
Cholesterol panel (lipid panel): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $34.16 Aetna — Aetna Performance (N R): $36.90 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $47.16 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $55.20 All Other Medicaid — All Other Medicaid (R): $26.50 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $12.46 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $46.37 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $42.58 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.08 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LIPID PANEL LCC	$27.50	$15.40	$5.53 – $102.36
Cholesterol panel (lipid panel): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $17.02 Aetna — Aetna Performance (N R): $18.38 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $23.49 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $27.50 All Other Medicaid — All Other Medicaid (R): $13.20 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $12.46 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $23.10 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $21.21 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG LIPID PANEL QUEST	$34.20	$19.15	$6.88 – $102.36
Cholesterol panel (lipid panel): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $21.16 Aetna — Aetna Performance (N R): $22.86 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $29.22 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $34.20 All Other Medicaid — All Other Medicaid (R): $16.42 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $12.46 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $28.73 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $26.38 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RENAL FUNCTION PANEL	$231.20	$129.47	$8.08 – $231.20
Kidney function panel: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $143.07 Aetna — Aetna Performance (N R): $154.56 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $197.51 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $231.20 All Other Medicaid — All Other Medicaid (R): $110.98 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $8.08 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $194.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $178.35 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RENAL FUNCTION PANEL QUEST	$43.20	$24.19	$8.08 – $102.36
Kidney function panel: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $26.73 Aetna — Aetna Performance (N R): $28.88 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $36.91 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $43.20 All Other Medicaid — All Other Medicaid (R): $20.74 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $8.08 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $36.29 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $33.32 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RENAL FUNCTION PANEL RTR	$196.10	$109.82	$8.08 – $196.10
Kidney function panel: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $121.35 Aetna — Aetna Performance (N R): $131.09 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $167.53 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $196.10 All Other Medicaid — All Other Medicaid (R): $94.13 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $8.08 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $164.72 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $151.27 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG HEPATIC FUNCTION PANEL	$190.90	$106.90	$7.61 – $190.90
Liver function panel: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $118.13 Aetna — Aetna Performance (N R): $127.62 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $163.09 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $190.90 All Other Medicaid — All Other Medicaid (R): $91.63 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $7.61 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $160.36 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $147.26 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG HEPATIC FUNCTION PANEL QUEST	$29.70	$16.63	$5.98 – $102.36
Liver function panel: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $18.38 Aetna — Aetna Performance (N R): $19.85 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $25.37 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $29.70 All Other Medicaid — All Other Medicaid (R): $14.26 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $7.61 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $24.95 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $22.91 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $72.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $102.36
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG HEPATIC FUNCTION PANEL	$190.90	$106.90	$116.96 – $190.90
Liver function panel: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $116.96 Aetna — Aetna Performance (N R): $126.36 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $161.46 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $190.90 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $160.36 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $147.26 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $160.36
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG URINALYSIS COMPLETE	$130.20	$72.91	$2.95 – $130.20
Urine test (automated, with microscope): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $80.57 Aetna — Aetna Performance (N R): $87.04 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $111.23 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $130.20 All Other Medicaid — All Other Medicaid (R): $62.50 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $2.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $109.37 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $100.44 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $8.58 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $12.19
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG URINALYSIS COMPLETE QUEST	$38.10	$21.34	$2.95 – $38.10
Urine test (automated, with microscope): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $23.58 Aetna — Aetna Performance (N R): $25.47 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $32.55 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $38.10 All Other Medicaid — All Other Medicaid (R): $18.29 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $2.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $32 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $29.39 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $8.58 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $12.19
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG UA COMPLETE RTR	$130.20	$72.91	$2.95 – $130.20
Urine test (automated, with microscope): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $80.57 Aetna — Aetna Performance (N R): $87.04 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $111.23 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $130.20 All Other Medicaid — All Other Medicaid (R): $62.50 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $2.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $109.37 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $100.44 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $8.58 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $12.19
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG SPECIFIC GRAVITY URINE	$67.10	$37.58	$2.09 – $67.10
Urine test (automated, without microscope): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $41.52 Aetna — Aetna Performance (N R): $44.86 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $57.32 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $67.10 All Other Medicaid — All Other Medicaid (R): $32.21 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $2.09 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $56.36 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $51.76 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $6.14 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $8.72
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG URINALYSIS	$69.30	$38.81	$2.09 – $69.30
Urine test (automated, without microscope): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $42.88 Aetna — Aetna Performance (N R): $46.33 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $59.20 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $69.30 All Other Medicaid — All Other Medicaid (R): $33.26 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $2.09 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $58.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $53.46 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $6.14 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $8.72
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PROTEIN QUAL URINE	$69.30	$38.81	$2.09 – $69.30
Urine test (automated, without microscope): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $42.88 Aetna — Aetna Performance (N R): $46.33 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $59.20 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $69.30 All Other Medicaid — All Other Medicaid (R): $33.26 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $2.09 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $58.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $53.46 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $6.14 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $8.72
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSA-DIAGNOSTIC	$51.80	$29.01	$10.42 – $112.95
PSA (prostate specific antigen) blood test: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $32.05 Aetna — Aetna Performance (N R): $34.63 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $44.25 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $51.80 All Other Medicaid — All Other Medicaid (R): $24.86 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $17.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $43.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $39.96 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $79.52 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $112.95
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSA TOTAL DIAGNOSTIC LCC	$39.30	$22.01	$7.91 – $112.95
PSA (prostate specific antigen) blood test: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $24.32 Aetna — Aetna Performance (N R): $26.27 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $33.57 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $39.30 All Other Medicaid — All Other Medicaid (R): $18.86 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $17.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $33.01 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $30.32 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $79.53 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $112.95
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSATOTAL LCC	$31.70	$17.75	$6.38 – $112.95
PSA (prostate specific antigen) blood test: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $19.62 Aetna — Aetna Performance (N R): $21.19 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $27.08 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $31.70 All Other Medicaid — All Other Medicaid (R): $15.22 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $17.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $26.63 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $24.45 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $79.53 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $112.95
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG TSH	$44.70	$25.03	$8.99 – $111.49
Thyroid stimulating hormone (TSH) test: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $27.66 Aetna — Aetna Performance (N R): $29.88 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $38.19 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $44.70 All Other Medicaid — All Other Medicaid (R): $21.46 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $15.64 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $37.55 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $34.48 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $78.50 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $111.49
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG TSHBL30 OR 60	$56.60	$31.70	$11.39 – $111.49
Thyroid stimulating hormone (TSH) test: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $35.02 Aetna — Aetna Performance (N R): $37.84 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $48.35 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $56.60 All Other Medicaid — All Other Medicaid (R): $27.17 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $15.64 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $47.54 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $43.66 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $78.49 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $111.49
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CONGENITAL HYPOTHYROIDISM	$51.60	$28.90	$10.38 – $111.49
Thyroid stimulating hormone (TSH) test: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $31.93 Aetna — Aetna Performance (N R): $34.49 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $44.08 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $51.60 All Other Medicaid — All Other Medicaid (R): $24.77 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $15.64 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $43.34 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $39.80 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $78.50 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $111.49
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC W/DIFF	$76.80	$43.01	$6.79 – $76.80
Complete blood count (CBC) with differential: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $47.52 Aetna — Aetna Performance (N R): $51.34 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $65.61 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $76.80 All Other Medicaid — All Other Medicaid (R): $36.86 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $7.23 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $64.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $59.24 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $19.17 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $27.22
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC (INCLUDES DIFFERENTIAL AND PLATELETS) QUE	$34.20	$19.15	$6.79 – $34.20
Complete blood count (CBC) with differential: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $21.16 Aetna — Aetna Performance (N R): $22.86 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $29.22 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $34.20 All Other Medicaid — All Other Medicaid (R): $16.42 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $7.23 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $28.73 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $26.38 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $19.17 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $27.22
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC/DIFF RTR	$226.20	$126.67	$6.79 – $226.20
Complete blood count (CBC) with differential: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $139.97 Aetna — Aetna Performance (N R): $151.21 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $193.24 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $226.20 All Other Medicaid — All Other Medicaid (R): $108.58 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $7.23 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $190.01 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $174.49 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $19.17 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $27.22
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC	$239.70	$134.23	$6.02 – $239.70
Complete blood count (CBC), automated: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $148.33 Aetna — Aetna Performance (N R): $160.24 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $204.78 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $239.70 All Other Medicaid — All Other Medicaid (R): $115.06 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $6.02 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $201.35 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $184.90 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $17.54 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $24.91
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC QUEST	$31.80	$17.81	$6.02 – $31.80
Complete blood count (CBC), automated: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $19.68 Aetna — Aetna Performance (N R): $21.26 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $27.17 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $31.80 All Other Medicaid — All Other Medicaid (R): $15.26 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $6.02 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $26.71 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $24.53 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $17.54 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $24.91
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CBC RTR	$199.90	$111.94	$6.02 – $199.90
Complete blood count (CBC), automated: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $123.70 Aetna — Aetna Performance (N R): $133.63 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $170.77 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $199.90 All Other Medicaid — All Other Medicaid (R): $95.95 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $6.02 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $167.92 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $154.20 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $17.54 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $24.91
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PROTHOMBIN TIME	$76.80	$43.01	$3.99 – $85.98
Blood clotting time test (prothrombin time, PT): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $47.52 Aetna — Aetna Performance (N R): $51.34 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $65.61 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $76.80 All Other Medicaid — All Other Medicaid (R): $36.86 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $3.99 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $64.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $59.24 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $60.53 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $85.98
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG INR POCT	$144.40	$80.86	$3.99 – $144.40
Blood clotting time test (prothrombin time, PT): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $89.35 Aetna — Aetna Performance (N R): $96.53 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $123.36 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $144.40 All Other Medicaid — All Other Medicaid (R): $69.31 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $3.99 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $121.30 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $111.39 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $60.53 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $85.98
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PROTHROMBIN TIME QUEST	$37.20	$20.83	$3.99 – $85.98
Blood clotting time test (prothrombin time, PT): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $23.02 Aetna — Aetna Performance (N R): $24.87 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $31.78 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $37.20 All Other Medicaid — All Other Medicaid (R): $17.86 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $3.99 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $31.25 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $28.70 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $60.54 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $85.98
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG SCT SCREEN AND CONFIRM EACH	$76.80	$43.01	$5.60 – $85.98
Blood clotting test (partial thromboplastin time, PTT): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $47.52 Aetna — Aetna Performance (N R): $51.34 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $65.61 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $76.80 All Other Medicaid — All Other Medicaid (R): $36.86 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $5.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $64.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $59.24 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $60.53 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $85.98
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG ACTIVATED PTT	$76.80	$43.01	$5.60 – $85.98
Blood clotting test (partial thromboplastin time, PTT): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $47.52 Aetna — Aetna Performance (N R): $51.34 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $65.61 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $76.80 All Other Medicaid — All Other Medicaid (R): $36.86 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $5.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $64.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $59.24 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $60.53 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $85.98
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PARTIAL THROMBOPLASTIN TIME ACTIVATED QUEST	$49.20	$27.55	$5.60 – $85.98
Blood clotting test (partial thromboplastin time, PTT): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $30.44 Aetna — Aetna Performance (N R): $32.89 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $42.03 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $49.20 All Other Medicaid — All Other Medicaid (R): $23.62 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $5.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $41.33 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $37.95 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $60.53 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $85.98

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CT HEAD WO CONTRAST	$1,629.40	$912.46	$99.61 – $1,629.40
CT scan of the head or brain, without contrast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,008.27 Aetna — Aetna Performance (N R): $1,089.25 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,392 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,629.40 All Other Medicaid — All Other Medicaid (R): $782.11 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,368.70 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,256.92 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $333.28 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $473.30
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD CT HEAD BRAIN WO	$1,629.40	$912.46	$99.61 – $1,629.40
CT scan of the head or brain, without contrast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,008.27 Aetna — Aetna Performance (N R): $1,089.25 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,392 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,629.40 All Other Medicaid — All Other Medicaid (R): $782.11 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,368.70 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,256.92 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $333.28 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $473.30
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG CT HEAD WO CONTRAST	$1,629.40	$912.46	$998.33 – $1,629.40
CT scan of the head or brain, without contrast: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $998.33 Aetna — Aetna Performance (N R): $1,078.50 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,378.15 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,629.40 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,368.70 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,256.92 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $1,368.70
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MRI HEAD BRAIN WWO	$4,125.10	$2,310.06	$332.39 – $4,125.10
MRI of the brain, before and after contrast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $2,552.61 Aetna — Aetna Performance (N R): $2,757.63 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $3,524.07 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $4,125.10 All Other Medicaid — All Other Medicaid (R): $1,980.05 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $341.56 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,465.08 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $3,182.10 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $1,538.40 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $2,184.70
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD MRI HEAD BRAIN WWO	$4,125.10	$2,310.06	$2,527.45 – $4,125.10
MRI of the brain, before and after contrast: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $2,527.45 Aetna — Aetna Performance (N R): $2,730.40 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $3,489.01 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $4,125.10 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,465.08 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $3,182.10 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $3,465.08
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD XRAY CHEST 2 VIEWS PA AND LATERAL	$248.80	$139.33	$50.06 – $335.35
Chest X-ray, 2 views: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $153.96 Aetna — Aetna Performance (N R): $166.32 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $212.55 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $248.80 All Other Medicaid — All Other Medicaid (R): $119.42 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $85.21 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $208.99 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $191.92 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $236.12 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $335.35
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD XRAY CHEST 2 VIEWS PA AND LAT PORTABLE	$373.20	$208.99	$75.09 – $373.20
Chest X-ray, 2 views: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $230.94 Aetna — Aetna Performance (N R): $249.48 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $318.82 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $373.20 All Other Medicaid — All Other Medicaid (R): $179.14 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $85.21 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $313.49 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $287.89 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $236.12 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $335.35
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD XRAY CHEST 2 VIEWS PA AND LATERAL	$248.80	$139.33	$152.44 – $248.80
Chest X-ray, 2 views: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $152.44 Aetna — Aetna Performance (N R): $164.68 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $210.44 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $248.80 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $208.99 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $191.92 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $208.99
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD XRAY LUMBOSACRAL MINIMUM OF 4 VIEWS	$248.80	$139.33	$50.06 – $441.18
X-ray of the lower spine, at least 4 views: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $153.96 Aetna — Aetna Performance (N R): $166.32 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $212.55 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $248.80 All Other Medicaid — All Other Medicaid (R): $119.42 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $208.99 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $191.92 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $310.64 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $441.18
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD XRAY LUMBOSACRAL MINIMUM OF 4 VIEWS	$248.80	$139.33	$152.44 – $248.80
X-ray of the lower spine, at least 4 views: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $152.44 Aetna — Aetna Performance (N R): $164.68 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $210.44 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $248.80 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $208.99 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $191.92 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $208.99
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MRI SPINE LUMBAR WO	$2,475	$1,386	$227.33 – $2,475
MRI of the lower back (lumbar spine), without contrast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,531.53 Aetna — Aetna Performance (N R): $1,654.54 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,114.39 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,475 All Other Medicaid — All Other Medicaid (R): $1,188 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $233.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,079 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,909.22 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $917.14 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,302.45
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MRI SPINE LUMBAR WO LIMITED	$2,215.10	$1,240.46	$227.33 – $2,215.10
MRI of the lower back (lumbar spine), without contrast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,370.70 Aetna — Aetna Performance (N R): $1,480.79 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,892.36 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,215.10 All Other Medicaid — All Other Medicaid (R): $1,063.25 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $233.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,860.68 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,708.73 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $917.14 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,302.45
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD MRI SPINE LUMBAR WO	$2,475	$1,386	$1,516.43 – $2,475
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $1,516.43 Aetna — Aetna Performance (N R): $1,638.20 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,093.36 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,475 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,079 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,909.22 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $2,079
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CT PELVIS W CONTRAST	$2,444.30	$1,368.81	$167.11 – $2,444.30
CT scan of the pelvis, with contrast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,512.53 Aetna — Aetna Performance (N R): $1,634.01 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,088.17 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,444.30 All Other Medicaid — All Other Medicaid (R): $1,173.26 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $171.73 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,053.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,885.53 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $673.72 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $956.75
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD CT PELVIS W	$2,444.30	$1,368.81	$167.11 – $2,444.30
CT scan of the pelvis, with contrast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,512.53 Aetna — Aetna Performance (N R): $1,634.01 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,088.17 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,444.30 All Other Medicaid — All Other Medicaid (R): $1,173.26 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $171.73 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,053.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,885.53 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $673.72 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $956.75
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG CT PELVIS W CONTRAST	$2,444.30	$1,368.81	$1,497.62 – $2,444.30
CT scan of the pelvis, with contrast: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $1,497.62 Aetna — Aetna Performance (N R): $1,617.88 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,067.39 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,444.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,053.21 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,885.53 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $2,053.21
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MRI JOINT LOWER EXTREMITY WO	$3,712.50	$2,079	$227.33 – $3,712.50
MRI of a leg joint (such as the knee), without contrast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $2,297.30 Aetna — Aetna Performance (N R): $2,481.81 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $3,171.59 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,712.50 All Other Medicaid — All Other Medicaid (R): $1,782 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $233.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,118.50 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,863.82 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $967.20 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,373.53
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MRI JOINT LOWER EXTREMITY WO LIMITED	$2,784.70	$1,559.43	$227.33 – $2,784.70
MRI of a leg joint (such as the knee), without contrast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,723.17 Aetna — Aetna Performance (N R): $1,861.57 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,378.97 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,784.70 All Other Medicaid — All Other Medicaid (R): $1,336.66 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $233.60 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,339.15 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,148.12 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $967.20 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,373.53
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD MRI JOINT LOWER EXTREMITY WO	$3,712.50	$2,079	$2,274.65 – $3,712.50
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $2,274.65 Aetna — Aetna Performance (N R): $2,457.30 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $3,140.03 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,712.50 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,118.50 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,863.82 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $3,118.50
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD CT ABDOMEN PELVIS W	$3,258.90	$1,824.98	$325.69 – $3,258.90
CT scan of the abdomen and pelvis, with contrast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $2,016.61 Aetna — Aetna Performance (N R): $2,178.57 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,784.08 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,258.90 All Other Medicaid — All Other Medicaid (R): $1,564.27 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $341.56 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,737.48 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,513.92 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $919.07 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,305.18
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG RAD CT ABDOMEN PELVIS W	$3,258.90	$1,824.98	$1,996.73 – $3,258.90
CT scan of the abdomen and pelvis, with contrast: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $1,996.73 Aetna — Aetna Performance (N R): $2,157.07 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,756.38 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,258.90 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,737.48 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,513.92 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $2,737.48
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG US ABDOMEN COMPLETE	$724.80	$405.89	$99.61 – $811.12
Ultrasound of the abdomen, complete: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $448.51 Aetna — Aetna Performance (N R): $484.53 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $619.20 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $724.80 All Other Medicaid — All Other Medicaid (R): $347.90 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $608.83 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $559.11 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $571.11 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $811.12
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US ABDOMEN COMPLETE	$726.60	$406.90	$99.61 – $811.12
Ultrasound of the abdomen, complete: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $449.62 Aetna — Aetna Performance (N R): $485.73 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $620.73 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $726.60 All Other Medicaid — All Other Medicaid (R): $348.77 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $610.34 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $560.50 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $571.11 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $811.12
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US ABDOMEN COMPLETE PORTABLE	$1,089.90	$610.34	$99.61 – $1,089.90
Ultrasound of the abdomen, complete: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $674.43 Aetna — Aetna Performance (N R): $728.60 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $931.10 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,089.90 All Other Medicaid — All Other Medicaid (R): $523.15 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $915.52 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $840.75 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $571.11 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $811.12
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG US OB EQUAL OR GREATER THAN 14 WKS SINGLE GES	$817.40	$457.74	$99.61 – $921.32
Pregnancy ultrasound (after the first trimester): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $505.81 Aetna — Aetna Performance (N R): $546.43 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $698.30 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $817.40 All Other Medicaid — All Other Medicaid (R): $392.35 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $686.62 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $630.54 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $648.70 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $921.32
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US OB EQUAL OR GREATER THAN 14 WKS SINGLE	$817.40	$457.74	$99.61 – $921.32
Pregnancy ultrasound (after the first trimester): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $505.81 Aetna — Aetna Performance (N R): $546.43 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $698.30 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $817.40 All Other Medicaid — All Other Medicaid (R): $392.35 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $686.62 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $630.54 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $648.70 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $921.32
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US OB EQUAL OR GREATER THAN 14 WKS SNGL G	$1,178	$659.68	$99.61 – $1,178
Pregnancy ultrasound (after the first trimester): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $728.95 Aetna — Aetna Performance (N R): $787.49 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,006.37 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,178 All Other Medicaid — All Other Medicaid (R): $565.44 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $989.52 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $908.71 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $648.70 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $921.32
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG US PELVIS TRANSVAGINAL NON OB	$543.70	$304.47	$99.61 – $811.12
Transvaginal ultrasound: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $336.44 Aetna — Aetna Performance (N R): $363.46 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $464.48 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $543.70 All Other Medicaid — All Other Medicaid (R): $260.98 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $456.71 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $419.41 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $571.12 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $811.12
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US TRANSVAGINAL	$544.80	$305.09	$99.61 – $811.12
Transvaginal ultrasound: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $337.12 Aetna — Aetna Performance (N R): $364.20 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $465.42 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $544.80 All Other Medicaid — All Other Medicaid (R): $261.50 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $457.63 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $420.26 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $571.11 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $811.12
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD US PELVIS COMPLETE TV ADD ON	$272.50	$152.60	$54.83 – $811.12
Transvaginal ultrasound: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $168.62 Aetna — Aetna Performance (N R): $182.17 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $232.80 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $272.50 All Other Medicaid — All Other Medicaid (R): $130.80 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $102.36 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $228.90 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $210.21 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $571.12 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $811.12
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO UNI DIAGNOSTIC WWO CAD	$611.70	$342.55	$75.68 – $611.70
Diagnostic mammogram, one breast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $378.52 Aetna — Aetna Performance (N R): $408.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $522.58 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $611.70 All Other Medicaid — All Other Medicaid (R): $293.62 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $82.67 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $513.83 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $471.87 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $253.76 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $360.30
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO UNI DIAGNOSTIC 3D WWO CAD	$593	$332.08	$75.68 – $593
Diagnostic mammogram, one breast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $366.95 Aetna — Aetna Performance (N R): $396.42 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $506.60 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $593 All Other Medicaid — All Other Medicaid (R): $284.64 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $82.67 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $498.12 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $457.44 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $253.76 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $360.30
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO UNI DIAGNOSTIC ADDL VIEWS WWO CAD	$611.70	$342.55	$75.68 – $611.70
Diagnostic mammogram, one breast: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $378.52 Aetna — Aetna Performance (N R): $408.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $522.58 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $611.70 All Other Medicaid — All Other Medicaid (R): $293.62 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $82.67 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $513.83 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $471.87 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $253.76 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $360.30
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO BILAT DIAGNOSTIC WWO CAD	$611.70	$342.55	$75.68 – $611.70
Diagnostic mammogram, both breasts: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $378.52 Aetna — Aetna Performance (N R): $408.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $522.58 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $611.70 All Other Medicaid — All Other Medicaid (R): $293.62 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $105.89 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $513.83 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $471.87 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $253.76 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $360.30
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO BILAT DIAGNOSTIC 3D WWO CAD	$593	$332.08	$75.68 – $593
Diagnostic mammogram, both breasts: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $366.95 Aetna — Aetna Performance (N R): $396.42 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $506.60 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $593 All Other Medicaid — All Other Medicaid (R): $284.64 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $105.89 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $498.12 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $457.44 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $253.76 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $360.30
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO BILAT DIAGNOSTIC IMPLANT W ADDL VIE	$551.80	$309.01	$75.68 – $551.80
Diagnostic mammogram, both breasts: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $341.45 Aetna — Aetna Performance (N R): $368.88 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $471.40 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $551.80 All Other Medicaid — All Other Medicaid (R): $264.86 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $105.89 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $463.51 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $425.66 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $253.76 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $360.30
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO BILAT SCREENING WWO CAD	$458.80	$256.93	$75.68 – $458.80
Screening mammogram, both breasts: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $283.91 Aetna — Aetna Performance (N R): $306.71 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $391.95 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $458.80 All Other Medicaid — All Other Medicaid (R): $220.22 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $87.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $385.39 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $353.92 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $253.76 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $360.30
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO UNI SCREENING 3D WWO CAD	$437.80	$245.17	$75.68 – $437.80
Screening mammogram, both breasts: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $270.91 Aetna — Aetna Performance (N R): $292.67 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $374.01 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $437.80 All Other Medicaid — All Other Medicaid (R): $210.14 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $87.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $367.75 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $337.72 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $253.76 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $360.30
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG RAD MAMMO BILAT SCREENING 3D WWO CAD	$455.10	$254.86	$75.68 – $455.10
Screening mammogram, both breasts: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $281.62 Aetna — Aetna Performance (N R): $304.23 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $388.79 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $455.10 All Other Medicaid — All Other Medicaid (R): $218.45 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $87.12 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $382.28 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $351.06 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $253.76 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $360.30

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) · Hospital (facility) fee In the file: HCHG POLYSOMNOGRAPHY > 6YRS >4 PARAMETERS	$5,507.30	$3,084.09	$818.17 – $5,507.30
Sleep study (overnight, in a sleep lab): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $3,407.92 Aetna — Aetna Performance (N R): $3,681.63 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $4,704.89 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $5,507.30 All Other Medicaid — All Other Medicaid (R): $2,643.50 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $840.76 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $4,626.13 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $4,248.33 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $3,157.62 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $3,061.84
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG POLYSOMNOGRAPHY > 6YRS >4 PARAMETERS REDUCE	$4,130.30	$2,312.97	$818.17 – $4,130.30
Sleep study (overnight, in a sleep lab): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $2,555.83 Aetna — Aetna Performance (N R): $2,761.11 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $3,528.52 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $4,130.30 All Other Medicaid — All Other Medicaid (R): $1,982.54 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $840.76 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,469.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $3,186.11 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $3,157.62 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $3,061.84
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG POLYSOMNOGRAPHY > 6YRS >4 PARAMETERS	$5,507.30	$3,084.09	$3,374.32 – $5,507.30
Sleep study (overnight, in a sleep lab): rates for 7 insurance plans Aetna — Aetna Elevate (N R): $3,374.32 Aetna — Aetna Performance (N R): $3,645.28 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $4,658.07 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $5,507.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $4,626.13 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $4,248.33 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $4,626.13

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT THERAPEUTIC EXERCISE 15MIN	$145.50	$81.48	$23.16 – $145.50
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $90.04 Aetna — Aetna Performance (N R): $97.27 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $124.30 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $145.50 All Other Medicaid — All Other Medicaid (R): $69.84 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $27.31 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $122.22 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $112.24 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $78.65 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $111.67
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG OT THERAPEUTIC EXERCISE 15MIN	$145.50	$81.48	$23.16 – $145.50
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $90.04 Aetna — Aetna Performance (N R): $97.27 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $124.30 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $145.50 All Other Medicaid — All Other Medicaid (R): $69.84 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $27.31 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $122.22 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $112.24 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $78.65 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $111.67
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT THERAPEUTIC EXERCISE 59	$145.50	$81.48	$23.16 – $145.50
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $90.04 Aetna — Aetna Performance (N R): $97.27 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $124.30 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $145.50 All Other Medicaid — All Other Medicaid (R): $69.84 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $27.31 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $122.22 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $112.24 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $78.65 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $111.67
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL LOW COMPLEXITY	$429.20	$240.35	$64.71 – $429.20
Physical therapy evaluation (low complexity): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $265.59 Aetna — Aetna Performance (N R): $286.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $366.67 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid — All Other Medicaid (R): $206.02 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $216.96 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $308.06
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL LOW COMPLEXITY XE	$429.20	$240.35	$64.71 – $429.20
Physical therapy evaluation (low complexity): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $265.59 Aetna — Aetna Performance (N R): $286.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $366.67 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid — All Other Medicaid (R): $206.02 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $216.96 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $308.06
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL LOW COMPLEXITY XP	$429.20	$240.35	$64.71 – $429.20
Physical therapy evaluation (low complexity): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $265.59 Aetna — Aetna Performance (N R): $286.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $366.67 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid — All Other Medicaid (R): $206.02 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $216.96 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $308.06
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL MOD COMPLEXITY	$429.20	$240.35	$64.71 – $429.20
Physical therapy evaluation (moderate complexity): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $265.59 Aetna — Aetna Performance (N R): $286.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $366.67 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid — All Other Medicaid (R): $206.02 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $216.96 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $308.06
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL MOD COMPLEXITY XE	$429.20	$240.35	$64.71 – $429.20
Physical therapy evaluation (moderate complexity): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $265.59 Aetna — Aetna Performance (N R): $286.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $366.67 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid — All Other Medicaid (R): $206.02 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $216.96 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $308.06
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL MOD COMPLEXITY XP	$429.20	$240.35	$64.71 – $429.20
Physical therapy evaluation (moderate complexity): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $265.59 Aetna — Aetna Performance (N R): $286.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $366.67 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid — All Other Medicaid (R): $206.02 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $216.96 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $308.06
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL HIGH COMPLEXITY	$429.20	$240.35	$64.71 – $429.20
Physical therapy evaluation (high complexity): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $265.59 Aetna — Aetna Performance (N R): $286.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $366.67 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid — All Other Medicaid (R): $206.02 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $216.96 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $308.06
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL HIGH COMPLEXITY XE	$429.20	$240.35	$64.71 – $429.20
Physical therapy evaluation (high complexity): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $265.59 Aetna — Aetna Performance (N R): $286.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $366.67 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid — All Other Medicaid (R): $206.02 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $216.96 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $308.06
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PT EVAL HIGH COMPLEXITY XP	$429.20	$240.35	$64.71 – $429.20
Physical therapy evaluation (high complexity): 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $265.59 Aetna — Aetna Performance (N R): $286.92 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $366.67 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $429.20 All Other Medicaid — All Other Medicaid (R): $206.02 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $92.83 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $360.53 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $331.08 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $216.96 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $308.06
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 30 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $205.30
Psychotherapy, 30 minutes: 10 of 26 insurance plan rates Aetna — Aetna Elevate (N R): $127.04 Aetna — Aetna Performance (N R): $137.24 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $175.39 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 All Other Medicaid — All Other Medicaid (R): $98.54 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $173.78 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $81.43 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $85.53
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 30 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$125.79 – $205.30
Psychotherapy, 30 minutes: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $125.79 Aetna — Aetna Performance (N R): $135.89 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $173.64 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $172.45
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 45 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $205.30
Psychotherapy, 45 minutes: 10 of 26 insurance plan rates Aetna — Aetna Elevate (N R): $127.04 Aetna — Aetna Performance (N R): $137.24 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $175.39 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 All Other Medicaid — All Other Medicaid (R): $98.54 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $173.78 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $81.43 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $85.53
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 45 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$125.79 – $205.30
Psychotherapy, 45 minutes: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $125.79 Aetna — Aetna Performance (N R): $135.89 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $173.64 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $172.45
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 60 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $205.30
Psychotherapy, 60 minutes: 10 of 26 insurance plan rates Aetna — Aetna Elevate (N R): $127.04 Aetna — Aetna Performance (N R): $137.24 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $175.39 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 All Other Medicaid — All Other Medicaid (R): $98.54 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $173.78 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $81.43 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $85.53
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY 60 MIN PATIENT CK OR HBC ONLY	$205.30	$114.97	$125.79 – $205.30
Psychotherapy, 60 minutes: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $125.79 Aetna — Aetna Performance (N R): $135.89 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $173.64 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $205.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $172.45 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $158.37 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $172.45
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY FAMILY WO PATIENT 50 MIN	$310.10	$173.66	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $554.94
Family psychotherapy, without the patient: 10 of 26 insurance plan rates Aetna — Aetna Elevate (N R): $191.89 Aetna — Aetna Performance (N R): $207.30 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $264.92 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $310.10 All Other Medicaid — All Other Medicaid (R): $148.85 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $173.78 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $260.48 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $239.21 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $390.78 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $554.94
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY FAMILY WO PATIENT 50 MIN	$310.10	$173.66	$190 – $310.10
Family psychotherapy, without the patient: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $190 Aetna — Aetna Performance (N R): $205.26 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $262.28 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $310.10 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $260.48 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $239.21 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $260.48
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY FAMILY W PATIENT 50 MIN	$371	$207.76	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $576.36
Family psychotherapy, with the patient: 10 of 26 insurance plan rates Aetna — Aetna Elevate (N R): $229.57 Aetna — Aetna Performance (N R): $248.01 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $316.95 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $371 All Other Medicaid — All Other Medicaid (R): $178.08 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $173.78 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $311.64 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $286.19 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $405.86 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $576.36
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG PSYCHOTHERAPY FAMILY W PATIENT 50 MIN	$371	$207.76	$227.31 – $371
Family psychotherapy, with the patient: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $227.31 Aetna — Aetna Performance (N R): $245.56 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $313.79 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $371 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $311.64 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $286.19 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $311.64
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG GROUP PSYCHOTHERAPY CK OR HBC ONLY	$178.30	$99.85	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $178.30
Group psychotherapy: 10 of 26 insurance plan rates Aetna — Aetna Elevate (N R): $110.33 Aetna — Aetna Performance (N R): $119.19 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $152.32 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $178.30 All Other Medicaid — All Other Medicaid (R): $85.58 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $99.47 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $149.77 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $137.54 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $96 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $136.33
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HCHG GROUP PSYCHOTHERAPY CK OR HBC ONLY	$178.30	$99.85	$109.24 – $178.30
Group psychotherapy: rates for 7 insurance plans Aetna — Aetna Elevate (N R): $109.24 Aetna — Aetna Performance (N R): $118.02 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $150.81 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $178.30 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $149.77 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $137.54 First Health (A C E G H U B D N O R S) — First Health (ABDMNOSURV): $149.77

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG INJ EPIDUR INTERLAM SUBA LUMB SACRAL W GUIDE	$1,528.10	$855.74	$307.45 – $2,320.34
Spinal injection, lower back (epidural), with imaging guidance: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $945.59 Aetna — Aetna Performance (N R): $1,021.53 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,305.46 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,528.10 All Other Medicaid — All Other Medicaid (R): $733.49 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $691.10 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,283.60 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,178.78 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $1,633.92 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $2,320.34
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CT INJ EPIDURAL LUMBAR OR SACRAL W GUIDE	$1,528.10	$855.74	$307.45 – $2,320.34
Spinal injection, lower back (epidural), with imaging guidance: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $945.59 Aetna — Aetna Performance (N R): $1,021.53 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,305.46 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,528.10 All Other Medicaid — All Other Medicaid (R): $733.49 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $691.10 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,283.60 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,178.78 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $1,633.92 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $2,320.34
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG IR INJ EPIDURAL LUMBAR OR SACRAL W GUIDE	$1,528.10	$855.74	$307.45 – $2,320.34
Spinal injection, lower back (epidural), with imaging guidance: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $945.59 Aetna — Aetna Performance (N R): $1,021.53 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,305.46 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $1,528.10 All Other Medicaid — All Other Medicaid (R): $733.49 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $691.10 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,283.60 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,178.78 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $1,633.92 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $2,320.34
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG INJ TRANSFORAMINAL EPIDURAL LMBR/SAC 1 LVL W	$2,463.40	$1,379.50	$274.95 – $2,463.40
Nerve root injection, lower back, with imaging guidance: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,524.35 Aetna — Aetna Performance (N R): $1,646.78 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,104.48 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,463.40 All Other Medicaid — All Other Medicaid (R): $1,182.43 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $865.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,069.26 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,900.27 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $846.33 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,201.99
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG CT TRANSFORAMINAL LUMB OR SACRAL SNGL W CT GU	$2,321.90	$1,300.26	$274.95 – $2,321.90
Nerve root injection, lower back, with imaging guidance: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,436.79 Aetna — Aetna Performance (N R): $1,552.19 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,983.60 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,321.90 All Other Medicaid — All Other Medicaid (R): $1,114.51 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $865.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,950.40 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,791.11 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $846.33 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,201.99
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG IR INJ TRANS EPIDURAL LUMBAR W FLUORO	$2,309.40	$1,293.26	$274.95 – $2,309.40
Nerve root injection, lower back, with imaging guidance: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,429.06 Aetna — Aetna Performance (N R): $1,543.83 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $1,972.92 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,309.40 All Other Medicaid — All Other Medicaid (R): $1,108.51 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $865.95 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $1,939.90 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,781.47 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $846.33 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $1,201.99
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG DISCISSION OF SECONDARY MEMBRANOUS CATARACT	$2,541.60	$1,423.30	$511.37 – $4,429.94
Laser treatment of clouding after cataract surgery: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $1,572.74 Aetna — Aetna Performance (N R): $1,699.06 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,171.29 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $2,541.60 All Other Medicaid — All Other Medicaid (R): $1,219.97 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $538.48 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,134.94 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $1,960.59 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $3,119.12 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $4,429.94
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG DISCISSION OF SECONDARY MEMBRANOUS CATARACT U	$3,341.70	$1,871.35	$524.01 – $4,429.94
Laser treatment of clouding after cataract surgery: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $2,067.84 Aetna — Aetna Performance (N R): $2,233.93 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $2,854.81 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,341.70 All Other Medicaid — All Other Medicaid (R): $1,604.02 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $538.48 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $2,807.03 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,577.79 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $3,119.12 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $4,429.94
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HCHG DISCISSION OF SECONDARY MEMBRANOUS CATARACT B	$3,876.40	$2,170.78	$524.01 – $4,429.94
Laser treatment of clouding after cataract surgery: 10 of 25 insurance plan rates Aetna — Aetna Elevate (N R): $2,398.72 Aetna — Aetna Performance (N R): $2,591.37 Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): $3,311.61 All Other Contracted Care (A B C D E G H N O R S U) — All Other Contracted Care (A B C D M H N O R S U V): $3,876.40 All Other Medicaid — All Other Medicaid (R): $1,860.67 Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $538.48 Americas PPO (Araz) (B D N H O R S) — Americas PPO (Araz) (B D N H O R S V): $3,256.18 Americas PPO (Araz)(B D N O R S V) — Americas PPO (Araz)(B D N O R S V): $2,990.25 BC AWARE/Blue Plus (NR) — BC AWARE/Blue Plus (NR): $3,119.12 BC High Value/ Performance Network (R) — BC High Value/ Performance Network (R): $4,429.94

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$2,820.92 – $74,794.03
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 15 insurance plan rates Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $70,769.20 BCBS — BC Medicare (R): $3,129.87 Medica — Medica Medicare (R): $3,129.87 Medica Health System — Medica Dual Solutions (R): $3,513.07 Medica Health System — Medica PMAP (R): $38,133.36 Medicare — Medicare (R): $74,794.03 Medicare Other — All Other Medicare (R): $3,129.87 South Country Health Alliance — SCHA MSHO (R): $2,820.92 Aetna — Aetna Elevate (N R): 61.27% (a percentage in the contract, not a dollar amount) Aetna — Aetna Performance (N R): 66.19% (a percentage in the contract, not a dollar amount)
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$2,820.92 – $28,360.62
Spinal fusion (not neck), without major complications: 10 of 14 insurance plan rates Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $26,835.98 BCBS — BC Medicare (R): $3,129.87 Medica — Medica Medicare (R): $3,129.87 Medica Health System — Medica Dual Solutions (R): $3,513.07 Medicare — Medicare (R): $28,360.62 Medicare Other — All Other Medicare (R): $3,129.87 South Country Health Alliance — SCHA MSHO (R): $2,820.92 Aetna — Aetna Elevate (N R): 61.27% (a percentage in the contract, not a dollar amount) Aetna — Aetna Performance (N R): 66.19% (a percentage in the contract, not a dollar amount) Aetna Direct/Indirect Network — Aetna Direct/Indirect Network (N R): 84.58% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$2,820.92 – $15,252.91
Hip or knee replacement (major joint of the leg), without major complications: 10 of 15 insurance plan rates Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $14,434.06 BCBS — BC Medicare (R): $3,129.87 Medica — Medica Medicare (R): $3,129.87 Medica Health System — Medica Dual Solutions (R): $3,513.07 Medica Health System — Medica PMAP (R): $7,518.85 Medicare — Medicare (R): $15,252.91 Medicare Other — All Other Medicare (R): $3,129.87 South Country Health Alliance — SCHA MSHO (R): $2,820.92 Aetna — Aetna Elevate (N R): 61.27% (a percentage in the contract, not a dollar amount) Aetna — Aetna Performance (N R): 66.19% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$2,820.92 – $19,137.48
Neck (cervical) spinal fusion, without complications: 10 of 15 insurance plan rates Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $18,109.46 BCBS — BC Medicare (R): $3,129.87 Medica — Medica Medicare (R): $3,129.87 Medica Health System — Medica Dual Solutions (R): $3,513.07 Medica Health System — Medica PMAP (R): $9,516.19 Medicare — Medicare (R): $19,137.48 Medicare Other — All Other Medicare (R): $3,129.87 South Country Health Alliance — SCHA MSHO (R): $2,820.92 Aetna — Aetna Elevate (N R): 61.27% (a percentage in the contract, not a dollar amount) Aetna — Aetna Performance (N R): 66.19% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$2,820.92 – $10,035.63
Uterus and ovary surgery (not for cancer), without complications: 10 of 15 insurance plan rates Allina Aetna Medicare (R) — Allina Aetna Medicare (R): $9,497.69 BCBS — BC Medicare (R): $3,129.87 Medica — Medica Medicare (R): $3,129.87 Medica Health System — Medica Dual Solutions (R): $3,513.07 Medica Health System — Medica PMAP (R): $4,836.25 Medicare — Medicare (R): $10,035.63 Medicare Other — All Other Medicare (R): $3,129.87 South Country Health Alliance — SCHA MSHO (R): $2,820.92 Aetna — Aetna Elevate (N R): 61.27% (a percentage in the contract, not a dollar amount) Aetna — Aetna Performance (N R): 66.19% (a percentage in the contract, not a dollar amount)

Source: River Falls Area Hospital’s standard charges file (allinahealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 15, 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	1629 E Division St, River Falls, WI 54022
County	St. Croix County
State	Wisconsin
Phone	(715) 307‑6000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	5 of 5 stars
CMS Certification Number	521349
Name in Medicare records	RIVER FALLS AREA HOSPITAL
Profile level	Medicare data + hospital website
Official website	allinahealth.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
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.

Hospital overview — allinahealth.org
Services — allinahealth.org
Visiting us — allinahealth.org
River Falls Area Hospital |River Falls, Wisconsin | Allina Health — allinahealth.org
River Falls Area Hospital | Patient & visitor information — allinahealth.org
River Falls Area Hospital | Patient care, safety and satisfaction — allinahealth.org
Emergency Room in River Falls, WI | River Falls Area Hospital — allinahealth.org
Medical & Surgical Care Unit at River Falls Area Hospital — allinahealth.org
Orthopedic Care | River Falls Area Hospital | Allina Health — allinahealth.org
Women's Health Care | Gynecology | River Falls Area Hospital — allinahealth.org

River Falls Area Hospital

Summary

Profile from official sources

At a glance