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Acute Care Hospital

Roper Hospital

Charleston, South Carolina · Charleston County · Emergency services listed

Roper Hospital is an acute care hospital at 316 Calhoun St, Charleston, SC 29401. Phone: (843) 724-2800. It has an emergency department. Medicare overall rating: 4 of 5 stars (CMS, October 2026).

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked November 2, 2026).

Summary

Roper Hospital is an acute care hospital in Charleston, South Carolina. Medicare data lists emergency services. CMS overall star rating: 4 of 5 stars. Its official website lists 81 services, specialties and programs. Medicare lists 1,115 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

A general hospital for short-term care: emergencies, surgery, illness and injury. Most patients stay a few days. More about hospital types

Call(843) 724‑2800 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-11-02). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
4 of 5 stars4 of 5 stars · Medicare rating
332Beds (hospital website)
1,115Doctors and clinicians
81Services listed

Quick answers

Does Roper Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Roper Hospital. In a medical emergency, call 911.
Where is Roper Hospital?
316 Calhoun St, Charleston, SC 29401, in Charleston County, South Carolina.
What is the phone number of Roper Hospital?
(843) 724-2800, as listed by Medicare (CMS).
What is the Medicare star rating of Roper Hospital?
4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Roper Hospital for hospital-acquired conditions?
No. For fiscal year 2026, CMS lists no Medicare payment reduction for Roper Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.1159; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

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

Conditions treated[6][7]

Treatments[4][5][6][7]

Procedures[7]

Programs and centers[6][7]

  • Roper Rehabilitation Hospital (inpatient rehabilitation, located within Roper Hospital)
  • Roper Rehabilitation Hospital (66 beds, within Roper Hospital)
  • CARF-accredited inpatient adult rehabilitation: stroke, brain injury and spinal cord programs
  • Center for Spinal Cord Injury
  • Heart & Vascular Center
  • Valve clinic
  • Minimally invasive surgery center
  • Robotic Epicenter
  • Breast Care Center
  • Cancer Care program (with breast nurse navigator)
  • Sleep Wake Disorder Center
  • Cardiac Wellness and Rehabilitation
  • Hyperbaric & Undersea Medicine

Emergency care (hospital website)[5]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

Interpreters and languagesTranslation services are listed under patient services on the system's patients & visitors page[8]

Recognition[7]

  • Certified Primary Stroke Center
  • Geriatric Care accredited (Emergency Department)
  • CARF accredited inpatient adult rehabilitation programs
  • Accredited vascular lab

Doctors and clinicians (1,115)

1,115 doctors and other clinicians list Roper Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (1,115)

And 1,091 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Charleston

All hospitals in Charleston · Hospitals in Charleston 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

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

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

Clinics and urgent care

Pharmacies

Assisted living nearby

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

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 4 of 5 stars
Overall rating of the hospital4 of 5 stars
Would recommend the hospital5 of 5 stars
Nurses communicated well5 of 5 stars
Doctors communicated well4 of 5 stars
Patients got help quickly from staff4 of 5 stars
Staff explained medicines4 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean3 of 5 stars
Restfulness of Environment3 of 5 stars
Care Coordination4 of 5 stars
Symptoms After Stay4 of 5 stars
Rated the hospital 9 or 10 out of 1079%National average: 72%
Would definitely recommend the hospital81%National average: 71%
Nurses “always” communicated well84%National average: 80%
Doctors “always” communicated well84%National average: 80%
“Always” got help as soon as they wanted70%National average: 64%
Staff “always” explained medicines before giving them67%National average: 62%
Were given information about recovery at home89%National average: 86%
Room and bathroom “always” clean67%National average: 73%
Completed surveys2,803Response rate: 28%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.815No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.681No different from the national benchmark
Surgical site infections after colon surgery0.583No different from the national benchmark
MRSA bloodstream infections2.474Worse than the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.922No different from the national benchmark
Not reported to MedicareSurgical site infections after abdominal hysterectomy

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from 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 attack patients11.8%
Deaths within 30 days: heart failure patients9.9%
Deaths within 30 days: pneumonia patients14.4%
Deaths within 30 days: COPD patients8.4%
Deaths within 30 days: stroke patients12.1%
Deaths within 30 days: coronary bypass surgery (CABG)2.7%
Serious complications (patient safety indicator PSI-90)0.77No different from the national rate
Complications after hip or knee replacement4.1%

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)15.1%
Readmitted within 30 days: heart attack13.4%
Readmitted within 30 days: heart failure20.4%
Readmitted within 30 days: pneumonia19.1%
Readmitted within 30 days: COPD18.6%
Readmitted within 30 days: coronary bypass surgery10.9%
Readmitted within 30 days: hip or knee replacement5.1%

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)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)103 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)75%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Roper Hospital, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026NoCMS lists no payment reduction for this hospital.
Total HAC Score-0.1159Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart attack0.9577Fewer readmissions than expected
Heart failure0.9785Fewer readmissions than expected
Pneumonia0.9860Fewer readmissions than expected
COPD (chronic lung disease)0.9670Fewer readmissions than expected
Hip or knee replacement1.0685More readmissions than expected
Coronary bypass surgery (CABG)1.0010More readmissions than expected

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Hospital Value-Based Purchasing Program

What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.

CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.

Total Performance Score36.67 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)30.00 out of 100
Person and community engagement (patient survey)70.00 out of 100
Safety (infections and sepsis care)46.67 out of 100
Efficiency and cost reduction (Medicare spending)0.00 out of 100

Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio1.02Above the national median hospital (1.00): Medicare spent more

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

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 CharlestonBest hospitals in Charleston

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 65 common services exactly as Roper 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 →

Show the prices of 65 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) In the file: HC New Pt, E/M Level 3 $321 $208.65 Not listed in the file
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: HC New Pt, E/M Level 3 $321 $208.65 Not listed in the file
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) In the file: HC New Pt, Outpt Visit Level 3 $321 $208.65 Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: HC New Pt, E/M Level 4 $344 $223.60 Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: HC New Pt, Outpt Visit Level 4 $344 $223.60 Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) In the file: HC New Pt, Outpt Visit Level 4 $344 $223.60 Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: HC New Pt, E/M Level 5 $387 $251.55 Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: HC New Pt, Outpt Visit Level 5 $387 $251.55 Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · modifier 27 In the file: HC New Pt, E/M Level 5|MULTIPLE OUTPATIENT HOSPITAL E/M ENCOUNTERS ON THE SAME DATE $387 $251.55 Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: HC Est Pt, Outpt Visit Level 3 $257 $167.05 Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) In the file: HC Est Pt, Outpt Visit Level 3 $257 $167.05 Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: HC Est Pt, E/M Level 3 $257 $167.05 Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: HC Est Pt, Outpt Visit Level 4 $313 $203.45 Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: HC Est Pt, E/M Level 4 $313 $203.45 Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) In the file: HC Est Pt, Outpt Visit Level 4 $313 $203.45 Not listed in the file
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) In the file: HC ER Level 3 $1,556 $1,011.40 Not listed in the file
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HC ER Level 3 $1,556 $1,011.40 Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HC ER Level 4 $2,334 $1,517.10 Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) In the file: HC ER Level 4 $2,334 $1,517.10 Not listed in the file
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HC ER Level 5 $3,911 $2,542.15 Not listed in the file
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) In the file: HC ER Level 5 $3,911 $2,542.15 Not listed in the file
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · modifier 25 In the file: HC ER Level 5|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY THE SAME PHYSICIAN ON THE SAME DAY OF THE PROCEDURE $3,911 $2,542.15 Not listed in the file

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: HC Basic Metabolic Panel Calcium Total $330 $214.50 Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: HC Comprehensive Metabolic Panel $380 $247 Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier 91|ADJ In the file: HC Comprehensive Metabolic Panel|REPEAT CLINICAL DIAGNOSTIC LABORATORY TEST|ADJ $380 $247 Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: HC So1 Lipid Panel $55 $35.75 Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: HC Lipid Panel $191 $124.15 Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: HC So Lipid Panel $43 $27.95 Not listed in the file
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: HC Renal Function Panel $109 $70.85 Not listed in the file
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HC Hepatic Function Panel $317 $206.05 Not listed in the file
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HC So Hepatic Function Panel $30 $19.50 Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: HC Urinalysis W/ Microscopy $179 $116.35 Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Urinalysis, Auto, W/O Scope $96 $62.40 Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC So Urinalysis Routine $11 $7.15 Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: HC Assay of Prostate Specific Antigen Total $242 $157.30 Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: HC So1 Assay of Psa Total $57 $37.05 Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HC So Assay of Psa Total $338 $219.70 Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: HC So Tsh 3rd Generation $26 $16.90 Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: HC Thyroid Stimulating Hormone $293 $190.45 Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier GZ In the file: HC So Tsh 3rd Generation|NOT REASONABLE AND NECESSARY $26 $16.90 Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: HC Cbc $180 $117 Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier GZ In the file: HC Cbc|NOT REASONABLE AND NECESSARY $180 $117 Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HC Cbc (Hemogram) $116 $75.40 Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HC So Cbc W/O Diff $79 $51.35 Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier GZ In the file: HC Cbc (Hemogram)|NOT REASONABLE AND NECESSARY $116 $75.40 Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC So Prothrombin Time $36 $23.40 Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC So1 Prothrombin Time $7 $4.55 Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC Prothrombin Time $106 $68.90 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HC So2 Ptt $9 $5.85 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HC Ptt $120 $78 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HC So1 Ptt $36 $23.40 Not listed in the file

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: HC CT Brain W/O Contrast $2,762 $1,795.30 Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: HC MRI-Brain WO & W Contrast $3,486 $2,265.90 Not listed in the file
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: HC X-Ray Exam Chest 2 Views $718 $466.70 Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: HC L-Spine Min 4 Views $825 $536.25 Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: HC MRI-Spine Lumbar WO Contrast $4,976 $3,234.40 Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: HC CT Pelvis W/ Contrast $2,630 $1,709.50 Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: HC MRI Lower Ext Jnt W/O Cont $3,764 $2,446.60 Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: HC CT Abd/Pel W Cont $4,901 $3,185.65 Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: HC US Abdomen Complete $1,432 $930.80 Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: HC Fetal Eval 2-3 Trim Sgl Gest $1,288 $837.20 Not listed in the file
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: HC US Transvaginal, Non OB $1,439 $935.35 Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: HC Mammo Dgx Unilateral Incl Cad if Perf $629 $408.85 Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) In the file: HC Mammo Dgx Unilateral Incl Cad if Perf $629 $408.85 Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: HC Mammo Dgx Bilateral Incl Cad if Perf $710 $461.50 Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) In the file: HC Mammo Dgx Bilateral Incl Cad if Perf $710 $461.50 Not listed in the file
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) In the file: HC Mammo Screening Incl Cad if Perf $480 $312 Not listed in the file
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: HC Mammo Screening Incl Cad if Perf $480 $312 Not listed in the file

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: HC L Heart W Lvgram $7,469 $4,854.85 Not listed in the file
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) In the file: HC L Heart W Lvgram $7,469 $4,854.85 Not listed in the file
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: HC Ep Study WO Attempt/Induc Arrh $6,664 $4,331.60 Not listed in the file
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: HC Ep Tx Atrial Fib Pul Vn Isolat $32,110 $20,871.50 Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: HC Adult Sleep Study (Polysomnogram) $5,628 $3,658.20 Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) In the file: HC Adult Sleep Study (Polysomnogram) $5,628 $3,658.20 Not listed in the file

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: HC Pt Therapeutic Exercise,Ea 15 Min $195 $126.75 Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: HC Ot Ther Ex per 15 Min $195 $126.75 Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier KX|CQ|XU In the file: HC Ot Ther Ex per 15 Min|DOCUMENTATION ON FILE|SERVICES PROVIDED IN WHOLE OR IN PART BY A PTA FOR MEDICARE PAIENTS|UNUSUAL NON-OVERLAPPING S $195 $126.75 Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: HC Pt Eval Low Complex $174 $113.10 Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: HC Pt Eval Mod Complex $227 $147.55 Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: HC Pt Eval High Complex $326 $211.90 Not listed in the file

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier LT In the file: Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion|LEFT SIDE $19,209.77 $11,525.86 $3,713.66 – $3,899.35
Removal of breast growth (open surgery): rates for 4 insurance plans
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $3,899.35
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $3,713.66
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $3,713.66
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $3,713.66
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier RT In the file: Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion|RIGHT SIDE $16,668.48 $10,001.09 $3,899.35
Removal of breast growth (open surgery): rates for 2 insurance plans
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $3,899.35
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $3,899.35
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier RT In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft|RIGHT SIDE $53,800.60 $32,280.36 $12,177.08 – $12,785.93
Total hip replacement: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $12,603.27
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $12,603.27
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $12,785.93
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $12,177.08
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $12,177.08
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $12,177.08
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier LT In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft|LEFT SIDE $54,770.73 $32,862.44 $12,177.08 – $12,785.93
Total hip replacement: rates for 5 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $12,603.27
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $12,785.93
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $12,177.08
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $12,177.08
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $12,177.08
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier LT In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments|LEFT SIDE $57,336.70 $34,402.02 $12,177.08 – $12,785.93
Total knee replacement: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $12,603.27
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $12,603.27
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $12,785.93
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $12,785.93
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $12,177.08
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $12,177.08
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier RT In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments|RIGHT SIDE $56,419.12 $33,851.47 $12,177.08 – $12,785.93
Total knee replacement: rates for 4 insurance plans
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $12,785.93
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $12,177.08
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $12,177.08
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $12,177.08
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier RT In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls|RIGHT SIDE $45,202.47 $27,121.48 $6,882.29 – $7,226.40
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $7,123.17
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $7,123.17
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $7,226.40
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $6,882.29
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $6,882.29
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $6,882.29
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier RT|PO In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls|RIGHT SIDE|PO $52,209.17 $31,325.50 $6,882.29 – $7,226.40
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $7,123.17
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $7,226.40
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $7,226.40
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $6,882.29
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $6,882.29
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $6,882.29
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier LT|PO In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls|LEFT SIDE|PO $55,425.58 $33,255.35 $6,882.29 – $7,226.40
Shoulder arthroscopy: shaving of shoulder bone: rates for 5 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $7,123.17
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $7,226.40
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $6,882.29
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $6,882.29
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $6,882.29
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg $24,656.93 $14,794.16 $3,103.39 – $3,258.56
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $3,212.01
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $3,212.01
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $3,258.56
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $3,258.56
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $3,103.39
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $3,103.39
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier LT|PO In the file: Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg|LEFT SIDE|PO $21,036.48 $12,621.89 $3,103.39 – $3,258.56
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $3,212.01
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $3,212.01
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $3,258.56
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $3,258.56
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $3,103.39
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $3,103.39
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $3,103.39
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier XS|RT|PO In the file: Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg|SEPARATE STRUCTURE|RIGHT SIDE|PO $49,079.02 $29,447.41 $6,882.29 – $7,226.40
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $7,123.17
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $7,123.17
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $7,226.40
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $7,226.40
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $6,882.29
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $6,882.29
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $6,882.29
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy Transoral Diagnostic $10,139.13 $6,083.48 $860.25 – $903.26
Upper GI endoscopy (diagnostic): rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $890.35
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $890.35
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $903.26
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $903.26
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $860.25
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $860.25
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $860.25
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: HC Egd Diagnostic Brush Wash $2,447 $1,590.55 Not listed in the file
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 74 In the file: Esophagogastroduodenoscopy Transoral Diagnostic|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRA $7,667.07 $4,600.24 $860.25 – $903.26
Upper GI endoscopy (diagnostic): rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $890.35
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $890.35
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $903.26
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $903.26
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $860.25
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $860.25
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $860.25
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd Transoral Biopsy Single/Multiple $11,327.98 $6,796.79 $860.25 – $903.26
Upper GI endoscopy with biopsy: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $890.35
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $890.35
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $903.26
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $903.26
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $860.25
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $860.25
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 74 In the file: Egd Transoral Biopsy Single/Multiple|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRATION OF ANE $14,828.12 $8,896.87 $1,820.02 – $1,911.02
Upper GI endoscopy with biopsy: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $1,883.72
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $1,911.02
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $1,911.02
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $1,820.02
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $1,820.02
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $1,820.02
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier XU In the file: Egd Transoral Biopsy Single/Multiple|UNUSUAL NON-OVERLAPPING SERVICE $11,938.77 $7,163.26 $1,820.02 – $1,911.02
Upper GI endoscopy with biopsy: rates for 5 insurance plans
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $1,911.02
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $1,911.02
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $1,820.02
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $1,820.02
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $1,820.02
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd $10,139.13 $6,083.48 $882.03 – $926.14
Colonoscopy (diagnostic): rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $912.91
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $912.91
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $926.14
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $926.14
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $882.03
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $882.03
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 74 In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRATION $9,811.63 $5,886.98 $882.03 – $926.14
Colonoscopy (diagnostic): rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $912.91
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $912.91
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $926.14
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $926.14
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $882.03
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $882.03
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $882.03
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy W/Biopsy Single/Multiple $12,669.70 $7,601.82 $1,134.98 – $1,191.72
Colonoscopy with biopsy: rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $1,174.70
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $1,174.70
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $1,191.72
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $1,191.72
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $1,134.98
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $1,134.98
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $1,134.98
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier PT In the file: Colonoscopy W/Biopsy Single/Multiple|COLORECTAL CANCER SCREEN $11,052.48 $6,631.49 $1,134.98 – $1,191.72
Colonoscopy with biopsy: rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $1,174.70
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $1,174.70
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $1,191.72
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $1,191.72
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $1,134.98
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $1,134.98
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $1,134.98
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier PT|XU In the file: Colonoscopy W/Biopsy Single/Multiple|COLORECTAL CANCER SCREEN|UNUSUAL NON-OVERLAPPING SERVICE $15,043.82 $9,026.29 $1,134.98 – $1,191.72
Colonoscopy with biopsy: rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $1,174.70
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $1,174.70
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $1,191.72
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $1,191.72
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $1,134.98
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $1,134.98
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $1,134.98
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq $11,909.62 $7,145.77 $1,134.98 – $1,191.72
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $1,174.70
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $1,174.70
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $1,191.72
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $1,191.72
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $1,134.98
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $1,134.98
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier PT|XU In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq|COLORECTAL CANCER SCREEN|UNUSUAL NON-OVERLAPPING SERVICE $23,559.47 $14,135.68 $2,632.62 – $2,764.26
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $2,724.77
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $2,764.26
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $2,764.26
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $2,632.62
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $2,632.62
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $2,632.62
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 33 In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq|PREVENTIVE SERVICES $10,944.37 $6,566.62 $1,134.98 – $1,191.72
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $1,174.70
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $1,191.72
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $1,191.72
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $1,134.98
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $1,134.98
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $1,134.98
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Colon Ca Scrn Not Hi Rsk Ind $9,867.32 $5,920.39 $882.03 – $926.14
Screening colonoscopy (not high risk): rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $912.91
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $912.91
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $926.14
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $926.14
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $882.03
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $882.03
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier KX In the file: Colon Ca Scrn Not Hi Rsk Ind|DOCUMENTATION ON FILE $10,162.85 $6,097.71 $882.03 – $926.14
Screening colonoscopy (not high risk): rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $912.91
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $912.91
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $926.14
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $926.14
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $882.03
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $882.03
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $882.03
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier KX|74 In the file: Colon Ca Scrn Not Hi Rsk Ind|DOCUMENTATION ON FILE|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINIS $7,006.23 $4,203.74 $882.03 – $926.14
Screening colonoscopy (not high risk): rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $912.91
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $912.91
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $926.14
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $926.14
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $882.03
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $882.03
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $882.03
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy Surg Cholecystectomy $25,449.88 $15,269.93 $5,733.99 – $6,020.69
Gallbladder removal by laparoscope: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $5,934.68
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $6,020.69
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $6,020.69
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $5,733.99
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $5,733.99
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $5,733.99
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier RT In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible|RIGHT SIDE $26,451.93 $15,871.16 $3,395.89 – $3,565.69
Groin (inguinal) hernia repair, age 5 or older: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $3,514.75
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $3,514.75
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $3,565.69
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $3,565.69
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $3,395.89
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $3,395.89
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier LT In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible|LEFT SIDE $29,999.58 $17,999.75 $3,395.89 – $3,565.69
Groin (inguinal) hernia repair, age 5 or older: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $3,514.75
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $3,514.75
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $3,565.69
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $3,565.69
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $3,395.89
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $3,395.89
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Prostate Needle Biopsy Any Approach $19,624.37 $11,774.62 $120.13 – $126.14
Prostate biopsy: rates for 5 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $124.33
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $126.14
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $126.14
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $120.13
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $120.13
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier XS In the file: Prostate Needle Biopsy Any Approach|SEPARATE STRUCTURE $36,225.73 $21,735.44 $5,085.49 – $5,339.77
Prostate biopsy: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $5,263.48
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $5,339.77
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $5,339.77
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $5,085.49
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $5,085.49
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $5,085.49
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laps Surg Prst8ect Rpbic Rad W/Nrv Sparing Robot $112,313.43 $67,388.06 $10,082.05 – $10,586.16
Prostate removal by laparoscope (radical prostatectomy): rates for 4 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $10,434.93
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $10,586.16
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $10,082.05
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $10,082.05
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C $19,552 $11,731.20 $3,070.31 – $3,223.82
Hysteroscopy with biopsy of the uterus lining: rates for 6 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $3,177.77
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $3,223.82
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $3,223.82
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $3,070.31
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $3,070.31
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $3,070.31
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn $3,968.35 $2,381.01 $669.51 – $702.98
Spinal injection, lower back (epidural), with imaging guidance: rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $692.94
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $692.94
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $702.98
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $702.98
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $669.51
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $669.51
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $669.51
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn $2,230 $1,449.50 Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · modifier PO|XS In the file: Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn|PO|SEPARATE STRUCTURE $5,330.43 $3,198.26 $669.51 – $702.98
Spinal injection, lower back (epidural), with imaging guidance: rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $692.94
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $692.94
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $702.98
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $702.98
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $669.51
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $669.51
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $669.51
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: HC Trans, Esb, L/S, Single $2,817 $1,831.05 Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · modifier LT In the file: Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level|LEFT SIDE $3,983.85 $2,390.31 $838.89 – $880.84
Nerve root injection, lower back, with imaging guidance: rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $868.26
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $868.26
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $880.84
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $880.84
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $838.89
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $838.89
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $838.89
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · modifier LT|PO In the file: Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level|LEFT SIDE|PO $3,914.52 $2,348.71 $838.89 – $880.84
Nerve root injection, lower back, with imaging guidance: rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $868.26
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $868.26
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $880.84
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $880.84
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $838.89
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $838.89
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $838.89
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier RT In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne|RIGHT SIDE $13,016.33 $7,809.80 $1,852.10 – $1,944.70
Carpal tunnel release: rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $1,916.92
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $1,916.92
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $1,944.70
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $1,944.70
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $1,852.10
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $1,852.10
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $1,852.10
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier LT|PO In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne|LEFT SIDE|PO $10,392.50 $6,235.50 $1,852.10 – $1,944.70
Carpal tunnel release: rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $1,916.92
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $1,916.92
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $1,944.70
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $1,944.70
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $1,852.10
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $1,852.10
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $1,852.10
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier RT|XS|PO In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne|RIGHT SIDE|SEPARATE STRUCTURE|PO $27,264.38 $16,358.63 $6,882.29 – $7,226.40
Carpal tunnel release: rates for 7 insurance plans
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $7,123.17
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $7,123.17
  • HUMANA MEDICARE [1010] — HUMANA CHOICE-PPO MEDICARE [101003]: $7,226.40
  • HUMANA MEDICARE [1010] — HUMANA GOLD PLUS HMO [101001]: $7,226.40
  • UHC MEDICARE [1011] — UHC AARP MEDICARE ADVANTAGE [1011017]: $6,882.29
  • UHC MEDICARE [1011] — UHC MEDICARE COMPLETE [44]: $6,882.29
  • UHC MEDICARE [1011] — UNITEDHEALTHCARE DUAL COMPLETE [1011009]: $6,882.29

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $64,872.40 – $212,258
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 44 insurance plan rates
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $67,142.93
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $67,142.93
  • AL BCBS [5351] — AL BCBS [5351001]: $212,258
  • AR BCBS [5352] — AR BCBS [5352001]: $212,258
  • BCBS [3123] — BCBS OUT OF STATE [3123021]: $212,258
  • CA BCBS [5353] — CA BCBS [5353001]: $212,258
  • CIGNA MEDICARE [3497] — CIGNA HEALTHSPRING MEDICARE [349702]: $68,116.02
  • CIGNA MEDICARE [3497] — CIGNA PREFERRED MEDICARE HMO [3497003]: $68,116.02
  • CLOVER MEDICARE PPO [4057] — CLOVER MEDICARE PPO [4057001]: $68,116.02
  • DEVOTED HEALTH PLAN [4501] — DEVOTED HEALTH PLANS [4501001]: $64,872.40
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $12,791.07 – $43,031.63
Hip or knee replacement (major joint of the leg), without major complications: 10 of 48 insurance plan rates
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $13,238.76
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $13,238.76
  • AL BCBS [5351] — AL BCBS [5351001]: $43,031.63
  • AR BCBS [5352] — AR BCBS [5352001]: $43,031.63
  • BCBS [3123] — BCBS OUT OF STATE [3123021]: $43,031.63
  • CA BCBS [5353] — CA BCBS [5353001]: $43,031.63
  • CIGNA [3020] — CIGNA [3020001]: $37,954.97
  • CIGNA [3020] — CIGNA OPEN ACCESS PLUS OAP [30200027]: $37,954.97
  • CIGNA [3020] — CIGNA PPO [3020024]: $37,954.97
  • CIGNA MEDICARE [3497] — CIGNA HEALTHSPRING MEDICARE [349702]: $13,430.62
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $8,227.43 – $27,001.04
Uterus and ovary surgery (not for cancer), without complications: 10 of 48 insurance plan rates
  • AETNA MEDICARE [1003] — AETNA MEDICARE ADVANTAGE HMO [103003]: $8,515.39
  • AETNA MEDICARE [1003] — AETNA MEDICARE-ADVANTAGE PPO [103002]: $8,515.39
  • AL BCBS [5351] — AL BCBS [5351001]: $27,001.04
  • AR BCBS [5352] — AR BCBS [5352001]: $27,001.04
  • BCBS [3123] — BCBS OUT OF STATE [3123021]: $27,001.04
  • CA BCBS [5353] — CA BCBS [5353001]: $27,001.04
  • CIGNA [3020] — CIGNA [3020001]: $24,413.25
  • CIGNA [3020] — CIGNA OPEN ACCESS PLUS OAP [30200027]: $24,413.25
  • CIGNA [3020] — CIGNA PPO [3020024]: $24,413.25
  • CIGNA MEDICARE [3497] — CIGNA HEALTHSPRING MEDICARE [349702]: $8,638.80

Source: Roper Hospital’s standard charges file (rsfh.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 5, 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 typeAcute Care Hospital
Address316 Calhoun St, Charleston, SC 29401
CountyCharleston County
StateSouth Carolina
Phone(843) 724‑2800
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating4 of 5 stars
CMS Certification Number420087
Name in Medicare recordsROPER HOSPITAL
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(843) 724‑2000[4][5]
Official websitersfh.com
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-11-02.

  1. Roper Hospital — rsfh.com
  2. Emergency Care in Charleston, SC — rsfh.com
  3. Roper Rehabilitation Hospital — rsfh.com
  4. Roper Hospital Departments and Services — rsfh.com
  5. Patients & visitors — rsfh.com