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Acute Care Hospital

Sarasota Memorial Hospital

Sarasota, Florida · Sarasota County · Emergency services listed

Summary

Sarasota Memorial Hospital is an acute care hospital in Sarasota, Florida. Medicare data lists emergency services. CMS overall star rating: 5 of 5 stars. Its official website lists 61 services, specialties and programs. Medicare lists 2,219 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

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(941) 917‑9000 Directions Website Medicare profile
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Exterior of Sarasota Memorial Hospital
Photo: SMHCS, CC BY-SA 4.0, via Wikimedia Commons · source · licence

Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). 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
5 of 5 stars5 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
897Beds (hospital website)
2,219Doctors and clinicians
61Services listed

Quick answers

Does Sarasota Memorial Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Sarasota Memorial Hospital. In a medical emergency, call 911.
Where is Sarasota Memorial Hospital?
1700 S Tamiami Trl, Sarasota, FL 34239, in Sarasota County, Florida.
What is the phone number of Sarasota Memorial Hospital?
(941) 917-9000, as listed by Medicare (CMS).
What is the Medicare star rating of Sarasota Memorial Hospital?
5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][5][8][9][10][11]

Conditions treated[4][8][9][11]

Treatments[4][5][8][11]

  • Minimally invasive stroke thrombectomy
  • Neurosurgical and endovascular stroke therapies
  • Inpatient stroke rehabilitation
  • Inpatient rehabilitation
  • Direct angioplasty for heart attack
  • Hyperbaric medicine
  • Wound care
  • Labor and delivery

Procedures[8][9]

Programs and centers[4][8][9][10][11]

  • Comprehensive Stroke Center
  • Level II Trauma Center
  • Obstetrical Emergency Care Center
  • Level III Neonatal Intensive Care Unit
  • DASH (Direct Angioplasty Saves Hearts)
  • Heart Failure Center
  • Brian D. Jellison Cancer Institute Oncology Tower
  • Breast Health Center
  • Rehabilitation Pavilion (inpatient rehabilitation)
  • Cornell Behavioral Health Pavilion
  • Pediatric emergency care affiliation with Johns Hopkins All Children's

Emergency care (hospital website)[6]

Emergency roomYes

Visiting and practical information

VisitingMost areas allow visitors 9 a.m. to 9 p.m. daily; some units such as Critical Care have own schedules[5]
ParkingFree self-parking in campus garages; free valet at main, ER and Arlington Street entrances[6]
Patient portalMyChart

Recognition[8][9][11]

  • Magnet Recognition (ANCC)
  • Level II Trauma Center
  • Comprehensive Stroke Center (State of Florida; DNV certified)
  • Get With The Guidelines Stroke Gold Plus (AHA)
  • Get With The Guidelines Resuscitation Gold (AHA)
  • CMS 5-Star Overall Hospital Rating
  • Leapfrog 'A' Hospital Safety Grade
  • Baby-Friendly Hospital
  • Level III Maternal Care Verification (Joint Commission)
  • Commission on Cancer Accreditation
  • CARF accreditation: Comprehensive Rehabilitation and Stroke Specialty
  • ACC Heart Failure Accreditation
  • Hip & Knee Replacement Center of Excellence (DNV)
  • Mitral Valve Repair Reference Center (AHA / Mitral Foundation)
  • Blue Distinction Center: Knee and Hip Replacement, Spine Surgery, Cardiac Care
  • ACR Gold Standard Breast Imaging Center of Excellence
  • Certified Quality Breast Center of Excellence (NQMBC)
  • ACR Lung Cancer Screening Center
  • U.S. News high performer: Rehabilitation (2026-2027)

Doctors and clinicians (2,219)

2,219 doctors and other clinicians list Sarasota Memorial 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 (2,219)

And 2,195 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

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 licence 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 Sarasota Memorial 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) 3 of 5 stars
Overall rating of the hospital4 of 5 stars
Would recommend the hospital4 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean3 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1072%National average: 72%
Would definitely recommend the hospital77%National average: 71%
Nurses “always” communicated well77%National average: 80%
Doctors “always” communicated well75%National average: 80%
Staff “always” explained medicines before giving them58%National average: 62%
Were given information about recovery at home86%National average: 86%
Room and bathroom “always” clean66%National average: 74%
Area around the room “always” quiet at night49%National average: 60%
Completed surveys5,734Response rate: 30%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.857No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.322Better than the national benchmark
Surgical site infections after colon surgery0.668No different from the national benchmark
Surgical site infections after abdominal hysterectomy0.701No different from the national benchmark
MRSA bloodstream infections0.349Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.511Better than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

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

Deaths within 30 days: heart attack patients11.5%
Deaths within 30 days: heart failure patients9.2%
Deaths within 30 days: pneumonia patients13.5%
Deaths within 30 days: COPD patients7.6%
Deaths within 30 days: stroke patients10.8%
Deaths within 30 days: coronary bypass surgery (CABG)1.9%
Serious complications (patient safety indicator PSI-90)0.74Better than the national rate
Complications after hip or knee replacement2.9%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack14.2%
Readmitted within 30 days: heart failure21.2%
Readmitted within 30 days: pneumonia16.9%
Readmitted within 30 days: COPD20.5%
Readmitted within 30 days: coronary bypass surgery8.2%
Readmitted within 30 days: hip or knee replacement6.1%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)198 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)74%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in SarasotaBest hospitals in Florida

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 82 common services exactly as Sarasota Memorial Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: Outpatient Visit Low Level $496 $198.40 $309.50 – $396.80
New patient office visit (about 30–44 minutes): rates for 9 insurance plans
  • Aetna — International: $99.20
  • Aetna — Non-Gatekeeper: $375.47
  • Aetna — Signature: $86.80
  • Avmed — Commercial: $212.43
  • Cigna — PPO: $357.12
  • First Health — PPO: $241.53
  • United Healthcare — Indemnity: $372.50
  • United Healthcare — Options PPO: $309.50
  • USA Managed Care — PPO: $232.80
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) In the file: Outpatient Visit Low Level $496 $198.40 $309.50 – $396.80
New patient office visit (about 30–44 minutes): rates for 6 insurance plans
  • Aetna — International: $396.80
  • Aetna — Non-Gatekeeper: $375.47
  • Aetna — Signature: $347.20
  • Cigna — PPO: $357.12
  • United Healthcare — Indemnity: $372.50
  • United Healthcare — Options PPO: $309.50
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Outpatient Visit Low Level $486 $194.40 $354.78 – $403.38
New patient office visit (about 30–44 minutes): rates for 3 insurance plans
  • Avmed — Commercial: $354.78
  • First Health — PPO: $403.38
  • USA Managed Care — PPO: $388.80
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: Outpatient Visit Moderate Level $574 $229.60 $358.18 – $459.20
New patient office visit (about 45–59 minutes): rates for 9 insurance plans
  • Aetna — International: $117.60
  • Aetna — Non-Gatekeeper: $434.52
  • Aetna — Signature: $102.90
  • Avmed — Commercial: $325.58
  • Cigna — PPO: $413.28
  • First Health — PPO: $370.18
  • United Healthcare — Indemnity: $431.07
  • United Healthcare — Options PPO: $358.18
  • USA Managed Care — PPO: $356.80
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) In the file: Outpatient Visit Moderate Level $574 $229.60 $358.18 – $459.20
New patient office visit (about 45–59 minutes): rates for 6 insurance plans
  • Aetna — International: $459.20
  • Aetna — Non-Gatekeeper: $434.52
  • Aetna — Signature: $401.80
  • Cigna — PPO: $413.28
  • United Healthcare — Indemnity: $431.07
  • United Healthcare — Options PPO: $358.18
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: Outpatient Visit Moderate Level $563 $225.20 $410.99 – $467.29
New patient office visit (about 45–59 minutes): rates for 3 insurance plans
  • Avmed — Commercial: $410.99
  • First Health — PPO: $467.29
  • USA Managed Care — PPO: $450.40
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: Outpatient Visit High Level $837 $334.80 $522.29 – $669.60
New patient office visit (about 60–74 minutes): rates for 9 insurance plans
  • Aetna — International: $143.20
  • Aetna — Non-Gatekeeper: $633.61
  • Aetna — Signature: $125.30
  • Avmed — Commercial: $411.72
  • Cigna — PPO: $128.88
  • First Health — PPO: $468.12
  • United Healthcare — Indemnity: $628.59
  • United Healthcare — Options PPO: $522.29
  • USA Managed Care — PPO: $451.20
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) In the file: Outpatient Visit High Level $837 $334.80 $522.29 – $669.60
New patient office visit (about 60–74 minutes): rates for 6 insurance plans
  • Aetna — International: $669.60
  • Aetna — Non-Gatekeeper: $633.61
  • Aetna — Signature: $585.90
  • Cigna — PPO: $522
  • United Healthcare — Indemnity: $628.59
  • United Healthcare — Options PPO: $522.29
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Outpatient Visit High Level $711 $284.40 $519.03 – $590.13
New patient office visit (about 60–74 minutes): rates for 3 insurance plans
  • Avmed — Commercial: $519.03
  • First Health — PPO: $590.13
  • USA Managed Care — PPO: $568.80
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Outpatient Visit Low Level $481 $192.40 $300.14 – $384.80
Established patient office visit (about 20–29 minutes): rates for 9 insurance plans
  • Aetna — International: $94.40
  • Aetna — Non-Gatekeeper: $364.12
  • Aetna — Signature: $82.60
  • Avmed — Commercial: $166.44
  • Cigna — PPO: $346.32
  • First Health — PPO: $189.24
  • United Healthcare — Indemnity: $361.23
  • United Healthcare — Options PPO: $300.14
  • USA Managed Care — PPO: $182.40
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) In the file: Outpatient Visit Low Level $481 $192.40 $300.14 – $384.80
Established patient office visit (about 20–29 minutes): rates for 6 insurance plans
  • Aetna — International: $384.80
  • Aetna — Non-Gatekeeper: $364.12
  • Aetna — Signature: $336.70
  • Cigna — PPO: $346.32
  • United Healthcare — Indemnity: $361.23
  • United Healthcare — Options PPO: $300.14
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Outpatient Visit Low Level $472 $188.80 $344.56 – $391.76
Established patient office visit (about 20–29 minutes): rates for 3 insurance plans
  • Avmed — Commercial: $344.56
  • First Health — PPO: $391.76
  • USA Managed Care — PPO: $377.60
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Outpatient Visit Moderate Level $559 $223.60 $348.82 – $447.20
Established patient office visit (about 30–39 minutes): rates for 9 insurance plans
  • Aetna — International: $113.60
  • Aetna — Non-Gatekeeper: $423.16
  • Aetna — Signature: $99.40
  • Avmed — Commercial: $236.52
  • Cigna — PPO: $402.48
  • First Health — PPO: $268.92
  • United Healthcare — Indemnity: $419.81
  • United Healthcare — Options PPO: $348.82
  • USA Managed Care — PPO: $259.20
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) In the file: Outpatient Visit Moderate Level $559 $223.60 $348.82 – $447.20
Established patient office visit (about 30–39 minutes): rates for 6 insurance plans
  • Aetna — International: $447.20
  • Aetna — Non-Gatekeeper: $423.16
  • Aetna — Signature: $391.30
  • Cigna — PPO: $402.48
  • United Healthcare — Indemnity: $419.81
  • United Healthcare — Options PPO: $348.82
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Outpatient Visit Moderate Level $548 $219.20 $400.04 – $454.84
Established patient office visit (about 30–39 minutes): rates for 3 insurance plans
  • Avmed — Commercial: $400.04
  • First Health — PPO: $454.84
  • USA Managed Care — PPO: $438.40
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Off/op cnsltj new/est low 30 Not listed in the file Not listed in the file $70.51 – $370.37
Office consultation with a specialist (moderate): 10 of 14 insurance plan rates
  • Aetna — Worker's Compensation: $370.37
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $73.86
  • Careworks — Worker's Compensation: $370.37
  • Community Care Plan Oncology UPW — Medicaid HMO: $73.86
  • Enlyte — Worker's Compensation: $370.37
  • Florida Community Care Oncology UPW — Medicaid HMO: $88.63
  • Florida Community Care Oncology UPW — Medicare Advantage: $136.85
  • Molina Oncology UPW — Healthy Kids: $72.52
  • Molina Oncology UPW — Medicaid HMO: $72.52
  • Simply Healthcare Oncology UPW — Healthy Kids: $70.51
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · modifier 95|GT In the file: Off/op cnsltj new/est low 30 Not listed in the file Not listed in the file $129.39 – $250.90
Office consultation with a specialist (moderate): rates for 2 insurance plans
  • Aetna Oncology UPW — Commercial: $250.90
  • Aetna Oncology UPW — Medicare Advantage: $129.39
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Off/op cnsltj new/est mod 40 Not listed in the file Not listed in the file $106.96 – $241.33
Office consultation with a specialist (moderate to high): 10 of 14 insurance plan rates
  • Aetna — Worker's Compensation: $241.33
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $112.05
  • Careworks — Worker's Compensation: $241.33
  • Community Care Plan Oncology UPW — Medicaid HMO: $112.05
  • Enlyte — Worker's Compensation: $241.33
  • Florida Community Care Oncology UPW — Medicaid HMO: $134.46
  • Florida Community Care Oncology UPW — Medicare Advantage: $196.28
  • Molina Oncology UPW — Healthy Kids: $110.02
  • Molina Oncology UPW — Medicaid HMO: $110.02
  • Simply Healthcare Oncology UPW — Healthy Kids: $106.96
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · modifier 95|GT In the file: Off/op cnsltj new/est mod 40 Not listed in the file Not listed in the file $194.13 – $376.44
Office consultation with a specialist (moderate to high): rates for 2 insurance plans
  • Aetna Oncology UPW — Commercial: $376.44
  • Aetna Oncology UPW — Medicare Advantage: $194.13
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: Prev visit new age 18-39 Not listed in the file Not listed in the file $104.60 – $269.89
Preventive checkup, new patient, age 18–39: rates for 5 insurance plans
  • Aetna Oncology UPW — Commercial: $202.83
  • Aetna Oncology UPW — Medicare Advantage: $104.60
  • Florida Community Care Oncology UPW — Medicare Advantage: $155.11
  • United Healthcare Oncology UPW — Commercial: $135.34
  • United Healthcare Oncology UPW — Medicare Advantage: $129.26
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · modifier EP In the file: Prev visit new age 18-39 Not listed in the file Not listed in the file $75.04 – $94.33
Preventive checkup, new patient, age 18–39: rates for 8 insurance plans
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $78.61
  • Community Care Plan Oncology UPW — Medicaid HMO: $78.61
  • Florida Community Care Oncology UPW — Medicaid HMO: $94.33
  • Molina Oncology UPW — Healthy Kids: $77.19
  • Molina Oncology UPW — Medicaid HMO: $77.19
  • Simply Healthcare Oncology UPW — Healthy Kids: $75.04
  • Simply Healthcare Oncology UPW — Medicaid HMO: $75.04
  • Sunshine State Oncology UPW — Medicaid HMO: $75.04
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · modifier FP In the file: Prev visit new age 18-39 Not listed in the file Not listed in the file $104.56 – $131.44
Preventive checkup, new patient, age 18–39: rates for 8 insurance plans
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $109.53
  • Community Care Plan Oncology UPW — Medicaid HMO: $109.53
  • Florida Community Care Oncology UPW — Medicaid HMO: $131.44
  • Molina Oncology UPW — Healthy Kids: $107.55
  • Molina Oncology UPW — Medicaid HMO: $107.55
  • Simply Healthcare Oncology UPW — Healthy Kids: $104.56
  • Simply Healthcare Oncology UPW — Medicaid HMO: $104.56
  • Sunshine State Oncology UPW — Medicaid HMO: $104.56
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: Prev visit new age 40-64 Not listed in the file Not listed in the file $127.43 – $314.13
Preventive checkup, new patient, age 40–64: rates for 5 insurance plans
  • Aetna Oncology UPW — Commercial: $247.09
  • Aetna Oncology UPW — Medicare Advantage: $127.43
  • Florida Community Care Oncology UPW — Medicare Advantage: $178.94
  • United Healthcare Oncology UPW — Commercial: $156.63
  • United Healthcare Oncology UPW — Medicare Advantage: $149.12
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · modifier FP In the file: Prev visit new age 40-64 Not listed in the file Not listed in the file $120.37 – $151.32
Preventive checkup, new patient, age 40–64: rates for 8 insurance plans
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $126.10
  • Community Care Plan Oncology UPW — Medicaid HMO: $126.10
  • Florida Community Care Oncology UPW — Medicaid HMO: $151.32
  • Molina Oncology UPW — Healthy Kids: $123.81
  • Molina Oncology UPW — Medicaid HMO: $123.81
  • Simply Healthcare Oncology UPW — Healthy Kids: $120.37
  • Simply Healthcare Oncology UPW — Medicaid HMO: $120.37
  • Sunshine State Oncology UPW — Medicaid HMO: $120.37
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) In the file: Emergency Room Visit Moderate $2,541 $1,016.40 $1,585.58 – $2,032.80
Emergency room visit (moderate): rates for 6 insurance plans
  • Aetna — International: $2,032.80
  • Aetna — Non-Gatekeeper: $1,923.54
  • Aetna — Signature: $1,778.70
  • Cigna — PPO: $1,829.52
  • United Healthcare — Indemnity: $1,908.29
  • United Healthcare — Options PPO: $1,585.58
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency Room Visit Moderate $2,541 $1,016.40 $1,585.58 – $2,032.80
Emergency room visit (moderate): rates for 6 insurance plans
  • Aetna — International: $2,032.80
  • Aetna — Non-Gatekeeper: $1,923.54
  • Aetna — Signature: $1,778.70
  • Cigna — PPO: $1,829.52
  • United Healthcare — Indemnity: $1,908.29
  • United Healthcare — Options PPO: $1,585.58
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: Emergency Room Visit Moderate $2,491 $996.40 $1,818.43 – $2,067.53
Emergency room visit (moderate): rates for 3 insurance plans
  • Avmed — Commercial: $1,818.43
  • First Health — PPO: $2,067.53
  • USA Managed Care — PPO: $1,992.80
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) In the file: Emergency Room Visit High $3,921 $1,568.40 $2,446.70 – $3,136.80
Emergency room visit (moderately high): rates for 6 insurance plans
  • Aetna — International: $3,136.80
  • Aetna — Non-Gatekeeper: $2,968.20
  • Aetna — Signature: $2,744.70
  • Cigna — PPO: $2,823.12
  • United Healthcare — Indemnity: $2,944.67
  • United Healthcare — Options PPO: $2,446.70
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency Room Visit High $3,921 $1,568.40 $2,446.70 – $3,136.80
Emergency room visit (moderately high): rates for 6 insurance plans
  • Aetna — International: $3,136.80
  • Aetna — Non-Gatekeeper: $2,968.20
  • Aetna — Signature: $2,744.70
  • Cigna — PPO: $2,823.12
  • United Healthcare — Indemnity: $2,944.67
  • United Healthcare — Options PPO: $2,446.70
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Emergency Room Visit High $3,844 $1,537.60 $2,806.12 – $3,190.52
Emergency room visit (moderately high): rates for 3 insurance plans
  • Avmed — Commercial: $2,806.12
  • First Health — PPO: $3,190.52
  • USA Managed Care — PPO: $3,075.20
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) In the file: Emergency Room Visit Complex $5,030 $2,012 $3,138.72 – $4,024
Emergency room visit (high): rates for 6 insurance plans
  • Aetna — International: $4,024
  • Aetna — Non-Gatekeeper: $3,807.71
  • Aetna — Signature: $3,521
  • Cigna — PPO: $3,621.60
  • United Healthcare — Indemnity: $3,777.53
  • United Healthcare — Options PPO: $3,138.72
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency Room Visit Complex $5,030 $2,012 $3,138.72 – $4,024
Emergency room visit (high): rates for 6 insurance plans
  • Aetna — International: $4,024
  • Aetna — Non-Gatekeeper: $3,807.71
  • Aetna — Signature: $3,521
  • Cigna — PPO: $3,621.60
  • United Healthcare — Indemnity: $3,777.53
  • United Healthcare — Options PPO: $3,138.72
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: Emergency Room Visit Complex $4,931 $1,972.40 $3,599.63 – $4,092.73
Emergency room visit (high): rates for 3 insurance plans
  • Avmed — Commercial: $3,599.63
  • First Health — PPO: $4,092.73
  • USA Managed Care — PPO: $3,944.80

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) In the file: Basic Metabolic Panel (Calcium, Total) $139 $55.60 $76.65 – $115.37
Basic metabolic panel (blood test): rates for 3 insurance plans
  • Avmed — Commercial: $101.47
  • First Health — PPO: $115.37
  • USA Managed Care — PPO: $111.20
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Basic Metabolic Panel (Calcium, Total) $105 $42 $76.65 – $115.37
Basic metabolic panel (blood test): rates for 3 insurance plans
  • Avmed — Commercial: $76.65
  • First Health — PPO: $87.15
  • USA Managed Care — PPO: $84
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Basic metabolic pnl total ca Not listed in the file Not listed in the file $4.55 – $233.89
Basic metabolic panel (blood test): 10 of 14 insurance plan rates
  • Aetna — Gatekeeper: $39.14
  • Aetna — Medicare Advantage: $8.88
  • Aetna Oncology UPW — Commercial: $19.14
  • AmBetter — Individual Exchange: $22.84
  • Blue Cross — Medicare Advantage: $8.46
  • Blue Cross Oncology UPW — Medicare Advantage: $8.46
  • Cigna — Commercial: $17.33
  • Florida Community Care — Medicare Advantage: $9.31
  • Simply Freedom Optimum — Medicare Advantage: $8.88
  • United Healthcare — Individual Exchange: $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) In the file: Comprehensive Metabolic Panel $177 $70.80 $96.36 – $146.91
Comprehensive metabolic panel (blood test): rates for 9 insurance plans
  • Aetna — International: $144.80
  • Aetna — Non-Gatekeeper: $137.02
  • Aetna — Signature: $126.70
  • Avmed — Commercial: $129.21
  • Cigna — PPO: $130.32
  • First Health — PPO: $146.91
  • United Healthcare — Indemnity: $135.93
  • United Healthcare — Options PPO: $112.94
  • USA Managed Care — PPO: $141.60
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Comprehensive Metabolic Panel $132 $52.80 $96.36 – $146.91
Comprehensive metabolic panel (blood test): rates for 9 insurance plans
  • Aetna — International: $108
  • Aetna — Non-Gatekeeper: $102.20
  • Aetna — Signature: $94.50
  • Avmed — Commercial: $96.36
  • Cigna — PPO: $97.20
  • First Health — PPO: $109.56
  • United Healthcare — Indemnity: $101.38
  • United Healthcare — Options PPO: $84.24
  • USA Managed Care — PPO: $105.60
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Comprehen metabolic panel Not listed in the file Not listed in the file $4.55 – $347.64
Comprehensive metabolic panel (blood test): 10 of 27 insurance plan rates
  • Aetna — Gatekeeper: $48.86
  • Aetna — Medicare Advantage: $11.09
  • Aetna — Worker's Compensation: $347.64
  • Aetna Oncology UPW — Commercial: $23.90
  • AmBetter — Individual Exchange: $28.51
  • Amerihealth Caritas — Medicaid HMO: $5
  • Blue Cross — Medicare Advantage: $10.56
  • Blue Cross Oncology UPW — Medicare Advantage: $10.56
  • Careworks — Worker's Compensation: $347.64
  • Cigna — Commercial: $21.61
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric panel Not listed in the file Not listed in the file $4.55 – $257.34
Obstetric blood test panel: 10 of 36 insurance plan rates
  • Aetna — Medicare Advantage: $50.20
  • Aetna — Worker's Compensation: $257.34
  • Aetna Oncology UPW — Commercial: $108.15
  • Aetna Oncology UPW — Medicare Advantage: $51.16
  • AmBetter — Individual Exchange: $129.09
  • Amerihealth Caritas — Medicaid HMO: $5
  • Blue Cross — Medicare Advantage: $47.81
  • Blue Cross Oncology UPW — Blue Select: $71.24
  • Blue Cross Oncology UPW — Health Options: $76.50
  • Blue Cross Oncology UPW — Medicare Advantage: $47.81
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · modifier 26 In the file: Obstetric panel Not listed in the file Not listed in the file $6.26 – $7.86
Obstetric blood test panel: rates for 8 insurance plans
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $6.55
  • Community Care Plan Oncology UPW — Medicaid HMO: $6.55
  • Florida Community Care Oncology UPW — Medicaid HMO: $7.86
  • Molina Oncology UPW — Healthy Kids: $6.44
  • Molina Oncology UPW — Medicaid HMO: $6.44
  • Simply Healthcare Oncology UPW — Healthy Kids: $6.26
  • Simply Healthcare Oncology UPW — Medicaid HMO: $6.26
  • Sunshine State Oncology UPW — Medicaid HMO: $6.26
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · modifier TC In the file: Obstetric panel Not listed in the file Not listed in the file $25.01 – $31.44
Obstetric blood test panel: rates for 8 insurance plans
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $26.20
  • Community Care Plan Oncology UPW — Medicaid HMO: $26.20
  • Florida Community Care Oncology UPW — Medicaid HMO: $31.44
  • Molina Oncology UPW — Healthy Kids: $25.73
  • Molina Oncology UPW — Medicaid HMO: $25.73
  • Simply Healthcare Oncology UPW — Healthy Kids: $25.01
  • Simply Healthcare Oncology UPW — Medicaid HMO: $25.01
  • Sunshine State Oncology UPW — Medicaid HMO: $25.01
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: Lipid Panel $142 $56.80 $78.11 – $117.86
Cholesterol panel (lipid panel): rates for 9 insurance plans
  • Aetna — International: $116
  • Aetna — Non-Gatekeeper: $109.76
  • Aetna — Signature: $101.50
  • Avmed — Commercial: $103.66
  • Cigna — PPO: $104.40
  • First Health — PPO: $117.86
  • United Healthcare — Indemnity: $108.90
  • United Healthcare — Options PPO: $90.48
  • USA Managed Care — PPO: $113.60
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Lipid Panel $107 $42.80 $78.11 – $117.86
Cholesterol panel (lipid panel): rates for 9 insurance plans
  • Aetna — International: $87.20
  • Aetna — Non-Gatekeeper: $82.51
  • Aetna — Signature: $76.30
  • Avmed — Commercial: $78.11
  • Cigna — PPO: $78.48
  • First Health — PPO: $88.81
  • United Healthcare — Indemnity: $81.86
  • United Healthcare — Options PPO: $68.02
  • USA Managed Care — PPO: $85.60
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: Lipid Cardio IQ $33.26 $13.30 $20.75 – $26.61
Cholesterol panel (lipid panel): rates for 6 insurance plans
  • Aetna — International: $26.61
  • Aetna — Non-Gatekeeper: $25.18
  • Aetna — Signature: $23.28
  • Cigna — PPO: $23.95
  • United Healthcare — Indemnity: $24.98
  • United Healthcare — Options PPO: $20.75
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: Renal Function Panel $87.63 $35.05 $47.98 – $72.73
Kidney function panel: rates for 9 insurance plans
  • Aetna — International: $71.50
  • Aetna — Non-Gatekeeper: $67.66
  • Aetna — Signature: $62.57
  • Avmed — Commercial: $63.97
  • Cigna — PPO: $64.35
  • First Health — PPO: $72.73
  • United Healthcare — Indemnity: $67.12
  • United Healthcare — Options PPO: $55.77
  • USA Managed Care — PPO: $70.10
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal Function Panel $65.72 $26.29 $47.98 – $72.73
Kidney function panel: rates for 9 insurance plans
  • Aetna — International: $53.62
  • Aetna — Non-Gatekeeper: $50.74
  • Aetna — Signature: $46.92
  • Avmed — Commercial: $47.98
  • Cigna — PPO: $48.26
  • First Health — PPO: $54.55
  • United Healthcare — Indemnity: $50.34
  • United Healthcare — Options PPO: $41.83
  • USA Managed Care — PPO: $52.58
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal function panel Not listed in the file Not listed in the file $4.55 – $889.73
Kidney function panel: 10 of 27 insurance plan rates
  • Aetna — Gatekeeper: $40.15
  • Aetna — Medicare Advantage: $9.11
  • Aetna — Worker's Compensation: $174.35
  • Aetna Oncology UPW — Commercial: $19.65
  • AmBetter — Individual Exchange: $23.44
  • Amerihealth Caritas — Medicaid HMO: $5
  • Blue Cross — Medicare Advantage: $8.68
  • Blue Cross Oncology UPW — Medicare Advantage: $8.68
  • Careworks — Worker's Compensation: $174.35
  • Cigna — Commercial: $17.77
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: Hepatic Function Panel $149 $59.60 $69.26 – $119.20
Liver function panel: rates for 9 insurance plans
  • Aetna — International: $119.20
  • Aetna — Non-Gatekeeper: $112.79
  • Aetna — Signature: $104.30
  • Avmed — Commercial: $106.58
  • Cigna — PPO: $107.28
  • First Health — PPO: $121.18
  • United Healthcare — Indemnity: $111.90
  • United Healthcare — Options PPO: $92.98
  • USA Managed Care — PPO: $116.80
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic Function Panel $111 $44.40 $69.26 – $119.20
Liver function panel: rates for 9 insurance plans
  • Aetna — International: $88.80
  • Aetna — Non-Gatekeeper: $84.03
  • Aetna — Signature: $77.70
  • Avmed — Commercial: $79.57
  • Cigna — PPO: $79.92
  • First Health — PPO: $90.47
  • United Healthcare — Indemnity: $83.36
  • United Healthcare — Options PPO: $69.26
  • USA Managed Care — PPO: $87.20
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic function panel Not listed in the file Not listed in the file $4.55 – $281.72
Liver function panel: 10 of 37 insurance plan rates
  • Aetna — Gatekeeper: $37.76
  • Aetna — Medicare Advantage: $8.58
  • Aetna — Worker's Compensation: $281.72
  • Aetna Oncology UPW — Commercial: $18.49
  • Aetna Oncology UPW — Medicare Advantage: $8.74
  • AmBetter — Individual Exchange: $22.06
  • Amerihealth Caritas — Medicaid HMO: $5
  • Blue Cross — Medicare Advantage: $8.17
  • Blue Cross Oncology UPW — Blue Select: $12.17
  • Blue Cross Oncology UPW — Health Options: $13.07
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) In the file: Urinalysis Automated with Microscopy $67.13 $26.85 $31.42 – $53.70
Urine test (automated, with microscope): rates for 9 insurance plans
  • Aetna — International: $53.70
  • Aetna — Non-Gatekeeper: $50.82
  • Aetna — Signature: $46.99
  • Avmed — Commercial: $48.04
  • Cigna — PPO: $48.33
  • First Health — PPO: $54.62
  • United Healthcare — Indemnity: $50.41
  • United Healthcare — Options PPO: $41.89
  • USA Managed Care — PPO: $52.65
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis Automated with Microscopy $50.35 $20.14 $31.42 – $53.70
Urine test (automated, with microscope): rates for 9 insurance plans
  • Aetna — International: $40.28
  • Aetna — Non-Gatekeeper: $38.11
  • Aetna — Signature: $35.24
  • Avmed — Commercial: $36.03
  • Cigna — PPO: $36.25
  • First Health — PPO: $40.97
  • United Healthcare — Indemnity: $37.81
  • United Healthcare — Options PPO: $31.42
  • USA Managed Care — PPO: $39.49
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis auto w/scope Not listed in the file Not listed in the file $1.50 – $121.20
Urine test (automated, with microscope): 10 of 37 insurance plan rates
  • Aetna — Gatekeeper: $14.62
  • Aetna — Medicare Advantage: $3.33
  • Aetna — Worker's Compensation: $121.20
  • Aetna Oncology UPW — Commercial: $7.17
  • Aetna Oncology UPW — Medicare Advantage: $3.39
  • AmBetter — Individual Exchange: $8.56
  • Amerihealth Caritas — Medicaid HMO: $1.65
  • Blue Cross — Medicare Advantage: $3.17
  • Blue Cross Oncology UPW — Blue Select: $4.72
  • Blue Cross Oncology UPW — Health Options: $5.07
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) In the file: Urinalysis Non-automated without Microscopy $37.04 $14.82 $23.11 – $29.63
Urine test (manual, without microscope): rates for 9 insurance plans
  • Aetna — International: $29.92
  • Aetna — Non-Gatekeeper: $25.59
  • Aetna — Signature: $26.18
  • Avmed — Commercial: $26.77
  • Cigna — PPO: $26.67
  • First Health — PPO: $30.44
  • United Healthcare — Indemnity: $25.38
  • United Healthcare — Options PPO: $23.34
  • USA Managed Care — PPO: $29.34
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis Non-automated without Microscopy $27.50 $11 $20.08 – $30.44
Urine test (manual, without microscope): rates for 9 insurance plans
  • Aetna — International: $22.44
  • Aetna — Non-Gatekeeper: $21.23
  • Aetna — Signature: $19.63
  • Avmed — Commercial: $20.08
  • Cigna — PPO: $20.20
  • First Health — PPO: $22.83
  • United Healthcare — Indemnity: $25.38
  • United Healthcare — Options PPO: $21.09
  • USA Managed Care — PPO: $22
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: Urinalysis Non-automated without Microscopy $33.14 $13.26 $24.19 – $27.51
Urine test (manual, without microscope): rates for 3 insurance plans
  • Avmed — Commercial: $24.19
  • First Health — PPO: $27.51
  • USA Managed Care — PPO: $26.51
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) In the file: Urinalysis Automated without Microscopy $57.24 $22.90 $26.79 – $45.79
Urine test (automated, without microscope): rates for 9 insurance plans
  • Aetna — International: $45.79
  • Aetna — Non-Gatekeeper: $43.33
  • Aetna — Signature: $40.07
  • Avmed — Commercial: $40.97
  • Cigna — PPO: $41.21
  • First Health — PPO: $46.58
  • United Healthcare — Indemnity: $42.99
  • United Healthcare — Options PPO: $35.72
  • USA Managed Care — PPO: $44.90
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urinalysis Automated without Microscopy $42.93 $17.17 $26.79 – $45.79
Urine test (automated, without microscope): rates for 9 insurance plans
  • Aetna — International: $34.34
  • Aetna — Non-Gatekeeper: $32.50
  • Aetna — Signature: $30.05
  • Avmed — Commercial: $30.73
  • Cigna — PPO: $30.91
  • First Health — PPO: $34.93
  • United Healthcare — Indemnity: $32.24
  • United Healthcare — Options PPO: $26.79
  • USA Managed Care — PPO: $33.67
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urinalysis auto w/o scope Not listed in the file Not listed in the file $1.50 – $91.42
Urine test (automated, without microscope): 10 of 27 insurance plan rates
  • Aetna — Gatekeeper: $10.38
  • Aetna — Medicare Advantage: $2.36
  • Aetna — Worker's Compensation: $91.42
  • Aetna Oncology UPW — Commercial: $5.07
  • AmBetter — Individual Exchange: $6.08
  • Amerihealth Caritas — Medicaid HMO: $1.65
  • Blue Cross — Medicare Advantage: $2.25
  • Blue Cross Oncology UPW — Medicare Advantage: $2.25
  • Careworks — Worker's Compensation: $91.42
  • Cigna — Commercial: $4.60
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) In the file: Prostate Specific Antigen, Total $174 $69.60 $95.63 – $144.42
PSA (prostate specific antigen) blood test: rates for 3 insurance plans
  • Avmed — Commercial: $127.02
  • First Health — PPO: $144.42
  • USA Managed Care — PPO: $139.20
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate Specific Antigen, Total $131 $52.40 $95.63 – $144.42
PSA (prostate specific antigen) blood test: rates for 3 insurance plans
  • Avmed — Commercial: $95.63
  • First Health — PPO: $108.73
  • USA Managed Care — PPO: $104.80
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Prostate Specific Antigen, Total $16 $6.40 $11.68 – $13.28
PSA (prostate specific antigen) blood test: rates for 3 insurance plans
  • Avmed — Commercial: $11.68
  • First Health — PPO: $13.28
  • USA Managed Care — PPO: $12.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) In the file: Thyroid Stimulating Hormone $160 $64 $87.60 – $132.80
Thyroid stimulating hormone (TSH) test: rates for 9 insurance plans
  • Aetna — International: $130.40
  • Aetna — Non-Gatekeeper: $123.39
  • Aetna — Signature: $114.10
  • Avmed — Commercial: $116.80
  • Cigna — PPO: $117.36
  • First Health — PPO: $132.80
  • United Healthcare — Indemnity: $122.41
  • United Healthcare — Options PPO: $101.71
  • USA Managed Care — PPO: $128
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid Stimulating Hormone $120 $48 $87.60 – $132.80
Thyroid stimulating hormone (TSH) test: rates for 9 insurance plans
  • Aetna — International: $97.60
  • Aetna — Non-Gatekeeper: $92.35
  • Aetna — Signature: $85.40
  • Avmed — Commercial: $87.60
  • Cigna — PPO: $87.84
  • First Health — PPO: $99.60
  • United Healthcare — Indemnity: $91.62
  • United Healthcare — Options PPO: $76.13
  • USA Managed Care — PPO: $96
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Assay thyroid stim hormone Not listed in the file Not listed in the file $6.66 – $192.42
Thyroid stimulating hormone (TSH) test: 10 of 27 insurance plan rates
  • Aetna — Gatekeeper: $77.68
  • Aetna — Medicare Advantage: $17.64
  • Aetna — Worker's Compensation: $192.42
  • Aetna Oncology UPW — Commercial: $38.01
  • AmBetter — Individual Exchange: $45.36
  • Amerihealth Caritas — Medicaid HMO: $7.33
  • Blue Cross — Medicare Advantage: $16.80
  • Blue Cross Oncology UPW — Medicare Advantage: $16.80
  • Careworks — Worker's Compensation: $192.42
  • Cigna — Commercial: $34.40
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) In the file: Complete Blood Count, Auto Differential $123 $49.20 $66.96 – $102.09
Complete blood count (CBC) with differential: rates for 3 insurance plans
  • Avmed — Commercial: $89.79
  • First Health — PPO: $102.09
  • USA Managed Care — PPO: $98.40
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Complete Blood Count, Auto Differential $91.72 $36.69 $66.96 – $102.09
Complete blood count (CBC) with differential: rates for 3 insurance plans
  • Avmed — Commercial: $66.96
  • First Health — PPO: $76.13
  • USA Managed Care — PPO: $73.38
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Complete cbc w/auto diff wbc Not listed in the file Not listed in the file $2.97 – $167.97
Complete blood count (CBC) with differential: 10 of 27 insurance plan rates
  • Aetna — Gatekeeper: $35.95
  • Aetna — Medicare Advantage: $8.16
  • Aetna — Worker's Compensation: $167.97
  • Aetna Oncology UPW — Commercial: $17.57
  • AmBetter — Individual Exchange: $20.98
  • Amerihealth Caritas — Medicaid HMO: $3.26
  • Blue Cross — Medicare Advantage: $7.77
  • Blue Cross Oncology UPW — Medicare Advantage: $7.77
  • Careworks — Worker's Compensation: $167.97
  • Cigna — Commercial: $15.91
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) In the file: Complete Blood Count, Automated $108 $43.20 $59.07 – $89.64
Complete blood count (CBC), automated: rates for 3 insurance plans
  • Avmed — Commercial: $78.84
  • First Health — PPO: $89.64
  • USA Managed Care — PPO: $86.40
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Complete Blood Count, Automated $80.92 $32.37 $59.07 – $89.64
Complete blood count (CBC), automated: rates for 3 insurance plans
  • Avmed — Commercial: $59.07
  • First Health — PPO: $67.16
  • USA Managed Care — PPO: $64.74
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Complete cbc automated Not listed in the file Not listed in the file $2.97 – $131.83
Complete blood count (CBC), automated: 10 of 37 insurance plan rates
  • Aetna — Gatekeeper: $29.94
  • Aetna — Medicare Advantage: $6.79
  • Aetna — Worker's Compensation: $131.83
  • Aetna Oncology UPW — Commercial: $14.62
  • Aetna Oncology UPW — Medicare Advantage: $6.92
  • AmBetter — Individual Exchange: $17.47
  • Amerihealth Caritas — Medicaid HMO: $3.26
  • Blue Cross — Medicare Advantage: $6.47
  • Blue Cross Oncology UPW — Blue Select: $9.64
  • Blue Cross Oncology UPW — Health Options: $10.35
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time $50.63 $20.25 $2.23 – $108.44
Blood clotting time test (prothrombin time, PT): 10 of 36 insurance plan rates
  • Aetna — Gatekeeper: $18.17
  • Aetna — International: $40.50
  • Aetna — Medicare Advantage: $4.50
  • Aetna — Non-Gatekeeper: $38.33
  • Aetna — Signature: $35.44
  • Aetna — Worker's Compensation: $108.44
  • Aetna Oncology UPW — Commercial: $8.90
  • AmBetter — Individual Exchange: $11.58
  • Amerihealth Caritas — Medicaid HMO: $2.46
  • Avmed — Commercial: $36.24
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) In the file: Prothrombin time $67.50 $27 $31.59 – $54
Blood clotting time test (prothrombin time, PT): rates for 9 insurance plans
  • Aetna — International: $54
  • Aetna — Non-Gatekeeper: $51.10
  • Aetna — Signature: $47.25
  • Avmed — Commercial: $48.31
  • Cigna — PPO: $48.60
  • First Health — PPO: $54.93
  • United Healthcare — Indemnity: $50.69
  • United Healthcare — Options PPO: $42.12
  • USA Managed Care — PPO: $52.94
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) In the file: Prothrombin time; $26.84 $10.74 $16.75 – $21.47
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans
  • Aetna — International: $21.47
  • Aetna — Non-Gatekeeper: $20.32
  • Aetna — Signature: $18.79
  • Cigna — PPO: $19.32
  • United Healthcare — Indemnity: $20.16
  • United Healthcare — Options PPO: $16.75
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) In the file: Thromboplastin time partial (PTT), Heparin $99.28 $39.71 $54.35 – $82.40
Blood clotting test (partial thromboplastin time, PTT): rates for 3 insurance plans
  • Avmed — Commercial: $72.47
  • First Health — PPO: $82.40
  • USA Managed Care — PPO: $79.42
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time partial (PTT), Heparin $74.45 $29.78 $54.35 – $82.40
Blood clotting test (partial thromboplastin time, PTT): rates for 3 insurance plans
  • Avmed — Commercial: $54.35
  • First Health — PPO: $61.79
  • USA Managed Care — PPO: $59.56
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Thromboplastin time partial (PTT), LA Screen $37.59 $15.04 $27.44 – $31.20
Blood clotting test (partial thromboplastin time, PTT): rates for 3 insurance plans
  • Avmed — Commercial: $27.44
  • First Health — PPO: $31.20
  • USA Managed Care — PPO: $30.07

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 (hospital stay) In the file: CT Scan Head $4,430 $1,772 $2,764.32 – $3,544
CT scan of the head or brain, without contrast: rates for 6 insurance plans
  • Aetna — International: $3,544
  • Aetna — Non-Gatekeeper: $3,353.51
  • Aetna — Signature: $3,101
  • Cigna — PPO: $3,189.60
  • United Healthcare — Indemnity: $3,326.93
  • United Healthcare — Options PPO: $2,764.32
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT Scan Head $4,430 $1,772 $2,764.32 – $3,544
CT scan of the head or brain, without contrast: rates for 6 insurance plans
  • Aetna — International: $3,544
  • Aetna — Non-Gatekeeper: $3,353.51
  • Aetna — Signature: $3,101
  • Cigna — PPO: $3,189.60
  • United Healthcare — Indemnity: $3,326.93
  • United Healthcare — Options PPO: $2,764.32
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT Scan Head $4,343 $1,737.20 $3,170.39 – $3,604.69
CT scan of the head or brain, without contrast: rates for 3 insurance plans
  • Avmed — Commercial: $3,170.39
  • First Health — PPO: $3,604.69
  • USA Managed Care — PPO: $3,474.40
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI Brain, with/out Contrast $4,983 $1,993.20 $3,637.59 – $5,515.35
MRI of the brain, before and after contrast: rates for 3 insurance plans
  • Avmed — Commercial: $3,637.59
  • First Health — PPO: $4,135.89
  • USA Managed Care — PPO: $3,986.40
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) In the file: MRI Brain, with/out Contrast $6,645 $2,658 $3,637.59 – $5,515.35
MRI of the brain, before and after contrast: rates for 3 insurance plans
  • Avmed — Commercial: $4,850.85
  • First Health — PPO: $5,515.35
  • USA Managed Care — PPO: $5,316
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: Mri brain stem w/o & w/dye Not listed in the file Not listed in the file $254.63 – $5,139.88
MRI of the brain, before and after contrast: 10 of 23 insurance plan rates
  • Aetna — Gatekeeper: $5,139.88
  • Aetna — Medicare Advantage: $376.40
  • Aetna — Worker's Compensation: $3,962.19
  • AmBetter — Individual Exchange: $983.66
  • Amerihealth Caritas — Medicaid HMO: $280.09
  • Blue Cross — Medicare Advantage: $364.32
  • Blue Cross Oncology UPW — Medicare Advantage: $297.62
  • Careworks — Worker's Compensation: $3,962.19
  • Cigna — Commercial: $1,078.95
  • Community Care Plan — Medicaid HMO: $280.09
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) In the file: Radiology Exam Chest, 2 Views $918 $367.20 $502.24 – $761.94
Chest X-ray, 2 views: rates for 3 insurance plans
  • Avmed — Commercial: $670.14
  • First Health — PPO: $761.94
  • USA Managed Care — PPO: $734.40
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiology Exam Chest, 2 Views $688 $275.20 $502.24 – $761.94
Chest X-ray, 2 views: rates for 3 insurance plans
  • Avmed — Commercial: $502.24
  • First Health — PPO: $571.04
  • USA Managed Care — PPO: $550.40
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: Radiology Exam Chest, 2 Views $918 $367.20 $670.14 – $761.94
Chest X-ray, 2 views: rates for 3 insurance plans
  • Avmed — Commercial: $670.14
  • First Health — PPO: $761.94
  • USA Managed Care — PPO: $734.40
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) In the file: Radiology Exam, Lumbosacral Spine, 4/5 Views $1,515 $606 $830.01 – $1,257.45
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • Avmed — Commercial: $1,105.95
  • First Health — PPO: $1,257.45
  • USA Managed Care — PPO: $1,212
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Radiology Exam, Lumbosacral Spine, 4/5 Views $1,137 $454.80 $830.01 – $1,257.45
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • Avmed — Commercial: $830.01
  • First Health — PPO: $943.71
  • USA Managed Care — PPO: $909.60
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: X-ray exam l-2 spine 4/>vws Not listed in the file Not listed in the file $35.59 – $856.86
X-ray of the lower spine, at least 4 views: 10 of 23 insurance plan rates
  • Aetna — Gatekeeper: $388.07
  • Aetna — Medicare Advantage: $112.08
  • Aetna — Worker's Compensation: $856.86
  • AmBetter — Individual Exchange: $294.77
  • Amerihealth Caritas — Medicaid HMO: $39.15
  • Blue Cross — Medicare Advantage: $109.17
  • Blue Cross Oncology UPW — Medicare Advantage: $89.19
  • Careworks — Worker's Compensation: $856.86
  • Cigna — Commercial: $308.45
  • Community Care Plan — Medicaid HMO: $39.15
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) In the file: MRI Lumbar Spine $5,154 $2,061.60 $2,412.38 – $4,123.20
MRI of the lower back (lumbar spine), without contrast: rates for 9 insurance plans
  • Aetna — International: $4,123.20
  • Aetna — Non-Gatekeeper: $3,901.58
  • Aetna — Signature: $3,607.80
  • Avmed — Commercial: $3,688.69
  • Cigna — PPO: $3,710.88
  • First Health — PPO: $4,193.99
  • United Healthcare — Indemnity: $3,870.65
  • United Healthcare — Options PPO: $3,216.10
  • USA Managed Care — PPO: $4,042.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI Lumbar Spine $3,866 $1,546.40 $2,412.38 – $4,123.20
MRI of the lower back (lumbar spine), without contrast: rates for 9 insurance plans
  • Aetna — International: $3,092.80
  • Aetna — Non-Gatekeeper: $2,926.56
  • Aetna — Signature: $2,706.20
  • Avmed — Commercial: $2,766.70
  • Cigna — PPO: $2,783.52
  • First Health — PPO: $3,145.70
  • United Healthcare — Indemnity: $2,903.37
  • United Healthcare — Options PPO: $2,412.38
  • USA Managed Care — PPO: $3,032
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: Mri lumbar spine w/o dye Not listed in the file Not listed in the file $153.12 – $3,301.99
MRI of the lower back (lumbar spine), without contrast: 10 of 23 insurance plan rates
  • Aetna — Gatekeeper: $3,301.99
  • Aetna — Medicare Advantage: $254.76
  • Aetna — Worker's Compensation: $2,758.76
  • AmBetter — Individual Exchange: $672.74
  • Amerihealth Caritas — Medicaid HMO: $168.44
  • Blue Cross — Medicare Advantage: $249.16
  • Blue Cross Oncology UPW — Medicare Advantage: $203.55
  • Careworks — Worker's Compensation: $2,758.76
  • Cigna — Commercial: $687.47
  • Community Care Plan — Medicaid HMO: $168.44
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) In the file: CT Pelvis, with Contrast $6,948 $2,779.20 $3,804.03 – $5,766.84
CT scan of the pelvis, with contrast: rates for 3 insurance plans
  • Avmed — Commercial: $5,072.04
  • First Health — PPO: $5,766.84
  • USA Managed Care — PPO: $5,558.40
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT Pelvis, with Contrast $5,211 $2,084.40 $3,804.03 – $5,766.84
CT scan of the pelvis, with contrast: rates for 3 insurance plans
  • Avmed — Commercial: $3,804.03
  • First Health — PPO: $4,325.13
  • USA Managed Care — PPO: $4,168.80
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Ct pelvis w/dye Not listed in the file Not listed in the file $149.64 – $3,109.58
CT scan of the pelvis, with contrast: 10 of 23 insurance plan rates
  • Aetna — Gatekeeper: $2,288.18
  • Aetna — Medicare Advantage: $187.62
  • Aetna — Worker's Compensation: $3,109.58
  • AmBetter — Individual Exchange: $494.55
  • Amerihealth Caritas — Medicaid HMO: $227.59
  • Blue Cross — Medicare Advantage: $183.17
  • Blue Cross Oncology UPW — Medicare Advantage: $149.64
  • Careworks — Worker's Compensation: $3,109.58
  • Cigna — Commercial: $515.48
  • Community Care Plan — Medicaid HMO: $227.59
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: Mri jnt of lwr extre w/o dye Not listed in the file Not listed in the file $153.12 – $3,305.25
MRI of a leg joint (such as the knee), without contrast: 10 of 23 insurance plan rates
  • Aetna — Gatekeeper: $3,305.25
  • Aetna — Medicare Advantage: $254.76
  • Aetna — Worker's Compensation: $2,615.24
  • AmBetter — Individual Exchange: $672.74
  • Amerihealth Caritas — Medicaid HMO: $168.44
  • Blue Cross — Medicare Advantage: $249.16
  • Blue Cross Oncology UPW — Medicare Advantage: $203.55
  • Careworks — Worker's Compensation: $2,615.24
  • Cigna — Commercial: $687.47
  • Community Care Plan — Medicaid HMO: $168.44
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · modifier LT In the file: MRI Lower Extremity, Joint $3,984 $1,593.60 $2,181.97 – $3,306.72
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans
  • Avmed — Commercial: $2,908.32
  • First Health — PPO: $3,306.72
  • USA Managed Care — PPO: $3,187.20
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier LT In the file: MRI Lower Extremity, Joint $2,989 $1,195.60 $2,181.97 – $3,306.72
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans
  • Avmed — Commercial: $2,181.97
  • First Health — PPO: $2,480.87
  • USA Managed Care — PPO: $2,391.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) In the file: CT Abdomen/Pelvis, with Contrast $10,492 $4,196.80 $5,744.37 – $8,708.36
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans
  • Avmed — Commercial: $7,659.16
  • First Health — PPO: $8,708.36
  • USA Managed Care — PPO: $8,393.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT Abdomen/Pelvis, with Contrast $7,869 $3,147.60 $5,744.37 – $8,708.36
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans
  • Avmed — Commercial: $5,744.37
  • First Health — PPO: $6,531.27
  • USA Managed Care — PPO: $6,295.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: Ct abd & pelvis w/contrast Not listed in the file Not listed in the file $206.90 – $5,015.73
CT scan of the abdomen and pelvis, with contrast: 10 of 23 insurance plan rates
  • Aetna — Gatekeeper: $2,422.30
  • Aetna — Medicare Advantage: $376.40
  • Aetna — Worker's Compensation: $5,015.73
  • AmBetter — Individual Exchange: $983.66
  • Amerihealth Caritas — Medicaid HMO: $227.59
  • Blue Cross — Medicare Advantage: $364.32
  • Blue Cross Oncology UPW — Medicare Advantage: $297.62
  • Careworks — Worker's Compensation: $5,015.73
  • Cigna — Commercial: $1,078.95
  • Community Care Plan — Medicaid HMO: $227.59
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) In the file: US Exam Abdomen & Soft Tissue Abd Complete $2,846 $1,138.40 $1,557.82 – $2,362.18
Ultrasound of the abdomen, complete: rates for 9 insurance plans
  • Aetna — International: $2,322.40
  • Aetna — Non-Gatekeeper: $2,197.57
  • Aetna — Signature: $2,032.10
  • Avmed — Commercial: $2,077.58
  • Cigna — PPO: $2,090.16
  • First Health — PPO: $2,362.18
  • United Healthcare — Indemnity: $2,180.15
  • United Healthcare — Options PPO: $1,811.47
  • USA Managed Care — PPO: $2,276.80
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US Exam Abdomen & Soft Tissue Abd Complete $2,134 $853.60 $1,557.82 – $2,362.18
Ultrasound of the abdomen, complete: rates for 9 insurance plans
  • Aetna — International: $1,741.60
  • Aetna — Non-Gatekeeper: $1,647.99
  • Aetna — Signature: $1,523.90
  • Avmed — Commercial: $1,557.82
  • Cigna — PPO: $1,567.44
  • First Health — PPO: $1,771.22
  • United Healthcare — Indemnity: $1,634.93
  • United Healthcare — Options PPO: $1,358.45
  • USA Managed Care — PPO: $1,707.20
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) In the file: US Exam Abdomen, Complete $1,540 $616 $843.15 – $1,278.20
Ultrasound of the abdomen, complete: rates for 3 insurance plans
  • Avmed — Commercial: $1,124.20
  • First Health — PPO: $1,278.20
  • USA Managed Care — PPO: $1,232
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: US Exam Pregnant Uterus, =14 Weeks, Single $1,232 $492.80 $899.36 – $1,022.56
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans
  • Avmed — Commercial: $899.36
  • First Health — PPO: $1,022.56
  • USA Managed Care — PPO: $985.60
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) In the file: US Exam Pregnant Uterus, =14 Weeks, Single $1,232 $492.80 $674.52 – $1,022.56
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans
  • Avmed — Commercial: $899.36
  • First Health — PPO: $1,022.56
  • USA Managed Care — PPO: $985.60
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US Exam Pregnant Uterus, =14 Weeks, Single $924 $369.60 $674.52 – $1,022.56
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans
  • Avmed — Commercial: $674.52
  • First Health — PPO: $766.92
  • USA Managed Care — PPO: $739.20
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: US Exam, Transvaginal $1,120 $448 $817.60 – $929.60
Transvaginal ultrasound: rates for 3 insurance plans
  • Avmed — Commercial: $817.60
  • First Health — PPO: $929.60
  • USA Managed Care — PPO: $896
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) In the file: US Exam, Transvaginal $1,164 $465.60 $637.29 – $966.12
Transvaginal ultrasound: rates for 3 insurance plans
  • Avmed — Commercial: $849.72
  • First Health — PPO: $966.12
  • USA Managed Care — PPO: $931.20
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US Exam, Transvaginal $873 $349.20 $637.29 – $966.12
Transvaginal ultrasound: rates for 3 insurance plans
  • Avmed — Commercial: $637.29
  • First Health — PPO: $724.59
  • USA Managed Care — PPO: $698.40
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: Diagnostic Mammogram, Computer-Aided, Unilat $462 $184.80 $337.26 – $383.46
Diagnostic mammogram, one breast: rates for 3 insurance plans
  • Avmed — Commercial: $337.26
  • First Health — PPO: $383.46
  • USA Managed Care — PPO: $369.60
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: Dx mammo incl cad uni Not listed in the file Not listed in the file $29.35 – $413
Diagnostic mammogram, one breast: 10 of 20 insurance plan rates
  • Aetna — Gatekeeper: $413
  • Aetna — Medicare Advantage: $123.08
  • AmBetter — Individual Exchange: $243.54
  • Amerihealth Caritas — Medicaid HMO: $32.29
  • Blue Cross — Medicare Advantage: $90.20
  • Blue Cross Oncology UPW — Medicare Advantage: $89.61
  • Cigna — Commercial: $259.60
  • Community Care Plan — Medicaid HMO: $32.29
  • Florida Community Care — Medicaid HMO: $32.29
  • Florida Community Care — Medicare Advantage: $99.22
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier LT In the file: Diagnostic Mammogram, Computer-Aided, Unilat $462 $184.80 $337.26 – $383.46
Diagnostic mammogram, one breast: rates for 3 insurance plans
  • Avmed — Commercial: $337.26
  • First Health — PPO: $383.46
  • USA Managed Care — PPO: $369.60
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: Diagnostic Mammogram, Computer-Aided, Bilat $586 $234.40 $427.78 – $486.38
Diagnostic mammogram, both breasts: rates for 3 insurance plans
  • Avmed — Commercial: $427.78
  • First Health — PPO: $486.38
  • USA Managed Care — PPO: $468.80
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Dx mammo incl cad bi Not listed in the file Not listed in the file $29.35 – $413
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates
  • Aetna — Gatekeeper: $413
  • Aetna — Medicare Advantage: $154.76
  • AmBetter — Individual Exchange: $313.42
  • Amerihealth Caritas — Medicaid HMO: $32.29
  • Blue Cross — Medicare Advantage: $116.08
  • Blue Cross Oncology UPW — Medicare Advantage: $114.19
  • Cigna — Commercial: $332.92
  • Community Care Plan — Medicaid HMO: $32.29
  • Florida Community Care — Medicaid HMO: $32.29
  • Florida Community Care — Medicare Advantage: $127.69
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier 26 In the file: Dx mammo incl cad bi Not listed in the file Not listed in the file $31.65 – $123.98
Diagnostic mammogram, both breasts: 10 of 24 insurance plan rates
  • Aetna Oncology UPW — Commercial: $105.20
  • Aetna Oncology UPW — Medicare Advantage: $50.20
  • AmBetter Oncology UPW — Individual Exchange: $123.98
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $33.15
  • Blue Cross Oncology UPW — Blue Select: $65.84
  • Blue Cross Oncology UPW — Health Options: $70.70
  • Blue Cross Oncology UPW — Medicare Advantage: $46.92
  • Blue Cross Oncology UPW — Network Blue: $74.23
  • Blue Cross Oncology UPW — PPC PPO: $76
  • Blue Cross Oncology UPW — Traditional: $76
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: Screening Mammogram, Computer-Aid Detection $432 $172.80 $315.36 – $358.56
Screening mammogram, both breasts: rates for 3 insurance plans
  • Avmed — Commercial: $315.36
  • First Health — PPO: $408.36
  • USA Managed Care — PPO: $345.60
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Scr mammo bi incl cad Not listed in the file Not listed in the file $29.35 – $413
Screening mammogram, both breasts: 10 of 20 insurance plan rates
  • Aetna — Gatekeeper: $413
  • Aetna — Medicare Advantage: $125.36
  • AmBetter — Individual Exchange: $257.63
  • Amerihealth Caritas — Medicaid HMO: $32.29
  • Blue Cross — Medicare Advantage: $95.42
  • Blue Cross Oncology UPW — Medicare Advantage: $94.73
  • Cigna — Commercial: $274.47
  • Community Care Plan — Medicaid HMO: $32.29
  • Florida Community Care — Medicaid HMO: $32.29
  • Florida Community Care — Medicare Advantage: $104.96
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier 26 In the file: Scr mammo bi incl cad Not listed in the file Not listed in the file $24.69 – $94.82
Screening mammogram, both breasts: 10 of 24 insurance plan rates
  • Aetna Oncology UPW — Commercial: $79.30
  • Aetna Oncology UPW — Medicare Advantage: $37.82
  • AmBetter Oncology UPW — Individual Exchange: $94.82
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $25.86
  • Blue Cross Oncology UPW — Blue Select: $51
  • Blue Cross Oncology UPW — Health Options: $54.76
  • Blue Cross Oncology UPW — Medicare Advantage: $35.35
  • Blue Cross Oncology UPW — Network Blue: $57.50
  • Blue Cross Oncology UPW — PPC PPO: $58.87
  • Blue Cross Oncology UPW — Traditional: $58.87

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: Electrocardiogram complete Not listed in the file Not listed in the file $11.53 – $407.17
Electrocardiogram (ECG/EKG) with reading: 10 of 36 insurance plan rates
  • Aetna — Worker's Compensation: $407.17
  • Aetna Oncology UPW — Commercial: $34.73
  • Aetna Oncology UPW — Medicare Advantage: $16.37
  • AmBetter Oncology UPW — Individual Exchange: $37.56
  • Amerihealth Caritas — Medicaid HMO: $18.56
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $12.07
  • Blue Cross Oncology UPW — Blue Select: $20.21
  • Blue Cross Oncology UPW — Health Options: $21.71
  • Blue Cross Oncology UPW — Medicare Advantage: $15.30
  • Blue Cross Oncology UPW — Network Blue: $22.79
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) In the file: Left Heart Catheterization Ventriculography $22,321 $8,928.40 $13,928.30 – $17,856.80
Left heart catheterization (diagnostic): rates for 6 insurance plans
  • Aetna — International: $17,856.80
  • Aetna — Non-Gatekeeper: $16,897
  • Aetna — Signature: $15,624.70
  • Cigna — PPO: $16,071.12
  • United Healthcare — Indemnity: $16,763.07
  • United Healthcare — Options PPO: $13,928.30
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Left Heart Catheterization Ventriculography $22,321 $8,928.40 $13,928.30 – $17,856.80
Left heart catheterization (diagnostic): rates for 6 insurance plans
  • Aetna — International: $17,856.80
  • Aetna — Non-Gatekeeper: $16,897
  • Aetna — Signature: $15,624.70
  • Cigna — PPO: $16,071.12
  • United Healthcare — Indemnity: $16,763.07
  • United Healthcare — Options PPO: $13,928.30
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: Left Heart Catheterization Ventriculography $21,883 $8,753.20 $15,974.59 – $18,162.89
Left heart catheterization (diagnostic): rates for 3 insurance plans
  • Avmed — Commercial: $15,974.59
  • First Health — PPO: $18,162.89
  • USA Managed Care — PPO: $17,506.40
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) In the file: Electrophysiologic Eval Right Atrial/Bundle $9,549 $3,819.60 $5,958.58 – $7,639.20
Heart rhythm study (electrophysiology evaluation): rates for 6 insurance plans
  • Aetna — International: $7,639.20
  • Aetna — Non-Gatekeeper: $7,228.59
  • Aetna — Signature: $6,684.30
  • Cigna — PPO: $6,875.28
  • United Healthcare — Indemnity: $7,171.30
  • United Healthcare — Options PPO: $5,958.58
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Electrophysiologic Eval Right Atrial/Bundle $9,549 $3,819.60 $5,958.58 – $7,639.20
Heart rhythm study (electrophysiology evaluation): rates for 6 insurance plans
  • Aetna — International: $7,639.20
  • Aetna — Non-Gatekeeper: $7,228.59
  • Aetna — Signature: $6,684.30
  • Cigna — PPO: $6,875.28
  • United Healthcare — Indemnity: $7,171.30
  • United Healthcare — Options PPO: $5,958.58
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: Electrophysiologic Eval Right Atrial/Bundle $9,362 $3,744.80 $6,834.26 – $7,770.46
Heart rhythm study (electrophysiology evaluation): rates for 3 insurance plans
  • Avmed — Commercial: $6,834.26
  • First Health — PPO: $7,770.46
  • USA Managed Care — PPO: $7,489.60
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) In the file: Electrophysiology Eval Arrhythmia/Pulm Vein $64,976 $25,990.40 $40,545.02 – $51,980.80
Heart rhythm study with ablation for atrial fibrillation: rates for 6 insurance plans
  • Aetna — International: $51,980.80
  • Aetna — Non-Gatekeeper: $49,186.83
  • Aetna — Signature: $45,483.20
  • Cigna — PPO: $46,782.72
  • United Healthcare — Indemnity: $48,796.98
  • United Healthcare — Options PPO: $40,545.02
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Electrophysiology Eval Arrhythmia/Pulm Vein $64,976 $25,990.40 $40,545.02 – $51,980.80
Heart rhythm study with ablation for atrial fibrillation: rates for 6 insurance plans
  • Aetna — International: $51,980.80
  • Aetna — Non-Gatekeeper: $49,186.83
  • Aetna — Signature: $45,483.20
  • Cigna — PPO: $46,782.72
  • United Healthcare — Indemnity: $48,796.98
  • United Healthcare — Options PPO: $40,545.02
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: Electrophysiology Eval Arrhythmia/Pulm Vein $63,702 $25,480.80 $46,502.46 – $52,872.66
Heart rhythm study with ablation for atrial fibrillation: rates for 3 insurance plans
  • Avmed — Commercial: $46,502.46
  • First Health — PPO: $52,872.66
  • USA Managed Care — PPO: $50,961.60
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysom 6/> yrs 4/> param Not listed in the file Not listed in the file $477.75 – $5,785.35
Sleep study (overnight, in a sleep lab): 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage: $1,072.30
  • Aetna — Worker's Compensation: $5,785.35
  • AmBetter — Individual Exchange: $2,421.26
  • Amerihealth Caritas — Medicaid HMO: $525.52
  • Blue Cross — Medicare Advantage: $896.76
  • Blue Cross Oncology UPW — Medicare Advantage: $732.59
  • Careworks — Worker's Compensation: $5,785.35
  • Community Care Plan — Medicaid HMO: $525.52
  • Enlyte — Worker's Compensation: $5,785.35
  • Florida Community Care — Medicaid HMO: $525.52
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · modifier TC In the file: Polysom 6/> yrs 4/> param Not listed in the file Not listed in the file $411.25 – $1,274.35
Sleep study (overnight, in a sleep lab): 10 of 24 insurance plan rates
  • Aetna Oncology UPW — Commercial: $973.66
  • Aetna Oncology UPW — Medicare Advantage: $569.75
  • AmBetter Oncology UPW — Individual Exchange: $1,274.35
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $430.83
  • Blue Cross Oncology UPW — Blue Select: $699.03
  • Blue Cross Oncology UPW — Health Options: $750.64
  • Blue Cross Oncology UPW — Medicare Advantage: $532.48
  • Blue Cross Oncology UPW — Network Blue: $788.17
  • Blue Cross Oncology UPW — PPC PPO: $806.93
  • Blue Cross Oncology UPW — Traditional: $806.93
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · modifier 26 In the file: Polysom 6/> yrs 4/> param Not listed in the file Not listed in the file $93.03 – $305.83
Sleep study (overnight, in a sleep lab): 10 of 24 insurance plan rates
  • Aetna Oncology UPW — Commercial: $253.07
  • Aetna Oncology UPW — Medicare Advantage: $128.30
  • AmBetter Oncology UPW — Individual Exchange: $305.83
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $97.46
  • Blue Cross Oncology UPW — Blue Select: $162.73
  • Blue Cross Oncology UPW — Health Options: $174.75
  • Blue Cross Oncology UPW — Medicare Advantage: $119.91
  • Blue Cross Oncology UPW — Network Blue: $183.48
  • Blue Cross Oncology UPW — PPC PPO: $187.85
  • Blue Cross Oncology UPW — Traditional: $187.85

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: Therapeutic exercises Not listed in the file Not listed in the file $22.07 – $77.27
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 30 insurance plan rates
  • Aetna — Medicare Advantage: $29.51
  • AmBetter — Individual Exchange: $77.27
  • AmBetter Oncology UPW — Individual Exchange: $75.98
  • Amerihealth Caritas — Medicaid HMO: $24.28
  • Blue Cross — Medicare Advantage: $28.62
  • Blue Cross Oncology UPW — Blue Select: $41.19
  • Blue Cross Oncology UPW — Health Options: $44.24
  • Blue Cross Oncology UPW — Medicare Advantage: $30.90
  • Blue Cross Oncology UPW — Network Blue: $46.45
  • Blue Cross Oncology UPW — PPC PPO: $47.55
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · modifier GO In the file: OT Therapeutic Exercise/15 Minutes $233 $93.20 $145.39 – $186.40
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans
  • Aetna — International: $186.40
  • Aetna — Non-Gatekeeper: $176.38
  • Aetna — Signature: $163.10
  • Cigna — PPO: $146.16
  • United Healthcare — Indemnity: $174.98
  • United Healthcare — Options PPO: $145.39
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO In the file: OT Therapeutic Exercise/15 Minutes $233 $93.20 $145.39 – $186.40
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans
  • Aetna — International: $186.40
  • Aetna — Non-Gatekeeper: $176.38
  • Aetna — Signature: $163.10
  • Cigna — PPO: $167.76
  • United Healthcare — Indemnity: $174.98
  • United Healthcare — Options PPO: $145.39
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Pt eval low complex 20 min Not listed in the file Not listed in the file $74.55 – $260.17
Physical therapy evaluation (low complexity): 10 of 30 insurance plan rates
  • Aetna — Medicare Advantage: $100.59
  • AmBetter — Individual Exchange: $259.20
  • AmBetter Oncology UPW — Individual Exchange: $260.17
  • Amerihealth Caritas — Medicaid HMO: $172.51
  • Blue Cross — Medicare Advantage: $96
  • Blue Cross Oncology UPW — Blue Select: $140.44
  • Blue Cross Oncology UPW — Health Options: $150.81
  • Blue Cross Oncology UPW — Medicare Advantage: $86.11
  • Blue Cross Oncology UPW — Network Blue: $158.35
  • Blue Cross Oncology UPW — PPC PPO: $162.12
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · modifier GP In the file: PT Evaluation Low $405 $162 $252.72 – $324
Physical therapy evaluation (low complexity): rates for 6 insurance plans
  • Aetna — International: $324
  • Aetna — Non-Gatekeeper: $248.30
  • Aetna — Signature: $283.50
  • Cigna — PPO: $236.16
  • United Healthcare — Indemnity: $304.15
  • United Healthcare — Options PPO: $252.72
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: PT Evaluation Low $328 $131.20 $204.67 – $262.40
Physical therapy evaluation (low complexity): rates for 6 insurance plans
  • Aetna — International: $324
  • Aetna — Non-Gatekeeper: $306.58
  • Aetna — Signature: $283.50
  • Cigna — PPO: $291.60
  • United Healthcare — Indemnity: $304.15
  • United Healthcare — Options PPO: $204.67
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Pt eval mod complex 30 min Not listed in the file Not listed in the file $74.55 – $260.17
Physical therapy evaluation (moderate complexity): 10 of 30 insurance plan rates
  • Aetna — Medicare Advantage: $100.59
  • AmBetter — Individual Exchange: $259.20
  • AmBetter Oncology UPW — Individual Exchange: $260.17
  • Amerihealth Caritas — Medicaid HMO: $172.51
  • Blue Cross — Medicare Advantage: $96
  • Blue Cross Oncology UPW — Blue Select: $140.44
  • Blue Cross Oncology UPW — Health Options: $150.81
  • Blue Cross Oncology UPW — Medicare Advantage: $86.11
  • Blue Cross Oncology UPW — Network Blue: $158.35
  • Blue Cross Oncology UPW — PPC PPO: $162.12
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · modifier GP In the file: PT Evaluation Mod $393 $157.20 $245.23 – $314.40
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans
  • Aetna — International: $402.40
  • Aetna — Non-Gatekeeper: $297.50
  • Aetna — Signature: $352.10
  • Cigna — PPO: $282.96
  • United Healthcare — Indemnity: $377.75
  • United Healthcare — Options PPO: $313.87
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: PT Evaluation Mod $393 $157.20 $245.23 – $314.40
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans
  • Aetna — International: $402.40
  • Aetna — Non-Gatekeeper: $380.77
  • Aetna — Signature: $352.10
  • Cigna — PPO: $282.96
  • United Healthcare — Indemnity: $377.75
  • United Healthcare — Options PPO: $245.23
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Pt eval high complex 45 min Not listed in the file Not listed in the file $74.55 – $260.17
Physical therapy evaluation (high complexity): 10 of 30 insurance plan rates
  • Aetna — Medicare Advantage: $100.59
  • AmBetter — Individual Exchange: $259.20
  • AmBetter Oncology UPW — Individual Exchange: $260.17
  • Amerihealth Caritas — Medicaid HMO: $172.51
  • Blue Cross — Medicare Advantage: $96
  • Blue Cross Oncology UPW — Blue Select: $140.44
  • Blue Cross Oncology UPW — Health Options: $150.81
  • Blue Cross Oncology UPW — Medicare Advantage: $86.11
  • Blue Cross Oncology UPW — Network Blue: $158.35
  • Blue Cross Oncology UPW — PPC PPO: $162.12
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · modifier GP In the file: PT Evaluation High $459 $183.60 $286.42 – $367.20
Physical therapy evaluation (high complexity): rates for 6 insurance plans
  • Aetna — International: $575.20
  • Aetna — Non-Gatekeeper: $347.46
  • Aetna — Signature: $503.30
  • Cigna — PPO: $330.48
  • United Healthcare — Indemnity: $539.97
  • United Healthcare — Options PPO: $448.66
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: PT Evaluation High $459 $183.60 $286.42 – $367.20
Physical therapy evaluation (high complexity): rates for 6 insurance plans
  • Aetna — International: $575.20
  • Aetna — Non-Gatekeeper: $544.28
  • Aetna — Signature: $503.30
  • Cigna — PPO: $330.48
  • United Healthcare — Indemnity: $539.97
  • United Healthcare — Options PPO: $286.42
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) In the file: Therapy Patient 30 minutes $247 $98.80 $154.13 – $197.60
Psychotherapy, 30 minutes: rates for 6 insurance plans
  • Aetna — International: $197.60
  • Aetna — Non-Gatekeeper: $186.98
  • Aetna — Signature: $172.90
  • Cigna — PPO: $177.84
  • United Healthcare — Indemnity: $185.50
  • United Healthcare — Options PPO: $154.13
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Therapy Patient 30 minutes $247 $98.80 $154.13 – $197.60
Psychotherapy, 30 minutes: rates for 6 insurance plans
  • Aetna — International: $197.60
  • Aetna — Non-Gatekeeper: $186.98
  • Aetna — Signature: $172.90
  • Cigna — PPO: $177.84
  • United Healthcare — Indemnity: $185.50
  • United Healthcare — Options PPO: $154.13
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: Therapy Patient 30 minutes $332 $132.80 $242.36 – $275.56
Psychotherapy, 30 minutes: rates for 3 insurance plans
  • Avmed — Commercial: $242.36
  • First Health — PPO: $275.56
  • USA Managed Care — PPO: $265.60
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) In the file: Therapy Patient 45 minutes $370 $148 $230.88 – $296
Psychotherapy, 45 minutes: rates for 6 insurance plans
  • Aetna — International: $296
  • Aetna — Non-Gatekeeper: $280.09
  • Aetna — Signature: $259
  • Cigna — PPO: $266.40
  • United Healthcare — Indemnity: $277.87
  • United Healthcare — Options PPO: $230.88
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Therapy Patient 45 minutes $370 $148 $230.88 – $296
Psychotherapy, 45 minutes: rates for 6 insurance plans
  • Aetna — International: $296
  • Aetna — Non-Gatekeeper: $280.09
  • Aetna — Signature: $259
  • Cigna — PPO: $266.40
  • United Healthcare — Indemnity: $277.87
  • United Healthcare — Options PPO: $230.88
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: Psychotherapy w/Patient, 45 Min $270 $108 $197.10 – $224.10
Psychotherapy, 45 minutes: rates for 3 insurance plans
  • Avmed — Commercial: $197.10
  • First Health — PPO: $224.10
  • USA Managed Care — PPO: $216
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) In the file: Therapy Patient 60 minutes $494 $197.60 $308.26 – $395.20
Psychotherapy, 60 minutes: rates for 6 insurance plans
  • Aetna — International: $395.20
  • Aetna — Non-Gatekeeper: $373.96
  • Aetna — Signature: $345.80
  • Cigna — PPO: $355.68
  • United Healthcare — Indemnity: $370.99
  • United Healthcare — Options PPO: $308.26
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Therapy Patient 60 minutes $494 $197.60 $308.26 – $395.20
Psychotherapy, 60 minutes: rates for 6 insurance plans
  • Aetna — International: $395.20
  • Aetna — Non-Gatekeeper: $373.96
  • Aetna — Signature: $345.80
  • Cigna — PPO: $355.68
  • United Healthcare — Indemnity: $370.99
  • United Healthcare — Options PPO: $308.26
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: Therapy Patient 60 minutes $339 $135.60 $247.47 – $281.37
Psychotherapy, 60 minutes: rates for 3 insurance plans
  • Avmed — Commercial: $247.47
  • First Health — PPO: $281.37
  • USA Managed Care — PPO: $271.20
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psytx w/o pt 50 min Not listed in the file Not listed in the file $96.88 – $500.46
Family psychotherapy, without the patient: 10 of 33 insurance plan rates
  • Aetna — Medicare Advantage: $169.35
  • Aetna — Worker's Compensation: $243.79
  • AmBetter — Individual Exchange: $500.46
  • AmBetter Oncology UPW — Individual Exchange: $259.25
  • Amerihealth Caritas — Medicaid HMO: $113.31
  • Blue Cross — Medicare Advantage: $185.35
  • Blue Cross Oncology UPW — Blue Select: $142.92
  • Blue Cross Oncology UPW — Health Options: $153.47
  • Blue Cross Oncology UPW — Medicare Advantage: $151.42
  • Blue Cross Oncology UPW — Network Blue: $161.14
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · modifier 95|GT In the file: Family psytx w/o pt 50 min Not listed in the file Not listed in the file $115.97 – $224.88
Family psychotherapy, without the patient: rates for 2 insurance plans
  • Aetna Oncology UPW — Commercial: $224.88
  • Aetna Oncology UPW — Medicare Advantage: $115.97
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) In the file: Family Psychotherapy with Patient $346 $138.40 $215.90 – $276.80
Family psychotherapy, with the patient: rates for 6 insurance plans
  • Aetna — International: $276.80
  • Aetna — Non-Gatekeeper: $261.92
  • Aetna — Signature: $242.20
  • Cigna — PPO: $249.12
  • United Healthcare — Indemnity: $259.85
  • United Healthcare — Options PPO: $215.90
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family Psychotherapy with Patient $346 $138.40 $215.90 – $276.80
Family psychotherapy, with the patient: rates for 6 insurance plans
  • Aetna — International: $276.80
  • Aetna — Non-Gatekeeper: $261.92
  • Aetna — Signature: $242.20
  • Cigna — PPO: $249.12
  • United Healthcare — Indemnity: $259.85
  • United Healthcare — Options PPO: $215.90
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: Family Psychotherapy with Patient $339 $135.60 $247.47 – $281.37
Family psychotherapy, with the patient: rates for 3 insurance plans
  • Avmed — Commercial: $247.47
  • First Health — PPO: $281.37
  • USA Managed Care — PPO: $271.20
Group psychotherapy CPT 90853 · Inpatient (hospital stay) In the file: HOPS Group Psychotherapy $244 $97.60 $152.26 – $195.20
Group psychotherapy: rates for 6 insurance plans
  • Aetna — International: $195.20
  • Aetna — Non-Gatekeeper: $184.71
  • Aetna — Signature: $170.80
  • Cigna — PPO: $175.68
  • United Healthcare — Indemnity: $183.24
  • United Healthcare — Options PPO: $152.26
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: HOPS Group Psychotherapy $244 $97.60 $152.26 – $195.20
Group psychotherapy: rates for 6 insurance plans
  • Aetna — International: $195.20
  • Aetna — Non-Gatekeeper: $184.71
  • Aetna — Signature: $170.80
  • Cigna — PPO: $175.68
  • United Healthcare — Indemnity: $183.24
  • United Healthcare — Options PPO: $152.26
Group psychotherapy CPT 90853 · Inpatient or outpatient In the file: HOPS Group Psychotherapy $239 $95.60 $174.47 – $198.37
Group psychotherapy: rates for 3 insurance plans
  • Avmed — Commercial: $174.47
  • First Health — PPO: $198.37
  • USA Managed Care — PPO: $191.20

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Removal of breast lesion Not listed in the file Not listed in the file $859.58 – $11,039.77
Removal of breast growth (open surgery): 10 of 30 insurance plan rates
  • Aetna — Gatekeeper: $6,310
  • Aetna — Medicare Advantage: $4,035.94
  • Aetna — Worker's Compensation: $4,454.91
  • AmBetter — Individual Exchange: $11,039.77
  • AmBetter Oncology UPW — Individual Exchange: $1,152.01
  • Amerihealth Caritas — Medicaid HMO: $945.54
  • Blue Cross — Medicare Advantage: $4,088.80
  • Blue Cross Oncology UPW — Medicare Advantage: $3,340.27
  • Careworks — Worker's Compensation: $4,454.91
  • Cigna — Commercial: $5,750
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier 50 In the file: Removal of breast lesion Not listed in the file Not listed in the file $513.12 – $1,591.29
Removal of breast growth (open surgery): 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $1,341.93
  • Aetna Oncology UPW — Medicare Advantage: $681.89
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $537.54
  • Blue Cross Oncology UPW — Blue Select: $935.16
  • Blue Cross Oncology UPW — Health Options: $1,004.21
  • Blue Cross Oncology UPW — Medicare Advantage: $637.28
  • Blue Cross Oncology UPW — Network Blue: $1,054.41
  • Blue Cross Oncology UPW — PPC PPO: $1,079.52
  • Blue Cross Oncology UPW — Traditional: $1,079.52
  • Cigna Oncology UPW — Commercial: $972.56
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier 78 In the file: Removal of breast lesion Not listed in the file Not listed in the file $242.88 – $753.21
Removal of breast growth (open surgery): 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $635.18
  • Aetna Oncology UPW — Medicare Advantage: $322.76
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $254.44
  • Blue Cross Oncology UPW — Blue Select: $442.64
  • Blue Cross Oncology UPW — Health Options: $475.32
  • Blue Cross Oncology UPW — Medicare Advantage: $301.64
  • Blue Cross Oncology UPW — Network Blue: $499.09
  • Blue Cross Oncology UPW — PPC PPO: $510.97
  • Blue Cross Oncology UPW — Traditional: $510.97
  • Cigna Oncology UPW — Commercial: $460.34
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Total hip arthroplasty Not listed in the file Not listed in the file $1,147.59 – $36,199.36
Total hip replacement: 10 of 30 insurance plan rates
  • Aetna — Gatekeeper: $9,210
  • Aetna — Medicare Advantage: $13,561.23
  • Aetna — Worker's Compensation: $1,147.59
  • AmBetter — Individual Exchange: $36,199.36
  • AmBetter Oncology UPW — Individual Exchange: $3,502.06
  • Amerihealth Caritas — Medicaid HMO: $6,553.76
  • Blue Cross — Medicare Advantage: $13,407.17
  • Blue Cross Oncology UPW — Medicare Advantage: $10,952.74
  • Careworks — Worker's Compensation: $1,147.59
  • Cigna — Commercial: $15,000
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier 50 In the file: Total hip arthroplasty Not listed in the file Not listed in the file $1,565.52 – $4,385.42
Total hip replacement: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $4,385.42
  • Aetna Oncology UPW — Medicare Advantage: $1,946.82
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $1,640.06
  • Blue Cross Oncology UPW — Blue Select: $2,838.66
  • Blue Cross Oncology UPW — Health Options: $3,048.24
  • Blue Cross Oncology UPW — Medicare Advantage: $1,819.46
  • Blue Cross Oncology UPW — Network Blue: $3,200.64
  • Blue Cross Oncology UPW — PPC PPO: $3,276.86
  • Blue Cross Oncology UPW — Traditional: $3,276.86
  • Cigna Oncology UPW — Commercial: $2,956.53
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier 78 In the file: Total hip arthroplasty Not listed in the file Not listed in the file $720.14 – $2,017.29
Total hip replacement: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $2,017.29
  • Aetna Oncology UPW — Medicare Advantage: $895.54
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $754.43
  • Blue Cross Oncology UPW — Blue Select: $1,305.78
  • Blue Cross Oncology UPW — Health Options: $1,402.19
  • Blue Cross Oncology UPW — Medicare Advantage: $836.95
  • Blue Cross Oncology UPW — Network Blue: $1,472.29
  • Blue Cross Oncology UPW — PPC PPO: $1,507.35
  • Blue Cross Oncology UPW — Traditional: $1,507.35
  • Cigna Oncology UPW — Commercial: $1,360
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Total knee arthroplasty Not listed in the file Not listed in the file $3,496.15 – $36,199.36
Total knee replacement: 10 of 30 insurance plan rates
  • Aetna — Gatekeeper: $9,210
  • Aetna — Medicare Advantage: $13,561.23
  • Aetna — Worker's Compensation: $6,347.94
  • AmBetter — Individual Exchange: $36,199.36
  • AmBetter Oncology UPW — Individual Exchange: $3,496.15
  • Amerihealth Caritas — Medicaid HMO: $6,553.76
  • Blue Cross — Medicare Advantage: $13,407.17
  • Blue Cross Oncology UPW — Medicare Advantage: $10,952.74
  • Careworks — Worker's Compensation: $6,347.94
  • Cigna — Commercial: $15,000
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier 50 In the file: Total knee arthroplasty Not listed in the file Not listed in the file $1,563.51 – $4,383.32
Total knee replacement: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $4,383.32
  • Aetna Oncology UPW — Medicare Advantage: $1,941.84
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $1,637.96
  • Blue Cross Oncology UPW — Blue Select: $2,834.90
  • Blue Cross Oncology UPW — Health Options: $3,044.18
  • Blue Cross Oncology UPW — Medicare Advantage: $1,814.81
  • Blue Cross Oncology UPW — Network Blue: $3,196.38
  • Blue Cross Oncology UPW — PPC PPO: $3,272.49
  • Blue Cross Oncology UPW — Traditional: $3,272.49
  • Cigna Oncology UPW — Commercial: $2,951.54
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier 78 In the file: Total knee arthroplasty Not listed in the file Not listed in the file $719.21 – $2,016.32
Total knee replacement: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $2,016.32
  • Aetna Oncology UPW — Medicare Advantage: $893.25
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $753.46
  • Blue Cross Oncology UPW — Blue Select: $1,304.05
  • Blue Cross Oncology UPW — Health Options: $1,400.32
  • Blue Cross Oncology UPW — Medicare Advantage: $834.81
  • Blue Cross Oncology UPW — Network Blue: $1,470.33
  • Blue Cross Oncology UPW — PPC PPO: $1,505.35
  • Blue Cross Oncology UPW — Traditional: $1,505.35
  • Cigna Oncology UPW — Commercial: $1,357.71
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $466.78 – $7,453.55
Shoulder arthroscopy: shaving of shoulder bone: 10 of 22 insurance plan rates
  • Aetna — Gatekeeper: $6,310
  • Aetna — Worker's Compensation: $7,267.38
  • AmBetter Oncology UPW — Individual Exchange: $466.78
  • Amerihealth Caritas — Medicaid HMO: $1,518.31
  • Careworks — Worker's Compensation: $7,267.38
  • Cigna — Commercial: $5,750
  • Community Care Plan — Medicaid HMO: $1,518.31
  • Enlyte — Worker's Compensation: $7,267.38
  • Florida Community Care — Medicaid HMO: $1,518.31
  • Molina — Healthy Kids: $1,490.70
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier 80|81|82 In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $22.09 – $61.12
Shoulder arthroscopy: shaving of shoulder bone: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $61.12
  • Aetna Oncology UPW — Medicare Advantage: $26.71
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $23.14
  • Blue Cross Oncology UPW — Blue Select: $40.40
  • Blue Cross Oncology UPW — Health Options: $43.38
  • Blue Cross Oncology UPW — Medicare Advantage: $24.97
  • Blue Cross Oncology UPW — Network Blue: $45.55
  • Blue Cross Oncology UPW — PPC PPO: $46.64
  • Blue Cross Oncology UPW — Traditional: $46.64
  • Cigna Oncology UPW — Commercial: $42.04
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier 50 In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $207.09 – $572.99
Shoulder arthroscopy: shaving of shoulder bone: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $572.99
  • Aetna Oncology UPW — Medicare Advantage: $250.44
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $216.95
  • Blue Cross Oncology UPW — Blue Select: $378.74
  • Blue Cross Oncology UPW — Health Options: $406.70
  • Blue Cross Oncology UPW — Medicare Advantage: $234.06
  • Blue Cross Oncology UPW — Network Blue: $427.04
  • Blue Cross Oncology UPW — PPC PPO: $437.21
  • Blue Cross Oncology UPW — Traditional: $437.21
  • Cigna Oncology UPW — Commercial: $394.06
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthrs kne srg mnisectmy m/l Not listed in the file Not listed in the file $1,380.28 – $9,404
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 18 insurance plan rates
  • Aetna — Gatekeeper: $7,136
  • Aetna — Medicare Advantage: $3,419.72
  • AmBetter — Individual Exchange: $9,225.59
  • Blue Cross — Medicare Advantage: $3,416.88
  • Blue Cross Oncology UPW — Medicare Advantage: $2,791.36
  • Cigna — Commercial: $6,500
  • Florida Community Care — Medicare Advantage: $3,758.57
  • Oscar Health — Individual Exchange: $7,453.55
  • Simply Freedom Optimum — Medicare Advantage: $3,587.73
  • United Healthcare — Individual Exchange: $8,463
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Knee arthroscopy/surgery Not listed in the file Not listed in the file $1,380.28 – $9,404
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 12 insurance plan rates
  • Aetna — Worker's Compensation: $3,334.96
  • AmBetter Oncology UPW — Individual Exchange: $1,473.74
  • Amerihealth Caritas — Medicaid HMO: $1,518.31
  • Careworks — Worker's Compensation: $3,334.96
  • Community Care Plan — Medicaid HMO: $1,518.31
  • Enlyte — Worker's Compensation: $3,334.96
  • Florida Community Care — Medicaid HMO: $1,518.31
  • Molina — Healthy Kids: $1,490.70
  • Molina — Medicaid HMO: $1,490.70
  • Simply Healthcare — Healthy Kids: $1,380.28
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 50 In the file: Knee arthroscopy/surgery Not listed in the file Not listed in the file $669.15 – $1,729.34
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 15 insurance plan rates
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $701.01
  • Blue Cross Oncology UPW — Blue Select: $1,198.49
  • Blue Cross Oncology UPW — Health Options: $1,286.97
  • Blue Cross Oncology UPW — Network Blue: $1,351.32
  • Blue Cross Oncology UPW — PPC PPO: $1,383.50
  • Blue Cross Oncology UPW — Traditional: $1,383.50
  • Community Care Plan Oncology UPW — Medicaid HMO: $701.01
  • Florida Community Care Oncology UPW — Medicaid HMO: $841.21
  • Florida Community Care Oncology UPW — Medicare Advantage: $1,014.48
  • Molina Oncology UPW — Healthy Kids: $688.28
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $786.29 – $16,691.28
Removal of tonsils and adenoids (under age 12): 10 of 27 insurance plan rates
  • Aetna — Gatekeeper: $6,310
  • Aetna — Medicare Advantage: $6,234.92
  • AmBetter — Individual Exchange: $16,691.28
  • AmBetter Oncology UPW — Individual Exchange: $786.29
  • Amerihealth Caritas — Medicaid HMO: $1,496.19
  • Blue Cross — Medicare Advantage: $6,181.96
  • Blue Cross Oncology UPW — Medicare Advantage: $5,050.24
  • Cigna — Commercial: $5,750
  • Community Care Plan — Medicaid HMO: $1,496.19
  • Florida Community Care — Medicaid HMO: $1,496.19
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · modifier 78 In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $193.05 – $496.15
Removal of tonsils and adenoids (under age 12): 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $496.15
  • Aetna Oncology UPW — Medicare Advantage: $230.71
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $202.23
  • Blue Cross Oncology UPW — Blue Select: $343.55
  • Blue Cross Oncology UPW — Health Options: $368.91
  • Blue Cross Oncology UPW — Medicare Advantage: $215.62
  • Blue Cross Oncology UPW — Network Blue: $387.36
  • Blue Cross Oncology UPW — PPC PPO: $396.58
  • Blue Cross Oncology UPW — Traditional: $396.58
  • Cigna Oncology UPW — Commercial: $358.46
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: Esophagogastroduodenoscopy $4,661 $1,864.40 $2,908.46 – $3,728.80
Upper GI endoscopy (diagnostic): rates for 6 insurance plans
  • Aetna — International: $3,728.80
  • Aetna — Non-Gatekeeper: $3,528.38
  • Aetna — Signature: $3,262.70
  • Cigna — PPO: $3,355.92
  • United Healthcare — Indemnity: $3,500.41
  • United Healthcare — Options PPO: $2,908.46
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy $4,661 $1,864.40 $2,908.46 – $3,728.80
Upper GI endoscopy (diagnostic): rates for 6 insurance plans
  • Aetna — International: $3,728.80
  • Aetna — Non-Gatekeeper: $3,528.38
  • Aetna — Signature: $3,262.70
  • Cigna — PPO: $3,355.92
  • United Healthcare — Indemnity: $3,500.41
  • United Healthcare — Options PPO: $2,908.46
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: Esophagogastroduodenoscopy $4,570 $1,828 $3,336.10 – $3,793.10
Upper GI endoscopy (diagnostic): rates for 3 insurance plans
  • Avmed — Commercial: $3,336.10
  • First Health — PPO: $3,793.10
  • USA Managed Care — PPO: $3,656
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: Esophagogastroduodenoscopy, Biopsy $4,736 $1,894.40 $3,457.28 – $3,930.88
Upper GI endoscopy with biopsy: rates for 3 insurance plans
  • Avmed — Commercial: $3,457.28
  • First Health — PPO: $3,930.88
  • USA Managed Care — PPO: $3,788.80
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd biopsy single/multiple Not listed in the file Not listed in the file $109.91 – $4,942
Upper GI endoscopy with biopsy: 10 of 49 insurance plan rates
  • Aetna — Gatekeeper: $4,942
  • Aetna — Medicare Advantage: $988.16
  • Aetna — Worker's Compensation: $2,913.97
  • Aetna Oncology UPW — Commercial: $300.86
  • Aetna Oncology UPW — Medicare Advantage: $135.36
  • AmBetter — Individual Exchange: $2,557.29
  • AmBetter Oncology UPW — Individual Exchange: $367.39
  • Amerihealth Caritas — Medicaid HMO: $713.88
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $115.14
  • Blue Cross — Medicare Advantage: $947.14
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) In the file: Colonoscopy $4,904 $1,961.60 $3,060.10 – $3,923.20
Colonoscopy (diagnostic): rates for 6 insurance plans
  • Aetna — International: $3,923.20
  • Aetna — Non-Gatekeeper: $3,712.33
  • Aetna — Signature: $3,432.80
  • Cigna — PPO: $3,530.88
  • United Healthcare — Indemnity: $3,682.90
  • United Healthcare — Options PPO: $3,060.10
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy $4,904 $1,961.60 $3,060.10 – $3,923.20
Colonoscopy (diagnostic): rates for 6 insurance plans
  • Aetna — International: $3,923.20
  • Aetna — Non-Gatekeeper: $3,712.33
  • Aetna — Signature: $3,432.80
  • Cigna — PPO: $3,530.88
  • United Healthcare — Indemnity: $3,682.90
  • United Healthcare — Options PPO: $3,060.10
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: Colonoscopy $4,808 $1,923.20 $3,509.84 – $3,990.64
Colonoscopy (diagnostic): rates for 3 insurance plans
  • Avmed — Commercial: $3,509.84
  • First Health — PPO: $3,990.64
  • USA Managed Care — PPO: $3,846.40
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: Colonoscopy, Biopsy $5,274 $2,109.60 $3,850.02 – $4,377.42
Colonoscopy with biopsy: rates for 3 insurance plans
  • Avmed — Commercial: $3,850.02
  • First Health — PPO: $4,377.42
  • USA Managed Care — PPO: $4,219.20
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy and biopsy Not listed in the file Not listed in the file $159.78 – $4,942
Colonoscopy with biopsy: 10 of 49 insurance plan rates
  • Aetna — Gatekeeper: $4,942
  • Aetna — Medicare Advantage: $1,242.72
  • Aetna — Worker's Compensation: $2,557.72
  • Aetna Oncology UPW — Commercial: $436.58
  • Aetna Oncology UPW — Medicare Advantage: $195.44
  • AmBetter — Individual Exchange: $3,373.99
  • AmBetter Oncology UPW — Individual Exchange: $531.36
  • Amerihealth Caritas — Medicaid HMO: $700.57
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $167.38
  • Blue Cross — Medicare Advantage: $1,249.62
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: Colonoscopy, Snare Removal $5,274 $2,109.60 $3,850.02 – $4,377.42
Colonoscopy with removal of polyps (snare): rates for 3 insurance plans
  • Avmed — Commercial: $3,850.02
  • First Health — PPO: $4,377.42
  • USA Managed Care — PPO: $4,219.20
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colonoscopy w/lesion removal Not listed in the file Not listed in the file $201.34 – $4,942
Colonoscopy with removal of polyps (snare): 10 of 52 insurance plan rates
  • Aetna — Gatekeeper: $4,942
  • Aetna — Medicare Advantage: $1,242.72
  • Aetna — Worker's Compensation: $2,008.67
  • Aetna Oncology UPW — Commercial: $554.67
  • Aetna Oncology UPW — Medicare Advantage: $245.55
  • AmBetter — Individual Exchange: $3,373.99
  • AmBetter Oncology UPW — Individual Exchange: $672.79
  • Amerihealth Caritas — Medicaid HMO: $700.57
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $210.92
  • Blue Cross — Medicare Advantage: $1,249.62
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient In the file: Colonoscopy, Endoscopic Ultrasound $5,138 $2,055.20 $3,750.74 – $4,264.54
Ultrasound of the lower bowel by endoscope: rates for 3 insurance plans
  • Avmed — Commercial: $3,750.74
  • First Health — PPO: $4,264.54
  • USA Managed Care — PPO: $4,110.40
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $204.02 – $7,453.55
Ultrasound of the lower bowel by endoscope: 10 of 52 insurance plan rates
  • Aetna — Gatekeeper: $4,942
  • Aetna — Medicare Advantage: $1,242.72
  • Aetna — Worker's Compensation: $2,008.67
  • Aetna Oncology UPW — Commercial: $561.30
  • Aetna Oncology UPW — Medicare Advantage: $247.99
  • AmBetter — Individual Exchange: $3,373.99
  • AmBetter Oncology UPW — Individual Exchange: $680.54
  • Amerihealth Caritas — Medicaid HMO: $700.57
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $213.73
  • Blue Cross — Medicare Advantage: $1,249.62
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) In the file: Colorectal Cancer Screening $3,297 $1,318.80 $2,057.33 – $2,637.60
Screening colonoscopy (not high risk): rates for 6 insurance plans
  • Aetna — International: $2,637.60
  • Aetna — Non-Gatekeeper: $2,495.83
  • Aetna — Signature: $2,307.90
  • Cigna — PPO: $2,373.84
  • United Healthcare — Indemnity: $2,476.05
  • United Healthcare — Options PPO: $2,057.33
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Colorectal Cancer Screening $3,297 $1,318.80 $2,057.33 – $2,637.60
Screening colonoscopy (not high risk): rates for 6 insurance plans
  • Aetna — International: $2,637.60
  • Aetna — Non-Gatekeeper: $2,495.83
  • Aetna — Signature: $2,307.90
  • Cigna — PPO: $2,373.84
  • United Healthcare — Indemnity: $2,476.05
  • United Healthcare — Options PPO: $2,057.33
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: Colorectal Cancer Screening $3,232 $1,292.80 $2,359.36 – $2,682.56
Screening colonoscopy (not high risk): rates for 3 insurance plans
  • Avmed — Commercial: $2,359.36
  • First Health — PPO: $2,682.56
  • USA Managed Care — PPO: $2,585.60
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $255.25 – $17,045.69
Gallbladder removal by laparoscope: 10 of 30 insurance plan rates
  • Aetna — Gatekeeper: $9,365
  • Aetna — Medicare Advantage: $6,149.24
  • Aetna — Worker's Compensation: $1,415.86
  • AmBetter — Individual Exchange: $17,045.69
  • AmBetter Oncology UPW — Individual Exchange: $1,833.98
  • Amerihealth Caritas — Medicaid HMO: $2,639.62
  • Blue Cross — Medicare Advantage: $6,313.22
  • Blue Cross Oncology UPW — Medicare Advantage: $5,157.47
  • Careworks — Worker's Compensation: $1,415.86
  • Cigna — Commercial: $8,535
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 78 In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $435.61 – $1,168.23
Gallbladder removal by laparoscope: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $1,168.23
  • Aetna Oncology UPW — Medicare Advantage: $578.90
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $456.35
  • Blue Cross Oncology UPW — Blue Select: $801.88
  • Blue Cross Oncology UPW — Health Options: $861.09
  • Blue Cross Oncology UPW — Medicare Advantage: $541.02
  • Blue Cross Oncology UPW — Network Blue: $904.14
  • Blue Cross Oncology UPW — PPC PPO: $925.67
  • Blue Cross Oncology UPW — Traditional: $925.67
  • Cigna Oncology UPW — Commercial: $836.08
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 80|81|82 In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $86.05 – $230.76
Gallbladder removal by laparoscope: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $230.76
  • Aetna Oncology UPW — Medicare Advantage: $114.35
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $90.14
  • Blue Cross Oncology UPW — Blue Select: $158.40
  • Blue Cross Oncology UPW — Health Options: $170.09
  • Blue Cross Oncology UPW — Medicare Advantage: $106.87
  • Blue Cross Oncology UPW — Network Blue: $178.60
  • Blue Cross Oncology UPW — PPC PPO: $182.85
  • Blue Cross Oncology UPW — Traditional: $182.85
  • Cigna Oncology UPW — Commercial: $165.15
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $1,450.60 – $13,980.88
Groin (inguinal) hernia repair, age 5 or older: 10 of 30 insurance plan rates
  • Aetna — Gatekeeper: $7,136
  • Aetna — Medicare Advantage: $3,719.52
  • Aetna — Worker's Compensation: $13,980.88
  • AmBetter — Individual Exchange: $10,095.14
  • AmBetter Oncology UPW — Individual Exchange: $1,450.60
  • Amerihealth Caritas — Medicaid HMO: $2,751.61
  • Blue Cross — Medicare Advantage: $3,738.94
  • Blue Cross Oncology UPW — Medicare Advantage: $3,054.46
  • Careworks — Worker's Compensation: $13,980.88
  • Cigna — Commercial: $6,500
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 50 In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $641.01 – $1,704.65
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $1,704.65
  • Aetna Oncology UPW — Medicare Advantage: $857.93
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $671.52
  • Blue Cross Oncology UPW — Blue Select: $1,175.73
  • Blue Cross Oncology UPW — Health Options: $1,262.54
  • Blue Cross Oncology UPW — Medicare Advantage: $801.80
  • Blue Cross Oncology UPW — Network Blue: $1,325.67
  • Blue Cross Oncology UPW — PPC PPO: $1,357.23
  • Blue Cross Oncology UPW — Traditional: $1,357.23
  • Cigna Oncology UPW — Commercial: $1,224.64
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 78 In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $346.15 – $920.51
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $920.51
  • Aetna Oncology UPW — Medicare Advantage: $463.28
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $362.62
  • Blue Cross Oncology UPW — Blue Select: $634.89
  • Blue Cross Oncology UPW — Health Options: $681.77
  • Blue Cross Oncology UPW — Medicare Advantage: $432.97
  • Blue Cross Oncology UPW — Network Blue: $715.86
  • Blue Cross Oncology UPW — PPC PPO: $732.90
  • Blue Cross Oncology UPW — Traditional: $732.90
  • Cigna Oncology UPW — Commercial: $661.30
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy of prostate Not listed in the file Not listed in the file $103.49 – $7,453.55
Prostate biopsy: 10 of 38 insurance plan rates
  • Aetna — Gatekeeper: $4,942
  • Aetna — Medicare Advantage: $2,159.06
  • Aetna — Worker's Compensation: $5,108.15
  • Aetna Oncology UPW — Commercial: $280.19
  • Aetna Oncology UPW — Medicare Advantage: $144.50
  • AmBetter Oncology UPW — Individual Exchange: $348.49
  • Amerihealth Caritas — Medicaid HMO: $1,208.34
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $108.41
  • Blue Cross Oncology UPW — Blue Select: $185.72
  • Blue Cross Oncology UPW — Health Options: $199.44
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $3,041.12 – $29,971.39
Prostate removal by laparoscope (radical prostatectomy): 10 of 29 insurance plan rates
  • Aetna — Gatekeeper: $9,365
  • Aetna — Medicare Advantage: $10,973.10
  • Aetna — Worker's Compensation: $6,129.16
  • AmBetter — Individual Exchange: $29,971.39
  • AmBetter Oncology UPW — Individual Exchange: $3,199.53
  • Amerihealth Caritas — Medicaid HMO: $3,345.23
  • Blue Cross — Medicare Advantage: $11,100.52
  • Blue Cross Oncology UPW — Medicare Advantage: $9,068.36
  • Careworks — Worker's Compensation: $6,129.16
  • Community Care Plan — Medicaid HMO: $3,345.23
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · modifier 78 In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $795.71 – $2,573.87
Prostate removal by laparoscope (radical prostatectomy): 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $2,573.87
  • Aetna Oncology UPW — Medicare Advantage: $993.02
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $833.60
  • Blue Cross Oncology UPW — Blue Select: $1,428.48
  • Blue Cross Oncology UPW — Health Options: $1,533.94
  • Blue Cross Oncology UPW — Medicare Advantage: $928.06
  • Blue Cross Oncology UPW — Network Blue: $1,610.64
  • Blue Cross Oncology UPW — PPC PPO: $1,648.99
  • Blue Cross Oncology UPW — Traditional: $1,648.99
  • Cigna Oncology UPW — Commercial: $1,494.62
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · modifier 80|81|82 In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $153.39 – $496.17
Prostate removal by laparoscope (radical prostatectomy): 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $496.17
  • Aetna Oncology UPW — Medicare Advantage: $191.43
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $160.69
  • Blue Cross Oncology UPW — Blue Select: $275.37
  • Blue Cross Oncology UPW — Health Options: $295.70
  • Blue Cross Oncology UPW — Medicare Advantage: $178.90
  • Blue Cross Oncology UPW — Network Blue: $310.48
  • Blue Cross Oncology UPW — PPC PPO: $317.88
  • Blue Cross Oncology UPW — Traditional: $317.88
  • Cigna Oncology UPW — Commercial: $288.12
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy biopsy Not listed in the file Not listed in the file $630.29 – $9,127.25
Hysteroscopy with biopsy of the uterus lining: 10 of 24 insurance plan rates
  • Aetna — Gatekeeper: $6,310
  • Aetna — Medicare Advantage: $3,351.12
  • AmBetter — Individual Exchange: $9,127.25
  • AmBetter Oncology UPW — Individual Exchange: $630.29
  • Amerihealth Caritas — Medicaid HMO: $1,720.82
  • Blue Cross — Medicare Advantage: $3,380.46
  • Blue Cross Oncology UPW — Medicare Advantage: $2,761.61
  • Community Care Plan — Medicaid HMO: $1,720.82
  • Florida Community Care — Medicaid HMO: $1,720.82
  • Florida Community Care — Medicare Advantage: $3,718.51
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 62 In the file: Hysteroscopy biopsy Not listed in the file Not listed in the file $115.36 – $1,701.96
Hysteroscopy with biopsy of the uterus lining: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $305.67
  • Aetna Oncology UPW — Medicare Advantage: $142.34
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $120.85
  • Blue Cross Oncology UPW — Blue Select: $209.73
  • Blue Cross Oncology UPW — Health Options: $225.21
  • Blue Cross Oncology UPW — Medicare Advantage: $133.03
  • Blue Cross Oncology UPW — Network Blue: $236.47
  • Blue Cross Oncology UPW — PPC PPO: $242.10
  • Blue Cross Oncology UPW — Traditional: $242.10
  • Cigna Oncology UPW — Commercial: $219.94
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: Inject Diagnose/Therapy, Lumbar/Sacral $2,432 $972.80 $1,775.36 – $2,018.56
Spinal injection, lower back (epidural), with imaging guidance: rates for 3 insurance plans
  • Avmed — Commercial: $1,775.36
  • First Health — PPO: $2,018.56
  • USA Managed Care — PPO: $1,945.60
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Njx interlaminar lmbr/sac Not listed in the file Not listed in the file $79.62 – $8,385.26
Spinal injection, lower back (epidural), with imaging guidance: 10 of 51 insurance plan rates
  • Aetna — Gatekeeper: $3,881
  • Aetna — Medicare Advantage: $729.90
  • Aetna — Worker's Compensation: $2,221.89
  • Aetna Oncology UPW — Commercial: $209.48
  • Aetna Oncology UPW — Medicare Advantage: $97.32
  • AmBetter — Individual Exchange: $1,990.28
  • AmBetter Oncology UPW — Individual Exchange: $263.93
  • Amerihealth Caritas — Medicaid HMO: $531.54
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $83.41
  • Blue Cross — Medicare Advantage: $737.14
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Inject Foramen Epidural Lumbar/Sacral $2,463 $985.20 $1,536.91 – $1,970.40
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans
  • Aetna — International: $1,970.40
  • Aetna — Non-Gatekeeper: $1,864.49
  • Aetna — Signature: $1,724.10
  • Cigna — PPO: $1,773.36
  • United Healthcare — Indemnity: $1,849.71
  • United Healthcare — Options PPO: $1,536.91
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) In the file: Inject Foramen Epidural Lumbar/Sacral $2,463 $985.20 $1,536.91 – $1,970.40
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans
  • Aetna — International: $1,970.40
  • Aetna — Non-Gatekeeper: $1,864.49
  • Aetna — Signature: $1,724.10
  • Cigna — PPO: $1,773.36
  • United Healthcare — Indemnity: $1,849.71
  • United Healthcare — Options PPO: $1,536.91
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) In the file: Inject Foramen Epidural Lumbar/Sacral Single $2,694 $1,077.60 $1,681.06 – $2,155.20
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans
  • Aetna — International: $2,155.20
  • Aetna — Non-Gatekeeper: $2,039.36
  • Aetna — Signature: $1,885.80
  • Cigna — PPO: $1,939.68
  • United Healthcare — Indemnity: $2,023.19
  • United Healthcare — Options PPO: $1,681.06
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $879.73 – $7,930
Carpal tunnel release: 10 of 30 insurance plan rates
  • Aetna — Gatekeeper: $4,942
  • Aetna — Medicare Advantage: $2,058.16
  • Aetna — Worker's Compensation: $4,425.70
  • AmBetter — Individual Exchange: $5,505.82
  • AmBetter Oncology UPW — Individual Exchange: $1,184.54
  • Amerihealth Caritas — Medicaid HMO: $967.70
  • Blue Cross — Blue Select: $4,316
  • Blue Cross — Health Options: $3,690
  • Blue Cross — Medicare Advantage: $2,039.19
  • Blue Cross — Network Blue: $4,509
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 50 In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $542.48 – $1,375.46
Carpal tunnel release: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $1,361.84
  • Aetna Oncology UPW — Medicare Advantage: $689.79
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $568.31
  • Blue Cross Oncology UPW — Blue Select: $964.86
  • Blue Cross Oncology UPW — Health Options: $1,036.10
  • Blue Cross Oncology UPW — Medicare Advantage: $644.67
  • Blue Cross Oncology UPW — Network Blue: $1,087.91
  • Blue Cross Oncology UPW — PPC PPO: $1,113.81
  • Blue Cross Oncology UPW — Traditional: $1,113.81
  • Cigna Oncology UPW — Commercial: $1,000.03
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 78 In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $274.85 – $696.90
Carpal tunnel release: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $690
  • Aetna Oncology UPW — Medicare Advantage: $349.49
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $287.94
  • Blue Cross Oncology UPW — Blue Select: $488.86
  • Blue Cross Oncology UPW — Health Options: $524.95
  • Blue Cross Oncology UPW — Medicare Advantage: $326.63
  • Blue Cross Oncology UPW — Network Blue: $551.21
  • Blue Cross Oncology UPW — PPC PPO: $564.33
  • Blue Cross Oncology UPW — Traditional: $564.33
  • Cigna Oncology UPW — Commercial: $506.67
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: After cataract laser surgery Not listed in the file Not listed in the file $370.27 – $7,453.55
Laser treatment of clouding after cataract surgery: 10 of 30 insurance plan rates
  • Aetna — Gatekeeper: $4,942
  • Aetna — Medicare Advantage: $578.21
  • Aetna — Worker's Compensation: $4,377.82
  • AmBetter — Individual Exchange: $1,550.75
  • AmBetter Oncology UPW — Individual Exchange: $801.85
  • Amerihealth Caritas — Medicaid HMO: $407.30
  • Blue Cross — Medicare Advantage: $574.35
  • Blue Cross Oncology UPW — Medicare Advantage: $469.21
  • Careworks — Worker's Compensation: $4,377.82
  • Cigna — Commercial: $4,500
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · modifier 50 In the file: After cataract laser surgery Not listed in the file Not listed in the file $371.58 – $1,016.28
Laser treatment of clouding after cataract surgery: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $956.55
  • Aetna Oncology UPW — Medicare Advantage: $437.49
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $389.27
  • Blue Cross Oncology UPW — Blue Select: $644.61
  • Blue Cross Oncology UPW — Health Options: $692.21
  • Blue Cross Oncology UPW — Medicare Advantage: $408.87
  • Blue Cross Oncology UPW — Network Blue: $726.81
  • Blue Cross Oncology UPW — PPC PPO: $744.12
  • Blue Cross Oncology UPW — Traditional: $744.12
  • Cigna Oncology UPW — Commercial: $676.94
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · modifier 78 In the file: After cataract laser surgery Not listed in the file Not listed in the file $173.40 – $474.26
Laser treatment of clouding after cataract surgery: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $446.39
  • Aetna Oncology UPW — Medicare Advantage: $204.16
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $181.66
  • Blue Cross Oncology UPW — Blue Select: $300.82
  • Blue Cross Oncology UPW — Health Options: $323.03
  • Blue Cross Oncology UPW — Medicare Advantage: $190.81
  • Blue Cross Oncology UPW — Network Blue: $339.18
  • Blue Cross Oncology UPW — PPC PPO: $347.26
  • Blue Cross Oncology UPW — Traditional: $347.26
  • Cigna Oncology UPW — Commercial: $315.90
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $1,112.36 – $9,300
Cataract removal with lens implant: 10 of 30 insurance plan rates
  • Aetna — Gatekeeper: $8,029
  • Aetna — Medicare Advantage: $2,403.82
  • Aetna — Worker's Compensation: $4,377.82
  • AmBetter — Individual Exchange: $6,507.04
  • AmBetter Oncology UPW — Individual Exchange: $1,405.92
  • Amerihealth Caritas — Medicaid HMO: $1,223.60
  • Blue Cross — Blue Select: $4,316
  • Blue Cross — Health Options: $3,690
  • Blue Cross — Medicare Advantage: $2,410.01
  • Blue Cross — Network Blue: $4,509
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · modifier 50 In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $648.65 – $1,974.63
Cataract removal with lens implant: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $1,974.63
  • Aetna Oncology UPW — Medicare Advantage: $742.56
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $679.53
  • Blue Cross Oncology UPW — Blue Select: $1,132.49
  • Blue Cross Oncology UPW — Health Options: $1,216.10
  • Blue Cross Oncology UPW — Medicare Advantage: $693.98
  • Blue Cross Oncology UPW — Network Blue: $1,276.91
  • Blue Cross Oncology UPW — PPC PPO: $1,307.31
  • Blue Cross Oncology UPW — Traditional: $1,307.31
  • Cigna Oncology UPW — Commercial: $1,186.91
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · modifier 78 In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $302.70 – $921.49
Cataract removal with lens implant: 10 of 23 insurance plan rates
  • Aetna Oncology UPW — Commercial: $921.49
  • Aetna Oncology UPW — Medicare Advantage: $346.53
  • Amerihealth Caritas Oncology UPW — Medicaid HMO: $317.11
  • Blue Cross Oncology UPW — Blue Select: $528.49
  • Blue Cross Oncology UPW — Health Options: $567.51
  • Blue Cross Oncology UPW — Medicare Advantage: $323.86
  • Blue Cross Oncology UPW — Network Blue: $595.89
  • Blue Cross Oncology UPW — PPC PPO: $610.08
  • Blue Cross Oncology UPW — Traditional: $610.08
  • Cigna Oncology UPW — Commercial: $553.89

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: Obstetrical care Not listed in the file Not listed in the file $1,519.81 – $6,738.15
Vaginal delivery, with care before and after: 10 of 29 insurance plan rates
  • Aetna Oncology UPW — Commercial: $4,563.02
  • Aetna Oncology UPW — Medicare Advantage: $2,529.47
  • AmBetter Oncology UPW — Individual Exchange: $6,738.15
  • Amerihealth Caritas — Medicaid HMO: $1,671.79
  • Blue Cross — Blue Select: $3,292
  • Blue Cross — Health Options: $3,680
  • Blue Cross — Network Blue: $4,033
  • Blue Cross — PPC PPO: $5,466
  • Blue Cross — Traditional: $5,099
  • Blue Cross Oncology UPW — Blue Select: $3,606.30
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Cesarean delivery Not listed in the file Not listed in the file $1,680.71 – $7,545.29
Cesarean delivery (C-section), with care before and after: 10 of 29 insurance plan rates
  • Aetna Oncology UPW — Commercial: $5,076.81
  • Aetna Oncology UPW — Medicare Advantage: $2,848.71
  • AmBetter Oncology UPW — Individual Exchange: $7,545.29
  • Amerihealth Caritas — Medicaid HMO: $1,848.79
  • Blue Cross — Blue Select: $3,292
  • Blue Cross — Health Options: $3,680
  • Blue Cross — Network Blue: $4,033
  • Blue Cross — PPC PPO: $5,466
  • Blue Cross — Traditional: $5,099
  • Blue Cross Oncology UPW — Blue Select: $4,034.47
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Vbac delivery Not listed in the file Not listed in the file $1,519.81 – $7,119.79
Vaginal delivery after a previous C-section, with care before and after: 10 of 29 insurance plan rates
  • Aetna Oncology UPW — Commercial: $4,800.44
  • Aetna Oncology UPW — Medicare Advantage: $2,688.20
  • AmBetter Oncology UPW — Individual Exchange: $7,119.79
  • Amerihealth Caritas — Medicaid HMO: $1,671.79
  • Blue Cross — Blue Select: $3,292
  • Blue Cross — Health Options: $3,680
  • Blue Cross — Network Blue: $4,033
  • Blue Cross — PPC PPO: $5,466
  • Blue Cross — Traditional: $5,099
  • Blue Cross Oncology UPW — Blue Select: $3,808.12

Source: Sarasota Memorial Hospital’s standard charges file (smh.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 30, 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 typeAcute Care Hospital
Address1700 S Tamiami Trl, Sarasota, FL 34239
CountySarasota County
StateFlorida
Phone(941) 917‑9000
Emergency servicesYes
OwnershipGovernment - Hospital District or Authority
Medicare overall rating5 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number100087
Name in Medicare recordsSARASOTA MEMORIAL HOSPITAL
Profile levelMedicare data + hospital website
Name on the hospital’s websiteSarasota Memorial Hospital - Sarasota Campus
Official websitesmh.com
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
  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 2026-10-30.

  1. Sarasota Memorial Hospital - Sarasota Campus — smh.com
  2. Visiting Hours — smh.com
  3. Parking & Valet — smh.com
  4. Emergency Rooms & Trauma Center — smh.com
  5. Awards & Honors — smh.com
  6. About Sarasota Memorial Health Care System — smh.com
  7. Comprehensive Stroke Center — smh.com