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Acute Care Hospital

Schneck Medical Center

Seymour, Indiana · Jackson County · Emergency services listed

Summary

Schneck Medical Center is an acute care hospital in Seymour, Indiana. Medicare data lists emergency services. CMS overall star rating: 4 of 5 stars. Its official website lists 15 services, specialties and programs. Medicare lists 277 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

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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
4 of 5 stars4 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
15Services listed

Quick answers

Does Schneck Medical Center have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Schneck Medical Center. In a medical emergency, call 911.
Where is Schneck Medical Center?
411 W Tipton St, Seymour, IN 47274, in Jackson County, Indiana.
What is the phone number of Schneck Medical Center?
(812) 522-2349, as listed by Medicare (CMS).
What is the Medicare star rating of Schneck Medical Center?
4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4]

Emergency care (hospital website)[4]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

ParkingPark in the surface lot next to the main entrance[4]
Patient portalMySchneck

Recognition[4]

  • Breast Center of Excellence (American College of Radiology)

Doctors and clinicians (277)

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

Main specialties

Doctors with a page on this site (277)

And 253 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 Schneck Medical Center reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

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

Summary star rating (all survey topics) 4 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 well3 of 5 stars
Staff explained medicines4 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean4 of 5 stars
Quiet at night3 of 5 stars
Rated the hospital 9 or 10 out of 1073%National average: 72%
Would definitely recommend the hospital71%National average: 71%
Nurses “always” communicated well74%National average: 80%
Doctors “always” communicated well76%National average: 80%
Staff “always” explained medicines before giving them62%National average: 62%
Were given information about recovery at home89%National average: 86%
Room and bathroom “always” clean72%National average: 74%
Area around the room “always” quiet at night50%National average: 60%
Completed surveys283Response rate: 24%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)Not reported to Medicare
Surgical site infections after colon surgery0.646No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infectionsNot reported to Medicare
Clostridioides difficile (C. diff) intestinal infections0No different from 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 patientsNot reported to Medicare
Deaths within 30 days: heart failure patients15.7%
Deaths within 30 days: pneumonia patients16%
Deaths within 30 days: COPD patientsToo few cases to report
Deaths within 30 days: stroke patients11.2%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)0.96No different from the national rate
Complications after hip or knee replacementToo few cases to report

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 attackNot reported to Medicare
Readmitted within 30 days: heart failure19.9%
Readmitted within 30 days: pneumonia16.1%
Readmitted within 30 days: COPDToo few cases to report
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacementToo few cases to report

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)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)159 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)69%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.

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 84 common services exactly as Schneck Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: CLINIC NEW LEVEL 3-ONC PRO $292 $204.40 $140.16 – $876
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: Clinic/Op New Visit Levl 3,Hos-HOSPSWB $306 $214.20 $102.28 – $260.10
New patient office visit (about 30–44 minutes): rates for 9 insurance plans
  • Anthem — HMO: $106.19
  • Anthem — PPO: $106.19
  • Anthem — Traditional: $106.19
  • SIHO — Fully Insured: $122.74
  • SIHO — Self Insured: $122.74
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: Clinic/Op New Visit Levl 3,Hos-HOSPIN $306 $214.20 $102.28 – $260.10
New patient office visit (about 30–44 minutes): rates for 9 insurance plans
  • Anthem — HMO: $106.19
  • Anthem — PPO: $106.19
  • Anthem — Traditional: $106.19
  • SIHO — Fully Insured: $122.74
  • SIHO — Self Insured: $122.74
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: CLINIC NEW LEVEL 4-ONC PRO $423 $296.10 $203.04 – $1,269
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: CLINIC NEW LEVEL 4-ROC MD PRO $430 $301 $206.40 – $1,290
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: Clinic/Op New Visit Levl 4,Hos-HOSPSWB $383 $268.10 $153.78 – $325.55
New patient office visit (about 45–59 minutes): rates for 9 insurance plans
  • Anthem — HMO: $162.17
  • Anthem — PPO: $162.17
  • Anthem — Traditional: $162.17
  • SIHO — Fully Insured: $184.54
  • SIHO — Self Insured: $184.54
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: CLINIC NEW LEVEL 5-ONC PRO $517 $361.90 $248.16 – $1,551
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: CLINIC NEW LEVEL 5-ROC MD PRO $539 $377.30 $258.72 – $1,617
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: Clinic/Op New Visit Levl 5,Hos-HOSPSWB $459 $321.30 $201.30 – $390.15
New patient office visit (about 60–74 minutes): rates for 9 insurance plans
  • Anthem — HMO: $201.30
  • Anthem — PPO: $201.30
  • Anthem — Traditional: $201.30
  • SIHO — Fully Insured: $243.54
  • SIHO — Self Insured: $243.54
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: CLINIC NEW LEVEL 3-ROC MD PRO $297 $207.90 $142.56 – $891
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: CLINIC EST LEVEL 3,ONC PRO $200 $140 $96 – $600
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: CLINIC EST LEVEL 3-ROC MD PRO $205 $143.50 $98.40 – $615
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: CLINIC EST LEVEL 4-ONC PRO $266 $186.20 $127.68 – $798
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: CLINIC EST LEVEL 4-ROC MD PRO $293 $205.10 $140.64 – $879
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: OP MED E&M EST LVL 4,POSTOP PR $209 $146.30 $100.32 – $198.55
Established patient office visit (about 30–39 minutes): rates for 9 insurance plans
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
  • SIHO — Self Insured: 69.9% (a percentage in the contract, not a dollar amount)
  • United Healthcare: 78.7% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Offic/Op Conslt New/Est Lv3,H-HOSPSWB $241 $168.70 $106.19 – $204.85
Office consultation with a specialist (moderate): rates for 7 insurance plans
  • Anthem — HMO: $106.19
  • Anthem — PPO: $106.19
  • Anthem — Traditional: $106.19
  • SIHO — Fully Insured: $144.60
  • SIHO — Self Insured: $144.60
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Offic/Op Conslt New/Est Lv3,H-HOSPIN $241 $168.70 $106.19 – $204.85
Office consultation with a specialist (moderate): rates for 7 insurance plans
  • Anthem — HMO: $106.19
  • Anthem — PPO: $106.19
  • Anthem — Traditional: $106.19
  • SIHO — Fully Insured: $144.60
  • SIHO — Self Insured: $144.60
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Offic/Op Conslt New/Est Lv3,H-HOSPER $241 $168.70 $106.19 – $204.85
Office consultation with a specialist (moderate): rates for 7 insurance plans
  • Anthem — HMO: $106.19
  • Anthem — PPO: $106.19
  • Anthem — Traditional: $106.19
  • SIHO — Fully Insured: $144.60
  • SIHO — Self Insured: $144.60
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Offic/Op Conslt New/Est Lv4,H-HOSPSWB $316 $221.20 $162.17 – $268.60
Office consultation with a specialist (moderate to high): rates for 7 insurance plans
  • Anthem — HMO: $162.17
  • Anthem — PPO: $162.17
  • Anthem — Traditional: $162.17
  • SIHO — Fully Insured: $189.60
  • SIHO — Self Insured: $189.60
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Offic/Op Conslt New/Est Lv4,H-HOSPOP $316 $221.20 $162.17 – $268.60
Office consultation with a specialist (moderate to high): rates for 7 insurance plans
  • Anthem — HMO: $162.17
  • Anthem — PPO: $162.17
  • Anthem — Traditional: $162.17
  • SIHO — Fully Insured: $189.60
  • SIHO — Self Insured: $189.60
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Offic/Op Conslt New/Est Lv4,H-HOSPIN $316 $221.20 $162.17 – $268.60
Office consultation with a specialist (moderate to high): rates for 7 insurance plans
  • Anthem — HMO: $162.17
  • Anthem — PPO: $162.17
  • Anthem — Traditional: $162.17
  • SIHO — Fully Insured: $189.60
  • SIHO — Self Insured: $189.60
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · modifier 0 In the file: Init PM Vis New Pt 18-39 YrsPC-JPPUC $179 $125.30 $107.40 – $152.15
Preventive checkup, new patient, age 18–39: rates for 7 insurance plans
  • Anthem — HMO: $131.20
  • Anthem — PPO: $131.20
  • Anthem — Traditional: $131.20
  • SIHO — Fully Insured: $107.40
  • SIHO — Self Insured: $107.40
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · modifier 0 In the file: Init PM Vis New Pt 18-39 YrsPC-SFCWC $179 $125.30 $107.40 – $152.15
Preventive checkup, new patient, age 18–39: rates for 7 insurance plans
  • Anthem — HMO: $131.20
  • Anthem — PPO: $131.20
  • Anthem — Traditional: $131.20
  • SIHO — Fully Insured: $107.40
  • SIHO — Self Insured: $107.40
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · modifier 0 In the file: Init PM Vis New Pt 18-39 YrsPC-SFCSC $179 $125.30 $107.40 – $152.15
Preventive checkup, new patient, age 18–39: rates for 7 insurance plans
  • Anthem — HMO: $131.20
  • Anthem — PPO: $131.20
  • Anthem — Traditional: $131.20
  • SIHO — Fully Insured: $107.40
  • SIHO — Self Insured: $107.40
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · modifier 0 In the file: Init PM Vis New Pt 40-64 YrsPC-JPPUC $189 $132.30 $113.40 – $161.10
Preventive checkup, new patient, age 40–64: rates for 7 insurance plans
  • Anthem — HMO: $161.10
  • Anthem — PPO: $161.10
  • Anthem — Traditional: $161.10
  • SIHO — Fully Insured: $113.40
  • SIHO — Self Insured: $113.40
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · modifier 0 In the file: Init PM Vis New Pt 40-64 YrsPC-SFCWC $189 $132.30 $113.40 – $161.10
Preventive checkup, new patient, age 40–64: rates for 7 insurance plans
  • Anthem — HMO: $161.10
  • Anthem — PPO: $161.10
  • Anthem — Traditional: $161.10
  • SIHO — Fully Insured: $113.40
  • SIHO — Self Insured: $113.40
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · modifier 0 In the file: Init PM Vis New Pt 40-64 YrsPC-SFCSC $189 $132.30 $113.40 – $161.10
Preventive checkup, new patient, age 40–64: rates for 7 insurance plans
  • Anthem — HMO: $161.10
  • Anthem — PPO: $161.10
  • Anthem — Traditional: $161.10
  • SIHO — Fully Insured: $113.40
  • SIHO — Self Insured: $113.40
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LEVEL 3 EMERGENCY ROOM CARE $613 $429.10 $278.89 – $2,143.70
Emergency room visit (moderate): 10 of 12 insurance plan rates
  • Anthem — HMO: $2,143.70
  • Anthem — PPO: $2,143.70
  • Anthem — Traditional: $2,143.70
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · modifier 0 In the file: Emergency Dept Vst Lvl 3 PC-PODT $237 $165.90 $64.70 – $201.45
Emergency room visit (moderate): rates for 9 insurance plans
  • Anthem — HMO: $94.45
  • Anthem — PPO: $94.45
  • Anthem — Traditional: $94.45
  • SIHO — Fully Insured: $77.64
  • SIHO — Self Insured: $77.64
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · modifier 0 In the file: Emergency Dept Vst Lvl 3 PC-POD $237 $165.90 $64.70 – $201.45
Emergency room visit (moderate): rates for 9 insurance plans
  • Anthem — HMO: $94.45
  • Anthem — PPO: $94.45
  • Anthem — Traditional: $94.45
  • SIHO — Fully Insured: $77.64
  • SIHO — Self Insured: $77.64
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: LEVEL 4 EMERGENCY ROOM CARE $907 $634.90 $426.30 – $2,823.13
Emergency room visit (moderately high): 10 of 12 insurance plan rates
  • Anthem — HMO: $2,823.13
  • Anthem — PPO: $2,823.13
  • Anthem — Traditional: $2,823.13
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · modifier 0 In the file: Emergency Dept Vst Lvl 4 PC-PODT $342 $239.40 $110.18 – $290.70
Emergency room visit (moderately high): rates for 9 insurance plans
  • Anthem — HMO: $159.95
  • Anthem — PPO: $159.95
  • Anthem — Traditional: $159.95
  • SIHO — Fully Insured: $132.22
  • SIHO — Self Insured: $132.22
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · modifier 0 In the file: Emergency Dept Vst Lvl 4 PC-POD $342 $239.40 $110.18 – $290.70
Emergency room visit (moderately high): rates for 9 insurance plans
  • Anthem — HMO: $159.95
  • Anthem — PPO: $159.95
  • Anthem — Traditional: $159.95
  • SIHO — Fully Insured: $132.22
  • SIHO — Self Insured: $132.22
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: LEVEL 5 EMERGENCY ROOM CARE $1,028 $719.60 $493.44 – $3,032.55
Emergency room visit (high): 10 of 12 insurance plan rates
  • Anthem — HMO: $3,032.55
  • Anthem — PPO: $3,032.55
  • Anthem — Traditional: $3,032.55
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency Dept Visit Lvl 5,Hos-HOSPIN $357 $249.90 $159.69 – $303.45
Emergency room visit (high): rates for 9 insurance plans
  • Anthem — HMO: $237.74
  • Anthem — PPO: $237.74
  • Anthem — Traditional: $237.74
  • SIHO — Fully Insured: $191.63
  • SIHO — Self Insured: $191.63
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency Dept Visit Lvl 5,Hos-HOSPER $357 $249.90 $159.69 – $303.45
Emergency room visit (high): rates for 9 insurance plans
  • Anthem — HMO: $237.74
  • Anthem — PPO: $237.74
  • Anthem — Traditional: $237.74
  • SIHO — Fully Insured: $191.63
  • SIHO — Self Insured: $191.63
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC METABOL PANEL $72 $50.40 $8.46 – $108
Basic metabolic panel (blood test): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC METABOL PANL,WLHSA $15 $10.50 $7.20 – $22.50
Basic metabolic panel (blood test): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: METABOLIC PANEL COMPREHENSIVE $96 $67.20 $10.56 – $144
Comprehensive metabolic panel (blood test): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: METABOLIC PANL COMPREH,WLHSA $15 $10.50 $7.20 – $22.50
Comprehensive metabolic panel (blood test): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PANEL $82 $57.40 $13.39 – $123
Cholesterol panel (lipid panel): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PANEL,WLHSA $15 $10.50 $7.20 – $22.76
Cholesterol panel (lipid panel): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: RENAL FUNCTION PANEL $44 $30.80 $8.68 – $66
Kidney function panel: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HEPATIC FUNCTION $42 $29.40 $8.17 – $63
Liver function panel: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HEPATIC FUNCTION,WLHSA $15 $10.50 $7.20 – $22.50
Liver function panel: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URINALYSIS-AUTO W/MICRO $57 $39.90 $3.17 – $85.50
Urine test (automated, with microscope): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · modifier 0 In the file: Autom Urine Dip w Micro PC-JPPUC $32 $22.40 $2.35 – $27.20
Urine test (automated, with microscope): rates for 7 insurance plans
  • Anthem — HMO: $2.35
  • Anthem — PPO: $2.35
  • Anthem — Traditional: $2.35
  • SIHO — Fully Insured: $19.20
  • SIHO — Self Insured: $19.20
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · modifier 0 In the file: Autom Urine Dip w Micro PC-SFCWC $32 $22.40 $2.35 – $27.20
Urine test (automated, with microscope): rates for 7 insurance plans
  • Anthem — HMO: $2.35
  • Anthem — PPO: $2.35
  • Anthem — Traditional: $2.35
  • SIHO — Fully Insured: $19.20
  • SIHO — Self Insured: $19.20
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: SPECIFIC GRAVITY;NON AUTOMATED $55 $38.50 $3.48 – $82.50
Urine test (manual, without microscope): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Non-Autom UA wo Micro TC-OBGYN $27 $18.90 $2.09 – $22.95
Urine test (manual, without microscope): rates for 7 insurance plans
  • Anthem — HMO: $2.09
  • Anthem — PPO: $2.09
  • Anthem — Traditional: $2.09
  • SIHO — Fully Insured: $16.20
  • SIHO — Self Insured: $16.20
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Non-Autom UA wo Micro TC-OBGYNER $27 $18.90 $2.09 – $22.95
Urine test (manual, without microscope): rates for 7 insurance plans
  • Anthem — HMO: $2.09
  • Anthem — PPO: $2.09
  • Anthem — Traditional: $2.09
  • SIHO — Fully Insured: $16.20
  • SIHO — Self Insured: $16.20
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: URINALYSIS W/O MICROSCOPY $14 $9.80 $2.25 – $21
Urine test (automated, without microscope): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Autom UA wo Micro TC-OBGYN $21 $14.70 $1.66 – $17.85
Urine test (automated, without microscope): rates for 7 insurance plans
  • Anthem — HMO: $1.66
  • Anthem — PPO: $1.66
  • Anthem — Traditional: $1.66
  • SIHO — Fully Insured: $12.60
  • SIHO — Self Insured: $12.60
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Autom UA wo Micro TC-OBGYNER $21 $14.70 $1.66 – $17.85
Urine test (automated, without microscope): rates for 7 insurance plans
  • Anthem — HMO: $1.66
  • Anthem — PPO: $1.66
  • Anthem — Traditional: $1.66
  • SIHO — Fully Insured: $12.60
  • SIHO — Self Insured: $12.60
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PROSTATIC SPECIFIC ANTIGEN TTL $91 $63.70 $18.39 – $136.50
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: TSH $98 $68.60 $16.80 – $147
Thyroid stimulating hormone (TSH) test: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: TSH,WLHSA $15 $10.50 $7.20 – $28.56
Thyroid stimulating hormone (TSH) test: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC COMPLETE W PLT W AUTOM DIF $59 $41.30 $7.77 – $88.50
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CBC COMPL PLT AUT DIF,WLHSA $15 $10.50 $7.20 – $22.50
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: CBC COMPLETE AUTOM W PLT $51 $35.70 $6.47 – $76.50
Complete blood count (CBC), automated: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: CBC COMPL AUTOM W PLT,WLHSA $15 $10.50 $6.47 – $22.50
Complete blood count (CBC), automated: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PROTHROMBIN TIME $22 $15.40 $4.29 – $33
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PROTHROMBIN TIME,WLHSA $15 $10.50 $4.29 – $22.50
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · modifier 0 In the file: Prothrombin Time PC-JPPUC $26 $18.20 $2.91 – $22.10
Blood clotting time test (prothrombin time, PT): rates for 7 insurance plans
  • Anthem — HMO: $2.91
  • Anthem — PPO: $2.91
  • Anthem — Traditional: $2.91
  • SIHO — Fully Insured: $15.60
  • SIHO — Self Insured: $15.60
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PARTIAL THROMBOPLASTIN TIME $32 $22.40 $6.01 – $48
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT; PLASMA OR WHOLE BLOOD $78 $54.60 $6.01 – $117
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PART THROMBOPLAS TIME,WLHSA $15 $10.50 $6.01 – $22.50
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 150% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 150% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT-HEAD WO/CONTRAST $1,500 $1,050 $106.81 – $2,598.58
CT scan of the head or brain, without contrast: 10 of 12 insurance plan rates
  • Anthem — HMO: $2,598.58
  • Anthem — PPO: $2,598.58
  • Anthem — Traditional: $2,598.58
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI-BRAIN STEM WO/W CONTRAST $3,248 $2,273.60 $356.43 – $3,181.04
MRI of the brain, before and after contrast: 10 of 12 insurance plan rates
  • Anthem — HMO: $3,181.04
  • Anthem — PPO: $3,181.04
  • Anthem — Traditional: $3,181.04
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-RAY CHEST 2 VIEWS $407 $284.90 $88.91 – $1,221
Chest X-ray, 2 views: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-RAY CHEST 2 VIEWS,WLHSA $20 $14 $9.60 – $151.15
Chest X-ray, 2 views: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: X-Ray Chest 2 Views-SFCWC $129 $90.30 $28.46 – $109.65
Chest X-ray, 2 views: rates for 9 insurance plans
  • Anthem — HMO: $28.46
  • Anthem — PPO: $28.46
  • Anthem — Traditional: $28.46
  • SIHO — Fully Insured: $36.47
  • SIHO — Self Insured: $36.47
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: LUMBAR SPINE MIN 4V $707 $494.90 $106.81 – $671.65
X-ray of the lower spine, at least 4 views: rates for 9 insurance plans
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
  • SIHO — Self Insured: 69.9% (a percentage in the contract, not a dollar amount)
  • United Healthcare: 78.7% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Lumbar Spine Min 4v-SFCWC $159 $111.30 $46.90 – $135.15
X-ray of the lower spine, at least 4 views: rates for 9 insurance plans
  • Anthem — HMO: $53.08
  • Anthem — PPO: $53.08
  • Anthem — Traditional: $53.08
  • SIHO — Fully Insured: $56.28
  • SIHO — Self Insured: $56.28
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Lumbar Spine Min 4v-SFCSC $159 $111.30 $46.90 – $135.15
X-ray of the lower spine, at least 4 views: rates for 9 insurance plans
  • Anthem — HMO: $53.08
  • Anthem — PPO: $53.08
  • Anthem — Traditional: $53.08
  • SIHO — Fully Insured: $56.28
  • SIHO — Self Insured: $56.28
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI-LUMBAR SPINE WO/CONT $2,751 $1,925.70 $243.77 – $3,181.04
MRI of the lower back (lumbar spine), without contrast: 10 of 12 insurance plan rates
  • Anthem — HMO: $3,181.04
  • Anthem — PPO: $3,181.04
  • Anthem — Traditional: $3,181.04
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT-PELVIS W/CONTRAST $1,808 $1,265.60 $179.20 – $2,598.58
CT scan of the pelvis, with contrast: 10 of 12 insurance plan rates
  • Anthem — HMO: $2,598.58
  • Anthem — PPO: $2,598.58
  • Anthem — Traditional: $2,598.58
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI-LOW EXTREM JOINT W/O CONTR $2,825 $1,977.50 $243.77 – $3,181.04
MRI of a leg joint (such as the knee), without contrast: 10 of 12 insurance plan rates
  • Anthem — HMO: $3,181.04
  • Anthem — PPO: $3,181.04
  • Anthem — Traditional: $3,181.04
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI-LOW EXT JNT WO CNTRST BIL $2,825 $1,977.50 $243.77 – $3,181.04
MRI of a leg joint (such as the knee), without contrast: 10 of 12 insurance plan rates
  • Anthem — HMO: $3,181.04
  • Anthem — PPO: $3,181.04
  • Anthem — Traditional: $3,181.04
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: MRI-LOW EX JNT WO CONTR,REDUCE $2,840 $1,988 $243.77 – $3,181.04
MRI of a leg joint (such as the knee), without contrast: 10 of 12 insurance plan rates
  • Anthem — HMO: $3,181.04
  • Anthem — PPO: $3,181.04
  • Anthem — Traditional: $3,181.04
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT-ABD & PELVIS W/CNTRST $3,226 $2,258.20 $356.43 – $3,064.70
CT scan of the abdomen and pelvis, with contrast: 10 of 12 insurance plan rates
  • Anthem — HMO: $2,598.58
  • Anthem — PPO: $2,598.58
  • Anthem — Traditional: $2,598.58
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT-ENTEROGRAPHY SMALL BOWEL $4,457 $3,119.90 $356.43 – $4,234.15
CT scan of the abdomen and pelvis, with contrast: 10 of 12 insurance plan rates
  • Anthem — HMO: $2,598.58
  • Anthem — PPO: $2,598.58
  • Anthem — Traditional: $2,598.58
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: U/S-ABDOMEN (COMPLETE) $958 $670.60 $106.81 – $910.10
Ultrasound of the abdomen, complete: 10 of 12 insurance plan rates
  • Anthem — HMO: $504.03
  • Anthem — PPO: $504.03
  • Anthem — Traditional: $504.03
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: U/S-OB >/= 14 WKS, SNGL FETUS $918 $642.60 $106.81 – $872.10
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates
  • Anthem — HMO: $504.03
  • Anthem — PPO: $504.03
  • Anthem — Traditional: $504.03
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ob US=>14 Wk Sing Fetusexplexp-OBGYN $335 $234.50 $121.54 – $284.75
Pregnancy ultrasound (after the first trimester): rates for 9 insurance plans
  • Anthem — HMO: $143.89
  • Anthem — PPO: $143.89
  • Anthem — Traditional: $143.89
  • SIHO — Fully Insured: $145.85
  • SIHO — Self Insured: $145.85
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ob US=>14 Wk Sing Fetusexplexp-OBGYNER $335 $234.50 $121.54 – $284.75
Pregnancy ultrasound (after the first trimester): rates for 9 insurance plans
  • Anthem — HMO: $143.89
  • Anthem — PPO: $143.89
  • Anthem — Traditional: $143.89
  • SIHO — Fully Insured: $145.85
  • SIHO — Self Insured: $145.85
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: U/S-TRANSVAGINAL;SUBSEQUENT $288 $201.60 $106.81 – $504.03
Transvaginal ultrasound: 10 of 12 insurance plan rates
  • Anthem — HMO: $504.03
  • Anthem — PPO: $504.03
  • Anthem — Traditional: $504.03
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: U/S-TRANSVAGINAL;COMPLETE $547 $382.90 $106.81 – $519.65
Transvaginal ultrasound: 10 of 12 insurance plan rates
  • Anthem — HMO: $504.03
  • Anthem — PPO: $504.03
  • Anthem — Traditional: $504.03
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US Non-Ob Transvaginal Exp-OBGYN $351 $245.70 $105.30 – $298.35
Transvaginal ultrasound: rates for 9 insurance plans
  • Anthem — HMO: $105.30
  • Anthem — PPO: $105.30
  • Anthem — Traditional: $105.30
  • SIHO — Fully Insured: $127.57
  • SIHO — Self Insured: $127.57
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: DX MAMMO UNIL INCL CAD $357 $249.90 $171.36 – $1,071
Diagnostic mammogram, one breast: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: DX MAMMO BILAT INCL CAD $450 $315 $216 – $1,350
Diagnostic mammogram, both breasts: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: SCREEN MAMMO BILAT INCL CAD $376 $263.20 $180.48 – $1,128
Screening mammogram, both breasts: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: SCREEN MAMMO UNIL INCL CAD $330 $231 $158.40 – $990
Screening mammogram, both breasts: 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)

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: 12 Lead Ekg; Global Exp-JPPBPC $69 $48.30 $12.97 – $58.65
Electrocardiogram (ECG/EKG) with reading: rates for 9 insurance plans
  • Anthem — HMO: $24.45
  • Anthem — PPO: $24.45
  • Anthem — Traditional: $24.45
  • SIHO — Fully Insured: $15.56
  • SIHO — Self Insured: $15.56
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: 12 Lead Ekg; Global Exp-PED $69 $48.30 $12.97 – $58.65
Electrocardiogram (ECG/EKG) with reading: rates for 9 insurance plans
  • Anthem — HMO: $24.45
  • Anthem — PPO: $24.45
  • Anthem — Traditional: $24.45
  • SIHO — Fully Insured: $15.56
  • SIHO — Self Insured: $15.56
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: 12 Lead Ekg; Global Exp-IMOP $69 $48.30 $12.97 – $58.65
Electrocardiogram (ECG/EKG) with reading: rates for 9 insurance plans
  • Anthem — HMO: $24.45
  • Anthem — PPO: $24.45
  • Anthem — Traditional: $24.45
  • SIHO — Fully Insured: $15.56
  • SIHO — Self Insured: $15.56
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · modifier 0 In the file: LEFT HEART CATHETERIZATION INCLUDING INTRAPROCEDURAL INJECTION(S) FOR LEFT VENTRICULOGRAPHY, IMAGING SUPERVISION AND INTERPRETATION, WHEN PE Not listed in the file Not listed in the file $13,880.70
Left heart catheterization (diagnostic): rates for 3 insurance plans
  • Anthem — HMO: $13,880.70
  • Anthem — PPO: $13,880.70
  • Anthem — Traditional: $13,880.70
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · modifier 0 In the file: TX ATRIAL FIB PULM VEIN ISOL Not listed in the file Not listed in the file $57,793.04
Heart rhythm study with ablation for atrial fibrillation: rates for 3 insurance plans
  • Anthem — HMO: $57,793.04
  • Anthem — PPO: $57,793.04
  • Anthem — Traditional: $57,793.04
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRPHY >/6YO,<6HRS DIS $1,105 $773.50 $530.40 – $3,315
Sleep study (overnight, in a sleep lab): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAPHY >/6YO,ATT TECH $4,070 $2,849 $877.34 – $12,210
Sleep study (overnight, in a sleep lab): 10 of 12 insurance plan rates
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Anthem — HMO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — PPO: 300% (a percentage in the contract, not a dollar amount)
  • Anthem — Traditional: 300% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOM- INSPIRE TITRATION $4,070 $2,849 $877.34 – $3,866.50
Sleep study (overnight, in a sleep lab): rates for 9 insurance plans
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
  • SIHO — Self Insured: 69.9% (a percentage in the contract, not a dollar amount)
  • United Healthcare: 78.7% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: PT-THERAPEUTIC EXERCISE8-15MIN $220 $154 $105.60 – $575.14
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 12 insurance plan rates
  • Anthem — HMO: $575.14
  • Anthem — PPO: $575.14
  • Anthem — Traditional: $575.14
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: PTA-THERAPEUTIC EXERC 8-15 MIN $220 $154 $105.60 – $575.14
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 12 insurance plan rates
  • Anthem — HMO: $575.14
  • Anthem — PPO: $575.14
  • Anthem — Traditional: $575.14
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: PT-THERABAND THER EX, 8-15MIN $220 $154 $105.60 – $575.14
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 12 insurance plan rates
  • Anthem — HMO: $575.14
  • Anthem — PPO: $575.14
  • Anthem — Traditional: $575.14
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: PT-EVAL LOW COMPLEX 20 MIN $186 $130.20 $89.28 – $575.14
Physical therapy evaluation (low complexity): 10 of 12 insurance plan rates
  • Anthem — HMO: $575.14
  • Anthem — PPO: $575.14
  • Anthem — Traditional: $575.14
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: PT-EVAL MOD COMPLEX 30 MIN $281 $196.70 $134.88 – $575.14
Physical therapy evaluation (moderate complexity): 10 of 12 insurance plan rates
  • Anthem — HMO: $575.14
  • Anthem — PPO: $575.14
  • Anthem — Traditional: $575.14
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: PT-EVAL HIGH COMPLEX 45 MIN $422 $295.40 $202.56 – $575.14
Physical therapy evaluation (high complexity): 10 of 12 insurance plan rates
  • Anthem — HMO: $575.14
  • Anthem — PPO: $575.14
  • Anthem — Traditional: $575.14
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy w Pt 16-37 Min PC-PEDMH $286 $200.20 $52.91 – $243.10
Psychotherapy, 30 minutes: rates for 9 insurance plans
  • Anthem — HMO: $52.91
  • Anthem — PPO: $52.91
  • Anthem — Traditional: $52.91
  • SIHO — Fully Insured: $92.28
  • SIHO — Self Insured: $92.28
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy w Pt 16-37 Min PC-PSYCHTO $335 $234.50 $52.91 – $284.75
Psychotherapy, 30 minutes: rates for 9 insurance plans
  • Anthem — HMO: $52.91
  • Anthem — PPO: $52.91
  • Anthem — Traditional: $52.91
  • SIHO — Fully Insured: $92.28
  • SIHO — Self Insured: $92.28
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy w Pt 16-37 Min PC-PSYCHTH $335 $234.50 $52.91 – $284.75
Psychotherapy, 30 minutes: rates for 9 insurance plans
  • Anthem — HMO: $52.91
  • Anthem — PPO: $52.91
  • Anthem — Traditional: $52.91
  • SIHO — Fully Insured: $92.28
  • SIHO — Self Insured: $92.28
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy Pt/Fam38-52MinPC-PEDMH $355 $248.50 $80.77 – $301.75
Psychotherapy, 45 minutes: rates for 9 insurance plans
  • Anthem — HMO: $80.77
  • Anthem — PPO: $80.77
  • Anthem — Traditional: $80.77
  • SIHO — Fully Insured: $121.81
  • SIHO — Self Insured: $121.81
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy Pt/Fam38-52MinPC-PSYCHTO $458 $320.60 $80.77 – $389.30
Psychotherapy, 45 minutes: rates for 9 insurance plans
  • Anthem — HMO: $80.77
  • Anthem — PPO: $80.77
  • Anthem — Traditional: $80.77
  • SIHO — Fully Insured: $121.81
  • SIHO — Self Insured: $121.81
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy Pt/Fam38-52MinPC-PSYCHTH $458 $320.60 $80.77 – $389.30
Psychotherapy, 45 minutes: rates for 9 insurance plans
  • Anthem — HMO: $80.77
  • Anthem — PPO: $80.77
  • Anthem — Traditional: $80.77
  • SIHO — Fully Insured: $121.81
  • SIHO — Self Insured: $121.81
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy w Pt >53 Min PC-PEDMH $422 $295.40 $121.83 – $358.70
Psychotherapy, 60 minutes: rates for 9 insurance plans
  • Anthem — HMO: $121.83
  • Anthem — PPO: $121.83
  • Anthem — Traditional: $121.83
  • SIHO — Fully Insured: $180.35
  • SIHO — Self Insured: $180.35
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy w Pt >53 Min PC-PSYCHTO $422 $295.40 $121.83 – $358.70
Psychotherapy, 60 minutes: rates for 9 insurance plans
  • Anthem — HMO: $121.83
  • Anthem — PPO: $121.83
  • Anthem — Traditional: $121.83
  • SIHO — Fully Insured: $180.35
  • SIHO — Self Insured: $180.35
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy w Pt >53 Min PC-PSYCHTH $422 $295.40 $121.83 – $358.70
Psychotherapy, 60 minutes: rates for 9 insurance plans
  • Anthem — HMO: $121.83
  • Anthem — PPO: $121.83
  • Anthem — Traditional: $121.83
  • SIHO — Fully Insured: $180.35
  • SIHO — Self Insured: $180.35
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy Fam woPt 50Min PC-PEDMH $445 $311.50 $80.46 – $378.25
Family psychotherapy, without the patient: rates for 9 insurance plans
  • Anthem — HMO: $80.46
  • Anthem — PPO: $80.46
  • Anthem — Traditional: $80.46
  • SIHO — Fully Insured: $116.10
  • SIHO — Self Insured: $116.10
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy Fam woPt 50Min PC-PSYCHTO $445 $311.50 $80.46 – $378.25
Family psychotherapy, without the patient: rates for 9 insurance plans
  • Anthem — HMO: $80.46
  • Anthem — PPO: $80.46
  • Anthem — Traditional: $80.46
  • SIHO — Fully Insured: $116.10
  • SIHO — Self Insured: $116.10
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · modifier 0 In the file: Psychothapy Fam woPt 50Min PC-PSYCHTH $445 $311.50 $80.46 – $378.25
Family psychotherapy, without the patient: rates for 9 insurance plans
  • Anthem — HMO: $80.46
  • Anthem — PPO: $80.46
  • Anthem — Traditional: $80.46
  • SIHO — Fully Insured: $116.10
  • SIHO — Self Insured: $116.10
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · modifier 0 In the file: Psych FamilyTherapy w Pt PC-PEDMH $445 $311.50 $95.91 – $378.25
Family psychotherapy, with the patient: rates for 9 insurance plans
  • Anthem — HMO: $95.91
  • Anthem — PPO: $95.91
  • Anthem — Traditional: $95.91
  • SIHO — Fully Insured: $121.08
  • SIHO — Self Insured: $121.08
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · modifier 0 In the file: Psych FamilyTherapy w Pt PC-PSYCHTO $445 $311.50 $95.91 – $378.25
Family psychotherapy, with the patient: rates for 9 insurance plans
  • Anthem — HMO: $95.91
  • Anthem — PPO: $95.91
  • Anthem — Traditional: $95.91
  • SIHO — Fully Insured: $121.08
  • SIHO — Self Insured: $121.08
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · modifier 0 In the file: Psych FamilyTherapy w Pt PC-PSYCHTH $445 $311.50 $95.91 – $378.25
Family psychotherapy, with the patient: rates for 9 insurance plans
  • Anthem — HMO: $95.91
  • Anthem — PPO: $95.91
  • Anthem — Traditional: $95.91
  • SIHO — Fully Insured: $121.08
  • SIHO — Self Insured: $121.08
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · modifier 0 In the file: Psych GrpTherapyNot MultiFamPC-PEDMH $170 $119 $27.30 – $144.50
Group psychotherapy: rates for 9 insurance plans
  • Anthem — HMO: $29
  • Anthem — PPO: $29
  • Anthem — Traditional: $29
  • SIHO — Fully Insured: $32.76
  • SIHO — Self Insured: $32.76
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · modifier 0 In the file: Psych GrpTherapyNot MultiFamPC-PSYCHTO $215 $150.50 $27.30 – $182.75
Group psychotherapy: rates for 9 insurance plans
  • Anthem — HMO: $29
  • Anthem — PPO: $29
  • Anthem — Traditional: $29
  • SIHO — Fully Insured: $32.76
  • SIHO — Self Insured: $32.76
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · modifier 0 In the file: Psych GrpTherapyNot MultiFamPC-PSYCHTH $215 $150.50 $27.30 – $182.75
Group psychotherapy: rates for 9 insurance plans
  • Anthem — HMO: $29
  • Anthem — PPO: $29
  • Anthem — Traditional: $29
  • SIHO — Fully Insured: $32.76
  • SIHO — Self Insured: $32.76
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Rmv of Brst Lsn 1+ Exp-SURG $1,569 $1,098.30 $374.85 – $1,333.65
Removal of breast growth (open surgery): rates for 9 insurance plans
  • Anthem — HMO: $505.98
  • Anthem — PPO: $505.98
  • Anthem — Traditional: $505.98
  • SIHO — Fully Insured: $449.82
  • SIHO — Self Insured: $449.82
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Rem of Brst les 1+ Bil Proexp-SURG $2,353 $1,647.10 $374.85 – $2,000.05
Removal of breast growth (open surgery): rates for 9 insurance plans
  • Anthem — HMO: $505.98
  • Anthem — PPO: $505.98
  • Anthem — Traditional: $505.98
  • SIHO — Fully Insured: $449.82
  • SIHO — Self Insured: $449.82
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Removal of Breast Lesion 1+ PC-JPPBPC $734 $513.80 $374.85 – $693.47
Removal of breast growth (open surgery): rates for 9 insurance plans
  • Anthem — HMO: $505.98
  • Anthem — PPO: $505.98
  • Anthem — Traditional: $505.98
  • SIHO — Fully Insured: $449.82
  • SIHO — Self Insured: $449.82
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Total Hip Arthroplasty PC-ORTHOS $17,600 $12,320 $1,154.08 – $14,960
Total hip replacement: rates for 9 insurance plans
  • Anthem — HMO: $1,975
  • Anthem — PPO: $1,975
  • Anthem — Traditional: $1,975
  • SIHO — Fully Insured: $1,384.90
  • SIHO — Self Insured: $1,384.90
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Total Hip Arthroplasty PC-ORTHOIP $17,600 $12,320 $1,154.08 – $14,960
Total hip replacement: rates for 9 insurance plans
  • Anthem — HMO: $1,975
  • Anthem — PPO: $1,975
  • Anthem — Traditional: $1,975
  • SIHO — Fully Insured: $1,384.90
  • SIHO — Self Insured: $1,384.90
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier 50 In the file: Total Hip Arthroplasty PC-ORTHOOP $17,600 $12,320 $1,154.08 – $14,960
Total hip replacement: rates for 9 insurance plans
  • Anthem — HMO: $1,975
  • Anthem — PPO: $1,975
  • Anthem — Traditional: $1,975
  • SIHO — Fully Insured: $1,384.90
  • SIHO — Self Insured: $1,384.90
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Total Knee Arthroplasty PC-ORTHOS $7,208 $5,045.60 $1,152.73 – $6,126.80
Total knee replacement: rates for 9 insurance plans
  • Anthem — HMO: $2,089.40
  • Anthem — PPO: $2,089.40
  • Anthem — Traditional: $2,089.40
  • SIHO — Fully Insured: $1,383.28
  • SIHO — Self Insured: $1,383.28
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Total Knee Arthroplasty PC-ORTHOOP $7,208 $5,045.60 $1,152.73 – $6,126.80
Total knee replacement: rates for 9 insurance plans
  • Anthem — HMO: $2,089.40
  • Anthem — PPO: $2,089.40
  • Anthem — Traditional: $2,089.40
  • SIHO — Fully Insured: $1,383.28
  • SIHO — Self Insured: $1,383.28
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Total Knee Arthroplasty PC-ORTHOIP $7,208 $5,045.60 $1,152.73 – $6,126.80
Total knee replacement: rates for 9 insurance plans
  • Anthem — HMO: $2,089.40
  • Anthem — PPO: $2,089.40
  • Anthem — Traditional: $2,089.40
  • SIHO — Fully Insured: $1,383.28
  • SIHO — Self Insured: $1,383.28
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier 0 In the file: Arthrosc Shldr;Decomp SA SpcPC-ORTHOS $4,747 $3,322.90 $152.82 – $4,034.95
Shoulder arthroscopy: shaving of shoulder bone: rates for 9 insurance plans
  • Anthem — HMO: $940.30
  • Anthem — PPO: $940.30
  • Anthem — Traditional: $940.30
  • SIHO — Fully Insured: $183.38
  • SIHO — Self Insured: $183.38
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier 0 In the file: Arthrosc Shldr;Decomp SA SpcPC-ORTHOOP $4,747 $3,322.90 $152.82 – $4,034.95
Shoulder arthroscopy: shaving of shoulder bone: rates for 9 insurance plans
  • Anthem — HMO: $940.30
  • Anthem — PPO: $940.30
  • Anthem — Traditional: $940.30
  • SIHO — Fully Insured: $183.38
  • SIHO — Self Insured: $183.38
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier 0 In the file: Arthrosc Shldr;Decomp SA SpcPC-ORTHOIP $4,747 $3,322.90 $152.82 – $4,034.95
Shoulder arthroscopy: shaving of shoulder bone: rates for 9 insurance plans
  • Anthem — HMO: $940.30
  • Anthem — PPO: $940.30
  • Anthem — Traditional: $940.30
  • SIHO — Fully Insured: $183.38
  • SIHO — Self Insured: $183.38
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 0 In the file: Arthrosc Kne;MeniscectM or LPC-ORTHOS $4,208 $2,945.60 $494.35 – $3,576.80
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 9 insurance plans
  • Anthem — HMO: $791.70
  • Anthem — PPO: $791.70
  • Anthem — Traditional: $791.70
  • SIHO — Fully Insured: $593.22
  • SIHO — Self Insured: $593.22
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 0 In the file: Arthrosc Kne;MeniscectM or LPC-ORTHOOP $4,208 $2,945.60 $494.35 – $3,576.80
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 9 insurance plans
  • Anthem — HMO: $791.70
  • Anthem — PPO: $791.70
  • Anthem — Traditional: $791.70
  • SIHO — Fully Insured: $593.22
  • SIHO — Self Insured: $593.22
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 0 In the file: Arthrosc Kne;MeniscectM or LPC-ORTHOIP $4,208 $2,945.60 $494.35 – $3,576.80
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 9 insurance plans
  • Anthem — HMO: $791.70
  • Anthem — PPO: $791.70
  • Anthem — Traditional: $791.70
  • SIHO — Fully Insured: $593.22
  • SIHO — Self Insured: $593.22
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · modifier 0 In the file: Remove Tonsils and Adenoids PC-ENTOP $667 $466.90 $267.16 – $566.95
Removal of tonsils and adenoids (under age 12): rates for 9 insurance plans
  • Anthem — HMO: $358.30
  • Anthem — PPO: $358.30
  • Anthem — Traditional: $358.30
  • SIHO — Fully Insured: $320.59
  • SIHO — Self Insured: $320.59
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · modifier 0 In the file: Remove Tonsils and Adenoids PC-ENTIP $667 $466.90 $267.16 – $566.95
Removal of tonsils and adenoids (under age 12): rates for 9 insurance plans
  • Anthem — HMO: $358.30
  • Anthem — PPO: $358.30
  • Anthem — Traditional: $358.30
  • SIHO — Fully Insured: $320.59
  • SIHO — Self Insured: $320.59
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · modifier 0 In the file: REMOVE TONSILS AND ADENOIDS Not listed in the file Not listed in the file $17,084.75
Removal of tonsils and adenoids (under age 12): rates for 3 insurance plans
  • Anthem — HMO: $17,084.75
  • Anthem — PPO: $17,084.75
  • Anthem — Traditional: $17,084.75
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 0 In the file: EGD Transoral Dx Brush Wash PC-JPPSPB $612 $428.40 $154.21 – $520.20
Upper GI endoscopy (diagnostic): rates for 9 insurance plans
  • Anthem — HMO: $154.21
  • Anthem — PPO: $154.21
  • Anthem — Traditional: $154.21
  • SIHO — Fully Insured: $307.38
  • SIHO — Self Insured: $307.38
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 0 In the file: EGD Transoral Dx Brush Wash PC-JPPBPC $612 $428.40 $154.21 – $520.20
Upper GI endoscopy (diagnostic): rates for 9 insurance plans
  • Anthem — HMO: $154.21
  • Anthem — PPO: $154.21
  • Anthem — Traditional: $154.21
  • SIHO — Fully Insured: $307.38
  • SIHO — Self Insured: $307.38
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 0 In the file: EGD Transoral Dx Brush Wash PC-HOSPSWB $386 $270.20 $154.21 – $473.88
Upper GI endoscopy (diagnostic): rates for 9 insurance plans
  • Anthem — HMO: $154.21
  • Anthem — PPO: $154.21
  • Anthem — Traditional: $154.21
  • SIHO — Fully Insured: $307.38
  • SIHO — Self Insured: $307.38
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 0 In the file: EGD FlexTransoral BxSng/MultPC-JPPSPB $676 $473.20 $269.76 – $612.68
Upper GI endoscopy with biopsy: rates for 9 insurance plans
  • Anthem — HMO: $269.76
  • Anthem — PPO: $269.76
  • Anthem — Traditional: $269.76
  • SIHO — Fully Insured: $397.42
  • SIHO — Self Insured: $397.42
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 0 In the file: EGD FlexTransoral BxSng/MultPC-JPPBPC $676 $473.20 $269.76 – $612.68
Upper GI endoscopy with biopsy: rates for 9 insurance plans
  • Anthem — HMO: $269.76
  • Anthem — PPO: $269.76
  • Anthem — Traditional: $269.76
  • SIHO — Fully Insured: $397.42
  • SIHO — Self Insured: $397.42
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 0 In the file: EGD FlexTransoral BxSng/MultPC-HOSPSWB $687 $480.90 $269.76 – $612.68
Upper GI endoscopy with biopsy: rates for 9 insurance plans
  • Anthem — HMO: $269.76
  • Anthem — PPO: $269.76
  • Anthem — Traditional: $269.76
  • SIHO — Fully Insured: $397.42
  • SIHO — Self Insured: $397.42
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 0 In the file: Colonoscopy Flex Dx Brsh/WshPC-JPPSPB $898 $628.60 $297.75 – $763.30
Colonoscopy (diagnostic): rates for 9 insurance plans
  • Anthem — HMO: $297.75
  • Anthem — PPO: $297.75
  • Anthem — Traditional: $297.75
  • SIHO — Fully Insured: $365.11
  • SIHO — Self Insured: $365.11
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 0 In the file: Colonoscopy Flex Dx Brsh/WshPC-JPPBPC $898 $628.60 $297.75 – $763.30
Colonoscopy (diagnostic): rates for 9 insurance plans
  • Anthem — HMO: $297.75
  • Anthem — PPO: $297.75
  • Anthem — Traditional: $297.75
  • SIHO — Fully Insured: $365.11
  • SIHO — Self Insured: $365.11
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 0 In the file: Colonoscopy Flex Dx Brsh/WshPC-ORTHOS $732 $512.40 $297.75 – $622.20
Colonoscopy (diagnostic): rates for 9 insurance plans
  • Anthem — HMO: $297.75
  • Anthem — PPO: $297.75
  • Anthem — Traditional: $297.75
  • SIHO — Fully Insured: $365.11
  • SIHO — Self Insured: $365.11
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier 0 In the file: Colonoscopy FlexwBx;Sgl/MultPC-JPPSPB $994 $695.80 $358.77 – $844.90
Colonoscopy with biopsy: rates for 9 insurance plans
  • Anthem — HMO: $358.77
  • Anthem — PPO: $358.77
  • Anthem — Traditional: $358.77
  • SIHO — Fully Insured: $461.62
  • SIHO — Self Insured: $461.62
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier 0 In the file: Colonoscopy FlexwBx;Sgl/MultPC-JPPBPC $994 $695.80 $180.09 – $844.90
Colonoscopy with biopsy: rates for 9 insurance plans
  • Anthem — HMO: $358.77
  • Anthem — PPO: $358.77
  • Anthem — Traditional: $358.77
  • SIHO — Fully Insured: $216.11
  • SIHO — Self Insured: $216.11
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier 0 In the file: Colonoscopy FlexwBx;Sgl/MultPC-SURGOP $889 $622.30 $180.09 – $755.65
Colonoscopy with biopsy: rates for 9 insurance plans
  • Anthem — HMO: $358.77
  • Anthem — PPO: $358.77
  • Anthem — Traditional: $358.77
  • SIHO — Fully Insured: $216.11
  • SIHO — Self Insured: $216.11
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 0 In the file: Colonscpy Flex Rem Les Snarepc-JPPSPB $1,046 $732.20 $405.04 – $889.10
Colonoscopy with removal of polyps (snare): rates for 9 insurance plans
  • Anthem — HMO: $425.99
  • Anthem — PPO: $425.99
  • Anthem — Traditional: $425.99
  • SIHO — Fully Insured: $486.05
  • SIHO — Self Insured: $486.05
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 0 In the file: Colonscpy Flex Rem Les Snarepc-JPPBPC $1,046 $732.20 $227.59 – $889.10
Colonoscopy with removal of polyps (snare): rates for 9 insurance plans
  • Anthem — HMO: $425.99
  • Anthem — PPO: $425.99
  • Anthem — Traditional: $425.99
  • SIHO — Fully Insured: $273.11
  • SIHO — Self Insured: $273.11
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 0 In the file: Colonscpy Flex Rem Les Snarepc-SURGOP $1,151 $805.70 $227.59 – $978.35
Colonoscopy with removal of polyps (snare): rates for 9 insurance plans
  • Anthem — HMO: $425.99
  • Anthem — PPO: $425.99
  • Anthem — Traditional: $425.99
  • SIHO — Fully Insured: $273.11
  • SIHO — Self Insured: $273.11
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · modifier 0 In the file: COLONOSCOPY W/ENDOSCOPE US Not listed in the file Not listed in the file $6,614.09
Ultrasound of the lower bowel by endoscope: rates for 3 insurance plans
  • Anthem — HMO: $6,614.09
  • Anthem — PPO: $6,614.09
  • Anthem — Traditional: $6,614.09
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier 0 In the file: Scrn Colonoscopy No Hi-Riskpc-JPPSPB $576 $403.20 $304.42 – $563.18
Screening colonoscopy (not high risk): rates for 9 insurance plans
  • Anthem — HMO: $347.38
  • Anthem — PPO: $347.38
  • Anthem — Traditional: $347.38
  • SIHO — Fully Insured: $365.30
  • SIHO — Self Insured: $365.30
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier 0 In the file: Scrn Colonoscopy No Hi-Riskpc-JPPBPC $576 $403.20 $165.74 – $489.60
Screening colonoscopy (not high risk): rates for 9 insurance plans
  • Anthem — HMO: $347.38
  • Anthem — PPO: $347.38
  • Anthem — Traditional: $347.38
  • SIHO — Fully Insured: $198.89
  • SIHO — Self Insured: $198.89
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier 0 In the file: Scrn Colonoscopy No Hi-Riskpc-SURGOP $471 $329.70 $165.74 – $400.35
Screening colonoscopy (not high risk): rates for 9 insurance plans
  • Anthem — HMO: $347.38
  • Anthem — PPO: $347.38
  • Anthem — Traditional: $347.38
  • SIHO — Fully Insured: $198.89
  • SIHO — Self Insured: $198.89
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 0 In the file: Laparoscopy;Cholecystecomy PC-SURGOP $2,614 $1,829.80 $587.64 – $2,221.90
Gallbladder removal by laparoscope: rates for 9 insurance plans
  • Anthem — HMO: $892
  • Anthem — PPO: $892
  • Anthem — Traditional: $892
  • SIHO — Fully Insured: $705.17
  • SIHO — Self Insured: $705.17
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 0 In the file: Laparoscopy;Cholecystecomy PC-SURGIP $2,614 $1,829.80 $587.64 – $2,221.90
Gallbladder removal by laparoscope: rates for 9 insurance plans
  • Anthem — HMO: $892
  • Anthem — PPO: $892
  • Anthem — Traditional: $892
  • SIHO — Fully Insured: $705.17
  • SIHO — Self Insured: $705.17
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 0 In the file: Laparoscopy;Cholecystecomy PC-SURGER $2,614 $1,829.80 $587.64 – $2,221.90
Gallbladder removal by laparoscope: rates for 9 insurance plans
  • Anthem — HMO: $892
  • Anthem — PPO: $892
  • Anthem — Traditional: $892
  • SIHO — Fully Insured: $705.17
  • SIHO — Self Insured: $705.17
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 0 In the file: Prp I/Hern Init Reduc 5+ Yr PC-SURGOP $1,464 $1,024.80 $467.34 – $1,244.40
Groin (inguinal) hernia repair, age 5 or older: rates for 9 insurance plans
  • Anthem — HMO: $557
  • Anthem — PPO: $557
  • Anthem — Traditional: $557
  • SIHO — Fully Insured: $560.81
  • SIHO — Self Insured: $560.81
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 0 In the file: Prp I/Hern Init Reduc 5+ Yr PC-SURGIP $1,464 $1,024.80 $467.34 – $1,244.40
Groin (inguinal) hernia repair, age 5 or older: rates for 9 insurance plans
  • Anthem — HMO: $557
  • Anthem — PPO: $557
  • Anthem — Traditional: $557
  • SIHO — Fully Insured: $560.81
  • SIHO — Self Insured: $560.81
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 0 In the file: Prp I/Hern Init Reduc 5+ Yr PC-SURGER $1,464 $1,024.80 $467.34 – $1,244.40
Groin (inguinal) hernia repair, age 5 or older: rates for 9 insurance plans
  • Anthem — HMO: $557
  • Anthem — PPO: $557
  • Anthem — Traditional: $557
  • SIHO — Fully Insured: $560.81
  • SIHO — Self Insured: $560.81
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier 0 In the file: Prostate Needle Punch Bx PC-UROLOP $571 $399.70 $113.56 – $485.35
Prostate biopsy: rates for 9 insurance plans
  • Anthem — HMO: $113.56
  • Anthem — PPO: $113.56
  • Anthem — Traditional: $113.56
  • SIHO — Fully Insured: $260.69
  • SIHO — Self Insured: $260.69
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier 0 In the file: Prostate Needle Punch Bx PC-UROL $825 $577.50 $113.56 – $701.25
Prostate biopsy: rates for 9 insurance plans
  • Anthem — HMO: $113.56
  • Anthem — PPO: $113.56
  • Anthem — Traditional: $113.56
  • SIHO — Fully Insured: $260.69
  • SIHO — Self Insured: $260.69
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier 0 In the file: Prostate Needle Punch Bx PC-UROLIP $571 $399.70 $113.56 – $485.35
Prostate biopsy: rates for 9 insurance plans
  • Anthem — HMO: $113.56
  • Anthem — PPO: $113.56
  • Anthem — Traditional: $113.56
  • SIHO — Fully Insured: $260.69
  • SIHO — Self Insured: $260.69
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · modifier 0 In the file: Laparo Radical statectomy PC-UROLOP $4,656 $3,259.20 $1,084.42 – $3,957.60
Prostate removal by laparoscope (radical prostatectomy): rates for 9 insurance plans
  • Anthem — HMO: $2,182.14
  • Anthem — PPO: $2,182.14
  • Anthem — Traditional: $2,182.14
  • SIHO — Fully Insured: $1,301.30
  • SIHO — Self Insured: $1,301.30
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · modifier 0 In the file: Laparo Radical statectomy PC-UROLIP $4,656 $3,259.20 $1,084.42 – $3,957.60
Prostate removal by laparoscope (radical prostatectomy): rates for 9 insurance plans
  • Anthem — HMO: $2,182.14
  • Anthem — PPO: $2,182.14
  • Anthem — Traditional: $2,182.14
  • SIHO — Fully Insured: $1,301.30
  • SIHO — Self Insured: $1,301.30
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · modifier 0 In the file: LAPARO RADICAL PROSTATECTOMY Not listed in the file Not listed in the file $38,112.85
Prostate removal by laparoscope (radical prostatectomy): rates for 3 insurance plans
  • Anthem — HMO: $38,112.85
  • Anthem — PPO: $38,112.85
  • Anthem — Traditional: $38,112.85
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 0 In the file: Hysteroscopy;w X Endo/PolypPC-OBGYNOP $1,384 $968.80 $207.46 – $1,176.40
Hysteroscopy with biopsy of the uterus lining: rates for 9 insurance plans
  • Anthem — HMO: $221.83
  • Anthem — PPO: $221.83
  • Anthem — Traditional: $221.83
  • SIHO — Fully Insured: $248.95
  • SIHO — Self Insured: $248.95
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 0 In the file: Hysteroscopy;w X Endo/PolypPC-OBGYNIP $1,384 $968.80 $207.46 – $1,176.40
Hysteroscopy with biopsy of the uterus lining: rates for 9 insurance plans
  • Anthem — HMO: $221.83
  • Anthem — PPO: $221.83
  • Anthem — Traditional: $221.83
  • SIHO — Fully Insured: $248.95
  • SIHO — Self Insured: $248.95
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · modifier 0 In the file: HYSTEROSCOPY BIOPSY Not listed in the file Not listed in the file $6,614.09
Hysteroscopy with biopsy of the uterus lining: rates for 3 insurance plans
  • Anthem — HMO: $6,614.09
  • Anthem — PPO: $6,614.09
  • Anthem — Traditional: $6,614.09
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · modifier 0 In the file: Inj IL Lmbr/Sac Plc wImgGuidPC-ORTHOS $708 $495.60 $97.56 – $601.80
Spinal injection, lower back (epidural), with imaging guidance: rates for 9 insurance plans
  • Anthem — HMO: $97.56
  • Anthem — PPO: $97.56
  • Anthem — Traditional: $97.56
  • SIHO — Fully Insured: $275.63
  • SIHO — Self Insured: $275.63
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · modifier 0 In the file: Inj IL Lmbr/Sac Plc wImgGuidPC-ORTHOOP $708 $495.60 $97.56 – $601.80
Spinal injection, lower back (epidural), with imaging guidance: rates for 9 insurance plans
  • Anthem — HMO: $97.56
  • Anthem — PPO: $97.56
  • Anthem — Traditional: $97.56
  • SIHO — Fully Insured: $275.63
  • SIHO — Self Insured: $275.63
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · modifier 0 In the file: Inj IL Lmbr/Sac Plc wImgGuidPC-ORTHOIP $708 $495.60 $90.71 – $601.80
Spinal injection, lower back (epidural), with imaging guidance: rates for 9 insurance plans
  • Anthem — HMO: $97.56
  • Anthem — PPO: $97.56
  • Anthem — Traditional: $97.56
  • SIHO — Fully Insured: $108.85
  • SIHO — Self Insured: $108.85
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: INJ A/S TRNS EP;L/S SG L,A PRO $562 $393.40 $269.76 – $1,536.17
Nerve root injection, lower back, with imaging guidance: rates for 9 insurance plans
  • Aetna — Cofinity: 93% (a percentage in the contract, not a dollar amount)
  • Aetna — First: 91% (a percentage in the contract, not a dollar amount)
  • Cigna: 88.7% (a percentage in the contract, not a dollar amount)
  • Humana: 77.25% (a percentage in the contract, not a dollar amount)
  • Multiplan: 95% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 87% (a percentage in the contract, not a dollar amount)
  • SIHO — Fully Insured: 48% (a percentage in the contract, not a dollar amount)
  • SIHO — Self Insured: 69.9% (a percentage in the contract, not a dollar amount)
  • United Healthcare: 78.7% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · modifier 0 In the file: Inj Epid Lumb/SacrSnglLvlPC-PAINOP $623 $436.10 $101.84 – $529.55
Nerve root injection, lower back, with imaging guidance: rates for 9 insurance plans
  • Anthem — HMO: $102.74
  • Anthem — PPO: $102.74
  • Anthem — Traditional: $102.74
  • SIHO — Fully Insured: $122.21
  • SIHO — Self Insured: $122.21
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · modifier 0 In the file: Inj Epid Lumb/SacrSnglLvlPC-PAINIP $623 $436.10 $101.84 – $529.55
Nerve root injection, lower back, with imaging guidance: rates for 9 insurance plans
  • Anthem — HMO: $102.74
  • Anthem — PPO: $102.74
  • Anthem — Traditional: $102.74
  • SIHO — Fully Insured: $122.21
  • SIHO — Self Insured: $122.21
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 0 In the file: Neuroplasty;MedNerv-CarpTunnPC-ORTHOS $2,797 $1,957.90 $407.72 – $2,377.45
Carpal tunnel release: rates for 9 insurance plans
  • Anthem — HMO: $466.35
  • Anthem — PPO: $466.35
  • Anthem — Traditional: $466.35
  • SIHO — Fully Insured: $489.26
  • SIHO — Self Insured: $489.26
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 0 In the file: Neuroplasty;MedNerv-CarpTunnPC-ORTHOOP $2,797 $1,957.90 $407.72 – $2,377.45
Carpal tunnel release: rates for 9 insurance plans
  • Anthem — HMO: $466.35
  • Anthem — PPO: $466.35
  • Anthem — Traditional: $466.35
  • SIHO — Fully Insured: $489.26
  • SIHO — Self Insured: $489.26
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 0 In the file: Neuroplasty;MedNerv-CarpTunnPC-ORTHO $1,255 $878.50 $407.72 – $1,066.75
Carpal tunnel release: rates for 9 insurance plans
  • Anthem — HMO: $466.35
  • Anthem — PPO: $466.35
  • Anthem — Traditional: $466.35
  • SIHO — Fully Insured: $489.26
  • SIHO — Self Insured: $489.26
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · modifier 0 In the file: AFTER CATARACT LASER SURGERY Not listed in the file Not listed in the file $4,705.68
Laser treatment of clouding after cataract surgery: rates for 3 insurance plans
  • Anthem — HMO: $4,705.68
  • Anthem — PPO: $4,705.68
  • Anthem — Traditional: $4,705.68
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · modifier 0 In the file: CATARACT SURG W/IOL 1 STAGE Not listed in the file Not listed in the file $6,614.09
Cataract removal with lens implant: rates for 3 insurance plans
  • Anthem — HMO: $6,614.09
  • Anthem — PPO: $6,614.09
  • Anthem — Traditional: $6,614.09

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · modifier 0 In the file: Routine Ob Care Pro PC-OBGYNOP $3,142 $2,199.40 $2,122.89 – $3,927.35
Vaginal delivery, with care before and after: rates for 9 insurance plans
  • Anthem — HMO: $2,200
  • Anthem — PPO: $2,200
  • Anthem — Traditional: $2,200
  • SIHO — Fully Insured: $2,547.47
  • SIHO — Self Insured: $2,547.47
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · modifier 0 In the file: Routine Ob Care Pro PC-OBGYNIP $3,142 $2,199.40 $2,122.89 – $3,927.35
Vaginal delivery, with care before and after: rates for 9 insurance plans
  • Anthem — HMO: $2,200
  • Anthem — PPO: $2,200
  • Anthem — Traditional: $2,200
  • SIHO — Fully Insured: $2,547.47
  • SIHO — Self Insured: $2,547.47
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · modifier 0 In the file: OBSTETRICAL CARE Not listed in the file Not listed in the file $13,880.70
Vaginal delivery, with care before and after: rates for 3 insurance plans
  • Anthem — HMO: $13,880.70
  • Anthem — PPO: $13,880.70
  • Anthem — Traditional: $13,880.70
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · modifier 0 In the file: CSection w Ante/PostpartCarePC-OBGYNOP $4,080 $2,856 $2,200 – $4,332.94
Cesarean delivery (C-section), with care before and after: rates for 9 insurance plans
  • Anthem — HMO: $2,200
  • Anthem — PPO: $2,200
  • Anthem — Traditional: $2,200
  • SIHO — Fully Insured: $2,810.56
  • SIHO — Self Insured: $2,810.56
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · modifier 0 In the file: CSection w Ante/PostpartCarePC-OBGYNIP $4,080 $2,856 $2,200 – $4,332.94
Cesarean delivery (C-section), with care before and after: rates for 9 insurance plans
  • Anthem — HMO: $2,200
  • Anthem — PPO: $2,200
  • Anthem — Traditional: $2,200
  • SIHO — Fully Insured: $2,810.56
  • SIHO — Self Insured: $2,810.56
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · modifier 0 In the file: CESAREAN DELIVERY Not listed in the file Not listed in the file $13,880.70
Cesarean delivery (C-section), with care before and after: rates for 3 insurance plans
  • Anthem — HMO: $13,880.70
  • Anthem — PPO: $13,880.70
  • Anthem — Traditional: $13,880.70
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · modifier 0 In the file: Rout Ob Care VagDlv & Pp Vbpc-OBGYNOP $7,214 $5,049.80 $2,021.25 – $6,131.90
Vaginal delivery after a previous C-section, with care before and after: rates for 9 insurance plans
  • Anthem — HMO: $2,021.25
  • Anthem — PPO: $2,021.25
  • Anthem — Traditional: $2,021.25
  • SIHO — Fully Insured: $2,647.98
  • SIHO — Self Insured: $2,647.98
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · modifier 0 In the file: Rout Ob Care VagDlv & Pp Vbpc-OBGYNIP $7,214 $5,049.80 $2,021.25 – $6,131.90
Vaginal delivery after a previous C-section, with care before and after: rates for 9 insurance plans
  • Anthem — HMO: $2,021.25
  • Anthem — PPO: $2,021.25
  • Anthem — Traditional: $2,021.25
  • SIHO — Fully Insured: $2,647.98
  • SIHO — Self Insured: $2,647.98
  • Aetna — Cofinity: 166.5% (a percentage in the contract, not a dollar amount)
  • Caresource: 90% (a percentage in the contract, not a dollar amount)
  • Multiplan: 76.5% (a percentage in the contract, not a dollar amount)
  • Sagamore — Commerical: 76.5% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · modifier 0 In the file: VBAC DELIVERY Not listed in the file Not listed in the file $13,880.70
Vaginal delivery after a previous C-section, with care before and after: rates for 3 insurance plans
  • Anthem — HMO: $13,880.70
  • Anthem — PPO: $13,880.70
  • Anthem — Traditional: $13,880.70

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $64,331.99 – $159,713.99
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 12 insurance plan rates
  • Anthem — HMO: $159,713.99
  • Anthem — PPO: $159,713.99
  • Anthem — Traditional: $159,713.99
  • SIHO — Fully Insured: $75,890.76
  • SIHO — Self Insured: $87,751.72
  • United Healthcare: $82,958.14
  • Aetna MC Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Anthem MC Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Caresource: 170% (a percentage in the contract, not a dollar amount)
  • Humana MC Advantage: 100% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $12,684.50 – $31,491.22
Hip or knee replacement (major joint of the leg), without major complications: 10 of 12 insurance plan rates
  • Anthem — HMO: $31,491.22
  • Anthem — PPO: $31,491.22
  • Anthem — Traditional: $31,491.22
  • SIHO — Fully Insured: $14,963.58
  • SIHO — Self Insured: $17,302.23
  • United Healthcare: $16,357.07
  • Aetna MC Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Anthem MC Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Caresource: 170% (a percentage in the contract, not a dollar amount)
  • Humana MC Advantage: 100% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $16,054.06 – $39,856.66
Neck (cervical) spinal fusion, without complications: 10 of 12 insurance plan rates
  • Anthem — HMO: $39,856.66
  • Anthem — PPO: $39,856.66
  • Anthem — Traditional: $39,856.66
  • SIHO — Fully Insured: $18,938.56
  • SIHO — Self Insured: $21,898.46
  • United Healthcare: $20,702.22
  • Aetna MC Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Anthem MC Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Caresource: 170% (a percentage in the contract, not a dollar amount)
  • Humana MC Advantage: 100% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $8,158.88 – $20,255.67
Uterus and ovary surgery (not for cancer), without complications: 10 of 12 insurance plan rates
  • Anthem — HMO: $20,255.67
  • Anthem — PPO: $20,255.67
  • Anthem — Traditional: $20,255.67
  • SIHO — Fully Insured: $9,624.82
  • SIHO — Self Insured: $11,129.08
  • United Healthcare: $10,521.14
  • Aetna MC Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Anthem MC Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Caresource: 170% (a percentage in the contract, not a dollar amount)
  • Humana MC Advantage: 100% (a percentage in the contract, not a dollar amount)

Source: Schneck Medical Center’s standard charges file (d188lfxfyq6i9j.cloudfront.net, CSV, CMS template 2.0.0; it can be a very large file), last updated by the hospital on November 2, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital typeAcute Care Hospital
Address411 W Tipton St, Seymour, IN 47274
CountyJackson County
StateIndiana
Phone(812) 522‑2349
Emergency servicesYes
OwnershipGovernment - Local
Medicare overall rating4 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number150065
Name in Medicare recordsSCHNECK MEDICAL CENTER
Profile levelMedicare data + hospital website
Official websiteschneckmed.org
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 2026-11-02.

  1. Schneck Medical Center | Schneck Medical Center — schneckmed.org