Does Scotland County Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Scotland County Hospital. In a medical emergency, call 911.

Where is Scotland County Hospital?

450 E Sigler Avenue, Memphis, MO 63555, in Scotland County, Missouri.

What is the phone number of Scotland County Hospital?

(660) 465-8511, as listed by Medicare (CMS).

What is the Medicare star rating of Scotland County Hospital?

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

Scotland County Hospital — Phone, Address & ER

Quick answers

Does Scotland County Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Scotland County Hospital. In a medical emergency, call 911.
Where is Scotland County Hospital?: 450 E Sigler Avenue, Memphis, MO 63555, in Scotland County, Missouri.
What is the phone number of Scotland County Hospital?: (660) 465-8511, as listed by Medicare (CMS).
What is the Medicare star rating of Scotland County Hospital?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Specialties and care areas^[4][5]

Oncology
Radiology
Laboratory
Surgery
Therapy Services
Women's Center
Skilled Nursing
Senior Life Solutions
Rural Health Clinics
Vascular Care

Programs and centers^[4]

Senior Life Solutions (SLS)
Lifeline

Emergency care (hospital website)^[4][6]

Emergency room	Yes
Open 24/7	Yes

Recognition^[4][5]

Critical Access Hospital

Doctors and clinicians (75)

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

Main specialties

Doctors with a page on this site (75)

Aaron C. Neisen, DOFamily Practice
Anna EslickNurse Practitioner
Babak Rejaie, MDDiagnostic Radiology
Baydon E. Hilton, DODermatology
Beth M. Schrage, NPNurse Practitioner
Blake M. Kramer, DODiagnostic Radiology
Brandi A. WhiteNurse Practitioner
Brenna A. Smith, NPNurse Practitioner
Brigitte R. Cormier, DOFamily Practice
Brittany EgleyNurse Practitioner
Bryan W. Tanner, CNACertified Registered Nurse Anesthetist (CRNA)
Celeste M. Miller-Parish, DOGeneral Surgery
Christian A. Khoury, MDHematology/Oncology
Curtis D. Burton, MDOrthopedic Surgery
Daniel E. Schneider, MDUrology
Danielle MillerNurse Practitioner
Dennis W. Ozment, MDRheumatology
Elliot Deblieck, DOFamily Practice
Farooq Junaid, DOCardiovascular Disease (Cardiology)
Gary M. Early, DOFamily Practice
Hannah J. Braungardt, DOFamily Practice
Heather R. Martin, DOFamily Practice
Iqbal Khan, MDNeurology
Irving L. Schwartz, MDCardiovascular Disease (Cardiology)

And 51 more: the button below opens the full list.

Other emergency rooms nearby

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

Van Buren County Hospital22 mi · Keosauqua, IA · Critical Access Hospital
Davis County Hospital24 mi · Bloomfield, IA · Critical Access Hospital
Northeast Regional Medical Center29 mi · Kirksville, MO · Acute Care Hospital
Jefferson County Health Center38 mi · Fairfield, IA · Critical Access Hospital
Ottumwa Regional Health Center41 mi · Ottumwa, IA · Acute Care Hospital

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

Other hospitals near Memphis

MercyOne Centerville Medical Center43 mi · Centerville, IA · Critical Access Hospital

Hospitals in Scotland County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Knox County Nursing Home District21 mi · Edina, MO · 1 of 5 stars
Schuyler County Nursing Home District21 mi · Queen City, MO · 2 of 5 stars
Country Lane Manor21 mi · Keosauqua, IA · 1 of 5 stars

All nursing homes in the state →

Home health agencies

Scotland County Home Health Agency2.0 mi · Memphis, MO · 2 of 5 stars
Knox County Health Department Home Health Agency22 mi · Edina, MO · 2 of 5 stars
Van Buren County PHNS23 mi · Keosauqua, IA · 2.5 of 5 stars

All home health agencies 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

Memphis Community Health Center1.0 mi · Memphis, MO · Community health center
Northeast Family Health20 mi · Edina, MO · Community health center
RHCHC Davis County Community Schools23 mi · Bloomfield, IA · Community health center

Clinics and urgent care

Memphis Medical Services2.0 mi · Memphis, MO · Rural health clinic
Fox River Medical Clinic12 mi · Cantril, IA · Rural health clinic
Wyaconda Medical Services16 mi · Wyaconda, MO · Rural health clinic

Pharmacies

Scotland County Community Health Development Services, Inc.2.0 mi · Memphis, MO · Community/retail pharmacy
Scotland County Pharmacy Inc2.0 mi · Memphis, MO · Community/retail pharmacy

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

What patients said (patient survey)

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

Rated the hospital 9 or 10 out of 10	78%National average: 72%
Would definitely recommend the hospital	74%National average: 71%
Nurses “always” communicated well	80%National average: 80%
Doctors “always” communicated well	85%National average: 80%
“Always” got help as soon as they wanted	73%National average: 64%
Staff “always” explained medicines before giving them	57%National average: 62%
Were given information about recovery at home	81%National average: 86%
Room and bathroom “always” clean	76%National average: 73%
Not reported to Medicare	Summary star rating (all survey topics); Overall rating of the hospital; Would recommend the hospital; Nurses communicated well; Doctors communicated well; Patients got help quickly from staff; Staff explained medicines; Information about recovery at home; Room and bathroom kept clean; Restfulness of Environment; Care Coordination; Symptoms After Stay
Completed surveys	85Response rate: 28%

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

Complications and deaths

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

Deaths within 30 days: pneumonia patients	15.9%
Deaths within 30 days: COPD patients	8.7%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG); Serious complications (patient safety indicator PSI-90); Complications after hip or knee replacement
Too few cases to report	Deaths within 30 days: heart attack patients; Deaths within 30 days: heart failure patients; Deaths within 30 days: stroke patients

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	16.5%
Readmitted within 30 days: pneumonia	17.2%
Not reported to Medicare	Readmitted within 30 days: heart attack; Readmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement
Too few cases to report	Readmitted within 30 days: heart failure; Readmitted within 30 days: COPD

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

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

Average (median) time patients spent in the emergency room before leaving (OP-18b)	119 minutesNational average: 162 minutes
Not reported to Medicare	Patients who left the emergency room before being seen (OP-22); Sepsis patients who got all the recommended early care (SEP-1)

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Missouri Best hospitals in Missouri

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 75 common services exactly as Scotland County Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

$ 13 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Show the prices of 75 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF OFFICE/OP NEW LEVEL 3	$288	$201.60	$92.55 – $139.37
New patient office visit (about 30–44 minutes): 10 of 13 insurance plan rates Aetna — All Products Counselor: $120.15 Aetna — All Products Physician: $120.15 Aetna — All Products Psychology: $120.15 Anthem — All Products Facility: $107.07 Anthem — All Products Non-Facility: $107.07 Anthem — Managed Medicaid: $92.91 Cigna — All Products: $122.86 Coventry — All Products: $139.37 HealthLink — All Products: $92.55 HealthLink — All Products - NF: $244.80
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF OFFICE/OP NEW LEVEL 3	$288	$201.60	$74.88 – $244.80
New patient office visit (about 30–44 minutes): rates for 10 insurance plans Aetna — All Products: $201.60 Anthem — All Products: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Cigna — All Products: $216 Coventry — All Products: $244.80 HealthLink — All Products: $216 HomeState — All Products: $104.83 Humana — All Products: $244.80 Humana — Medicare Advantage: $74.88 UHC — All Products: $216 UHC — Medicare Advantage: $74.88
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF OFFICE/OP NEW LEVEL 4	$431	$301.70	$138.56 – $207.84
New patient office visit (about 45–59 minutes): 10 of 13 insurance plan rates Aetna — All Products Counselor: $195.45 Aetna — All Products Physician: $195.45 Aetna — All Products Psychology: $195.45 Anthem — All Products Facility: $154.65 Anthem — All Products Non-Facility: $154.65 Anthem — Managed Medicaid: $138.56 Cigna — All Products: $191.37 Coventry — All Products: $207.84 HealthLink — All Products: $156.56 HealthLink — All Products - NF: $366.35
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF OFFICE/OP NEW LEVEL 4	$431	$301.70	$112.06 – $366.35
New patient office visit (about 45–59 minutes): rates for 10 insurance plans Aetna — All Products: $301.70 Anthem — All Products: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Cigna — All Products: $323.25 Coventry — All Products: $366.35 HealthLink — All Products: $323.25 HomeState — All Products: $156.88 Humana — All Products: $366.35 Humana — Medicare Advantage: $112.06 UHC — All Products: $323.25 UHC — Medicare Advantage: $112.06
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF OFFICE/OP NEW LEVEL 5	$500	$350	$183.27 – $274.91
New patient office visit (about 60–74 minutes): 10 of 13 insurance plan rates Aetna — All Products Counselor: $265.77 Aetna — All Products Physician: $265.77 Aetna — All Products Psychology: $265.77 Anthem — All Products Facility: $196.83 Anthem — All Products Non-Facility: $196.83 Anthem — Managed Medicaid: $183.27 Cigna — All Products: $242.43 Coventry — All Products: $274.91 HealthLink — All Products: $203.59 HealthLink — All Products - NF: $425
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF OFFICE/OP NEW LEVEL 5	$500	$350	$130 – $425
New patient office visit (about 60–74 minutes): rates for 10 insurance plans Aetna — All Products: $350 Anthem — All Products: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Cigna — All Products: $375 Coventry — All Products: $425 HealthLink — All Products: $375 HomeState — All Products: $182 Humana — All Products: $425 Humana — Medicare Advantage: $130 UHC — All Products: $375 UHC — Medicare Advantage: $130
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF OFFICE/OP EST LEVEL 3	$270	$189	$61.05 – $112.82
Established patient office visit (about 20–29 minutes): 10 of 13 insurance plan rates Aetna — All Products Counselor: $96.50 Aetna — All Products Physician: $96.50 Aetna — All Products Psychology: $96.50 Anthem — All Products Facility: $63 Anthem — All Products Non-Facility: $63 Anthem — Managed Medicaid: $75.21 Cigna — All Products: $81.88 Coventry — All Products: $112.82 HealthLink — All Products: $61.05 HealthLink — All Products - NF: $229.50
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF OFFICE/OP EST LEVEL 3	$270	$189	$70.20 – $229.50
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans Aetna — All Products: $189 Anthem — All Products: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Cigna — All Products: $202.50 Coventry — All Products: $229.50 HealthLink — All Products: $202.50 HomeState — All Products: $98.28 Humana — All Products: $229.50 Humana — Medicare Advantage: $70.20 UHC — All Products: $202.50 UHC — Medicare Advantage: $70.20
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP EST LEVEL 3	$253	$177.10	$65.78 – $215.05
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans Aetna — All Products: $177.10 Anthem — All Products: $194.81 Cigna — All Products: $189.75 Coventry — All Products: $215.05 HealthLink — All Products: $189.75 HomeState — All Products: $92.09 Humana — All Products: $215.05 Humana — Medicare Advantage: $65.78 UHC — All Products: $189.75 UHC — Medicare Advantage: $65.78
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF OFFICE/OP EST LEVEL 4	$360	$252	$90.85 – $159.23
Established patient office visit (about 30–39 minutes): 10 of 13 insurance plan rates Aetna — All Products Counselor: $142.28 Aetna — All Products Physician: $142.28 Aetna — All Products Psychology: $142.28 Anthem — All Products Facility: $90.85 Anthem — All Products Non-Facility: $90.85 Anthem — Managed Medicaid: $106.15 Cigna — All Products: $123.67 Coventry — All Products: $159.23 HealthLink — All Products: $94.39 HealthLink — All Products - NF: $306
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF OFFICE/OP EST LEVEL 4	$360	$252	$93.60 – $306
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans Aetna — All Products: $252 Anthem — All Products: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Cigna — All Products: $270 Coventry — All Products: $306 HealthLink — All Products: $270 HomeState — All Products: $131.04 Humana — All Products: $306 Humana — Medicare Advantage: $93.60 UHC — All Products: $270 UHC — Medicare Advantage: $93.60
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP EST LEVEL 4	$358	$250.60	$93.08 – $304.30
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans Aetna — All Products: $250.60 Anthem — All Products: $275.66 Cigna — All Products: $268.50 Coventry — All Products: $304.30 HealthLink — All Products: $268.50 HomeState — All Products: $130.31 Humana — All Products: $304.30 Humana — Medicare Advantage: $93.08 UHC — All Products: $268.50 UHC — Medicare Advantage: $93.08
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30	$273	$191.10	$70.98 – $232.05
Office consultation with a specialist (moderate): rates for 10 insurance plans Aetna — All Products: $191.10 Anthem — All Products: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Cigna — All Products: $204.75 Coventry — All Products: $232.05 HealthLink — All Products: $204.75 HomeState — All Products: $99.37 Humana — All Products: $232.05 Humana — Medicare Advantage: $70.98 UHC — All Products: $204.75 UHC — Medicare Advantage: $70.98
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	$389	$272.30	$101.14 – $330.65
Office consultation with a specialist (moderate to high): rates for 10 insurance plans Aetna — All Products: $272.30 Anthem — All Products: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Cigna — All Products: $291.75 Coventry — All Products: $330.65 HealthLink — All Products: $291.75 HomeState — All Products: $141.60 Humana — All Products: $330.65 Humana — Medicare Advantage: $101.14 UHC — All Products: $291.75 UHC — Medicare Advantage: $101.14
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF PREV VISIT NEW AGE 18-39	$125	$87.50	$32.50 – $106.25
Preventive checkup, new patient, age 18–39: rates for 10 insurance plans Aetna — All Products: $87.50 Anthem — All Products: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Cigna — All Products: $93.75 Coventry — All Products: $106.25 HealthLink — All Products: $93.75 HomeState — All Products: $45.50 Humana — All Products: $106.25 Humana — Medicare Advantage: $32.50 UHC — All Products: $93.75 UHC — Medicare Advantage: $32.50
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier EP In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$91.81 – $100.99
Preventive checkup, new patient, age 18–39: rates for 3 insurance plans Anthem — Managed Medicaid: $91.81 Homestate — Managed Medicaid: $98.24 UHC — Managed Medicaid: $100.99
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF PREV VISIT NEW AGE 40-64	$125	$87.50	$32.50 – $106.25
Preventive checkup, new patient, age 40–64: rates for 10 insurance plans Aetna — All Products: $87.50 Anthem — All Products: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Cigna — All Products: $93.75 Coventry — All Products: $106.25 HealthLink — All Products: $93.75 HomeState — All Products: $45.50 Humana — All Products: $106.25 Humana — Medicare Advantage: $32.50 UHC — All Products: $93.75 UHC — Medicare Advantage: $32.50
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF ED LEVEL 3	$351	$245.70	$59.80 – $258.37
Emergency room visit (moderate): 10 of 17 insurance plan rates Aetna — All Products Counselor: $104.49 Aetna — All Products Physician: $104.49 Aetna — All Products Psychology: $104.49 Anthem — All Products Facility: $74.55 Anthem — All Products Non-Facility: $74.55 Anthem — Managed Medicaid: $59.80 Anthem — Medicare Advantage: $278.89 Cigna — All Products: $86.36 Coventry — All Products: $89.70 HealthLink — All Products: $100
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LEVEL 3	$567	$396.90	$147.42 – $481.95
Emergency room visit (moderate): 10 of 13 insurance plan rates Aetna — All Products: $396.90 Anthem — All Products: $436.59 Anthem — Managed Medicaid: $246.07 Cigna — All Products: $425.25 Coventry — All Products: $481.95 HealthLink — All Products: $425.25 HomeState — All Products: $206.39 Homestate — Managed Medicaid: $263.29 Humana — All Products: $481.95 Humana — Medicare Advantage: $147.42
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF ED LEVEL 4	$520	$364	$100.99 – $394.95
Emergency room visit (moderately high): 10 of 17 insurance plan rates Aetna — All Products Counselor: $177.83 Aetna — All Products Physician: $177.83 Aetna — All Products Psychology: $177.83 Anthem — All Products Facility: $116.55 Anthem — All Products Non-Facility: $116.55 Anthem — Managed Medicaid: $100.99 Anthem — Medicare Advantage: $426.30 Cigna — All Products: $161.36 Coventry — All Products: $151.49 HealthLink — All Products: $150.44
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LEVEL 4	$842	$589.40	$218.92 – $715.70
Emergency room visit (moderately high): 10 of 13 insurance plan rates Aetna — All Products: $589.40 Anthem — All Products: $648.34 Anthem — Managed Medicaid: $376.14 Cigna — All Products: $631.50 Coventry — All Products: $715.70 HealthLink — All Products: $631.50 HomeState — All Products: $306.49 Homestate — Managed Medicaid: $402.47 Humana — All Products: $715.70 Humana — Medicare Advantage: $218.92
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF ED LEVEL 5	$794	$555.80	$146.64 – $563.68
Emergency room visit (high): 10 of 17 insurance plan rates Aetna — All Products Counselor: $257.64 Aetna — All Products Physician: $257.64 Aetna — All Products Psychology: $257.64 Anthem — All Products Facility: $182.70 Anthem — All Products Non-Facility: $182.70 Anthem — Managed Medicaid: $146.64 Anthem — Medicare Advantage: $608.43 Cigna — All Products: $240.34 Coventry — All Products: $219.96 HealthLink — All Products: $222.90
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LEVEL 5	$1,039	$727.30	$270.14 – $883.15
Emergency room visit (high): 10 of 13 insurance plan rates Aetna — All Products: $727.30 Anthem — All Products: $800.03 Anthem — Managed Medicaid: $536.84 Cigna — All Products: $779.25 Coventry — All Products: $883.15 HealthLink — All Products: $779.25 HomeState — All Products: $378.20 Homestate — Managed Medicaid: $574.42 Humana — All Products: $883.15 Humana — Medicare Advantage: $270.14

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BMP	$174	$121.80	$1.30 – $11
Basic metabolic panel (blood test): 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $133.98 Anthem — Managed Medicaid: $7.61 Cigna — All Products: $130.50 Coventry — All Products: $11 HealthLink — All Products: $130.50 HomeState — All Products: $63.34 Homestate — Managed Medicaid: $8.14 Humana — All Products: $147.90 Humana — Medicare Advantage: $45.24
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL	$194	$135.80	$1.30 – $13.73
Comprehensive metabolic panel (blood test): 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $149.38 Anthem — Managed Medicaid: $9.50 Cigna — All Products: $145.50 Coventry — All Products: $13.73 HealthLink — All Products: $145.50 HomeState — All Products: $70.62 Homestate — Managed Medicaid: $10.17 Humana — All Products: $164.90 Humana — Medicare Advantage: $50.44
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$418	$292.60	$1.30 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $62.15
Obstetric blood test panel: 10 of 13 insurance plan rates Aetna — All Products: $1.30 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Anthem — All Products: $321.86 Anthem — Managed Medicaid: $43.03 Cigna — All Products: $313.50 Coventry — All Products: $62.15 HealthLink — All Products: $313.50 HomeState — All Products: $152.15 Homestate — Managed Medicaid: $46.04 Humana — All Products: $355.30 Humana — Medicare Advantage: $108.68
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$276	$193.20	$1.30 – $17.41
Cholesterol panel (lipid panel): 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $212.52 Anthem — Managed Medicaid: $12.05 Cigna — All Products: $207 Coventry — All Products: $17.41 HealthLink — All Products: $207 HomeState — All Products: $100.46 Homestate — Managed Medicaid: $12.89 Humana — All Products: $234.60 Humana — Medicare Advantage: $71.76
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$178	$124.60	$1.30 – $11.28
Kidney function panel: 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $137.06 Anthem — Managed Medicaid: $7.81 Cigna — All Products: $133.50 Coventry — All Products: $11.28 HealthLink — All Products: $133.50 HomeState — All Products: $64.79 Homestate — Managed Medicaid: $8.36 Humana — All Products: $151.30 Humana — Medicare Advantage: $46.28
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$193	$135.10	$1.30 – $10.62
Liver function panel: 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $148.61 Anthem — Managed Medicaid: $7.35 Cigna — All Products: $144.75 Coventry — All Products: $10.62 HealthLink — All Products: $144.75 HomeState — All Products: $70.25 Homestate — Managed Medicaid: $7.86 Humana — All Products: $164.05 Humana — Medicare Advantage: $50.18
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE	$77	$53.90	$1.30 – $4.12
Urine test (automated, with microscope): 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $59.29 Anthem — Managed Medicaid: $2.85 Cigna — All Products: $57.75 Coventry — All Products: $4.12 HealthLink — All Products: $57.75 HomeState — All Products: $28.03 Homestate — Managed Medicaid: $3.05 Humana — All Products: $65.45 Humana — Medicare Advantage: $20.02
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	$23	$16.10	$1.30 – $4.52
Urine test (manual, without microscope): 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $17.71 Anthem — Managed Medicaid: $3.13 Cigna — All Products: $17.25 Coventry — All Products: $4.52 HealthLink — All Products: $17.25 HomeState — All Products: $8.37 Homestate — Managed Medicaid: $3.35 Humana — All Products: $19.55 Humana — Medicare Advantage: $5.98
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE	$65	$45.50	$1.30 – $2.93
Urine test (automated, without microscope): 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $50.05 Anthem — Managed Medicaid: $2.03 Cigna — All Products: $48.75 Coventry — All Products: $2.93 HealthLink — All Products: $48.75 HomeState — All Products: $23.66 Homestate — Managed Medicaid: $2.17 Humana — All Products: $55.25 Humana — Medicare Advantage: $16.90
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL	$212	$148.40	$1.30 – $23.91
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $163.24 Anthem — Managed Medicaid: $16.55 Cigna — All Products: $159 Coventry — All Products: $23.91 HealthLink — All Products: $159 HomeState — All Products: $77.17 Homestate — Managed Medicaid: $17.71 Humana — All Products: $180.20 Humana — Medicare Advantage: $55.12
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH	$220	$154	$1.30 – $21.84
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $169.40 Anthem — Managed Medicaid: $15.12 Cigna — All Products: $165 Coventry — All Products: $21.84 HealthLink — All Products: $165 HomeState — All Products: $80.08 Homestate — Managed Medicaid: $16.18 Humana — All Products: $187 Humana — Medicare Advantage: $57.20
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC	$270	$189	$1.30 – $10.10
Complete blood count (CBC) with differential: 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $207.90 Anthem — Managed Medicaid: $6.99 Cigna — All Products: $202.50 Coventry — All Products: $10.10 HealthLink — All Products: $202.50 HomeState — All Products: $98.28 Homestate — Managed Medicaid: $7.48 Humana — All Products: $229.50 Humana — Medicare Advantage: $70.20
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED	$106	$74.20	$1.30 – $8.41
Complete blood count (CBC), automated: 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $81.62 Anthem — Managed Medicaid: $5.82 Cigna — All Products: $79.50 Coventry — All Products: $8.41 HealthLink — All Products: $79.50 HomeState — All Products: $38.58 Homestate — Managed Medicaid: $6.23 Humana — All Products: $90.10 Humana — Medicare Advantage: $27.56
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$77	$53.90	$1.30 – $5.58
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $59.29 Anthem — Managed Medicaid: $3.86 Cigna — All Products: $57.75 Coventry — All Products: $5.58 HealthLink — All Products: $57.75 HomeState — All Products: $28.03 Homestate — Managed Medicaid: $4.13 Humana — All Products: $65.45 Humana — Medicare Advantage: $20.02
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL	$160	$112	$1.30 – $7.81
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates Aetna — All Products: $1.30 Anthem — All Products: $123.20 Anthem — Managed Medicaid: $5.41 Cigna — All Products: $120 Coventry — All Products: $7.81 HealthLink — All Products: $120 HomeState — All Products: $58.24 Homestate — Managed Medicaid: $5.79 Humana — All Products: $136 Humana — Medicare Advantage: $41.60

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF CT HEAD/BRAIN W/O CONTRAST	$264	$184.80	$94.24 – $294
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates Aetna — All Products Counselor: $157.11 Aetna — All Products Physician: $157.11 Aetna — All Products Psychology: $157.11 Anthem — All Products Facility: $294 Anthem — All Products Non-Facility: $294 Anthem — Managed Medicaid: $136.59 Anthem — Medicare Advantage: $106.81 Cigna — All Products: $158.75 Coventry — All Products: $204.89 HealthLink — All Products: $149.83
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O CONTRAST	$1,333	$933.10	$346.58 – $1,133.05
CT scan of the head or brain, without contrast: 10 of 13 insurance plan rates Aetna — All Products: $933.10 Anthem — All Products: $1,026.41 Anthem — Managed Medicaid: $94.24 Cigna — All Products: $999.75 Coventry — All Products: $1,133.05 HealthLink — All Products: $999.75 HomeState — All Products: $485.21 Homestate — Managed Medicaid: $100.84 Humana — All Products: $1,133.05 Humana — Medicare Advantage: $346.58
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF MRI BRAIN W/O & W/ CONTRAST	$602	$421.40	$314.49 – $1,393.35
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates Aetna — All Products Counselor: $472.59 Aetna — All Products Physician: $472.59 Aetna — All Products Psychology: $472.59 Anthem — All Products Facility: $1,393.35 Anthem — All Products Non-Facility: $1,393.35 Anthem — Managed Medicaid: $378.51 Anthem — Medicare Advantage: $356.43 Cigna — All Products: $478.26 Coventry — All Products: $567.77 HealthLink — All Products: $483.89
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN W/O & W/ CONTRAST	$3,030	$2,121	$787.80 – $2,575.50
MRI of the brain, before and after contrast: 10 of 13 insurance plan rates Aetna — All Products: $2,121 Anthem — All Products: $2,333.10 Anthem — Managed Medicaid: $314.49 Cigna — All Products: $2,272.50 Coventry — All Products: $2,575.50 HealthLink — All Products: $2,272.50 HomeState — All Products: $1,102.92 Homestate — Managed Medicaid: $336.50 Humana — All Products: $2,575.50 Humana — Medicare Advantage: $787.80
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN W/ CONTRAST	$1,867	$1,306.90	$485.42 – $1,586.95
MRI of the brain, before and after contrast: 10 of 13 insurance plan rates Aetna — All Products: $1,306.90 Anthem — All Products: $1,437.59 Anthem — Managed Medicaid: $314.49 Cigna — All Products: $1,400.25 Coventry — All Products: $1,586.95 HealthLink — All Products: $1,400.25 HomeState — All Products: $679.59 Homestate — Managed Medicaid: $336.50 Humana — All Products: $1,586.95 Humana — Medicare Advantage: $485.42
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF XR CHEST 2 VIEWS	$63	$44.10	$21.53 – $63
Chest X-ray, 2 views: 10 of 14 insurance plan rates Aetna — All Products Counselor: $48.59 Aetna — All Products Physician: $48.59 Aetna — All Products Psychology: $48.59 Anthem — All Products Facility: $47.25 Anthem — All Products Non-Facility: $47.25 Anthem — Managed Medicaid: $21.53 Anthem — Medicare Advantage: $63 Cigna — All Products: $47.25 Coventry — All Products: $32.30 HealthLink — All Products - NF: $53.55
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR CHEST 2 VIEWS	$453	$317.10	$117.78 – $385.05
Chest X-ray, 2 views: 10 of 13 insurance plan rates Aetna — All Products: $317.10 Anthem — All Products: $348.81 Anthem — Managed Medicaid: $78.45 Cigna — All Products: $339.75 Coventry — All Products: $385.05 HealthLink — All Products: $339.75 HomeState — All Products: $164.89 Homestate — Managed Medicaid: $83.94 Humana — All Products: $385.05 Humana — Medicare Advantage: $117.78
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF XR LUMBOSACRAL SPINE>4 VIEW	$159	$111.30	$39.33 – $98.95
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates Aetna — All Products Counselor: $74.82 Aetna — All Products Physician: $74.82 Aetna — All Products Psychology: $74.82 Anthem — All Products Facility: $68.25 Anthem — All Products Non-Facility: $68.25 Anthem — Managed Medicaid: $41.07 Anthem — Medicare Advantage: $106.81 Cigna — All Products: $39.33 Coventry — All Products: $61.61 HealthLink — All Products: $62.87
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR LUMBOSACRAL SPINE >4 VIEWS	$768	$537.60	$199.68 – $652.80
X-ray of the lower spine, at least 4 views: 10 of 13 insurance plan rates Aetna — All Products: $537.60 Anthem — All Products: $591.36 Anthem — Managed Medicaid: $94.24 Cigna — All Products: $576 Coventry — All Products: $652.80 HealthLink — All Products: $576 HomeState — All Products: $279.55 Homestate — Managed Medicaid: $100.84 Humana — All Products: $652.80 Humana — Medicare Advantage: $199.68
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF MRI LUMBAR SPINE W/O CONTRA	$422	$295.40	$215.09 – $719.25
MRI of the lower back (lumbar spine), without contrast: 10 of 17 insurance plan rates Aetna — All Products Counselor: $284.21 Aetna — All Products Physician: $284.21 Aetna — All Products Psychology: $284.21 Anthem — All Products Facility: $719.25 Anthem — All Products Non-Facility: $719.25 Anthem — Managed Medicaid: $244.56 Anthem — Medicare Advantage: $243.77 Cigna — All Products: $306.63 Coventry — All Products: $366.84 HealthLink — All Products: $285.52
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O CONTRAST	$1,886	$1,320.20	$490.36 – $1,603.10
MRI of the lower back (lumbar spine), without contrast: 10 of 13 insurance plan rates Aetna — All Products: $1,320.20 Anthem — All Products: $1,452.22 Anthem — Managed Medicaid: $215.09 Cigna — All Products: $1,414.50 Coventry — All Products: $1,603.10 HealthLink — All Products: $1,414.50 HomeState — All Products: $686.50 Homestate — Managed Medicaid: $230.15 Humana — All Products: $1,603.10 Humana — Medicare Advantage: $490.36
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI THORACIC SPNE W/ CONTRAST	$1,761	$1,232.70	$457.86 – $1,496.85
MRI of the lower back (lumbar spine), without contrast: 10 of 13 insurance plan rates Aetna — All Products: $1,232.70 Anthem — All Products: $1,355.97 Anthem — Managed Medicaid: $215.09 Cigna — All Products: $1,320.75 Coventry — All Products: $1,496.85 HealthLink — All Products: $1,320.75 HomeState — All Products: $641 Homestate — Managed Medicaid: $230.15 Humana — All Products: $1,496.85 Humana — Medicare Advantage: $457.86
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF CT PELVIS W/ CONTRAST	$302.10	$211.47	$158.12 – $421.05
CT scan of the pelvis, with contrast: 10 of 17 insurance plan rates Aetna — All Products Counselor: $302.10 Aetna — All Products Physician: $302.10 Aetna — All Products Psychology: $302.10 Anthem — All Products Facility: $421.05 Anthem — All Products Non-Facility: $421.05 Anthem — Managed Medicaid: $216.28 Anthem — Medicare Advantage: $179.20 Cigna — All Products: $235.10 Coventry — All Products: $302.10 HealthLink — All Products: $287.35
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/ CONTRAST	$1,365	$955.50	$354.90 – $1,160.25
CT scan of the pelvis, with contrast: 10 of 13 insurance plan rates Aetna — All Products: $955.50 Anthem — All Products: $1,051.05 Anthem — Managed Medicaid: $158.12 Cigna — All Products: $1,023.75 Coventry — All Products: $1,160.25 HealthLink — All Products: $1,023.75 HomeState — All Products: $496.86 Homestate — Managed Medicaid: $169.19 Humana — All Products: $1,160.25 Humana — Medicare Advantage: $354.90
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/O CONTRAST	$1,323	$926.10	$343.98 – $1,124.55
CT scan of the pelvis, with contrast: 10 of 13 insurance plan rates Aetna — All Products: $926.10 Anthem — All Products: $1,018.71 Anthem — Managed Medicaid: $158.12 Cigna — All Products: $992.25 Coventry — All Products: $1,124.55 HealthLink — All Products: $992.25 HomeState — All Products: $481.57 Homestate — Managed Medicaid: $169.19 Humana — All Products: $1,124.55 Humana — Medicare Advantage: $343.98
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF MRI LOW EXT JT W/O CONTRAST	$406	$284.20	$215.09 – $612.15
MRI of a leg joint (such as the knee), without contrast: 10 of 17 insurance plan rates Aetna — All Products Counselor: $300.51 Aetna — All Products Physician: $300.51 Aetna — All Products Psychology: $300.51 Anthem — All Products Facility: $612.15 Anthem — All Products Non-Facility: $612.15 Anthem — Managed Medicaid: $244.56 Anthem — Medicare Advantage: $243.77 Cigna — All Products: $300 Coventry — All Products: $366.84 HealthLink — All Products: $300.77
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LOW EXT JT W/O CONTRAST LT	$1,603	$1,122.10	$416.78 – $1,362.55
MRI of a leg joint (such as the knee), without contrast: 10 of 13 insurance plan rates Aetna — All Products: $1,122.10 Anthem — All Products: $1,234.31 Anthem — Managed Medicaid: $215.09 Cigna — All Products: $1,202.25 Coventry — All Products: $1,362.55 HealthLink — All Products: $1,202.25 HomeState — All Products: $583.49 Homestate — Managed Medicaid: $230.15 Humana — All Products: $1,362.55 Humana — Medicare Advantage: $416.78
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LOW EXT JT W/O CONTRAST RT	$1,603	$1,122.10	$416.78 – $1,362.55
MRI of a leg joint (such as the knee), without contrast: 10 of 13 insurance plan rates Aetna — All Products: $1,122.10 Anthem — All Products: $1,234.31 Anthem — Managed Medicaid: $215.09 Cigna — All Products: $1,202.25 Coventry — All Products: $1,362.55 HealthLink — All Products: $1,202.25 HomeState — All Products: $583.49 Homestate — Managed Medicaid: $230.15 Humana — All Products: $1,362.55 Humana — Medicare Advantage: $416.78
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF CT ABD & PELVIS W/ CONTRAST	$1,000	$700	$66.03 – $448.56
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates Aetna — All Products Counselor: $448.56 Aetna — All Products Physician: $448.56 Aetna — All Products Psychology: $448.56 Anthem — All Products Facility: $442.72 Anthem — All Products Non-Facility: $442.72 Anthem — Managed Medicaid: $66.03 Anthem — Medicare Advantage: $356.43 Cigna — All Products: $750 Coventry — All Products: $99.05 HealthLink — All Products: $399.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/ CONTRAST	$2,472	$1,730.40	$642.72 – $2,101.20
CT scan of the abdomen and pelvis, with contrast: 10 of 13 insurance plan rates Aetna — All Products: $1,730.40 Anthem — All Products: $1,903.44 Anthem — Managed Medicaid: $314.49 Cigna — All Products: $1,854 Coventry — All Products: $2,101.20 HealthLink — All Products: $1,854 HomeState — All Products: $899.81 Homestate — Managed Medicaid: $336.50 Humana — All Products: $2,101.20 Humana — Medicare Advantage: $642.72
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/O CONTRAST	$1,896	$1,327.20	$492.96 – $1,611.60
CT scan of the abdomen and pelvis, with contrast: 10 of 13 insurance plan rates Aetna — All Products: $1,327.20 Anthem — All Products: $1,459.92 Anthem — Managed Medicaid: $314.49 Cigna — All Products: $1,422 Coventry — All Products: $1,611.60 HealthLink — All Products: $1,422 HomeState — All Products: $690.14 Homestate — Managed Medicaid: $336.50 Humana — All Products: $1,611.60 Humana — Medicare Advantage: $492.96
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF US ABDOMEN COMPLETE	$199.50	$139.65	$68.70 – $167.97
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates Aetna — All Products Counselor: $167.97 Aetna — All Products Physician: $167.97 Aetna — All Products Psychology: $167.97 Anthem — All Products Facility: $157.50 Anthem — All Products Non-Facility: $157.50 Anthem — Managed Medicaid: $68.70 Anthem — Medicare Advantage: $106.81 Cigna — All Products: $100.14 Coventry — All Products: $103.05 HealthLink — All Products: $159.20
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMEN COMPLETE	$901	$630.70	$234.26 – $765.85
Ultrasound of the abdomen, complete: 10 of 13 insurance plan rates Aetna — All Products: $630.70 Anthem — All Products: $693.77 Anthem — Managed Medicaid: $94.24 Cigna — All Products: $675.75 Coventry — All Products: $765.85 HealthLink — All Products: $675.75 HomeState — All Products: $327.96 Homestate — Managed Medicaid: $100.84 Humana — All Products: $765.85 Humana — Medicare Advantage: $234.26
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US CHEST REAL TIME	$289	$202.30	$75.14 – $245.65
Ultrasound of the abdomen, complete: 10 of 13 insurance plan rates Aetna — All Products: $202.30 Anthem — All Products: $222.53 Anthem — Managed Medicaid: $94.24 Cigna — All Products: $216.75 Coventry — All Products: $245.65 HealthLink — All Products: $216.75 HomeState — All Products: $105.20 Homestate — Managed Medicaid: $100.84 Humana — All Products: $245.65 Humana — Medicare Advantage: $75.14
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF US PREG UTRS 1ST SNGL>14 WK	$212	$148.40	$68.70 – $195.96
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates Aetna — All Products Counselor: $195.96 Aetna — All Products Physician: $195.96 Aetna — All Products Psychology: $195.96 Anthem — All Products Facility: $176.40 Anthem — All Products Non-Facility: $176.40 Anthem — Managed Medicaid: $68.70 Anthem — Medicare Advantage: $106.81 Cigna — All Products: $107.73 Coventry — All Products: $103.05 HealthLink — All Products: $185.92
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREG UTERUS 1ST SNGL>14 WKS	$603	$422.10	$156.78 – $512.55
Pregnancy ultrasound (after the first trimester): 10 of 13 insurance plan rates Aetna — All Products: $422.10 Anthem — All Products: $464.31 Anthem — Managed Medicaid: $94.24 Cigna — All Products: $452.25 Coventry — All Products: $512.55 HealthLink — All Products: $452.25 HomeState — All Products: $219.49 Homestate — Managed Medicaid: $100.84 Humana — All Products: $512.55 Humana — Medicare Advantage: $156.78
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREG UTERUS 1ST EA ADD<14WK	$250	$175	$65 – $212.50
Pregnancy ultrasound (after the first trimester): 10 of 13 insurance plan rates Aetna — All Products: $175 Anthem — All Products: $192.50 Anthem — Managed Medicaid: $94.24 Cigna — All Products: $187.50 Coventry — All Products: $212.50 HealthLink — All Products: $187.50 HomeState — All Products: $91 Homestate — Managed Medicaid: $100.84 Humana — All Products: $212.50 Humana — Medicare Advantage: $65
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF US TRANSVAGINAL	$190	$133	$68.70 – $171.93
Transvaginal ultrasound: 10 of 17 insurance plan rates Aetna — All Products Counselor: $171.93 Aetna — All Products Physician: $171.93 Aetna — All Products Psychology: $171.93 Anthem — All Products Facility: $127.05 Anthem — All Products Non-Facility: $127.05 Anthem — Managed Medicaid: $68.70 Anthem — Medicare Advantage: $106.81 Cigna — All Products: $87.80 Coventry — All Products: $103.05 HealthLink — All Products: $157.86
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAGINAL	$528	$369.60	$137.28 – $448.80
Transvaginal ultrasound: 10 of 13 insurance plan rates Aetna — All Products: $369.60 Anthem — All Products: $406.56 Anthem — Managed Medicaid: $94.24 Cigna — All Products: $396 Coventry — All Products: $448.80 HealthLink — All Products: $396 HomeState — All Products: $192.19 Homestate — Managed Medicaid: $100.84 Humana — All Products: $448.80 Humana — Medicare Advantage: $137.28
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US DPLR VELOCIMETRY UA	$306	$214.20	$79.56 – $260.10
Transvaginal ultrasound: 10 of 13 insurance plan rates Aetna — All Products: $214.20 Anthem — All Products: $235.62 Anthem — Managed Medicaid: $94.24 Cigna — All Products: $229.50 Coventry — All Products: $260.10 HealthLink — All Products: $229.50 HomeState — All Products: $111.38 Homestate — Managed Medicaid: $100.84 Humana — All Products: $260.10 Humana — Medicare Advantage: $79.56
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF MM MAMMO DX DDI 2D UNI	$146	$102.20	$32.42 – $146
Diagnostic mammogram, one breast: 10 of 15 insurance plan rates Aetna — All Products Counselor: $146 Aetna — All Products Physician: $146 Aetna — All Products Psychology: $146 Anthem — All Products Facility: $117.60 Anthem — All Products Non-Facility: $117.60 Anthem — Managed Medicaid: $32.42 Anthem — Medicare Advantage: $110.68 Cigna — All Products: $109.50 Coventry — All Products: $48.63 HealthLink — All Products: $128.14
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MM MAMMO DX DDI 2D UNI LT	$790	$553	$205.40 – $671.50
Diagnostic mammogram, one breast: 10 of 13 insurance plan rates Aetna — All Products: $553 Anthem — All Products: $608.30 Anthem — Managed Medicaid: $107.41 Cigna — All Products: $592.50 Coventry — All Products: $671.50 HealthLink — All Products: $592.50 HomeState — All Products: $287.56 Homestate — Managed Medicaid: $114.93 Humana — All Products: $671.50 Humana — Medicare Advantage: $205.40
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MM MAMMO DX DDI 2D UNI RT	$790	$553	$205.40 – $671.50
Diagnostic mammogram, one breast: 10 of 13 insurance plan rates Aetna — All Products: $553 Anthem — All Products: $608.30 Anthem — Managed Medicaid: $107.41 Cigna — All Products: $592.50 Coventry — All Products: $671.50 HealthLink — All Products: $592.50 HomeState — All Products: $287.56 Homestate — Managed Medicaid: $114.93 Humana — All Products: $671.50 Humana — Medicare Advantage: $205.40
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF MM MAMMO DX DDI 2D BIL	$169	$118.30	$40.09 – $169
Diagnostic mammogram, both breasts: 10 of 15 insurance plan rates Aetna — All Products Counselor: $169 Aetna — All Products Physician: $169 Aetna — All Products Psychology: $169 Anthem — All Products Facility: $137.55 Anthem — All Products Non-Facility: $137.55 Anthem — Managed Medicaid: $40.09 Anthem — Medicare Advantage: $140.14 Cigna — All Products: $126.75 Coventry — All Products: $60.14 HealthLink — All Products: $161.18
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MM MAMMO DX DDI 2D BIL	$848	$593.60	$220.48 – $720.80
Diagnostic mammogram, both breasts: 10 of 13 insurance plan rates Aetna — All Products: $593.60 Anthem — All Products: $652.96 Anthem — Managed Medicaid: $136.04 Cigna — All Products: $636 Coventry — All Products: $720.80 HealthLink — All Products: $636 HomeState — All Products: $308.67 Homestate — Managed Medicaid: $145.56 Humana — All Products: $720.80 Humana — Medicare Advantage: $220.48
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MM MAMMO DBT BIL	$848	$593.60	$220.48 – $720.80
Diagnostic mammogram, both breasts: 10 of 13 insurance plan rates Aetna — All Products: $593.60 Anthem — All Products: $652.96 Anthem — Managed Medicaid: $136.04 Cigna — All Products: $636 Coventry — All Products: $720.80 HealthLink — All Products: $636 HomeState — All Products: $308.67 Homestate — Managed Medicaid: $145.56 Humana — All Products: $720.80 Humana — Medicare Advantage: $220.48
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF MM MAMMO SCREEN DDI BIL	$286	$200.20	$30.42 – $184.46
Screening mammogram, both breasts: 10 of 15 insurance plan rates Aetna — All Products Counselor: $184.46 Aetna — All Products Physician: $184.46 Aetna — All Products Psychology: $184.46 Anthem — All Products Facility: $126 Anthem — All Products Non-Facility: $126 Anthem — Managed Medicaid: $30.42 Anthem — Medicare Advantage: $112.43 Cigna — All Products: $214.50 Coventry — All Products: $45.63 HealthLink — All Products: $118.90
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MM MAMMO SCREEN DDI BIL	$315	$220.50	$81.90 – $267.75
Screening mammogram, both breasts: 10 of 13 insurance plan rates Aetna — All Products: $220.50 Anthem — All Products: $242.55 Anthem — Managed Medicaid: $109.32 Cigna — All Products: $236.25 Coventry — All Products: $267.75 HealthLink — All Products: $236.25 HomeState — All Products: $114.66 Homestate — Managed Medicaid: $116.97 Humana — All Products: $267.75 Humana — Medicare Advantage: $81.90
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MM MAMMO SCREEN TOMO	$294	$205.80	$76.44 – $249.90
Screening mammogram, both breasts: 10 of 13 insurance plan rates Aetna — All Products: $205.80 Anthem — All Products: $226.38 Anthem — Managed Medicaid: $109.32 Cigna — All Products: $220.50 Coventry — All Products: $249.90 HealthLink — All Products: $220.50 HomeState — All Products: $107.02 Homestate — Managed Medicaid: $116.97 Humana — All Products: $249.90 Humana — Medicare Advantage: $76.44

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: JO-1 ANTIBODY SEND OUT	$107	$74.90	$27.82 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $90.95
Sleep study (overnight, in a sleep lab): 10 of 13 insurance plan rates Aetna — All Products: $74.90 Anthem — All Products: $82.39 Anthem — Managed Medicaid: $107 Cigna — All Products: $80.25 Coventry — All Products: $90.95 HealthLink — All Products: $80.25 HomeState — All Products: $38.95 Homestate — Managed Medicaid: $828.30 Humana — All Products: $90.95 Humana — Medicare Advantage: $27.82 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT THER PROC/EXER EA 15M	$164	$114.80	$42.64 – $139.40
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 13 insurance plan rates Aetna — All Products: $114.80 Anthem — All Products: $126.28 Anthem — Managed Medicaid: $25.56 Cigna — All Products: $123 Coventry — All Products: $139.40 HealthLink — All Products: $123 HomeState — All Products: $59.70 Homestate — Managed Medicaid: $27.35 Humana — All Products: $139.40 Humana — Medicare Advantage: $42.64
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OT THER PROC/EXER EA 15M	$175	$122.50	$45.50 – $148.75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 13 insurance plan rates Aetna — All Products: $122.50 Anthem — All Products: $134.75 Anthem — Managed Medicaid: $25.56 Cigna — All Products: $131.25 Coventry — All Products: $148.75 HealthLink — All Products: $131.25 HomeState — All Products: $63.70 Homestate — Managed Medicaid: $27.35 Humana — All Products: $148.75 Humana — Medicare Advantage: $45.50
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 96 In the file: THERAPEUTIC EXERCISES	Not listed in the file	Not listed in the file	$25.56 – $28.12
Physical therapy: therapeutic exercise (each 15 minutes): rates for 3 insurance plans Anthem — Managed Medicaid: $25.56 Homestate — Managed Medicaid: $27.35 UHC — Managed Medicaid: $28.12
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20M	$261	$182.70	$67.86 – $221.85
Physical therapy evaluation (low complexity): 10 of 13 insurance plan rates Aetna — All Products: $182.70 Anthem — All Products: $200.97 Anthem — Managed Medicaid: $86.09 Cigna — All Products: $195.75 Coventry — All Products: $221.85 HealthLink — All Products: $195.75 HomeState — All Products: $95 Homestate — Managed Medicaid: $92.12 Humana — All Products: $221.85 Humana — Medicare Advantage: $67.86
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 96 In the file: PT EVAL LOW COMPLEX 20 MIN	Not listed in the file	Not listed in the file	$86.09 – $94.70
Physical therapy evaluation (low complexity): rates for 3 insurance plans Anthem — Managed Medicaid: $86.09 Homestate — Managed Medicaid: $92.12 UHC — Managed Medicaid: $94.70
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier EP In the file: PT EVAL LOW COMPLEX 20 MIN	Not listed in the file	Not listed in the file	$86.09 – $94.70
Physical therapy evaluation (low complexity): rates for 3 insurance plans Anthem — Managed Medicaid: $86.09 Homestate — Managed Medicaid: $92.12 UHC — Managed Medicaid: $94.70
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30M	$293.93	$205.75	$76.42 – $249.84
Physical therapy evaluation (moderate complexity): 10 of 13 insurance plan rates Aetna — All Products: $205.75 Anthem — All Products: $226.33 Anthem — Managed Medicaid: $86.09 Cigna — All Products: $220.45 Coventry — All Products: $249.84 HealthLink — All Products: $220.45 HomeState — All Products: $106.99 Homestate — Managed Medicaid: $92.12 Humana — All Products: $249.84 Humana — Medicare Advantage: $76.42
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 96 In the file: PT EVAL MOD COMPLEX 30 MIN	Not listed in the file	Not listed in the file	$86.09 – $94.70
Physical therapy evaluation (moderate complexity): rates for 3 insurance plans Anthem — Managed Medicaid: $86.09 Homestate — Managed Medicaid: $92.12 UHC — Managed Medicaid: $94.70
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier EP In the file: PT EVAL MOD COMPLEX 30 MIN	Not listed in the file	Not listed in the file	$86.09 – $94.70
Physical therapy evaluation (moderate complexity): rates for 3 insurance plans Anthem — Managed Medicaid: $86.09 Homestate — Managed Medicaid: $92.12 UHC — Managed Medicaid: $94.70
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45M	$475	$332.50	$123.50 – $403.75
Physical therapy evaluation (high complexity): 10 of 13 insurance plan rates Aetna — All Products: $332.50 Anthem — All Products: $365.75 Anthem — Managed Medicaid: $86.09 Cigna — All Products: $356.25 Coventry — All Products: $403.75 HealthLink — All Products: $356.25 HomeState — All Products: $172.90 Homestate — Managed Medicaid: $92.12 Humana — All Products: $403.75 Humana — Medicare Advantage: $123.50
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 96 In the file: PT EVAL HIGH COMPLEX 45 MIN	Not listed in the file	Not listed in the file	$86.09 – $94.70
Physical therapy evaluation (high complexity): rates for 3 insurance plans Anthem — Managed Medicaid: $86.09 Homestate — Managed Medicaid: $92.12 UHC — Managed Medicaid: $94.70
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier EP In the file: PT EVAL HIGH COMPLEX 45 MIN	Not listed in the file	Not listed in the file	$86.09 – $94.70
Physical therapy evaluation (high complexity): rates for 3 insurance plans Anthem — Managed Medicaid: $86.09 Homestate — Managed Medicaid: $92.12 UHC — Managed Medicaid: $94.70
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX IND W/ PT 30M	$582	$407.40	$151.32 – $494.70
Psychotherapy, 30 minutes: 10 of 13 insurance plan rates Aetna — All Products: $407.40 Anthem — All Products: $448.14 Anthem — Managed Medicaid: $160 Cigna — All Products: $436.50 Coventry — All Products: $494.70 HealthLink — All Products: $436.50 HomeState — All Products: $211.85 Homestate — Managed Medicaid: $171.20 Humana — All Products: $494.70 Humana — Medicare Advantage: $151.32
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX IND W/ PT 45M	$824	$576.80	$214.24 – $700.40
Psychotherapy, 45 minutes: 10 of 13 insurance plan rates Aetna — All Products: $576.80 Anthem — All Products: $634.48 Anthem — Managed Medicaid: $160 Cigna — All Products: $618 Coventry — All Products: $700.40 HealthLink — All Products: $618 HomeState — All Products: $299.94 Homestate — Managed Medicaid: $171.20 Humana — All Products: $700.40 Humana — Medicare Advantage: $214.24
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX IND W/ PT 60M	$876	$613.20	$227.76 – $744.60
Psychotherapy, 60 minutes: 10 of 13 insurance plan rates Aetna — All Products: $613.20 Anthem — All Products: $674.52 Anthem — Managed Medicaid: $160 Cigna — All Products: $657 Coventry — All Products: $744.60 HealthLink — All Products: $657 HomeState — All Products: $318.86 Homestate — Managed Medicaid: $171.20 Humana — All Products: $744.60 Humana — Medicare Advantage: $227.76
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX FAMILY W/O PT 50M	$795	$556.50	$206.70 – $675.75
Family psychotherapy, without the patient: 10 of 13 insurance plan rates Aetna — All Products: $556.50 Anthem — All Products: $612.15 Anthem — Managed Medicaid: $160 Cigna — All Products: $596.25 Coventry — All Products: $675.75 HealthLink — All Products: $596.25 HomeState — All Products: $289.38 Homestate — Managed Medicaid: $171.20 Humana — All Products: $675.75 Humana — Medicare Advantage: $206.70
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX FAMILY W/ PT 50M	$870	$609	$226.20 – $739.50
Family psychotherapy, with the patient: 10 of 13 insurance plan rates Aetna — All Products: $609 Anthem — All Products: $669.90 Anthem — Managed Medicaid: $160 Cigna — All Products: $652.50 Coventry — All Products: $739.50 HealthLink — All Products: $652.50 HomeState — All Products: $316.68 Homestate — Managed Medicaid: $171.20 Humana — All Products: $739.50 Humana — Medicare Advantage: $226.20
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX GROUP OTHER	$953	$667.10	$247.78 – $810.05
Group psychotherapy: 10 of 13 insurance plan rates Aetna — All Products: $667.10 Anthem — All Products: $733.81 Anthem — Managed Medicaid: $91.58 Cigna — All Products: $714.75 Coventry — All Products: $810.05 HealthLink — All Products: $714.75 HomeState — All Products: $346.89 Homestate — Managed Medicaid: $97.99 Humana — All Products: $810.05 Humana — Medicare Advantage: $247.78

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF EXC CYST BREAST LESION	$917	$641.90	$394.12 – $917
Removal of breast growth (open surgery): 10 of 17 insurance plan rates Aetna — All Products Counselor: $619.07 Aetna — All Products Physician: $619.07 Aetna — All Products Psychology: $619.07 Anthem — All Products Facility: $489.30 Anthem — All Products Non-Facility: $489.30 Anthem — Managed Medicaid: $394.12 Anthem — Medicare Advantage: $917 Cigna — All Products: $556.86 Coventry — All Products: $591.18 HealthLink — All Products: $554.34
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF TOTAL HIP ARTHROPLASTY	$2,550	$1,785	$1,489.57 – $2,550
Total hip replacement: 10 of 17 insurance plan rates Aetna — All Products Counselor: $1,891.68 Aetna — All Products Physician: $1,891.68 Aetna — All Products Psychology: $1,891.68 Anthem — All Products Facility: $2,071.65 Anthem — All Products Non-Facility: $2,071.65 Anthem — Managed Medicaid: $1,489.57 Anthem — Medicare Advantage: $2,550 Cigna — All Products: $1,853.27 Coventry — All Products: $2,234.36 HealthLink — All Products: $1,972.37
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$11,573.41 – $12,730.75
Total hip replacement: rates for 3 insurance plans Anthem — Managed Medicaid: $11,573.41 Homestate — Managed Medicaid: $12,383.55 UHC — Managed Medicaid: $12,730.75
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$17,360.12 – $19,096.13
Total hip replacement: rates for 3 insurance plans Anthem — Managed Medicaid: $17,360.12 Homestate — Managed Medicaid: $18,575.33 UHC — Managed Medicaid: $19,096.13
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF TOTAL KNEE ARTHROPLASTY	$2,250	$1,575	$965.28 – $2,250
Total knee replacement: 10 of 17 insurance plan rates Aetna — All Products Counselor: $1,888.79 Aetna — All Products Physician: $1,888.79 Aetna — All Products Psychology: $1,888.79 Anthem — All Products Facility: $2,180.85 Anthem — All Products Non-Facility: $2,180.85 Anthem — Managed Medicaid: $965.28 Anthem — Medicare Advantage: $2,250 Cigna — All Products: $1,984.38 Coventry — All Products: $1,447.92 HealthLink — All Products: $1,971.92
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$11,573.41 – $12,730.75
Total knee replacement: rates for 3 insurance plans Anthem — Managed Medicaid: $11,573.41 Homestate — Managed Medicaid: $12,383.55 UHC — Managed Medicaid: $12,730.75
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$17,360.12 – $19,096.13
Total knee replacement: rates for 3 insurance plans Anthem — Managed Medicaid: $17,360.12 Homestate — Managed Medicaid: $18,575.33 UHC — Managed Medicaid: $19,096.13
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF SHO ARTHRS SRG DECOMPRESS	$1,906	$1,334.20	$250.83 – $1,017.45
Shoulder arthroscopy: shaving of shoulder bone: 10 of 13 insurance plan rates Aetna — All Products Counselor: $250.83 Aetna — All Products Physician: $250.83 Aetna — All Products Psychology: $250.83 Anthem — All Products Facility: $1,017.45 Anthem — All Products Non-Facility: $1,017.45 Anthem — Managed Medicaid: $503.70 Cigna — All Products: $840.48 Coventry — All Products: $755.55 HealthLink — All Products: $259.50 HealthLink — All Products - NF: $1,620.10
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF ARTHR KNEE MENIS MED OR LAT	$2,279	$1,595.30	$589.95 – $2,279
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 17 insurance plan rates Aetna — All Products Counselor: $804.11 Aetna — All Products Physician: $804.11 Aetna — All Products Psychology: $804.11 Anthem — All Products Facility: $857.85 Anthem — All Products Non-Facility: $857.85 Anthem — Managed Medicaid: $589.95 Anthem — Medicare Advantage: $2,279 Cigna — All Products: $795.75 Coventry — All Products: $884.93 HealthLink — All Products: $773.60
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$2,949.54 – $3,244.49
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 3 insurance plans Anthem — Managed Medicaid: $2,949.54 Homestate — Managed Medicaid: $3,156.01 UHC — Managed Medicaid: $3,244.49
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$4,424.31 – $4,866.74
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 3 insurance plans Anthem — Managed Medicaid: $4,424.31 Homestate — Managed Medicaid: $4,734.01 UHC — Managed Medicaid: $4,866.74
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF EGD DIAGNOSTIC BRUSH WASH	$610	$427	$178.11 – $610
Upper GI endoscopy (diagnostic): 10 of 17 insurance plan rates Aetna — All Products Counselor: $178.11 Aetna — All Products Physician: $178.11 Aetna — All Products Psychology: $178.11 Anthem — All Products Facility: $207.90 Anthem — All Products Non-Facility: $207.90 Anthem — Managed Medicaid: $231 Anthem — Medicare Advantage: $610 Cigna — All Products: $356.44 Coventry — All Products: $346.50 HealthLink — All Products: $270.65
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH	$1,611	$1,127.70	$418.86 – $1,369.35
Upper GI endoscopy (diagnostic): 10 of 13 insurance plan rates Aetna — All Products: $1,127.70 Anthem — All Products: $1,240.47 Anthem — Managed Medicaid: $817.60 Cigna — All Products: $1,208.25 Coventry — All Products: $1,369.35 HealthLink — All Products: $1,208.25 HomeState — All Products: $586.40 Homestate — Managed Medicaid: $874.83 Humana — All Products: $1,369.35 Humana — Medicare Advantage: $418.86
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF EGD BIOPSY SINGLE/MULTIPLE	$775	$542.50	$201.26 – $775
Upper GI endoscopy with biopsy: 10 of 17 insurance plan rates Aetna — All Products Counselor: $201.26 Aetna — All Products Physician: $201.26 Aetna — All Products Psychology: $201.26 Anthem — All Products Facility: $233.10 Anthem — All Products Non-Facility: $233.10 Anthem — Managed Medicaid: $295.49 Anthem — Medicare Advantage: $775 Cigna — All Products: $413.60 Coventry — All Products: $443.24 HealthLink — All Products: $304.23
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	$1,974	$1,381.80	$513.24 – $1,677.90
Upper GI endoscopy with biopsy: 10 of 13 insurance plan rates Aetna — All Products: $1,381.80 Anthem — All Products: $1,519.98 Anthem — Managed Medicaid: $817.60 Cigna — All Products: $1,480.50 Coventry — All Products: $1,677.90 HealthLink — All Products: $1,480.50 HomeState — All Products: $718.54 Homestate — Managed Medicaid: $874.83 Humana — All Products: $1,677.90 Humana — Medicare Advantage: $513.24
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF COLONOSCOPY DIAGNOSTIC	$1,099	$769.30	$267.75 – $880.23
Colonoscopy (diagnostic): 10 of 17 insurance plan rates Aetna — All Products Counselor: $267.75 Aetna — All Products Physician: $267.75 Aetna — All Products Psychology: $267.75 Anthem — All Products Facility: $317.10 Anthem — All Products Non-Facility: $317.10 Anthem — Managed Medicaid: $417.45 Anthem — Medicare Advantage: $950.10 Cigna — All Products: $476.53 Coventry — All Products: $626.18 HealthLink — All Products: $408.92
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY DIAGNOSTIC	$810	$567	$210.60 – $688.50
Colonoscopy (diagnostic): 10 of 13 insurance plan rates Aetna — All Products: $567 Anthem — All Products: $623.70 Anthem — Managed Medicaid: $810 Cigna — All Products: $607.50 Coventry — All Products: $688.50 HealthLink — All Products: $607.50 HomeState — All Products: $294.84 Homestate — Managed Medicaid: $896.99 Humana — All Products: $688.50 Humana — Medicare Advantage: $210.60
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF COLONOSCOPY W/ BIOPSY	$1,019	$713.30	$290.87 – $1,019
Colonoscopy with biopsy: 10 of 17 insurance plan rates Aetna — All Products Counselor: $290.87 Aetna — All Products Physician: $290.87 Aetna — All Products Psychology: $290.87 Anthem — All Products Facility: $342.30 Anthem — All Products Non-Facility: $342.30 Anthem — Managed Medicaid: $417.45 Anthem — Medicare Advantage: $1,019 Cigna — All Products: $571.94 Coventry — All Products: $626.18 HealthLink — All Products: $488.98
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ BIOPSY	$2,395	$1,676.50	$622.70 – $2,035.75
Colonoscopy with biopsy: 10 of 13 insurance plan rates Aetna — All Products: $1,676.50 Anthem — All Products: $1,844.15 Anthem — Managed Medicaid: $1,078.71 Cigna — All Products: $1,796.25 Coventry — All Products: $2,035.75 HealthLink — All Products: $1,796.25 HomeState — All Products: $871.78 Homestate — Managed Medicaid: $1,154.22 Humana — All Products: $2,035.75 Humana — Medicare Advantage: $622.70
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF COLONOSCOPY W/ LESION SNARE	$1,221	$854.70	$368.16 – $1,132.65
Colonoscopy with removal of polyps (snare): 10 of 17 insurance plan rates Aetna — All Products Counselor: $368.16 Aetna — All Products Physician: $368.16 Aetna — All Products Psychology: $368.16 Anthem — All Products Facility: $449.40 Anthem — All Products Non-Facility: $449.40 Anthem — Managed Medicaid: $417.45 Anthem — Medicare Advantage: $1,221 Cigna — All Products: $648.14 Coventry — All Products: $626.18 HealthLink — All Products: $580.67
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ LESION SNARE	$2,682	$1,877.40	$697.32 – $2,279.70
Colonoscopy with removal of polyps (snare): 10 of 13 insurance plan rates Aetna — All Products: $1,877.40 Anthem — All Products: $2,065.14 Anthem — Managed Medicaid: $1,078.71 Cigna — All Products: $2,011.50 Coventry — All Products: $2,279.70 HealthLink — All Products: $2,011.50 HomeState — All Products: $976.25 Homestate — Managed Medicaid: $1,154.22 Humana — All Products: $2,279.70 Humana — Medicare Advantage: $697.32
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF COLONOSCOPY SCREENING	$855	$598.50	$237.48 – $345.20
Screening colonoscopy (not high risk): 10 of 13 insurance plan rates Aetna — All Products Counselor: $268.26 Aetna — All Products Physician: $268.26 Aetna — All Products Psychology: $268.26 Anthem — All Products Facility: $345.20 Anthem — All Products Non-Facility: $345.20 Anthem — Medicare Advantage: $855 Cigna — All Products: $328.64 HealthLink — All Products: $237.48 HealthLink — All Products - NF: $726.75 HomeState — All Products: $855
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY SCREENING	$1,952	$1,366.40	$507.52 – $1,659.20
Screening colonoscopy (not high risk): rates for 10 insurance plans Aetna — All Products: $1,366.40 Anthem — All Products: $1,503.04 Cigna — All Products: $1,464 Coventry — All Products: $1,659.20 HealthLink — All Products: $1,464 HomeState — All Products: $710.53 Humana — All Products: $1,659.20 Humana — Medicare Advantage: $507.52 UHC — All Products: $1,464 UHC — Medicare Advantage: $507.52
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF LAPROSCOPIC CHOLECYSTECTOMY	$2,364	$1,654.80	$871.19 – $2,364
Gallbladder removal by laparoscope: 10 of 17 insurance plan rates Aetna — All Products Counselor: $977.52 Aetna — All Products Physician: $977.52 Aetna — All Products Psychology: $977.52 Anthem — All Products Facility: $928.20 Anthem — All Products Non-Facility: $928.20 Anthem — Managed Medicaid: $2,167.82 Anthem — Medicare Advantage: $2,364 Cigna — All Products: $912.75 Coventry — All Products: $2,364 HealthLink — All Products: $962.30
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$5,449.73 – $5,994.70
Gallbladder removal by laparoscope: rates for 3 insurance plans Anthem — Managed Medicaid: $5,449.73 Homestate — Managed Medicaid: $5,831.21 UHC — Managed Medicaid: $5,994.70
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF RPR HERN INIT ING REDUC>5YR	$2,607	$1,824.90	$397.19 – $2,607
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates Aetna — All Products Counselor: $775.29 Aetna — All Products Physician: $775.29 Aetna — All Products Psychology: $775.29 Anthem — All Products Facility: $568.05 Anthem — All Products Non-Facility: $568.05 Anthem — Managed Medicaid: $397.19 Anthem — Medicare Advantage: $2,607 Cigna — All Products: $634.53 Coventry — All Products: $595.79 HealthLink — All Products: $757.28
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$3,227.55 – $3,550.31
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans Anthem — Managed Medicaid: $3,227.55 Homestate — Managed Medicaid: $3,453.48 UHC — Managed Medicaid: $3,550.31
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$4,841.33 – $5,325.46
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans Anthem — Managed Medicaid: $4,841.33 Homestate — Managed Medicaid: $5,180.22 UHC — Managed Medicaid: $5,325.46
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF HYSTERSCPE W/BIOP W-W/O D&C	$1,175	$822.50	$340.43 – $1,175
Hysteroscopy with biopsy of the uterus lining: 10 of 17 insurance plan rates Aetna — All Products Counselor: $340.43 Aetna — All Products Physician: $340.43 Aetna — All Products Psychology: $340.43 Anthem — All Products Facility: $375.90 Anthem — All Products Non-Facility: $375.90 Anthem — Managed Medicaid: $1,054.13 Anthem — Medicare Advantage: $1,175 Cigna — All Products: $418.86 Coventry — All Products: $1,175 HealthLink — All Products: $387.54
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$2,918.10 – $3,209.91
Hysteroscopy with biopsy of the uterus lining: rates for 3 insurance plans Anthem — Managed Medicaid: $2,918.10 Homestate — Managed Medicaid: $3,122.37 UHC — Managed Medicaid: $3,209.91
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF NJX INTER LMBR/SAC W/ IMG	$3,800	$2,660	$138.46 – $668.14
Spinal injection, lower back (epidural), with imaging guidance: 10 of 15 insurance plan rates Aetna — All Products Counselor: $145.40 Aetna — All Products Physician: $145.40 Aetna — All Products Psychology: $145.40 Anthem — All Products Facility: $138.46 Anthem — All Products Non-Facility: $312.23 Anthem — Managed Medicaid: $277.59 Anthem — Medicare Advantage: $721.17 Cigna — All Products: $2,850 Coventry — All Products: $416.39 HealthLink — All Products: $148.35
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTER LMBR/SAC W/ IMG	$2,124	$1,486.80	$552.24 – $1,805.40
Spinal injection, lower back (epidural), with imaging guidance: 10 of 13 insurance plan rates Aetna — All Products: $1,486.80 Anthem — All Products: $1,635.48 Anthem — Managed Medicaid: $636.32 Cigna — All Products: $1,593 Coventry — All Products: $1,805.40 HealthLink — All Products: $1,593 HomeState — All Products: $773.14 Homestate — Managed Medicaid: $680.86 Humana — All Products: $1,805.40 Humana — Medicare Advantage: $552.24
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF NJX AA&/STRD TFRM EPI L/S 1	$3,000	$2,100	$132.30 – $837.18
Nerve root injection, lower back, with imaging guidance: 10 of 17 insurance plan rates Aetna — All Products Counselor: $162.75 Aetna — All Products Physician: $162.75 Aetna — All Products Psychology: $162.75 Anthem — All Products Facility: $132.30 Anthem — All Products Non-Facility: $132.30 Anthem — Managed Medicaid: $368 Anthem — Medicare Advantage: $903.63 Cigna — All Products: $312.48 Coventry — All Products: $552 HealthLink — All Products: $164.15
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	$2,163	$1,514.10	$562.38 – $1,838.55
Nerve root injection, lower back, with imaging guidance: 10 of 13 insurance plan rates Aetna — All Products: $1,514.10 Anthem — All Products: $1,665.51 Anthem — Managed Medicaid: $797.31 Cigna — All Products: $1,622.25 Coventry — All Products: $1,838.55 HealthLink — All Products: $1,622.25 HomeState — All Products: $787.33 Homestate — Managed Medicaid: $853.12 Humana — All Products: $1,838.55 Humana — Medicare Advantage: $562.38
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$1,195.97 – $1,315.57
Nerve root injection, lower back, with imaging guidance: rates for 3 insurance plans Anthem — Managed Medicaid: $1,195.97 Homestate — Managed Medicaid: $1,279.69 UHC — Managed Medicaid: $1,315.57
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF CARPAL TUNNEL RELEASE	$1,463	$1,024.10	$335.75 – $1,463
Carpal tunnel release: 10 of 17 insurance plan rates Aetna — All Products Counselor: $649.56 Aetna — All Products Physician: $649.56 Aetna — All Products Psychology: $649.56 Anthem — All Products Facility: $516.60 Anthem — All Products Non-Facility: $516.60 Anthem — Managed Medicaid: $335.75 Anthem — Medicare Advantage: $1,463 Cigna — All Products: $502.43 Coventry — All Products: $503.63 HealthLink — All Products: $602.61
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$1,760.28 – $1,936.31
Carpal tunnel release: rates for 3 insurance plans Anthem — Managed Medicaid: $1,760.28 Homestate — Managed Medicaid: $1,883.50 UHC — Managed Medicaid: $1,936.31
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$2,640.42 – $2,904.46
Carpal tunnel release: rates for 3 insurance plans Anthem — Managed Medicaid: $2,640.42 Homestate — Managed Medicaid: $2,825.25 UHC — Managed Medicaid: $2,904.46

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF OBSTETRICAL CARE	$3,075	$2,152.50	$1,802.10 – $3,075
Vaginal delivery, with care before and after: 10 of 13 insurance plan rates Aetna — All Products Counselor: $3,075 Aetna — All Products Physician: $3,075 Aetna — All Products Psychology: $3,075 Anthem — All Products Facility: $2,152.50 Anthem — All Products Non-Facility: $2,152.50 Anthem — Managed Medicaid: $1,802.10 Cigna — All Products: $2,319.90 Coventry — All Products: $2,703.15 HealthLink — All Products: $2,600 HealthLink — All Products - NF: $2,613.75
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF CESAREAN DEL W/ ANTE & POST	$3,755	$2,628.50	$1,987.76 – $3,755
Cesarean delivery (C-section), with care before and after: 10 of 13 insurance plan rates Aetna — All Products Counselor: $3,755 Aetna — All Products Physician: $3,755 Aetna — All Products Psychology: $3,755 Anthem — All Products Facility: $2,445.45 Anthem — All Products Non-Facility: $2,445.45 Anthem — Managed Medicaid: $1,987.76 Cigna — All Products: $2,627.43 Coventry — All Products: $2,981.64 HealthLink — All Products: $2,600 HealthLink — All Products - NF: $3,191.75

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$1,500
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 5 insurance plans HealthLink — All Products: $1,500 UHC — All Products: $1,500 Anthem — All Products: 77% (a percentage in the contract, not a dollar amount) Cigna — All Products: 75% (a percentage in the contract, not a dollar amount) Humana — All Products: 85% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major joint replacement or reattachment of lower extremity w/o MCC	Not listed in the file	Not listed in the file	$1,500
Hip or knee replacement (major joint of the leg), without major complications: rates for 5 insurance plans HealthLink — All Products: $1,500 UHC — All Products: $1,500 Anthem — All Products: 77% (a percentage in the contract, not a dollar amount) Cigna — All Products: 75% (a percentage in the contract, not a dollar amount) Humana — All Products: 85% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$1,500
Neck (cervical) spinal fusion, without complications: rates for 5 insurance plans HealthLink — All Products: $1,500 UHC — All Products: $1,500 Anthem — All Products: 77% (a percentage in the contract, not a dollar amount) Cigna — All Products: 75% (a percentage in the contract, not a dollar amount) Humana — All Products: 85% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$1,500
Uterus and ovary surgery (not for cancer), without complications: rates for 5 insurance plans HealthLink — All Products: $1,500 UHC — All Products: $1,500 Anthem — All Products: 77% (a percentage in the contract, not a dollar amount) Cigna — All Products: 75% (a percentage in the contract, not a dollar amount) Humana — All Products: 85% (a percentage in the contract, not a dollar amount)

Source: Scotland County Hospital’s standard charges file (scmohospital.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on October 24, 2026; retrieved November 5, 2026.

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

Hospital information

Hospital type	Critical Access Hospital
Address	450 E Sigler Avenue, Memphis, MO 63555
County	Scotland County
State	Missouri
Phone	(660) 465‑8511
Emergency services	Yes
Ownership	Government - Hospital District or Authority
Medicare overall rating	2 of 5 stars
CMS Certification Number	261310
Name in Medicare records	SCOTLAND COUNTY HOSPITAL
Profile level	Medicare data + hospital website
Official website	scmohospital.net
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Scotland County Hospital — scmohospital.net
Welcome To Scotland County Hospital — scmohospital.net
Contact — scmohospital.net

Scotland County Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas^[4][5]

Programs and centers^[4]

Emergency care (hospital website)^[4][6]

Recognition^[4][5]

Doctors and clinicians (75)

Main specialties

Doctors with a page on this site (75)

Other emergency rooms nearby

Other hospitals near Memphis

Nursing homes, hospice, home health and dialysis nearby

Nursing homes

Home health agencies

Community care nearby

Community health centers

Clinics and urgent care

Pharmacies

About the Medicare star rating

Medicare quality data

What patients said (patient survey)

Complications and deaths

Return visits to the hospital (readmissions)

Emergency room times and sepsis care

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

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

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Pregnancy and childbirth

Hospital stays (whole stay, MS-DRG)

Hospital information

Sources

From the hospital’s website

Scotland County Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas[4][5]

Programs and centers[4]

Emergency care (hospital website)[4][6]

Recognition[4][5]

Doctors and clinicians (75)

Main specialties

Doctors with a page on this site (75)

Other emergency rooms nearby

Other hospitals near Memphis

Nursing homes, hospice, home health and dialysis nearby

Nursing homes

Home health agencies

Community care nearby

Community health centers

Clinics and urgent care

Pharmacies

About the Medicare star rating

Medicare quality data

What patients said (patient survey)

Complications and deaths

Return visits to the hospital (readmissions)

Emergency room times and sepsis care

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

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

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Pregnancy and childbirth

Hospital stays (whole stay, MS-DRG)

Hospital information

Sources

From the hospital’s website

Specialties and care areas^[4][5]

Programs and centers^[4]

Emergency care (hospital website)^[4][6]

Recognition^[4][5]