Does Seymour Hospital have an emergency room?

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

Where is Seymour Hospital?

200 Stadium Drive, Seymour, TX 76380, in Baylor County, Texas.

What is the phone number of Seymour Hospital?

(940) 889-5572, as listed by Medicare (CMS).

What is the Medicare star rating of Seymour Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Seymour Hospital — Seymour, TX

Quick answers

Does Seymour Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Seymour Hospital. In a medical emergency, call 911.
Where is Seymour Hospital?: 200 Stadium Drive, Seymour, TX 76380, in Baylor County, Texas.
What is the phone number of Seymour Hospital?: (940) 889-5572, as listed by Medicare (CMS).
What is the Medicare star rating of Seymour Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^{[5][6][9][11]}

Laboratory
Radiology
Surgery
Labor and delivery
Rehabilitation
Cardiac rehabilitation
Pulmonary and respiratory
Wound care
Allergy clinic
Home health
Rural health clinic
Pain management
Physical therapy
Occupational therapy
Speech therapy

Conditions treated^[9]

Back pain
Knee pain
Foot or ankle pain
Elbow pain
Nerve pain
Joint pain
Headaches
Osteoarthritis
Carpal tunnel syndrome
Golfer's elbow
Peripheral neuropathy
Diabetic neuropathy
Complex regional pain syndrome

Treatments^[9][14]

Epidural steroid injection
Nerve blocks
Radiofrequency ablation
Spinal cord stimulation
Epidural anesthesia for labor

Procedures^[8][9]

X-ray
CT scan
Bone density scan
General ultrasound
Vascular ultrasound
MRI
Carpal tunnel release

Programs and centers^{[5][6][10][14]}

Swing bed facility
Randal Wellness Center
Cardiac rehabilitation program
Breastfeeding classes
Car seat education

Emergency care (hospital website)^{[4][5][7][15]}

Emergency room	Yes
Trauma designation	Level IV

Visiting and practical information

Patient portal	Patient portal

Recognition^[14]

Maternal and neonatal designation (Level 1 Labor and Delivery Hospital, per state requirements)

Doctors and clinicians (46)

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

Main specialties

And 22 more: the button below opens the full list.

Other emergency rooms nearby

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

Throckmorton County Memorial Hospital28 mi · Throckmorton, TX · Critical Access Hospital
Hamilton Hospital33 mi · Olney, TX · Critical Access Hospital
Knox County Hospital35 mi · Knox City, TX · Critical Access Hospital
Electra Memorial Hospital35 mi · Electra, TX · Critical Access Hospital
Wilbarger General Hospital39 mi · Vernon, TX · Acute Care Hospital

Other hospitals nearby

Haskell Memorial Hospital42 mi · Haskell, TX · Critical Access Hospital

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

Seymour Rehabilitation and Healthcare1.7 mi · Seymour, TX · 4 of 5 stars
Munday Nursing Center24 mi · Munday, TX · 3 of 5 stars

All nursing homes in the state →

Home health agencies

Seymour Hospital Home Health2.1 mi · Seymour, TX · 2 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.

Clinics and urgent care

Seymour Hospital Rural Health Clinic2.1 mi · Seymour, TX · Rural health clinic
Munday Clinic25 mi · Munday, TX · Rural health clinic

Pharmacies

Baylor County Hospital District2.1 mi · Seymour, TX · Community/retail pharmacy
United Supermarkets LLC2.1 mi · Seymour, TX · Community/retail pharmacy

Assisted living nearby

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

Just Like Home Seymour LLC2.1 mi · Seymour, TX

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	82%National average: 72%
Would definitely recommend the hospital	79%National average: 71%
Nurses “always” communicated well	86%National average: 80%
Doctors “always” communicated well	90%National average: 80%
Staff “always” explained medicines before giving them	73%National average: 62%
Were given information about recovery at home	92%National average: 86%
Room and bathroom “always” clean	97%National average: 74%
Area around the room “always” quiet at night	80%National average: 60%
Completed surveys	32Response rate: 21%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	15.6%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	17.8%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	72 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	82%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Texas Best hospitals in Texas

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 45 common services exactly as Seymour Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OFFICE VISIT NEW PT LEVEL 3	$255	$178.50	$165.75 – $263.08
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $178.50 Aetna - Medicare Advantage — Medicare Advantage: $263.08 Aetna - Meritain — UNKNOWN: $178.50 Aetna Medicaid — UNKNOWN: $235.25 Amerigroup Medicaid — UNKNOWN: $168.97 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $204 Cigna - HMO/PPO — HMO/PPO: $204 Firstcare Medicaid — UNKNOWN: $235.25 Galaxy Health Network — HMO/PPO/POS: $204 Humana Medicare Advantage — Medicare Advantage: $263.08
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: TREATMENT RM NP 31-45 MINUTES	$288	$201.60	$187.20 – $288
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $201.60 Aetna - Medicare Advantage — Medicare Advantage: $187.20 Aetna - Meritain — UNKNOWN: $201.60 Aetna Medicaid — UNKNOWN: $288 Amerigroup Medicaid — UNKNOWN: $288 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $230.40 Cigna - HMO/PPO — HMO/PPO: $230.40 Firstcare Medicaid — UNKNOWN: $288 Galaxy Health Network — HMO/PPO/POS: $230.40 Humana Medicare Advantage — Medicare Advantage: $187.20
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) In the file: OFFICE VISIT NEW PT LEVEL 3	$255	$178.50	$178.50 – $255
New patient office visit (about 30–44 minutes): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $178.50 Aetna - Medicare Advantage — Medicare Advantage: $255 Aetna - Meritain — UNKNOWN: $178.50 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $204 Cigna - HMO/PPO — HMO/PPO: $204 Galaxy Health Network — HMO/PPO/POS: $204
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OFFICE VISIT NEW PT LEVEL 4	$434	$303.80	$168.97 – $347.20
New patient office visit (about 45–59 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $303.80 Aetna - Medicare Advantage — Medicare Advantage: $263.08 Aetna - Meritain — UNKNOWN: $303.80 Aetna Medicaid — UNKNOWN: $235.25 Amerigroup Medicaid — UNKNOWN: $168.97 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $347.20 Cigna - HMO/PPO — HMO/PPO: $347.20 Firstcare Medicaid — UNKNOWN: $235.25 Galaxy Health Network — HMO/PPO/POS: $347.20 Humana Medicare Advantage — Medicare Advantage: $263.08
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) In the file: OFFICE VISIT NEW PT LEVEL 4	$434	$303.80	$303.80 – $434
New patient office visit (about 45–59 minutes): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $303.80 Aetna - Medicare Advantage — Medicare Advantage: $434 Aetna - Meritain — UNKNOWN: $303.80 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $347.20 Cigna - HMO/PPO — HMO/PPO: $347.20 Galaxy Health Network — HMO/PPO/POS: $347.20
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OFFICE VISIT NEW PT LEVEL 5	$557	$389.90	$168.97 – $445.60
New patient office visit (about 60–74 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $389.90 Aetna - Medicare Advantage — Medicare Advantage: $263.08 Aetna - Meritain — UNKNOWN: $389.90 Aetna Medicaid — UNKNOWN: $235.25 Amerigroup Medicaid — UNKNOWN: $168.97 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $445.60 Cigna - HMO/PPO — HMO/PPO: $445.60 Firstcare Medicaid — UNKNOWN: $235.25 Galaxy Health Network — HMO/PPO/POS: $445.60 Humana Medicare Advantage — Medicare Advantage: $263.08
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: PHY FEE O/P VISIT EVAL & MNG NEW PT	$540	$378	$351 – $540
New patient office visit (about 60–74 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $378 Aetna - Medicare Advantage — Medicare Advantage: $351 Aetna - Meritain — UNKNOWN: $378 Aetna Medicaid — UNKNOWN: $540 Amerigroup Medicaid — UNKNOWN: $540 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $432 Cigna - HMO/PPO — HMO/PPO: $432 Firstcare Medicaid — UNKNOWN: $540 Galaxy Health Network — HMO/PPO/POS: $432 Humana Medicare Advantage — Medicare Advantage: $351
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) In the file: OFFICE VISIT NEW PT LEVEL 5	$557	$389.90	$389.90 – $557
New patient office visit (about 60–74 minutes): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $389.90 Aetna - Medicare Advantage — Medicare Advantage: $557 Aetna - Meritain — UNKNOWN: $389.90 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $445.60 Cigna - HMO/PPO — HMO/PPO: $445.60 Galaxy Health Network — HMO/PPO/POS: $445.60
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OFFICE VISIT EST PT LEVEL 3	$168	$117.60	$109.20 – $263.08
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $117.60 Aetna - Medicare Advantage — Medicare Advantage: $263.08 Aetna - Meritain — UNKNOWN: $117.60 Aetna Medicaid — UNKNOWN: $235.25 Amerigroup Medicaid — UNKNOWN: $168.97 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $134.40 Cigna - HMO/PPO — HMO/PPO: $134.40 Firstcare Medicaid — UNKNOWN: $235.25 Galaxy Health Network — HMO/PPO/POS: $134.40 Humana Medicare Advantage — Medicare Advantage: $263.08
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: PHYS FEE EVAL FOR EST PT	$197	$137.90	$23.94 – $157.60
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $137.90 Aetna - Medicare Advantage — Medicare Advantage: $128.05 Aetna - Meritain — UNKNOWN: $137.90 Aetna Medicaid — UNKNOWN: $23.94 Amerigroup Medicaid — UNKNOWN: $23.94 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $157.60 Cigna - HMO/PPO — HMO/PPO: $157.60 Firstcare Medicaid — UNKNOWN: $23.94 Galaxy Health Network — HMO/PPO/POS: $157.60 Humana Medicare Advantage — Medicare Advantage: $128.05
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: LEVEL 3 FOLLOW UP	$70	$49	$23.94 – $56
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $49 Aetna - Medicare Advantage — Medicare Advantage: $45.50 Aetna - Meritain — UNKNOWN: $49 Aetna Medicaid — UNKNOWN: $23.94 Amerigroup Medicaid — UNKNOWN: $23.94 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $56 Cigna - HMO/PPO — HMO/PPO: $56 Firstcare Medicaid — UNKNOWN: $23.94 Galaxy Health Network — HMO/PPO/POS: $56 Humana Medicare Advantage — Medicare Advantage: $45.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OFFICE VISIT EST PT LEVEL 4	$259	$181.30	$168.35 – $263.08
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $181.30 Aetna - Medicare Advantage — Medicare Advantage: $263.08 Aetna - Meritain — UNKNOWN: $181.30 Aetna Medicaid — UNKNOWN: $235.25 Amerigroup Medicaid — UNKNOWN: $168.97 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $207.20 Cigna - HMO/PPO — HMO/PPO: $207.20 Firstcare Medicaid — UNKNOWN: $235.25 Galaxy Health Network — HMO/PPO/POS: $207.20 Humana Medicare Advantage — Medicare Advantage: $263.08
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: TREATMENT RM EST. PT 46-60 MIN	$363	$254.10	$47.68 – $290.40
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $254.10 Aetna - Medicare Advantage — Medicare Advantage: $235.95 Aetna - Meritain — UNKNOWN: $254.10 Aetna Medicaid — UNKNOWN: $47.68 Amerigroup Medicaid — UNKNOWN: $47.68 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $290.40 Cigna - HMO/PPO — HMO/PPO: $290.40 Firstcare Medicaid — UNKNOWN: $47.68 Galaxy Health Network — HMO/PPO/POS: $290.40 Humana Medicare Advantage — Medicare Advantage: $235.95
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: LEVEL 4 FOLLOW UP VISIT	$292	$204.40	$47.68 – $233.60
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $204.40 Aetna - Medicare Advantage — Medicare Advantage: $189.80 Aetna - Meritain — UNKNOWN: $204.40 Aetna Medicaid — UNKNOWN: $47.68 Amerigroup Medicaid — UNKNOWN: $47.68 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $233.60 Cigna - HMO/PPO — HMO/PPO: $233.60 Firstcare Medicaid — UNKNOWN: $47.68 Galaxy Health Network — HMO/PPO/POS: $233.60 Humana Medicare Advantage — Medicare Advantage: $189.80
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: PREVENTIVE CARE NEW PT AGE 18-39	$225	$157.50	$146.25 – $263.08
Preventive checkup, new patient, age 18–39: 10 of 15 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $157.50 Aetna - Medicare Advantage — Medicare Advantage: $263.08 Aetna - Meritain — UNKNOWN: $157.50 Aetna Medicaid — UNKNOWN: $235.25 Amerigroup Medicaid — UNKNOWN: $168.97 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $180 Cigna - HMO/PPO — HMO/PPO: $180 Firstcare Medicaid — UNKNOWN: $235.25 Galaxy Health Network — HMO/PPO/POS: $180 Humana Medicare Advantage — Medicare Advantage: $263.08
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) In the file: PREVENTIVE CARE NEW PT AGE 18-39	$225	$157.50	$157.50 – $225
Preventive checkup, new patient, age 18–39: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $157.50 Aetna - Medicare Advantage — Medicare Advantage: $225 Aetna - Meritain — UNKNOWN: $157.50 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $180 Cigna - HMO/PPO — HMO/PPO: $180 Galaxy Health Network — HMO/PPO/POS: $180
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: DR MUNOZ - ER/PHY FEE MOD COMPLEXITY	$213	$149.10	$138.45 – $605
Emergency room visit (moderate): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $149.10 Aetna - Medicare Advantage — Medicare Advantage: $237.60 Aetna - Meritain — UNKNOWN: $149.10 Aetna Medicaid — UNKNOWN: $213 Amerigroup Medicaid — UNKNOWN: $213 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $170.40 Cigna - HMO/PPO — HMO/PPO: $170.40 Firstcare Medicaid — UNKNOWN: $213 Galaxy Health Network — HMO/PPO/POS: $170.40 GEHA — HMO/PPO/POS: $605
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ER/ROOM EXTENDED	$486	$340.20	$237.60 – $605
Emergency room visit (moderate): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $340.20 Aetna - Medicare Advantage — Medicare Advantage: $237.60 Aetna - Meritain — UNKNOWN: $340.20 Aetna Medicaid — UNKNOWN: $267.30 Amerigroup Medicaid — UNKNOWN: $267.30 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $388.80 Cigna - HMO/PPO — HMO/PPO: $388.80 Firstcare Medicaid — UNKNOWN: $267.30 Galaxy Health Network — HMO/PPO/POS: $388.80 GEHA — HMO/PPO/POS: $605
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: ER/PHY FEE EXTENDED	$213	$149.10	$138.45 – $605
Emergency room visit (moderate): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $149.10 Aetna - Medicare Advantage — Medicare Advantage: $237.60 Aetna - Meritain — UNKNOWN: $149.10 Aetna Medicaid — UNKNOWN: $213 Amerigroup Medicaid — UNKNOWN: $213 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $170.40 Cigna - HMO/PPO — HMO/PPO: $170.40 Firstcare Medicaid — UNKNOWN: $213 Galaxy Health Network — HMO/PPO/POS: $170.40 GEHA — HMO/PPO/POS: $605
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ER DEPT/MODERATE COMPLEX	$854	$597.80	$370.04 – $949
Emergency room visit (moderately high): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $597.80 Aetna - Medicare Advantage — Medicare Advantage: $370.04 Aetna - Meritain — UNKNOWN: $597.80 Aetna Medicaid — UNKNOWN: $469.70 Amerigroup Medicaid — UNKNOWN: $469.70 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $683.20 Cigna - HMO/PPO — HMO/PPO: $683.20 Firstcare Medicaid — UNKNOWN: $469.70 Galaxy Health Network — HMO/PPO/POS: $683.20 GEHA — HMO/PPO/POS: $949
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: ER/PHY FEE MODERATE COMPL	$332	$232.40	$215.80 – $949
Emergency room visit (moderately high): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $232.40 Aetna - Medicare Advantage — Medicare Advantage: $370.04 Aetna - Meritain — UNKNOWN: $232.40 Aetna Medicaid — UNKNOWN: $332 Amerigroup Medicaid — UNKNOWN: $332 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $265.60 Cigna - HMO/PPO — HMO/PPO: $265.60 Firstcare Medicaid — UNKNOWN: $332 Galaxy Health Network — HMO/PPO/POS: $265.60 GEHA — HMO/PPO/POS: $949
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: DR MUNOZ - ER/PHY FEE MODERATE COMPL	$332	$232.40	$215.80 – $949
Emergency room visit (moderately high): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $232.40 Aetna - Medicare Advantage — Medicare Advantage: $370.04 Aetna - Meritain — UNKNOWN: $232.40 Aetna Medicaid — UNKNOWN: $332 Amerigroup Medicaid — UNKNOWN: $332 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $265.60 Cigna - HMO/PPO — HMO/PPO: $265.60 Firstcare Medicaid — UNKNOWN: $332 Galaxy Health Network — HMO/PPO/POS: $265.60 GEHA — HMO/PPO/POS: $949
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: DR MUNOZ - ER/PHY FEE HIGH COMPLEXITY	$515	$360.50	$334.75 – $1,125
Emergency room visit (high): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $360.50 Aetna - Medicare Advantage — Medicare Advantage: $531.49 Aetna - Meritain — UNKNOWN: $360.50 Aetna Medicaid — UNKNOWN: $515 Amerigroup Medicaid — UNKNOWN: $515 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $412 Cigna - HMO/PPO — HMO/PPO: $412 Firstcare Medicaid — UNKNOWN: $515 Galaxy Health Network — HMO/PPO/POS: $412 GEHA — HMO/PPO/POS: $1,125
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ER DEPT/HIGH COMPLEXITY	$854	$597.80	$469.70 – $1,125
Emergency room visit (high): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $597.80 Aetna - Medicare Advantage — Medicare Advantage: $531.49 Aetna - Meritain — UNKNOWN: $597.80 Aetna Medicaid — UNKNOWN: $469.70 Amerigroup Medicaid — UNKNOWN: $469.70 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $683.20 Cigna - HMO/PPO — HMO/PPO: $683.20 Firstcare Medicaid — UNKNOWN: $469.70 Galaxy Health Network — HMO/PPO/POS: $683.20 GEHA — HMO/PPO/POS: $1,125
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: ER/PHY FEE HIGH COMPLEXITY	$515	$360.50	$334.75 – $1,125
Emergency room visit (high): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $360.50 Aetna - Medicare Advantage — Medicare Advantage: $531.49 Aetna - Meritain — UNKNOWN: $360.50 Aetna Medicaid — UNKNOWN: $515 Amerigroup Medicaid — UNKNOWN: $515 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $412 Cigna - HMO/PPO — HMO/PPO: $412 Firstcare Medicaid — UNKNOWN: $515 Galaxy Health Network — HMO/PPO/POS: $412 GEHA — HMO/PPO/POS: $1,125

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BASIC METABOLIC PANEL (OLNEY)	$56	$39.20	$7.61 – $44.80
Basic metabolic panel (blood test): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $39.20 Aetna - Medicare Advantage — Medicare Advantage: $8.46 Aetna - Meritain — UNKNOWN: $39.20 Aetna Medicaid — UNKNOWN: $11.59 Amerigroup Medicaid — UNKNOWN: $11.59 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $44.80 Cigna - HMO/PPO — HMO/PPO: $44.80 Firstcare Medicaid — UNKNOWN: $11.59 Galaxy Health Network — HMO/PPO/POS: $44.80 GEHA — HMO/PPO/POS: $7.61
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BASIC METABOLIC PANEL	$56	$39.20	$7.61 – $44.80
Basic metabolic panel (blood test): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $39.20 Aetna - Medicare Advantage — Medicare Advantage: $8.46 Aetna - Meritain — UNKNOWN: $39.20 Aetna Medicaid — UNKNOWN: $11.59 Amerigroup Medicaid — UNKNOWN: $11.59 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $44.80 Cigna - HMO/PPO — HMO/PPO: $44.80 Firstcare Medicaid — UNKNOWN: $11.59 Galaxy Health Network — HMO/PPO/POS: $44.80 GEHA — HMO/PPO/POS: $7.61
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) In the file: BASIC METABOLIC PANEL (OLNEY)	$56	$39.20	$39.20 – $56
Basic metabolic panel (blood test): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $39.20 Aetna - Medicare Advantage — Medicare Advantage: $56 Aetna - Meritain — UNKNOWN: $39.20 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $44.80 Cigna - HMO/PPO — HMO/PPO: $44.80 Galaxy Health Network — HMO/PPO/POS: $44.80
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREHENSIVE METABOLIC PANEL (OLNEY)	$82	$57.40	$9.50 – $65.60
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $57.40 Aetna - Medicare Advantage — Medicare Advantage: $10.56 Aetna - Meritain — UNKNOWN: $57.40 Aetna Medicaid — UNKNOWN: $19.85 Amerigroup Medicaid — UNKNOWN: $19.85 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $65.60 Cigna - HMO/PPO — HMO/PPO: $65.60 Firstcare Medicaid — UNKNOWN: $19.85 Galaxy Health Network — HMO/PPO/POS: $65.60 GEHA — HMO/PPO/POS: $9.50
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREHENSIVE METABOLIC PANEL	$82	$57.40	$9.50 – $65.60
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $57.40 Aetna - Medicare Advantage — Medicare Advantage: $10.56 Aetna - Meritain — UNKNOWN: $57.40 Aetna Medicaid — UNKNOWN: $19.85 Amerigroup Medicaid — UNKNOWN: $19.85 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $65.60 Cigna - HMO/PPO — HMO/PPO: $65.60 Firstcare Medicaid — UNKNOWN: $19.85 Galaxy Health Network — HMO/PPO/POS: $65.60 GEHA — HMO/PPO/POS: $9.50
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMPREHENSIVE METABOLIC PANEL (LABCORP)	$82	$57.40	$9.50 – $65.60
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $57.40 Aetna - Medicare Advantage — Medicare Advantage: $10.56 Aetna - Meritain — UNKNOWN: $57.40 Aetna Medicaid — UNKNOWN: $19.85 Amerigroup Medicaid — UNKNOWN: $19.85 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $65.60 Cigna - HMO/PPO — HMO/PPO: $65.60 Firstcare Medicaid — UNKNOWN: $19.85 Galaxy Health Network — HMO/PPO/POS: $65.60 GEHA — HMO/PPO/POS: $9.50
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL W/ LDL, CALC	$103	$72.10	$12.05 – $82.40
Cholesterol panel (lipid panel): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $72.10 Aetna - Medicare Advantage — Medicare Advantage: $13.39 Aetna - Meritain — UNKNOWN: $72.10 Aetna Medicaid — UNKNOWN: $18.35 Amerigroup Medicaid — UNKNOWN: $18.35 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $82.40 Cigna - HMO/PPO — HMO/PPO: $82.40 Firstcare Medicaid — UNKNOWN: $18.35 Galaxy Health Network — HMO/PPO/POS: $82.40 GEHA — HMO/PPO/POS: $12.05
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: LIPID PANEL W/ LDL, CALC	$103	$72.10	$72.10 – $103
Cholesterol panel (lipid panel): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $72.10 Aetna - Medicare Advantage — Medicare Advantage: $103 Aetna - Meritain — UNKNOWN: $72.10 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $82.40 Cigna - HMO/PPO — HMO/PPO: $82.40 Galaxy Health Network — HMO/PPO/POS: $82.40
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$67	$46.90	$7.81 – $53.60
Kidney function panel: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $46.90 Aetna - Medicare Advantage — Medicare Advantage: $8.68 Aetna - Meritain — UNKNOWN: $46.90 Aetna Medicaid — UNKNOWN: $11.89 Amerigroup Medicaid — UNKNOWN: $11.89 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $53.60 Cigna - HMO/PPO — HMO/PPO: $53.60 Firstcare Medicaid — UNKNOWN: $11.89 Galaxy Health Network — HMO/PPO/POS: $53.60 GEHA — HMO/PPO/POS: $7.81
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: RENAL FUNCTION PANEL	$67	$46.90	$46.90 – $67
Kidney function panel: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $46.90 Aetna - Medicare Advantage — Medicare Advantage: $67 Aetna - Meritain — UNKNOWN: $46.90 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $53.60 Cigna - HMO/PPO — HMO/PPO: $53.60 Galaxy Health Network — HMO/PPO/POS: $53.60
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL	$63	$44.10	$7.35 – $50.40
Liver function panel: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $44.10 Aetna - Medicare Advantage — Medicare Advantage: $8.17 Aetna - Meritain — UNKNOWN: $44.10 Aetna Medicaid — UNKNOWN: $11.19 Amerigroup Medicaid — UNKNOWN: $11.19 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $50.40 Cigna - HMO/PPO — HMO/PPO: $50.40 Firstcare Medicaid — UNKNOWN: $11.19 Galaxy Health Network — HMO/PPO/POS: $50.40 GEHA — HMO/PPO/POS: $7.35
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: HEPATIC FUNCTION PANEL	$63	$44.10	$44.10 – $63
Liver function panel: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $44.10 Aetna - Medicare Advantage — Medicare Advantage: $63 Aetna - Meritain — UNKNOWN: $44.10 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $50.40 Cigna - HMO/PPO — HMO/PPO: $50.40 Galaxy Health Network — HMO/PPO/POS: $50.40
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: URINALYSIS W/ REFLEX MICRO	$20	$14	$2.85 – $16
Urine test (automated, with microscope): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $14 Aetna - Medicare Advantage — Medicare Advantage: $3.17 Aetna - Meritain — UNKNOWN: $14 Aetna Medicaid — UNKNOWN: $4.34 Amerigroup Medicaid — UNKNOWN: $4.34 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $16 Cigna - HMO/PPO — HMO/PPO: $16 Firstcare Medicaid — UNKNOWN: $4.34 Galaxy Health Network — HMO/PPO/POS: $16 GEHA — HMO/PPO/POS: $2.85
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: URINALYSIS, COMPLETE (LABCORP)	$26	$18.20	$2.85 – $20.80
Urine test (automated, with microscope): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $18.20 Aetna - Medicare Advantage — Medicare Advantage: $3.17 Aetna - Meritain — UNKNOWN: $18.20 Aetna Medicaid — UNKNOWN: $4.34 Amerigroup Medicaid — UNKNOWN: $4.34 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $20.80 Cigna - HMO/PPO — HMO/PPO: $20.80 Firstcare Medicaid — UNKNOWN: $4.34 Galaxy Health Network — HMO/PPO/POS: $20.80 GEHA — HMO/PPO/POS: $2.85
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) In the file: URINALYSIS W/ REFLEX MICRO	$20	$14	$14 – $20
Urine test (automated, with microscope): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $14 Aetna - Medicare Advantage — Medicare Advantage: $20 Aetna - Meritain — UNKNOWN: $14 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $16 Cigna - HMO/PPO — HMO/PPO: $16 Galaxy Health Network — HMO/PPO/POS: $16
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA AUTO W/O MICROSCOPY	$19	$13.30	$2.03 – $15.20
Urine test (automated, without microscope): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $13.30 Aetna - Medicare Advantage — Medicare Advantage: $2.25 Aetna - Meritain — UNKNOWN: $13.30 Aetna Medicaid — UNKNOWN: $3.08 Amerigroup Medicaid — UNKNOWN: $3.08 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $15.20 Cigna - HMO/PPO — HMO/PPO: $15.20 Firstcare Medicaid — UNKNOWN: $3.08 Galaxy Health Network — HMO/PPO/POS: $15.20 GEHA — HMO/PPO/POS: $2.03
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) In the file: UA AUTO W/O MICROSCOPY	$19	$13.30	$13.30 – $19
Urine test (automated, without microscope): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $13.30 Aetna - Medicare Advantage — Medicare Advantage: $19 Aetna - Meritain — UNKNOWN: $13.30 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $15.20 Cigna - HMO/PPO — HMO/PPO: $15.20 Galaxy Health Network — HMO/PPO/POS: $15.20
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA, DIAGNOSTIC	$141	$98.70	$16.55 – $112.80
PSA (prostate specific antigen) blood test: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $98.70 Aetna - Medicare Advantage — Medicare Advantage: $18.39 Aetna - Meritain — UNKNOWN: $98.70 Aetna Medicaid — UNKNOWN: $25.19 Amerigroup Medicaid — UNKNOWN: $25.19 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $112.80 Cigna - HMO/PPO — HMO/PPO: $112.80 Firstcare Medicaid — UNKNOWN: $25.19 Galaxy Health Network — HMO/PPO/POS: $112.80 GEHA — HMO/PPO/POS: $16.55
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) In the file: PSA, DIAGNOSTIC	$141	$98.70	$98.70 – $141
PSA (prostate specific antigen) blood test: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $98.70 Aetna - Medicare Advantage — Medicare Advantage: $141 Aetna - Meritain — UNKNOWN: $98.70 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $112.80 Cigna - HMO/PPO — HMO/PPO: $112.80 Galaxy Health Network — HMO/PPO/POS: $112.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH	$132	$92.40	$15.12 – $105.60
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $92.40 Aetna - Medicare Advantage — Medicare Advantage: $16.80 Aetna - Meritain — UNKNOWN: $92.40 Aetna Medicaid — UNKNOWN: $23.02 Amerigroup Medicaid — UNKNOWN: $23.02 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $105.60 Cigna - HMO/PPO — HMO/PPO: $105.60 Firstcare Medicaid — UNKNOWN: $23.02 Galaxy Health Network — HMO/PPO/POS: $105.60 GEHA — HMO/PPO/POS: $15.12
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH (LABCORP)	$132	$92.40	$15.12 – $105.60
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $92.40 Aetna - Medicare Advantage — Medicare Advantage: $16.80 Aetna - Meritain — UNKNOWN: $92.40 Aetna Medicaid — UNKNOWN: $23.02 Amerigroup Medicaid — UNKNOWN: $23.02 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $105.60 Cigna - HMO/PPO — HMO/PPO: $105.60 Firstcare Medicaid — UNKNOWN: $23.02 Galaxy Health Network — HMO/PPO/POS: $105.60 GEHA — HMO/PPO/POS: $15.12
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) In the file: TSH	$132	$92.40	$92.40 – $132
Thyroid stimulating hormone (TSH) test: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $92.40 Aetna - Medicare Advantage — Medicare Advantage: $132 Aetna - Meritain — UNKNOWN: $92.40 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $105.60 Cigna - HMO/PPO — HMO/PPO: $105.60 Galaxy Health Network — HMO/PPO/POS: $105.60
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CBC W/ DIFF	$60	$42	$6.99 – $48
Complete blood count (CBC) with differential: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $42 Aetna - Medicare Advantage — Medicare Advantage: $7.77 Aetna - Meritain — UNKNOWN: $42 Aetna Medicaid — UNKNOWN: $10.64 Amerigroup Medicaid — UNKNOWN: $10.64 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $48 Cigna - HMO/PPO — HMO/PPO: $48 Firstcare Medicaid — UNKNOWN: $10.64 Galaxy Health Network — HMO/PPO/POS: $48 GEHA — HMO/PPO/POS: $6.99
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CBC W/ DIFF (LABCORP)	$60	$42	$6.99 – $48
Complete blood count (CBC) with differential: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $42 Aetna - Medicare Advantage — Medicare Advantage: $7.77 Aetna - Meritain — UNKNOWN: $42 Aetna Medicaid — UNKNOWN: $10.64 Amerigroup Medicaid — UNKNOWN: $10.64 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $48 Cigna - HMO/PPO — HMO/PPO: $48 Firstcare Medicaid — UNKNOWN: $10.64 Galaxy Health Network — HMO/PPO/POS: $48 GEHA — HMO/PPO/POS: $6.99
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) In the file: CBC W/ DIFF	$60	$42	$42 – $60
Complete blood count (CBC) with differential: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $42 Aetna - Medicare Advantage — Medicare Advantage: $60 Aetna - Meritain — UNKNOWN: $42 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $48 Cigna - HMO/PPO — HMO/PPO: $48 Galaxy Health Network — HMO/PPO/POS: $48
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PT W/ INR	$26	$18.20	$3.86 – $20.80
Blood clotting time test (prothrombin time, PT): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $18.20 Aetna - Medicare Advantage — Medicare Advantage: $4.29 Aetna - Meritain — UNKNOWN: $18.20 Aetna Medicaid — UNKNOWN: $5.88 Amerigroup Medicaid — UNKNOWN: $5.88 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $20.80 Cigna - HMO/PPO — HMO/PPO: $20.80 Firstcare Medicaid — UNKNOWN: $5.88 Galaxy Health Network — HMO/PPO/POS: $20.80 GEHA — HMO/PPO/POS: $3.86
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) In the file: PT W/ INR	$26	$18.20	$18.20 – $26
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $18.20 Aetna - Medicare Advantage — Medicare Advantage: $26 Aetna - Meritain — UNKNOWN: $18.20 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $20.80 Cigna - HMO/PPO — HMO/PPO: $20.80 Galaxy Health Network — HMO/PPO/POS: $20.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: APTT	$40	$28	$5.41 – $32
Blood clotting test (partial thromboplastin time, PTT): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $28 Aetna - Medicare Advantage — Medicare Advantage: $6.01 Aetna - Meritain — UNKNOWN: $28 Aetna Medicaid — UNKNOWN: $8.23 Amerigroup Medicaid — UNKNOWN: $8.23 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $32 Cigna - HMO/PPO — HMO/PPO: $32 Firstcare Medicaid — UNKNOWN: $8.23 Galaxy Health Network — HMO/PPO/POS: $32 GEHA — HMO/PPO/POS: $5.41
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) In the file: APTT	$40	$28	$28 – $40
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $28 Aetna - Medicare Advantage — Medicare Advantage: $40 Aetna - Meritain — UNKNOWN: $28 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $32 Cigna - HMO/PPO — HMO/PPO: $32 Galaxy Health Network — HMO/PPO/POS: $32

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) · modifier TC In the file: CT HEAD WO	$1,773	$1,241.10	$103.64 – $1,418.40
CT scan of the head or brain, without contrast: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,241.10 Aetna - Medicare Advantage — Medicare Advantage: $103.64 Aetna - Meritain — UNKNOWN: $1,241.10 Aetna Medicaid — UNKNOWN: $134.67 Amerigroup Medicaid — UNKNOWN: $134.67 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,418.40 Cigna - HMO/PPO — HMO/PPO: $1,418.40 Firstcare Medicaid — UNKNOWN: $134.67 Galaxy Health Network — HMO/PPO/POS: $1,418.40 GEHA — HMO/PPO/POS: $850
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · modifier TC In the file: CT HEAD WO	$1,773	$1,241.10	$1,241.10 – $1,773
CT scan of the head or brain, without contrast: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $1,241.10 Aetna - Medicare Advantage — Medicare Advantage: $1,773 Aetna - Meritain — UNKNOWN: $1,241.10 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,418.40 Cigna - HMO/PPO — HMO/PPO: $1,418.40 Galaxy Health Network — HMO/PPO/POS: $1,418.40
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · modifier TC In the file: CT PELVIS W CONTRAST	$2,341	$1,638.70	$174.87 – $1,872.80
CT scan of the pelvis, with contrast: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,638.70 Aetna - Medicare Advantage — Medicare Advantage: $174.87 Aetna - Meritain — UNKNOWN: $1,638.70 Aetna Medicaid — UNKNOWN: $227.23 Amerigroup Medicaid — UNKNOWN: $227.23 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,872.80 Cigna - HMO/PPO — HMO/PPO: $1,872.80 Firstcare Medicaid — UNKNOWN: $227.23 Galaxy Health Network — HMO/PPO/POS: $1,872.80 GEHA — HMO/PPO/POS: $850
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · modifier TC In the file: CT PELVIS W CONTRAST	$2,341	$1,638.70	$1,638.70 – $2,341
CT scan of the pelvis, with contrast: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $1,638.70 Aetna - Medicare Advantage — Medicare Advantage: $2,341 Aetna - Meritain — UNKNOWN: $1,638.70 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,872.80 Cigna - HMO/PPO — HMO/PPO: $1,872.80 Galaxy Health Network — HMO/PPO/POS: $1,872.80
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI LOWER EXT JOINT WO LEFT	$2,027	$1,418.90	$226.44 – $1,621.60
MRI of a leg joint (such as the knee), without contrast: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,418.90 Aetna - Medicare Advantage — Medicare Advantage: $226.44 Aetna - Meritain — UNKNOWN: $1,418.90 Aetna Medicaid — UNKNOWN: $294.24 Amerigroup Medicaid — UNKNOWN: $294.24 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,621.60 Cigna - HMO/PPO — HMO/PPO: $1,621.60 Firstcare Medicaid — UNKNOWN: $294.24 Galaxy Health Network — HMO/PPO/POS: $1,621.60 GEHA — HMO/PPO/POS: $935
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) In the file: MRI LOWER EXT JOINT WO LEFT	$2,027	$1,418.90	$1,418.90 – $2,027
MRI of a leg joint (such as the knee), without contrast: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $1,418.90 Aetna - Medicare Advantage — Medicare Advantage: $2,027 Aetna - Meritain — UNKNOWN: $1,418.90 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,621.60 Cigna - HMO/PPO — HMO/PPO: $1,621.60 Galaxy Health Network — HMO/PPO/POS: $1,621.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · modifier TC In the file: CT ABDOMEN/PELVIS W CONTRAST	$2,251	$1,575.70	$357.26 – $1,800.80
CT scan of the abdomen and pelvis, with contrast: 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,575.70 Aetna - Medicare Advantage — Medicare Advantage: $357.26 Aetna - Meritain — UNKNOWN: $1,575.70 Aetna Medicaid — UNKNOWN: $464.22 Amerigroup Medicaid — UNKNOWN: $464.22 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,800.80 Cigna - HMO/PPO — HMO/PPO: $1,800.80 Firstcare Medicaid — UNKNOWN: $464.22 Galaxy Health Network — HMO/PPO/POS: $1,800.80 GEHA — HMO/PPO/POS: $850
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · modifier TC In the file: CT ABDOMEN/PELVIS W CONTRAST	$2,251	$1,575.70	$1,575.70 – $2,251
CT scan of the abdomen and pelvis, with contrast: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $1,575.70 Aetna - Medicare Advantage — Medicare Advantage: $2,251 Aetna - Meritain — UNKNOWN: $1,575.70 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,800.80 Cigna - HMO/PPO — HMO/PPO: $1,800.80 Galaxy Health Network — HMO/PPO/POS: $1,800.80
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US OB > OR = 14 WEEKS	$657	$459.90	$103.64 – $525.60
Pregnancy ultrasound (after the first trimester): 10 of 18 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $459.90 Aetna - Medicare Advantage — Medicare Advantage: $103.64 Aetna - Meritain — UNKNOWN: $459.90 Aetna Medicaid — UNKNOWN: $134.67 Amerigroup Medicaid — UNKNOWN: $134.67 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $525.60 Cigna - HMO/PPO — HMO/PPO: $525.60 Firstcare Medicaid — UNKNOWN: $134.67 Galaxy Health Network — HMO/PPO/POS: $525.60 GEHA — HMO/PPO/POS: $275
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) In the file: US OB > OR = 14 WEEKS	$657	$459.90	$459.90 – $657
Pregnancy ultrasound (after the first trimester): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $459.90 Aetna - Medicare Advantage — Medicare Advantage: $657 Aetna - Meritain — UNKNOWN: $459.90 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $525.60 Cigna - HMO/PPO — HMO/PPO: $525.60 Galaxy Health Network — HMO/PPO/POS: $525.60

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) · modifier GP In the file: PTA EXERCISE/THERAP/15M	$128	$89.60	$83.20 – $110
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $89.60 Aetna - Medicare Advantage — Medicare Advantage: $83.20 Aetna - Meritain — UNKNOWN: $89.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $102.40 Cigna - HMO/PPO — HMO/PPO: $102.40 Galaxy Health Network — HMO/PPO/POS: $102.40 GEHA — HMO/PPO/POS: $110 Humana Medicare Advantage — Medicare Advantage: $83.20 United HMO/PPO — HMO/PPO: $110 United Medicare Advantage — Medicare Advantage: $83.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: PT EXERCISE/THERAP/15M	$128	$89.60	$83.20 – $110
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $89.60 Aetna - Medicare Advantage — Medicare Advantage: $83.20 Aetna - Meritain — UNKNOWN: $89.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $102.40 Cigna - HMO/PPO — HMO/PPO: $102.40 Galaxy Health Network — HMO/PPO/POS: $102.40 GEHA — HMO/PPO/POS: $110 Humana Medicare Advantage — Medicare Advantage: $83.20 United HMO/PPO — HMO/PPO: $110 United Medicare Advantage — Medicare Advantage: $83.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · modifier GP In the file: PTA EXERCISE/THERAP/15M	$128	$89.60	$89.60 – $128
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $89.60 Aetna - Medicare Advantage — Medicare Advantage: $128 Aetna - Meritain — UNKNOWN: $89.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $102.40 Cigna - HMO/PPO — HMO/PPO: $102.40 Galaxy Health Network — HMO/PPO/POS: $102.40
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: PT EVAL LOW COMPLEX	$248	$173.60	$110 – $198.40
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $173.60 Aetna - Medicare Advantage — Medicare Advantage: $161.20 Aetna - Meritain — UNKNOWN: $173.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $198.40 Cigna - HMO/PPO — HMO/PPO: $198.40 Galaxy Health Network — HMO/PPO/POS: $198.40 GEHA — HMO/PPO/POS: $110 Humana Medicare Advantage — Medicare Advantage: $161.20 United HMO/PPO — HMO/PPO: $110 United Medicare Advantage — Medicare Advantage: $161.20
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · modifier GP In the file: PT EVAL LOW COMPLEX	$248	$173.60	$173.60 – $248
Physical therapy evaluation (low complexity): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $173.60 Aetna - Medicare Advantage — Medicare Advantage: $248 Aetna - Meritain — UNKNOWN: $173.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $198.40 Cigna - HMO/PPO — HMO/PPO: $198.40 Galaxy Health Network — HMO/PPO/POS: $198.40
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: PT EVAL MOD COMPLEX	$248	$173.60	$110 – $198.40
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $173.60 Aetna - Medicare Advantage — Medicare Advantage: $161.20 Aetna - Meritain — UNKNOWN: $173.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $198.40 Cigna - HMO/PPO — HMO/PPO: $198.40 Galaxy Health Network — HMO/PPO/POS: $198.40 GEHA — HMO/PPO/POS: $110 Humana Medicare Advantage — Medicare Advantage: $161.20 United HMO/PPO — HMO/PPO: $110 United Medicare Advantage — Medicare Advantage: $161.20
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · modifier GP In the file: PT EVAL MOD COMPLEX	$248	$173.60	$173.60 – $248
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $173.60 Aetna - Medicare Advantage — Medicare Advantage: $248 Aetna - Meritain — UNKNOWN: $173.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $198.40 Cigna - HMO/PPO — HMO/PPO: $198.40 Galaxy Health Network — HMO/PPO/POS: $198.40
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT EVAL HIGH COMPLEX	$248	$173.60	$110 – $198.40
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $173.60 Aetna - Medicare Advantage — Medicare Advantage: $161.20 Aetna - Meritain — UNKNOWN: $173.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $198.40 Cigna - HMO/PPO — HMO/PPO: $198.40 Galaxy Health Network — HMO/PPO/POS: $198.40 GEHA — HMO/PPO/POS: $110 Humana Medicare Advantage — Medicare Advantage: $161.20 United HMO/PPO — HMO/PPO: $110 United Medicare Advantage — Medicare Advantage: $161.20
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) In the file: PT EVAL HIGH COMPLEX	$248	$173.60	$173.60 – $248
Physical therapy evaluation (high complexity): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $173.60 Aetna - Medicare Advantage — Medicare Advantage: $248 Aetna - Meritain — UNKNOWN: $173.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $198.40 Cigna - HMO/PPO — HMO/PPO: $198.40 Galaxy Health Network — HMO/PPO/POS: $198.40
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: PSYTX PT&/FAMILY 30 MINUTES	$205	$143.50	$133.25
Psychotherapy, 30 minutes: 10 of 17 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $143.50 Aetna - Medicare Advantage — Medicare Advantage: $141.28 Aetna - Meritain — UNKNOWN: $143.50 Aetna Medicaid — UNKNOWN: $205 Amerigroup Medicaid — UNKNOWN: $205 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $164 Cigna - HMO/PPO — HMO/PPO: $164 Firstcare Medicaid — UNKNOWN: $205 Galaxy Health Network — HMO/PPO/POS: $164 GEHA — HMO/PPO/POS: $75
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: IND PSY W/WO FAMILY 16-37 MIN	$207	$144.90	$134.55 – $207
Psychotherapy, 30 minutes: 10 of 16 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $144.90 Aetna - Medicare Advantage — Medicare Advantage: $141.28 Aetna - Meritain — UNKNOWN: $144.90 Aetna Medicaid — UNKNOWN: $207 Amerigroup Medicaid — UNKNOWN: $207 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $165.60 Cigna - HMO/PPO — HMO/PPO: $165.60 Firstcare Medicaid — UNKNOWN: $207 Galaxy Health Network — HMO/PPO/POS: $165.60 Humana Medicare Advantage — Medicare Advantage: $134.55
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) In the file: IND PSY W/WO FAMILY 16-37 MIN	$207	$144.90	$144.90 – $207
Psychotherapy, 30 minutes: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $144.90 Aetna - Medicare Advantage — Medicare Advantage: $207 Aetna - Meritain — UNKNOWN: $144.90 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $165.60 Cigna - HMO/PPO — HMO/PPO: $165.60 Galaxy Health Network — HMO/PPO/POS: $165.60
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: PSY TX GR 1	$264	$184.80	$73.55 – $264
Group psychotherapy: 10 of 16 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $184.80 Aetna - Medicare Advantage — Medicare Advantage: $73.55 Aetna - Meritain — UNKNOWN: $184.80 Aetna Medicaid — UNKNOWN: $264 Amerigroup Medicaid — UNKNOWN: $264 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $211.20 Cigna - HMO/PPO — HMO/PPO: $211.20 Firstcare Medicaid — UNKNOWN: $264 Galaxy Health Network — HMO/PPO/POS: $211.20 Humana Medicare Advantage — Medicare Advantage: $171.60
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: PSY TX GR 2	$264	$184.80	$73.55 – $264
Group psychotherapy: 10 of 16 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $184.80 Aetna - Medicare Advantage — Medicare Advantage: $73.55 Aetna - Meritain — UNKNOWN: $184.80 Aetna Medicaid — UNKNOWN: $264 Amerigroup Medicaid — UNKNOWN: $264 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $211.20 Cigna - HMO/PPO — HMO/PPO: $211.20 Firstcare Medicaid — UNKNOWN: $264 Galaxy Health Network — HMO/PPO/POS: $211.20 Humana Medicare Advantage — Medicare Advantage: $171.60
Group psychotherapy CPT 90853 · Inpatient (hospital stay) In the file: PSY TX GR 1	$264	$184.80	$184.80 – $264
Group psychotherapy: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $184.80 Aetna - Medicare Advantage — Medicare Advantage: $264 Aetna - Meritain — UNKNOWN: $184.80 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $211.20 Cigna - HMO/PPO — HMO/PPO: $211.20 Galaxy Health Network — HMO/PPO/POS: $211.20

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: BREAST EX CYST/LESION	$4,184	$2,928.80	$100 – $3,347.20
Removal of breast growth (open surgery): 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $2,928.80 Aetna - Medicare Advantage — Medicare Advantage: $3,333.56 Aetna - Meritain — UNKNOWN: $2,928.80 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $3,347.20 Cigna - HMO/PPO — HMO/PPO: $3,347.20 Galaxy Health Network — HMO/PPO/POS: $3,347.20 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $2,719.60 Triwest — Federal: $3,333.56 United HMO/PPO — HMO/PPO: $100
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) In the file: BREAST EX CYST/LESION	$4,184	$2,928.80	$2,928.80 – $4,184
Removal of breast growth (open surgery): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $2,928.80 Aetna - Medicare Advantage — Medicare Advantage: $4,184 Aetna - Meritain — UNKNOWN: $2,928.80 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $3,347.20 Cigna - HMO/PPO — HMO/PPO: $3,347.20 Galaxy Health Network — HMO/PPO/POS: $3,347.20
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: PHY FEE/EGD	$792	$554.40	$100 – $800.48
Upper GI endoscopy (diagnostic): 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $554.40 Aetna - Medicare Advantage — Medicare Advantage: $800.48 Aetna - Meritain — UNKNOWN: $554.40 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $633.60 Cigna - HMO/PPO — HMO/PPO: $633.60 Galaxy Health Network — HMO/PPO/POS: $633.60 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $514.80 Triwest — Federal: $800.48 United HMO/PPO — HMO/PPO: $100
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: EGD	$1,750	$1,225	$100 – $1,400
Upper GI endoscopy (diagnostic): 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,225 Aetna - Medicare Advantage — Medicare Advantage: $800.48 Aetna - Meritain — UNKNOWN: $1,225 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,400 Cigna - HMO/PPO — HMO/PPO: $1,400 Galaxy Health Network — HMO/PPO/POS: $1,400 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $1,137.50 Triwest — Federal: $800.48 United HMO/PPO — HMO/PPO: $100
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: PHY FEE/EGD	$792	$554.40	$554.40 – $792
Upper GI endoscopy (diagnostic): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $554.40 Aetna - Medicare Advantage — Medicare Advantage: $792 Aetna - Meritain — UNKNOWN: $554.40 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $633.60 Cigna - HMO/PPO — HMO/PPO: $633.60 Galaxy Health Network — HMO/PPO/POS: $633.60
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: PHY FEE EGD W/BX	$840	$588	$100 – $800.48
Upper GI endoscopy with biopsy: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $588 Aetna - Medicare Advantage — Medicare Advantage: $800.48 Aetna - Meritain — UNKNOWN: $588 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $672 Cigna - HMO/PPO — HMO/PPO: $672 Galaxy Health Network — HMO/PPO/POS: $672 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $546 Triwest — Federal: $800.48 United HMO/PPO — HMO/PPO: $100
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: EGD W/BX	$1,750	$1,225	$100 – $1,400
Upper GI endoscopy with biopsy: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,225 Aetna - Medicare Advantage — Medicare Advantage: $800.48 Aetna - Meritain — UNKNOWN: $1,225 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,400 Cigna - HMO/PPO — HMO/PPO: $1,400 Galaxy Health Network — HMO/PPO/POS: $1,400 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $1,137.50 Triwest — Federal: $800.48 United HMO/PPO — HMO/PPO: $100
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) In the file: PHY FEE EGD W/BX	$840	$588	$588 – $840
Upper GI endoscopy with biopsy: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $588 Aetna - Medicare Advantage — Medicare Advantage: $840 Aetna - Meritain — UNKNOWN: $588 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $672 Cigna - HMO/PPO — HMO/PPO: $672 Galaxy Health Network — HMO/PPO/POS: $672
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: PHY FEE COLONOSCOPY	$532	$372.40	$100 – $805.84
Colonoscopy (diagnostic): 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $372.40 Aetna - Medicare Advantage — Medicare Advantage: $805.84 Aetna - Meritain — UNKNOWN: $372.40 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $425.60 Cigna - HMO/PPO — HMO/PPO: $425.60 Galaxy Health Network — HMO/PPO/POS: $425.60 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $345.80 Triwest — Federal: $805.84 United HMO/PPO — HMO/PPO: $100
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: COLONOSCOPY	$1,858	$1,300.60	$100 – $1,486.40
Colonoscopy (diagnostic): 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,300.60 Aetna - Medicare Advantage — Medicare Advantage: $805.84 Aetna - Meritain — UNKNOWN: $1,300.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,486.40 Cigna - HMO/PPO — HMO/PPO: $1,486.40 Galaxy Health Network — HMO/PPO/POS: $1,486.40 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $1,207.70 Triwest — Federal: $805.84 United HMO/PPO — HMO/PPO: $100
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) In the file: PHY FEE COLONOSCOPY	$532	$372.40	$372.40 – $532
Colonoscopy (diagnostic): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $372.40 Aetna - Medicare Advantage — Medicare Advantage: $532 Aetna - Meritain — UNKNOWN: $372.40 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $425.60 Cigna - HMO/PPO — HMO/PPO: $425.60 Galaxy Health Network — HMO/PPO/POS: $425.60
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: PHY FEE/COLONOSCOPY W/BX	$1,050	$735	$100 – $1,050.07
Colonoscopy with biopsy: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $735 Aetna - Medicare Advantage — Medicare Advantage: $1,050.07 Aetna - Meritain — UNKNOWN: $735 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $840 Cigna - HMO/PPO — HMO/PPO: $840 Galaxy Health Network — HMO/PPO/POS: $840 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $682.50 Triwest — Federal: $1,050.07 United HMO/PPO — HMO/PPO: $100
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/BIOPSY	$1,858	$1,300.60	$100 – $1,486.40
Colonoscopy with biopsy: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,300.60 Aetna - Medicare Advantage — Medicare Advantage: $1,050.07 Aetna - Meritain — UNKNOWN: $1,300.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,486.40 Cigna - HMO/PPO — HMO/PPO: $1,486.40 Galaxy Health Network — HMO/PPO/POS: $1,486.40 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $1,207.70 Triwest — Federal: $1,050.07 United HMO/PPO — HMO/PPO: $100
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/BIOPSY*	$1,811	$1,267.70	$100 – $1,448.80
Colonoscopy with biopsy: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,267.70 Aetna - Medicare Advantage — Medicare Advantage: $1,050.07 Aetna - Meritain — UNKNOWN: $1,267.70 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,448.80 Cigna - HMO/PPO — HMO/PPO: $1,448.80 Galaxy Health Network — HMO/PPO/POS: $1,448.80 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $1,177.15 Triwest — Federal: $1,050.07 United HMO/PPO — HMO/PPO: $100
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: PHY FEE/COLON POLYPECTOMY	$732	$512.40	$100 – $1,050.07
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $512.40 Aetna - Medicare Advantage — Medicare Advantage: $1,050.07 Aetna - Meritain — UNKNOWN: $512.40 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $585.60 Cigna - HMO/PPO — HMO/PPO: $585.60 Galaxy Health Network — HMO/PPO/POS: $585.60 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $475.80 Triwest — Federal: $1,050.07 United HMO/PPO — HMO/PPO: $100
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY & POLYPECTOMY	$1,849	$1,294.30	$100 – $1,479.20
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,294.30 Aetna - Medicare Advantage — Medicare Advantage: $1,050.07 Aetna - Meritain — UNKNOWN: $1,294.30 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,479.20 Cigna - HMO/PPO — HMO/PPO: $1,479.20 Galaxy Health Network — HMO/PPO/POS: $1,479.20 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $1,201.85 Triwest — Federal: $1,050.07 United HMO/PPO — HMO/PPO: $100
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY & POLYPECTOMY*	$924	$646.80	$100 – $1,050.07
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $646.80 Aetna - Medicare Advantage — Medicare Advantage: $1,050.07 Aetna - Meritain — UNKNOWN: $646.80 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $739.20 Cigna - HMO/PPO — HMO/PPO: $739.20 Galaxy Health Network — HMO/PPO/POS: $739.20 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $600.60 Triwest — Federal: $1,050.07 United HMO/PPO — HMO/PPO: $100
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLORECTAL SCREEN;COLONOSCOPY	$1,638	$1,146.60	$100 – $1,310.40
Screening colonoscopy (not high risk): 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,146.60 Aetna - Medicare Advantage — Medicare Advantage: $805.84 Aetna - Meritain — UNKNOWN: $1,146.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,310.40 Cigna - HMO/PPO — HMO/PPO: $1,310.40 Galaxy Health Network — HMO/PPO/POS: $1,310.40 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $1,064.70 Triwest — Federal: $805.84 United HMO/PPO — HMO/PPO: $100
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) In the file: COLORECTAL SCREEN;COLONOSCOPY	$1,638	$1,146.60	$1,146.60 – $1,638
Screening colonoscopy (not high risk): rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $1,146.60 Aetna - Medicare Advantage — Medicare Advantage: $1,638 Aetna - Meritain — UNKNOWN: $1,146.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,310.40 Cigna - HMO/PPO — HMO/PPO: $1,310.40 Galaxy Health Network — HMO/PPO/POS: $1,310.40
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: PHY FEE/ CHOLECYSTECTOMY	$1,950	$1,365	$100 – $5,054.12
Gallbladder removal by laparoscope: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $1,365 Aetna - Medicare Advantage — Medicare Advantage: $5,054.12 Aetna - Meritain — UNKNOWN: $1,365 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,560 Cigna - HMO/PPO — HMO/PPO: $1,560 Galaxy Health Network — HMO/PPO/POS: $1,560 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $1,267.50 Triwest — Federal: $5,054.12 United HMO/PPO — HMO/PPO: $100
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: CHOLECYST SCOPE	$9,260	$6,482	$100 – $7,408
Gallbladder removal by laparoscope: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $6,482 Aetna - Medicare Advantage — Medicare Advantage: $5,054.12 Aetna - Meritain — UNKNOWN: $6,482 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $7,408 Cigna - HMO/PPO — HMO/PPO: $7,408 Galaxy Health Network — HMO/PPO/POS: $7,408 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $6,019 Triwest — Federal: $5,054.12 United HMO/PPO — HMO/PPO: $100
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) In the file: PHY FEE/ CHOLECYSTECTOMY	$1,950	$1,365	$1,365 – $1,950
Gallbladder removal by laparoscope: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $1,365 Aetna - Medicare Advantage — Medicare Advantage: $1,950 Aetna - Meritain — UNKNOWN: $1,365 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $1,560 Cigna - HMO/PPO — HMO/PPO: $1,560 Galaxy Health Network — HMO/PPO/POS: $1,560
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PHY FEE HERNIA RPR/INGU >5	$4,917	$3,441.90	$100 – $3,933.60
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $3,441.90 Aetna - Medicare Advantage — Medicare Advantage: $3,434.53 Aetna - Meritain — UNKNOWN: $3,441.90 Aetna Medicaid — UNKNOWN: $1,151.54 Amerigroup Medicaid — UNKNOWN: $1,151.54 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $3,933.60 Cigna - HMO/PPO — HMO/PPO: $3,933.60 Firstcare Medicaid — UNKNOWN: $1,151.54 Galaxy Health Network — HMO/PPO/POS: $3,933.60 GEHA — HMO/PPO/POS: $100
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: HERNIA REP/INGU >5	$6,153	$4,307.10	$100 – $4,922.40
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $4,307.10 Aetna - Medicare Advantage — Medicare Advantage: $3,434.53 Aetna - Meritain — UNKNOWN: $4,307.10 Aetna Medicaid — UNKNOWN: $1,151.54 Amerigroup Medicaid — UNKNOWN: $1,151.54 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $4,922.40 Cigna - HMO/PPO — HMO/PPO: $4,922.40 Firstcare Medicaid — UNKNOWN: $1,151.54 Galaxy Health Network — HMO/PPO/POS: $4,922.40 GEHA — HMO/PPO/POS: $100
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) In the file: PHY FEE HERNIA RPR/INGU >5	$4,917	$3,441.90	$3,441.90 – $4,917
Groin (inguinal) hernia repair, age 5 or older: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $3,441.90 Aetna - Medicare Advantage — Medicare Advantage: $4,917 Aetna - Meritain — UNKNOWN: $3,441.90 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $3,933.60 Cigna - HMO/PPO — HMO/PPO: $3,933.60 Galaxy Health Network — HMO/PPO/POS: $3,933.60
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY W/ BX. OR POLYPEC	$5,040	$3,528	$100 – $4,032
Hysteroscopy with biopsy of the uterus lining: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $3,528 Aetna - Medicare Advantage — Medicare Advantage: $2,741.71 Aetna - Meritain — UNKNOWN: $3,528 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $4,032 Cigna - HMO/PPO — HMO/PPO: $4,032 Galaxy Health Network — HMO/PPO/POS: $4,032 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $3,276 Triwest — Federal: $2,741.71 United HMO/PPO — HMO/PPO: $100
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) In the file: HYSTEROSCOPY W/ BX. OR POLYPEC	$5,040	$3,528	$3,528 – $5,040
Hysteroscopy with biopsy of the uterus lining: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $3,528 Aetna - Medicare Advantage — Medicare Advantage: $5,040 Aetna - Meritain — UNKNOWN: $3,528 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $4,032 Cigna - HMO/PPO — HMO/PPO: $4,032 Galaxy Health Network — HMO/PPO/POS: $4,032
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: PHY FEE NJX DX/THER SBST INTRIMNR LMBR	$288	$201.60	$100 – $624.80
Spinal injection, lower back (epidural), with imaging guidance: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $201.60 Aetna - Medicare Advantage — Medicare Advantage: $624.80 Aetna - Meritain — UNKNOWN: $201.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $230.40 Cigna - HMO/PPO — HMO/PPO: $230.40 Galaxy Health Network — HMO/PPO/POS: $230.40 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $187.20 Triwest — Federal: $624.80 United HMO/PPO — HMO/PPO: $100
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) In the file: PHY FEE NJX DX/THER SBST INTRIMNR LMBR	$288	$201.60	$201.60 – $288
Spinal injection, lower back (epidural), with imaging guidance: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $201.60 Aetna - Medicare Advantage — Medicare Advantage: $288 Aetna - Meritain — UNKNOWN: $201.60 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $230.40 Cigna - HMO/PPO — HMO/PPO: $230.40 Galaxy Health Network — HMO/PPO/POS: $230.40
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: PHY FEEINJ ANES LUMBR/SACRAL SNGL LVL	$322	$225.40	$100 – $826.34
Nerve root injection, lower back, with imaging guidance: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $225.40 Aetna - Medicare Advantage — Medicare Advantage: $826.34 Aetna - Meritain — UNKNOWN: $225.40 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $257.60 Cigna - HMO/PPO — HMO/PPO: $257.60 Galaxy Health Network — HMO/PPO/POS: $257.60 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $209.30 Triwest — Federal: $826.34 United HMO/PPO — HMO/PPO: $100
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: INJ ANES AGENT/STEROID TRANS EPID LUM/SA	$717	$501.90	$100 – $826.34
Nerve root injection, lower back, with imaging guidance: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $501.90 Aetna - Medicare Advantage — Medicare Advantage: $826.34 Aetna - Meritain — UNKNOWN: $501.90 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $573.60 Cigna - HMO/PPO — HMO/PPO: $573.60 Galaxy Health Network — HMO/PPO/POS: $573.60 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $466.05 Triwest — Federal: $826.34 United HMO/PPO — HMO/PPO: $100
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) In the file: PHY FEEINJ ANES LUMBR/SACRAL SNGL LVL	$322	$225.40	$225.40 – $322
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $225.40 Aetna - Medicare Advantage — Medicare Advantage: $322 Aetna - Meritain — UNKNOWN: $225.40 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $257.60 Cigna - HMO/PPO — HMO/PPO: $257.60 Galaxy Health Network — HMO/PPO/POS: $257.60
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier TB In the file: CARPAL TUNNEL RELEASE	$3,712	$2,598.40	$100 – $2,969.60
Carpal tunnel release: 10 of 12 insurance plan rates Aetna - HMO/PPO — HMO/PPO/POS: $2,598.40 Aetna - Medicare Advantage — Medicare Advantage: $1,743.02 Aetna - Meritain — UNKNOWN: $2,598.40 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $2,969.60 Cigna - HMO/PPO — HMO/PPO: $2,969.60 Galaxy Health Network — HMO/PPO/POS: $2,969.60 GEHA — HMO/PPO/POS: $100 Humana Medicare Advantage — Medicare Advantage: $2,412.80 Triwest — Federal: $1,743.02 United HMO/PPO — HMO/PPO: $100
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · modifier TB In the file: CARPAL TUNNEL RELEASE	$3,712	$2,598.40	$2,598.40 – $3,712
Carpal tunnel release: rates for 6 insurance plans Aetna - HMO/PPO — HMO/PPO/POS: $2,598.40 Aetna - Medicare Advantage — Medicare Advantage: $3,712 Aetna - Meritain — UNKNOWN: $2,598.40 BCBS - HMO/PPO/Blue Advantage — HMO/PPO/Blue Advantage: $2,969.60 Cigna - HMO/PPO — HMO/PPO: $2,969.60 Galaxy Health Network — HMO/PPO/POS: $2,969.60

Source: Seymour Hospital’s standard charges file (seymourhospital.slicedhealth.io, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 14, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	200 Stadium Drive, Seymour, TX 76380
County	Baylor County
State	Texas
Phone	(940) 889‑5572
Emergency services	Yes
Ownership	Government - Hospital District or Authority
Medicare overall rating	Not rated by CMS
CMS Certification Number	451399
Name in Medicare records	SEYMOUR HOSPITAL
Profile level	Medicare data + hospital website
Official website	seymourhospital.com
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Seymour Hospital — seymourhospital.com
About — seymourhospital.com
Departments — seymourhospital.com
Home, Seymour Hospital, Seymour, Texas — seymourhospital.com
Radiology, Seymour Hospital, Seymour, Texas — seymourhospital.com
Surgery Department, Seymour Hospital, Seymour, Texas — seymourhospital.com
Cardiac Rehabilitation, Seymour Hospital, Seymour, Texas — seymourhospital.com
Rehabilitation - Seymour Hospital — seymourhospital.com
Labor and Delivery, Seymour Hospital, Seymour, Texas — seymourhospital.com
Business Office, Seymour Hospital, Seymour, Texas — seymourhospital.com

Seymour Hospital

Summary

Profile from official sources

At a glance