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Acute Care Hospital

Southwest General Health Center

Middleburg Heights, Ohio · Cuyahoga County · Emergency services listed

Summary

Southwest General Health Center is an acute care hospital in Middleburg Heights, Ohio. Medicare data lists emergency services. CMS overall star rating: 4 of 5 stars. Its official website lists 51 services, specialties and programs. Medicare lists 621 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

Call(440) 816‑8000 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
4 of 5 stars4 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
368Beds (hospital website)
621Doctors and clinicians
51Services listed

Quick answers

Does Southwest General Health Center have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Southwest General Health Center. In a medical emergency, call 911.
Where is Southwest General Health Center?
18697 Bagley Road, Middleburg Heights, OH 44130, in Cuyahoga County, Ohio.
What is the phone number of Southwest General Health Center?
(440) 816-8000, as listed by Medicare (CMS).
What is the Medicare star rating of Southwest General Health Center?
4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[5][6][7][8][9][10][11]

Conditions treated[5][6][7][9][11]

Treatments[6][8][10][11]

Procedures[7][8][9][10]

Programs and centers[5][6][8][10][11]

  • Heart failure program
  • Breast Center
  • Trauma Service (main campus)
  • Maternity services
  • Oakview Behavioral Health Services

Emergency care (hospital website)[4][5][9]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel III
Stroke designationPrimary Stroke Center (The Joint Commission)

Visiting and practical information

VisitingVisitation open 24 hours; preferred times 11 a.m.-8 p.m. Behavioral health units by appointment only[12]

Recognition[4][5][6][8][9]

  • Level III trauma center (verified by American College of Surgeons)
  • Primary Stroke Center certification (The Joint Commission)
  • Heart Failure certification (The Joint Commission)
  • Community Hospital Comprehensive Cancer Program (ACS Commission on Cancer)

Doctors and clinicians (621)

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

Main specialties

Doctors with a page on this site (621)

And 597 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 3 of 5 stars
Overall rating of the hospital4 of 5 stars
Would recommend the hospital4 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean2 of 5 stars
Quiet at night3 of 5 stars
Rated the hospital 9 or 10 out of 1073%National average: 72%
Would definitely recommend the hospital73%National average: 71%
Nurses “always” communicated well80%National average: 80%
Doctors “always” communicated well76%National average: 80%
Staff “always” explained medicines before giving them56%National average: 62%
Were given information about recovery at home86%National average: 86%
Room and bathroom “always” clean63%National average: 74%
Area around the room “always” quiet at night55%National average: 60%
Completed surveys1,245Response rate: 26%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.569No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.733No different from the national benchmark
Surgical site infections after colon surgery0.288No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.434Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients10.8%
Deaths within 30 days: heart failure patients9.7%
Deaths within 30 days: pneumonia patients12.7%
Deaths within 30 days: COPD patients6.9%
Deaths within 30 days: stroke patients14.2%
Deaths within 30 days: coronary bypass surgery (CABG)2.4%
Serious complications (patient safety indicator PSI-90)1.4Worse than the national rate
Complications after hip or knee replacement3.3%

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 attack15.4%
Readmitted within 30 days: heart failure22.9%
Readmitted within 30 days: pneumonia18.5%
Readmitted within 30 days: COPD18.5%
Readmitted within 30 days: coronary bypass surgery12%
Readmitted within 30 days: hip or knee replacement5.9%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)199 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)5%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)89%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 OhioBest hospitals in Ohio

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Southwest General Health Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE VISIT-NEW PT DETAILED $209 $156.75 $720
New patient office visit (about 30–44 minutes): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE VISIT-NEW PT DETAILED $200 Not listed in the file $70.42 – $103.34
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $70.42
  • Anthem — Blue Access OH 1 & 2: $81.45
  • ANTHEM — Managed Medicare: $76.55
  • Anthem BCBS — All Products: $101.81
  • Buckeye — Managed Medicaid: $42.22
  • CARESOURCE — Managed Medicaid: $42.22
  • CIGNA — All Products: $103.34
  • HEALTH DESIGN PLUS — All Products: $95.69
  • HEALTHSPAN — All Products: $84.21
  • HUMANA — Managed Medicaid: $42.22
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE VISIT-NEW PT COMPREHENSIVE MOD $314 $235.50 $720
New patient office visit (about 45–59 minutes): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE VISIT-NEW PT COMPREHENSIVE MOD $300 Not listed in the file $115.05 – $168.18
New patient office visit (about 45–59 minutes): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $115.05
  • Anthem — Blue Access OH 1 & 2: $132.55
  • ANTHEM — Managed Medicare: $124.58
  • Anthem BCBS — All Products: $165.69
  • Buckeye — Managed Medicaid: $68.35
  • CARESOURCE — Managed Medicaid: $68.35
  • CIGNA — All Products: $168.18
  • HEALTH DESIGN PLUS — All Products: $155.73
  • HEALTHSPAN — All Products: $137.04
  • HUMANA — Managed Medicaid: $68.35
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE VISIT-NEW PT COMPREHENS HI COMPLX $416 $312 $720
New patient office visit (about 60–74 minutes): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE VISIT-NEW PT COMPREHENS HI COMPLX $400 Not listed in the file $157.69 – $228.83
New patient office visit (about 60–74 minutes): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $157.69
  • Anthem — Blue Access OH 1 & 2: $180.35
  • ANTHEM — Managed Medicare: $169.50
  • Anthem BCBS — All Products: $225.44
  • Buckeye — Managed Medicaid: $92.75
  • CARESOURCE — Managed Medicaid: $92.75
  • CIGNA — All Products: $228.83
  • HEALTH DESIGN PLUS — All Products: $211.88
  • HEALTHSPAN — All Products: $186.45
  • HUMANA — Managed Medicaid: $92.75
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE VISIT-EST PT EXPANDED LOW COMPLEX $170 $127.50 $720
Established patient office visit (about 20–29 minutes): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE VISIT-EST PT EXPANDED LOW COMPLEX $170 Not listed in the file $56.51 – $82.98
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $56.51
  • Anthem — Blue Access OH 1 & 2: $65.40
  • ANTHEM — Managed Medicare: $61.47
  • Anthem BCBS — All Products: $81.76
  • Buckeye — Managed Medicaid: $33.74
  • CARESOURCE — Managed Medicaid: $33.74
  • CIGNA — All Products: $82.98
  • HEALTH DESIGN PLUS — All Products: $76.84
  • HEALTHSPAN — All Products: $67.62
  • HUMANA — Managed Medicaid: $33.74
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE VISIT-EST PT DETAILED MOD COMPLEX $240 $180 $720
Established patient office visit (about 30–39 minutes): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE VISIT-EST PT DETAILED MOD COMPLEX $235 Not listed in the file $83.18 – $122.20
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $83.18
  • Anthem — Blue Access OH 1 & 2: $96.31
  • ANTHEM — Managed Medicare: $90.52
  • Anthem BCBS — All Products: $120.39
  • Buckeye — Managed Medicaid: $49.49
  • CARESOURCE — Managed Medicaid: $49.49
  • CIGNA — All Products: $122.20
  • HEALTH DESIGN PLUS — All Products: $113.15
  • HEALTHSPAN — All Products: $99.57
  • HUMANA — Managed Medicaid: $49.49
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE CONSULT, DETAILED; LOW COMPLX $195 $146.25 $720
Office consultation with a specialist (moderate): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE CONSULT, DETAILED; LOW COMPLX $195 Not listed in the file $47.76
Office consultation with a specialist (moderate): rates for 6 insurance plans
  • Buckeye — Managed Medicaid: $47.76
  • CARESOURCE — Managed Medicaid: $47.76
  • CIGNA — All Products: $195
  • HUMANA — Managed Medicaid: $47.76
  • MOLINA — Managed Medicaid: $47.76
  • United Healthcare — Managed Medicaid: $47.76
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE CONSULT, COMPREHENSV; MOD COMPLEX $290 $217.50 $720
Office consultation with a specialist (moderate to high): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE CONSULT, COMPREHENSV; MOD COMPLEX $290 Not listed in the file $76.31
Office consultation with a specialist (moderate to high): rates for 6 insurance plans
  • Buckeye — Managed Medicaid: $76.31
  • CARESOURCE — Managed Medicaid: $76.31
  • CIGNA — All Products: $290
  • HUMANA — Managed Medicaid: $76.31
  • MOLINA — Managed Medicaid: $76.31
  • United Healthcare — Managed Medicaid: $76.31
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INIT COMP 18-39YR PREVNT MED, EVAL/MGMT $205 $153.75 $720
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: INIT COMP 18-39YR PREVNT MED, EVAL/MGMT $205 Not listed in the file $48.97
Preventive checkup, new patient, age 18–39: rates for 6 insurance plans
  • Buckeye — Managed Medicaid: $48.97
  • CARESOURCE — Managed Medicaid: $48.97
  • CIGNA — All Products: $205
  • HUMANA — Managed Medicaid: $48.97
  • MOLINA — Managed Medicaid: $48.97
  • United Healthcare — Managed Medicaid: $48.97
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INIT COMP 40-64YR PREVNT MED, EVAL/MGMT $240 $180 $720
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: INIT COMP 40-64YR PREVNT MED, EVAL/MGMT $240 Not listed in the file $62.29
Preventive checkup, new patient, age 40–64: rates for 6 insurance plans
  • Buckeye — Managed Medicaid: $62.29
  • CARESOURCE — Managed Medicaid: $62.29
  • CIGNA — All Products: $240
  • HUMANA — Managed Medicaid: $62.29
  • MOLINA — Managed Medicaid: $62.29
  • United Healthcare — Managed Medicaid: $62.29
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LEVEL 3 $1,056 $792 $110.38 – $1,199
Emergency room visit (moderate): 10 of 34 insurance plan rates
  • Aetna — All Products: $1,199
  • Aetna — Managed Medicare: $256.69
  • Anthem — All Products: $256.69
  • Anthem — Managed Medicare: $256.69
  • Aultcare — Managed Medicare: $570.24
  • Buckeye — ACA Exchange: $346.53
  • Buckeye — Managed Medicare: $256.69
  • CareSource — Managed Medicare: $436.37
  • Cigna — All Products: $713.89
  • Clarity Health — All Products: $422.40
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERG DEPT VISIT, EXPANDED; MOD COMPLEX $130 $97.50 $720
Emergency room visit (moderate): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERG DEPT VISIT, EXPANDED; MOD COMPLEX $130 Not listed in the file $66.53 – $89.82
Emergency room visit (moderate): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $68.71
  • Anthem — Blue Access OH 1 & 2: $70.79
  • ANTHEM — Managed Medicare: $66.53
  • Anthem BCBS — All Products: $88.48
  • Buckeye — Managed Medicaid: $37.68
  • CARESOURCE — Managed Medicaid: $37.68
  • CIGNA — All Products: $89.82
  • HEALTH DESIGN PLUS — All Products: $83.16
  • HEALTHSPAN — All Products: $73.18
  • HUMANA — Managed Medicaid: $37.68
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99284 ED LEVEL 4 $1,559 $1,169.25 $169.74 – $1,908
Emergency room visit (moderately high): 10 of 34 insurance plan rates
  • Aetna — All Products: $1,908
  • Aetna — Managed Medicare: $394.75
  • Anthem — All Products: $394.75
  • Anthem — Managed Medicare: $394.75
  • Aultcare — Managed Medicare: $841.86
  • Buckeye — ACA Exchange: $532.92
  • Buckeye — Managed Medicare: $394.75
  • CareSource — Managed Medicare: $671.08
  • Cigna — All Products: $1,091.24
  • Clarity Health — All Products: $623.60
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERG DEPT VISIT, DETAILED; MOD COMPLEX $200 $150 $720
Emergency room visit (moderately high): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERG DEPT VISIT, DETAILED; MOD COMPLEX $200 Not listed in the file $113.61 – $153.37
Emergency room visit (moderately high): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $117.03
  • Anthem — Blue Access OH 1 & 2: $120.88
  • ANTHEM — Managed Medicare: $113.61
  • Anthem BCBS — All Products: $151.10
  • Buckeye — Managed Medicaid: $62.91
  • CARESOURCE — Managed Medicaid: $62.91
  • CIGNA — All Products: $153.37
  • HEALTH DESIGN PLUS — All Products: $142.01
  • HEALTHSPAN — All Products: $124.97
  • HUMANA — Managed Medicaid: $62.91
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99285 ED LEVEL 5 $2,618 $1,963.50 $244.40 – $3,480
Emergency room visit (high): 10 of 34 insurance plan rates
  • Aetna — All Products: $3,480
  • Aetna — Managed Medicare: $568.37
  • Anthem — All Products: $568.37
  • Anthem — Managed Medicare: $568.37
  • Aultcare — Managed Medicare: $1,413.72
  • Buckeye — ACA Exchange: $767.30
  • Buckeye — Managed Medicare: $568.37
  • CareSource — Managed Medicare: $966.23
  • Cigna — All Products: $1,557.43
  • Clarity Health — All Products: $1,047.20
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERG DEPT VISIT, COMPREH; HIGH COMPLEX $280 $210 $720
Emergency room visit (high): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERG DEPT VISIT, COMPREH; HIGH COMPLEX $280 Not listed in the file $164.83 – $222.52
Emergency room visit (high): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $169.59
  • Anthem — Blue Access OH 1 & 2: $175.38
  • ANTHEM — Managed Medicare: $164.83
  • Anthem BCBS — All Products: $219.22
  • Buckeye — Managed Medicaid: $94.23
  • CARESOURCE — Managed Medicaid: $94.23
  • CIGNA — All Products: $222.52
  • HEALTH DESIGN PLUS — All Products: $206.04
  • HEALTHSPAN — All Products: $181.31
  • HUMANA — Managed Medicaid: $94.23

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL $115 $86.25 $36.80 – $115
Basic metabolic panel (blood test): 10 of 34 insurance plan rates
  • Aetna — All Products: $67.19
  • Aetna — Managed Medicare: $8.46
  • Anthem — All Products: $8.46
  • Anthem — Managed Medicare: $8.46
  • Aultcare — Managed Medicare: $62.10
  • Buckeye — ACA Exchange: $11.42
  • Buckeye — Managed Medicare: $8.46
  • CareSource — Managed Medicare: $14.38
  • Cigna — All Products: $58.82
  • Clarity Health — All Products: $46
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL (DO NOT USE W/ 800 $63 $47.25 $720
Basic metabolic panel (blood test): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BASIC METABOLIC PNL TOTAL CA Not listed in the file Not listed in the file $58.82
Basic metabolic panel (blood test): rates for 1 insurance plan
  • Cigna — All Products: $58.82
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC $234 $175.50 $74.88 – $234
Comprehensive metabolic panel (blood test): 10 of 34 insurance plan rates
  • Aetna — All Products: $136.73
  • Aetna — Managed Medicare: $10.56
  • Anthem — All Products: $10.56
  • Anthem — Managed Medicare: $10.56
  • Aultcare — Managed Medicare: $126.36
  • Buckeye — ACA Exchange: $14.26
  • Buckeye — Managed Medicare: $10.56
  • CareSource — Managed Medicare: $17.95
  • Cigna — All Products: $73.41
  • Clarity Health — All Products: $93.60
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL (DO NOT US $64 $48 $720
Comprehensive metabolic panel (blood test): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COMPREHENSIVE METABOLIC PANEL (DO NOT US $64 Not listed in the file $64
Comprehensive metabolic panel (blood test): rates for 1 insurance plan
  • CIGNA — All Products: $64
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL $166 $124.50 $20.56 – $81.28
Obstetric blood test panel: 10 of 34 insurance plan rates
  • Aetna — All Products: $96.99
  • Aetna — Managed Medicare: $47.81
  • Anthem — All Products: $47.81
  • Anthem — Managed Medicare: $47.81
  • Aultcare — Managed Medicare: $89.64
  • Buckeye — ACA Exchange: $64.54
  • Buckeye — Managed Medicare: $47.81
  • CareSource — Managed Medicare: $81.28
  • Cigna — All Products: $332.42
  • Clarity Health — All Products: $66.40
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL $152 $114 $5.76 – $22.76
Cholesterol panel (lipid panel): 10 of 34 insurance plan rates
  • Aetna — All Products: $88.81
  • Aetna — Managed Medicare: $13.39
  • Anthem — All Products: $13.39
  • Anthem — Managed Medicare: $13.39
  • Aultcare — Managed Medicare: $82.08
  • Buckeye — ACA Exchange: $18.08
  • Buckeye — Managed Medicare: $13.39
  • CareSource — Managed Medicare: $22.76
  • Cigna — All Products: $93.10
  • Clarity Health — All Products: $60.80
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIPID PANEL $61 $45.75 $720
Cholesterol panel (lipid panel): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LIPID PANEL $61 Not listed in the file $61
Cholesterol panel (lipid panel): rates for 1 insurance plan
  • CIGNA — All Products: $61
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL $148 $111 $47.36 – $148
Kidney function panel: 10 of 34 insurance plan rates
  • Aetna — All Products: $86.48
  • Aetna — Managed Medicare: $8.68
  • Anthem — All Products: $8.68
  • Anthem — Managed Medicare: $8.68
  • Aultcare — Managed Medicare: $79.92
  • Buckeye — ACA Exchange: $11.72
  • Buckeye — Managed Medicare: $8.68
  • CareSource — Managed Medicare: $14.76
  • Cigna — All Products: $60.35
  • Clarity Health — All Products: $59.20
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: RENAL FUNCTION PANEL Not listed in the file Not listed in the file $60.35
Kidney function panel: rates for 1 insurance plan
  • Cigna — All Products: $60.35
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL $125 $93.75 $40 – $125
Liver function panel: 10 of 34 insurance plan rates
  • Aetna — All Products: $73.04
  • Aetna — Managed Medicare: $8.17
  • Anthem — All Products: $8.17
  • Anthem — Managed Medicare: $8.17
  • Aultcare — Managed Medicare: $67.50
  • Buckeye — ACA Exchange: $11.03
  • Buckeye — Managed Medicare: $8.17
  • CareSource — Managed Medicare: $13.89
  • Cigna — All Products: $56.80
  • Clarity Health — All Products: $50
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATITIS FUNCTION PANEL (DO NOT USE W/ $44 $33 $720
Liver function panel: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: HEPATITIS FUNCTION PANEL (DO NOT USE W/ $44 Not listed in the file $44
Liver function panel: rates for 1 insurance plan
  • CIGNA — All Products: $44
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE $81 $60.75 $1.36 – $5.39
Urine test (automated, with microscope): 10 of 34 insurance plan rates
  • Aetna — All Products: $47.33
  • Aetna — Managed Medicare: $3.17
  • Anthem — All Products: $3.17
  • Anthem — Managed Medicare: $3.17
  • Aultcare — Managed Medicare: $43.74
  • Buckeye — ACA Exchange: $4.28
  • Buckeye — Managed Medicare: $3.17
  • CareSource — Managed Medicare: $5.39
  • Cigna — All Products: $22.03
  • Clarity Health — All Products: $32.40
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS, DIP STICK/TABLET REAGENT; NO $30 $22.50 $720
Urine test (manual, without microscope): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: URINALYSIS, DIP STICK/TABLET REAGENT; NO $30 Not listed in the file $30
Urine test (manual, without microscope): rates for 1 insurance plan
  • CIGNA — All Products: $30
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO WO MICRO $51 $38.25 $0.97 – $3.83
Urine test (automated, without microscope): 10 of 34 insurance plan rates
  • Aetna — All Products: $29.80
  • Aetna — Managed Medicare: $2.25
  • Anthem — All Products: $2.25
  • Anthem — Managed Medicare: $2.25
  • Aultcare — Managed Medicare: $27.54
  • Buckeye — ACA Exchange: $3.04
  • Buckeye — Managed Medicare: $2.25
  • CareSource — Managed Medicare: $3.83
  • Cigna — All Products: $15.65
  • Clarity Health — All Products: $20.40
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PH URINE $51 $38.25 $0.97 – $3.83
Urine test (automated, without microscope): 10 of 34 insurance plan rates
  • Aetna — All Products: $29.80
  • Aetna — Managed Medicare: $2.25
  • Anthem — All Products: $2.25
  • Anthem — Managed Medicare: $2.25
  • Aultcare — Managed Medicare: $27.54
  • Buckeye — ACA Exchange: $3.04
  • Buckeye — Managed Medicare: $2.25
  • CareSource — Managed Medicare: $3.83
  • Cigna — All Products: $15.65
  • Clarity Health — All Products: $20.40
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPECIFIC GRAVITY URINE $51 $38.25 $0.97 – $3.83
Urine test (automated, without microscope): 10 of 34 insurance plan rates
  • Aetna — All Products: $29.80
  • Aetna — Managed Medicare: $2.25
  • Anthem — All Products: $2.25
  • Anthem — Managed Medicare: $2.25
  • Aultcare — Managed Medicare: $27.54
  • Buckeye — ACA Exchange: $3.04
  • Buckeye — Managed Medicare: $2.25
  • CareSource — Managed Medicare: $3.83
  • Cigna — All Products: $15.65
  • Clarity Health — All Products: $20.40
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL (ARUP-REF LAB) $175 $131.25 $56 – $175
PSA (prostate specific antigen) blood test: 10 of 34 insurance plan rates
  • Aetna — All Products: $102.25
  • Aetna — Managed Medicare: $18.39
  • Anthem — All Products: $18.39
  • Anthem — Managed Medicare: $18.39
  • Aultcare — Managed Medicare: $94.50
  • Buckeye — ACA Exchange: $24.83
  • Buckeye — Managed Medicare: $18.39
  • CareSource — Managed Medicare: $31.26
  • Cigna — All Products: $127.86
  • Clarity Health — All Products: $70
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROSTATIC SPECIFIC AG $144 $108 $7.91 – $31.26
PSA (prostate specific antigen) blood test: 10 of 34 insurance plan rates
  • Aetna — All Products: $84.14
  • Aetna — Managed Medicare: $18.39
  • Anthem — All Products: $18.39
  • Anthem — Managed Medicare: $18.39
  • Aultcare — Managed Medicare: $77.76
  • Buckeye — ACA Exchange: $24.83
  • Buckeye — Managed Medicare: $18.39
  • CareSource — Managed Medicare: $31.26
  • Cigna — All Products: $127.86
  • Clarity Health — All Products: $57.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULAT HORMONE $134 $100.50 $42.88 – $134
Thyroid stimulating hormone (TSH) test: 10 of 34 insurance plan rates
  • Aetna — All Products: $78.30
  • Aetna — Managed Medicare: $16.80
  • Anthem — All Products: $16.80
  • Anthem — Managed Medicare: $16.80
  • Aultcare — Managed Medicare: $72.36
  • Buckeye — ACA Exchange: $22.68
  • Buckeye — Managed Medicare: $16.80
  • CareSource — Managed Medicare: $28.56
  • Cigna — All Products: $116.82
  • Clarity Health — All Products: $53.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: ASSAY THYROID STIM HORMONE Not listed in the file Not listed in the file $116.82
Thyroid stimulating hormone (TSH) test: rates for 1 insurance plan
  • Cigna — All Products: $116.82
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC WITH AUTOMATED DIFF $85 $63.75 $3.34 – $13.21
Complete blood count (CBC) with differential: 10 of 34 insurance plan rates
  • Aetna — All Products: $49.67
  • Aetna — Managed Medicare: $7.77
  • Anthem — All Products: $7.77
  • Anthem — Managed Medicare: $7.77
  • Aultcare — Managed Medicare: $45.90
  • Buckeye — ACA Exchange: $10.49
  • Buckeye — Managed Medicare: $7.77
  • CareSource — Managed Medicare: $13.21
  • Cigna — All Products: $54.03
  • Clarity Health — All Products: $34
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: COMPLETE CBC W/AUTO DIFF WBC Not listed in the file Not listed in the file $54.03
Complete blood count (CBC) with differential: rates for 1 insurance plan
  • Cigna — All Products: $54.03
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC WITHOUT DIFF $65 $48.75 $2.78 – $11
Complete blood count (CBC), automated: 10 of 34 insurance plan rates
  • Aetna — All Products: $37.98
  • Aetna — Managed Medicare: $6.47
  • Anthem — All Products: $6.47
  • Anthem — Managed Medicare: $6.47
  • Aultcare — Managed Medicare: $35.10
  • Buckeye — ACA Exchange: $8.73
  • Buckeye — Managed Medicare: $6.47
  • CareSource — Managed Medicare: $11
  • Cigna — All Products: $45
  • Clarity Health — All Products: $26
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARUP-PROTHROMBIN TIME-D $49 $36.75 $15.68 – $49
Blood clotting time test (prothrombin time, PT): 10 of 34 insurance plan rates
  • Aetna — All Products: $28.63
  • Aetna — Managed Medicare: $4.29
  • Anthem — All Products: $4.29
  • Anthem — Managed Medicare: $4.29
  • Aultcare — Managed Medicare: $26.46
  • Buckeye — ACA Exchange: $5.79
  • Buckeye — Managed Medicare: $4.29
  • CareSource — Managed Medicare: $7.29
  • Cigna — All Products: $29.83
  • Clarity Health — All Products: $19.60
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUPUS ANTI-PROTH TIME-D $13 $9.75 $1.84 – $7.29
Blood clotting time test (prothrombin time, PT): 10 of 34 insurance plan rates
  • Aetna — All Products: $7.60
  • Aetna — Managed Medicare: $4.29
  • Anthem — All Products: $4.29
  • Anthem — Managed Medicare: $4.29
  • Aultcare — Managed Medicare: $7.02
  • Buckeye — ACA Exchange: $5.79
  • Buckeye — Managed Medicare: $4.29
  • CareSource — Managed Medicare: $7.29
  • Cigna — All Products: $29.83
  • Clarity Health — All Products: $5.20
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $13 $9.75 $1.84 – $7.29
Blood clotting time test (prothrombin time, PT): 10 of 34 insurance plan rates
  • Aetna — All Products: $7.60
  • Aetna — Managed Medicare: $4.29
  • Anthem — All Products: $4.29
  • Anthem — Managed Medicare: $4.29
  • Aultcare — Managed Medicare: $7.02
  • Buckeye — ACA Exchange: $5.79
  • Buckeye — Managed Medicare: $4.29
  • CareSource — Managed Medicare: $7.29
  • Cigna — All Products: $29.83
  • Clarity Health — All Products: $5.20
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARUP-REFLEX PTT $48 $36 $15.36 – $48
Blood clotting test (partial thromboplastin time, PTT): 10 of 34 insurance plan rates
  • Aetna — All Products: $28.05
  • Aetna — Managed Medicare: $6.01
  • Anthem — All Products: $6.01
  • Anthem — Managed Medicare: $6.01
  • Aultcare — Managed Medicare: $25.92
  • Buckeye — ACA Exchange: $8.11
  • Buckeye — Managed Medicare: $6.01
  • CareSource — Managed Medicare: $10.22
  • Cigna — All Products: $41.78
  • Clarity Health — All Products: $19.20
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARUP-PTT-D $52 $39 $16.64 – $52
Blood clotting test (partial thromboplastin time, PTT): 10 of 34 insurance plan rates
  • Aetna — All Products: $30.38
  • Aetna — Managed Medicare: $6.01
  • Anthem — All Products: $6.01
  • Anthem — Managed Medicare: $6.01
  • Aultcare — Managed Medicare: $28.08
  • Buckeye — ACA Exchange: $8.11
  • Buckeye — Managed Medicare: $6.01
  • CareSource — Managed Medicare: $10.22
  • Cigna — All Products: $41.78
  • Clarity Health — All Products: $20.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUPUS ANTI-PTT-D $27 $20.25 $2.58 – $10.22
Blood clotting test (partial thromboplastin time, PTT): 10 of 34 insurance plan rates
  • Aetna — All Products: $15.78
  • Aetna — Managed Medicare: $6.01
  • Anthem — All Products: $6.01
  • Anthem — Managed Medicare: $6.01
  • Aultcare — Managed Medicare: $14.58
  • Buckeye — ACA Exchange: $8.11
  • Buckeye — Managed Medicare: $6.01
  • CareSource — Managed Medicare: $10.22
  • Cigna — All Products: $41.78
  • Clarity Health — All Products: $10.80

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT BRAIN HEAD WO CONT $1,717 $1,287.75 $42.39 – $190.41
CT scan of the head or brain, without contrast: 10 of 34 insurance plan rates
  • Aetna — All Products: $190.41
  • Aetna — Managed Medicare: $98.58
  • Anthem — All Products: $98.58
  • Anthem — Managed Medicare: $98.58
  • Aultcare — Managed Medicare: $927.18
  • Buckeye — ACA Exchange: $133.08
  • Buckeye — Managed Medicare: $98.58
  • CareSource — Managed Medicare: $167.59
  • Cigna — All Products: $273.41
  • Clarity Health — All Products: $686.80
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT SCAN, HEAD/BRAIN; W/O CONTRAST MATL $75 $56.25 $720
CT scan of the head or brain, without contrast: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CT SCAN, HEAD/BRAIN; W/O CONTRAST MATL $75 Not listed in the file $97.95 – $132.23
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $99.88
  • Anthem — Blue Access OH 1 & 2: $104.22
  • ANTHEM — Managed Medicare: $97.95
  • Anthem BCBS — All Products: $130.27
  • Buckeye — Managed Medicaid: $100.97
  • CARESOURCE — Managed Medicaid: $100.97
  • CIGNA — All Products: $132.23
  • HEALTH DESIGN PLUS — All Products: $122.44
  • HEALTHSPAN — All Products: $107.75
  • HUMANA — Managed Medicaid: $100.97
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN W & W/O CONT $4,489 $3,366.75 $142.36 – $567.84
MRI of the brain, before and after contrast: 10 of 34 insurance plan rates
  • Aetna — All Products: $567.84
  • Aetna — Managed Medicare: $331.07
  • Anthem — All Products: $331.07
  • Anthem — Managed Medicare: $331.07
  • Aultcare — Managed Medicare: $2,424.06
  • Buckeye — ACA Exchange: $446.95
  • Buckeye — Managed Medicare: $331.07
  • CareSource — Managed Medicare: $562.83
  • Cigna — All Products: $912.37
  • Clarity Health — All Products: $1,795.60
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI, BRAIN; W/O CONTRAST, THEN W/ CONTRA $190 $142.50 $720
MRI of the brain, before and after contrast: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: MRI, BRAIN; W/O CONTRAST, THEN W/ CONTRA $190 Not listed in the file $292.10 – $394.34
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $296.39
  • Anthem — Blue Access OH 1 & 2: $310.79
  • ANTHEM — Managed Medicare: $292.10
  • Anthem BCBS — All Products: $388.49
  • Buckeye — Managed Medicaid: $319.74
  • CARESOURCE — Managed Medicaid: $319.74
  • CIGNA — All Products: $394.34
  • HEALTH DESIGN PLUS — All Products: $365.13
  • HEALTHSPAN — All Products: $321.31
  • HUMANA — Managed Medicaid: $319.74
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST EMPLOYEE (2V) $364 $273 $35.10 – $138.76
Chest X-ray, 2 views: 10 of 34 insurance plan rates
  • Aetna — All Products: $59
  • Aetna — Managed Medicare: $81.63
  • Anthem — All Products: $81.63
  • Anthem — Managed Medicare: $81.63
  • Aultcare — Managed Medicare: $196.56
  • Buckeye — ACA Exchange: $110.19
  • Buckeye — Managed Medicare: $81.63
  • CareSource — Managed Medicare: $138.76
  • Cigna — All Products: $227.59
  • Clarity Health — All Products: $145.60
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST 2 VIEWS $364 $273 $35.10 – $138.76
Chest X-ray, 2 views: 10 of 34 insurance plan rates
  • Aetna — All Products: $59
  • Aetna — Managed Medicare: $81.63
  • Anthem — All Products: $81.63
  • Anthem — Managed Medicare: $81.63
  • Aultcare — Managed Medicare: $196.56
  • Buckeye — ACA Exchange: $110.19
  • Buckeye — Managed Medicare: $81.63
  • CareSource — Managed Medicare: $138.76
  • Cigna — All Products: $227.59
  • Clarity Health — All Products: $145.60
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST 4V (2V W/ DIG SUB) $364 $273 $35.10 – $138.76
Chest X-ray, 2 views: 10 of 34 insurance plan rates
  • Aetna — All Products: $59
  • Aetna — Managed Medicare: $81.63
  • Anthem — All Products: $81.63
  • Anthem — Managed Medicare: $81.63
  • Aultcare — Managed Medicare: $196.56
  • Buckeye — ACA Exchange: $110.19
  • Buckeye — Managed Medicare: $81.63
  • CareSource — Managed Medicare: $138.76
  • Cigna — All Products: $227.59
  • Clarity Health — All Products: $145.60
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPINE LUMBAR W/OBLIQUES $759 $569.25 $42.39 – $167.59
X-ray of the lower spine, at least 4 views: 10 of 34 insurance plan rates
  • Aetna — All Products: $90.69
  • Aetna — Managed Medicare: $98.58
  • Anthem — All Products: $98.58
  • Anthem — Managed Medicare: $98.58
  • Aultcare — Managed Medicare: $409.86
  • Buckeye — ACA Exchange: $133.08
  • Buckeye — Managed Medicare: $98.58
  • CareSource — Managed Medicare: $167.59
  • Cigna — All Products: $273.41
  • Clarity Health — All Products: $303.60
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUMBO-SACRAL SPINE $759 $569.25 $42.39 – $167.59
X-ray of the lower spine, at least 4 views: 10 of 34 insurance plan rates
  • Aetna — All Products: $90.69
  • Aetna — Managed Medicare: $98.58
  • Anthem — All Products: $98.58
  • Anthem — Managed Medicare: $98.58
  • Aultcare — Managed Medicare: $409.86
  • Buckeye — ACA Exchange: $133.08
  • Buckeye — Managed Medicare: $98.58
  • CareSource — Managed Medicare: $167.59
  • Cigna — All Products: $273.41
  • Clarity Health — All Products: $303.60
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPINE LUMBAR W OBLIQUES $759 $569.25 $42.39 – $167.59
X-ray of the lower spine, at least 4 views: 10 of 34 insurance plan rates
  • Aetna — All Products: $90.69
  • Aetna — Managed Medicare: $98.58
  • Anthem — All Products: $98.58
  • Anthem — Managed Medicare: $98.58
  • Aultcare — Managed Medicare: $409.86
  • Buckeye — ACA Exchange: $133.08
  • Buckeye — Managed Medicare: $98.58
  • CareSource — Managed Medicare: $167.59
  • Cigna — All Products: $273.41
  • Clarity Health — All Products: $303.60
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE WO CONT $2,870 $2,152.50 $96.36 – $380.94
MRI of the lower back (lumbar spine), without contrast: 10 of 34 insurance plan rates
  • Aetna — All Products: $340.78
  • Aetna — Managed Medicare: $224.08
  • Anthem — All Products: $224.08
  • Anthem — Managed Medicare: $224.08
  • Aultcare — Managed Medicare: $1,549.80
  • Buckeye — ACA Exchange: $302.51
  • Buckeye — Managed Medicare: $224.08
  • CareSource — Managed Medicare: $380.94
  • Cigna — All Products: $623.98
  • Clarity Health — All Products: $1,148
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI, LUMBAR SPINE; W/O CONTRAST $125 $93.75 $720
MRI of the lower back (lumbar spine), without contrast: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: MRI, LUMBAR SPINE; W/O CONTRAST $125 Not listed in the file $175.30 – $236.66
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $179.54
  • Anthem — Blue Access OH 1 & 2: $186.52
  • ANTHEM — Managed Medicare: $175.30
  • Anthem BCBS — All Products: $233.15
  • Buckeye — Managed Medicaid: $188.36
  • CARESOURCE — Managed Medicaid: $188.36
  • CIGNA — All Products: $236.66
  • HEALTH DESIGN PLUS — All Products: $219.13
  • HEALTHSPAN — All Products: $192.83
  • HUMANA — Managed Medicaid: $188.36
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W IV CONTRAST $2,092 $1,569 $70.96 – $401.05
CT scan of the pelvis, with contrast: 10 of 34 insurance plan rates
  • Aetna — All Products: $401.05
  • Aetna — Managed Medicare: $165.03
  • Anthem — All Products: $165.03
  • Anthem — Managed Medicare: $165.03
  • Aultcare — Managed Medicare: $1,129.68
  • Buckeye — ACA Exchange: $222.79
  • Buckeye — Managed Medicare: $165.03
  • CareSource — Managed Medicare: $280.55
  • Cigna — All Products: $458.71
  • Clarity Health — All Products: $836.80
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JOINT LWR EXT WO CON $3,333 $2,499.75 $96.36 – $380.94
MRI of a leg joint (such as the knee), without contrast: 10 of 34 insurance plan rates
  • Aetna — All Products: $361.39
  • Aetna — Managed Medicare: $224.08
  • Anthem — All Products: $224.08
  • Anthem — Managed Medicare: $224.08
  • Aultcare — Managed Medicare: $1,799.82
  • Buckeye — ACA Exchange: $302.51
  • Buckeye — Managed Medicare: $224.08
  • CareSource — Managed Medicare: $380.94
  • Cigna — All Products: $623.98
  • Clarity Health — All Products: $1,333.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ENTEROGRAPHY $2,939 $2,204.25 $142.36 – $562.83
CT scan of the abdomen and pelvis, with contrast: 10 of 34 insurance plan rates
  • Aetna — All Products: $535.61
  • Aetna — Managed Medicare: $331.07
  • Anthem — All Products: $331.07
  • Anthem — Managed Medicare: $331.07
  • Aultcare — Managed Medicare: $1,587.06
  • Buckeye — ACA Exchange: $446.95
  • Buckeye — Managed Medicare: $331.07
  • CareSource — Managed Medicare: $562.83
  • Cigna — All Products: $912.37
  • Clarity Health — All Products: $1,175.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD/PELV WITH CONT $2,939 $2,204.25 $142.36 – $562.83
CT scan of the abdomen and pelvis, with contrast: 10 of 34 insurance plan rates
  • Aetna — All Products: $535.61
  • Aetna — Managed Medicare: $331.07
  • Anthem — All Products: $331.07
  • Anthem — Managed Medicare: $331.07
  • Aultcare — Managed Medicare: $1,587.06
  • Buckeye — ACA Exchange: $446.95
  • Buckeye — Managed Medicare: $331.07
  • CareSource — Managed Medicare: $562.83
  • Cigna — All Products: $912.37
  • Clarity Health — All Products: $1,175.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT SCAN ABDOMEN AND PELVIS $150 $112.50 $720
CT scan of the abdomen and pelvis, with contrast: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ABDOMINAL (COMPLETE)ECHO $370 $277.50 $42.39 – $202.33
Ultrasound of the abdomen, complete: 10 of 34 insurance plan rates
  • Aetna — All Products: $202.33
  • Aetna — Managed Medicare: $98.58
  • Anthem — All Products: $98.58
  • Anthem — Managed Medicare: $98.58
  • Aultcare — Managed Medicare: $199.80
  • Buckeye — ACA Exchange: $133.08
  • Buckeye — Managed Medicare: $98.58
  • CareSource — Managed Medicare: $167.59
  • Cigna — All Products: $273.41
  • Clarity Health — All Products: $148
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PORTABLE ABDM COMPL ECHO $1,314 $985.50 $42.39 – $202.33
Ultrasound of the abdomen, complete: 10 of 34 insurance plan rates
  • Aetna — All Products: $202.33
  • Aetna — Managed Medicare: $98.58
  • Anthem — All Products: $98.58
  • Anthem — Managed Medicare: $98.58
  • Aultcare — Managed Medicare: $709.56
  • Buckeye — ACA Exchange: $133.08
  • Buckeye — Managed Medicare: $98.58
  • CareSource — Managed Medicare: $167.59
  • Cigna — All Products: $273.41
  • Clarity Health — All Products: $525.60
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ABDOMEN COMPLETE ECHO $370 $277.50 $42.39 – $202.33
Ultrasound of the abdomen, complete: 10 of 34 insurance plan rates
  • Aetna — All Products: $202.33
  • Aetna — Managed Medicare: $98.58
  • Anthem — All Products: $98.58
  • Anthem — Managed Medicare: $98.58
  • Aultcare — Managed Medicare: $199.80
  • Buckeye — ACA Exchange: $133.08
  • Buckeye — Managed Medicare: $98.58
  • CareSource — Managed Medicare: $167.59
  • Cigna — All Products: $273.41
  • Clarity Health — All Products: $148
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GRAVID 14 WKS OR GREATER $1,050 $787.50 $42.39 – $235.22
Pregnancy ultrasound (after the first trimester): 10 of 34 insurance plan rates
  • Aetna — All Products: $235.22
  • Aetna — Managed Medicare: $98.58
  • Anthem — All Products: $98.58
  • Anthem — Managed Medicare: $98.58
  • Aultcare — Managed Medicare: $567
  • Buckeye — ACA Exchange: $133.08
  • Buckeye — Managed Medicare: $98.58
  • CareSource — Managed Medicare: $167.59
  • Cigna — All Products: $273.41
  • Clarity Health — All Products: $420
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MFM GRAVID 14 WKS OR > $1,050 $787.50 $42.39 – $235.22
Pregnancy ultrasound (after the first trimester): 10 of 34 insurance plan rates
  • Aetna — All Products: $235.22
  • Aetna — Managed Medicare: $98.58
  • Anthem — All Products: $98.58
  • Anthem — Managed Medicare: $98.58
  • Aultcare — Managed Medicare: $567
  • Buckeye — ACA Exchange: $133.08
  • Buckeye — Managed Medicare: $98.58
  • CareSource — Managed Medicare: $167.59
  • Cigna — All Products: $273.41
  • Clarity Health — All Products: $420
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ULTRASOUND, PREG UTER, AFTER 1ST TRI, TR $225 $168.75 $720
Pregnancy ultrasound (after the first trimester): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL ECHO NONOB $731 $548.25 $42.39 – $205.73
Transvaginal ultrasound: 10 of 34 insurance plan rates
  • Aetna — All Products: $205.73
  • Aetna — Managed Medicare: $98.58
  • Anthem — All Products: $98.58
  • Anthem — Managed Medicare: $98.58
  • Aultcare — Managed Medicare: $394.74
  • Buckeye — ACA Exchange: $133.08
  • Buckeye — Managed Medicare: $98.58
  • CareSource — Managed Medicare: $167.59
  • Cigna — All Products: $273.41
  • Clarity Health — All Products: $292.40
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ECHOGRAPHY, TRANSVAGINAL $220 $165 $720
Transvaginal ultrasound: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ECHOGRAPHY, TRANSVAGINAL $220 Not listed in the file $105.83 – $142.87
Transvaginal ultrasound: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $109.48
  • Anthem — Blue Access OH 1 & 2: $112.60
  • ANTHEM — Managed Medicare: $105.83
  • Anthem BCBS — All Products: $140.75
  • Buckeye — Managed Medicaid: $71.50
  • CARESOURCE — Managed Medicaid: $71.50
  • CIGNA — All Products: $142.87
  • HEALTH DESIGN PLUS — All Products: $132.29
  • HEALTHSPAN — All Products: $116.41
  • HUMANA — Managed Medicaid: $71.50
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIGITAL MAMM DIAG UNILAT $621 $465.75 $48.68 – $221.99
Diagnostic mammogram, one breast: 10 of 34 insurance plan rates
  • Aetna — All Products: $220.10
  • Aetna — Managed Medicare: $113.22
  • Anthem — All Products: $113.22
  • Anthem — Managed Medicare: $113.22
  • Aultcare — Managed Medicare: $335.34
  • Buckeye — ACA Exchange: $152.85
  • Buckeye — Managed Medicare: $113.22
  • CareSource — Managed Medicare: $192.47
  • Cigna — All Products: $221.99
  • Clarity Health — All Products: $248.40
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIGITAL MAMM DIAG BILAT $791 $593.25 $61.29 – $281.15
Diagnostic mammogram, both breasts: 10 of 34 insurance plan rates
  • Aetna — All Products: $277.10
  • Aetna — Managed Medicare: $142.54
  • Anthem — All Products: $142.54
  • Anthem — Managed Medicare: $142.54
  • Aultcare — Managed Medicare: $427.14
  • Buckeye — ACA Exchange: $192.43
  • Buckeye — Managed Medicare: $142.54
  • CareSource — Managed Medicare: $242.32
  • Cigna — All Products: $281.15
  • Clarity Health — All Products: $316.40
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIGITAL MAMM SCRN BILAT $624 $468 $49.63 – $225.75
Screening mammogram, both breasts: 10 of 34 insurance plan rates
  • Aetna — All Products: $224.38
  • Aetna — Managed Medicare: $115.42
  • Anthem — All Products: $115.42
  • Anthem — Managed Medicare: $115.42
  • Aultcare — Managed Medicare: $336.96
  • Buckeye — ACA Exchange: $155.82
  • Buckeye — Managed Medicare: $115.42
  • CareSource — Managed Medicare: $196.21
  • Cigna — All Products: $225.75
  • Clarity Health — All Products: $249.60
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: DIGITAL MAMM SCREEN UNIL $389 $291.75 $124.48 – $389
Screening mammogram, both breasts: 10 of 18 insurance plan rates
  • Aetna — All Products: $227.29
  • Aultcare — Managed Medicare: $210.06
  • Cigna — All Products: $214.34
  • Clarity Health — All Products: $155.60
  • Coventry — All Products: $268.41
  • First Health — All Products: $268.41
  • Health Design Plus — All Products: $143.93
  • HealthSmart — All Products: $124.48
  • HealthSmart Preferred — All Products: $175.05
  • HealthSpan — All Products: $155.60

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EKG; COMPLETE INT & REPORT $50 $37.50 $720
Electrocardiogram (ECG/EKG) with reading: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EKG; COMPLETE INT & REPORT $50 Not listed in the file $13.15 – $17.75
Electrocardiogram (ECG/EKG) with reading: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $14.59
  • Anthem — Blue Access OH 1 & 2: $13.99
  • ANTHEM — Managed Medicare: $13.15
  • Anthem BCBS — All Products: $17.49
  • Buckeye — Managed Medicaid: $13.90
  • CARESOURCE — Managed Medicaid: $13.90
  • CIGNA — All Products: $17.75
  • HEALTH DESIGN PLUS — All Products: $16.44
  • HEALTHSPAN — All Products: $14.47
  • HUMANA — Managed Medicaid: $13.90
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LV ONLY $7,145 $5,358.75 $1,282.15 – $6,593
Left heart catheterization (diagnostic): 10 of 34 insurance plan rates
  • Aetna — All Products: $6,593
  • Aetna — Managed Medicare: $2,981.74
  • Anthem — All Products: $2,981.74
  • Anthem — Managed Medicare: $2,981.74
  • Aultcare — Managed Medicare: $3,858.30
  • Buckeye — ACA Exchange: $4,025.35
  • Buckeye — Managed Medicare: $2,981.74
  • CareSource — Managed Medicare: $5,068.96
  • Cigna — All Products: $8,478.29
  • Clarity Health — All Products: $2,858
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION Not listed in the file Not listed in the file $3,024.82 – $14,167.84
Heart rhythm study (electrophysiology evaluation): 10 of 18 insurance plan rates
  • Aetna — Managed Medicare: $7,034.47
  • Anthem — All Products: $7,034.47
  • Anthem — Managed Medicare: $7,034.47
  • Buckeye — ACA Exchange: $9,496.54
  • Buckeye — Managed Medicare: $7,034.47
  • CareSource — Managed Medicare: $11,958.60
  • Cigna — All Products: $14,167.84
  • CommuniCare I-SNP — Managed Medicare: $7,034.47
  • Devoted — Managed Medicare: $7,034.47
  • Humana — Managed Medicare: $7,034.47
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EPS TRANSSEPTAL AFIB ABL $58,143 $43,607.25 $6,593 – $38,662.12
Heart rhythm study with ablation for atrial fibrillation: 10 of 34 insurance plan rates
  • Aetna — All Products: $6,593
  • Aetna — Managed Medicare: $22,742.42
  • Anthem — All Products: $22,742.42
  • Anthem — Managed Medicare: $22,742.42
  • Aultcare — Managed Medicare: $31,397.22
  • Buckeye — ACA Exchange: $30,702.27
  • Buckeye — Managed Medicare: $22,742.42
  • CareSource — Managed Medicare: $38,662.12
  • Cigna — All Products: $68,355.66
  • Clarity Health — All Products: $23,257.20
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMP EP EVAL A FIB $1,675 $1,256.25 $720
Heart rhythm study with ablation for atrial fibrillation: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COMP EP EVAL A FIB $1,675 Not listed in the file $797.04 – $1,176.48
Heart rhythm study with ablation for atrial fibrillation: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $797.04
  • Anthem — Blue Access OH 1 & 2: $927.24
  • ANTHEM — Managed Medicare: $871.47
  • Anthem BCBS — All Products: $1,159.06
  • Buckeye — Managed Medicaid: $815.03
  • CARESOURCE — Managed Medicaid: $815.03
  • CIGNA — All Products: $1,176.48
  • HEALTH DESIGN PLUS — All Products: $1,089.34
  • HEALTHSPAN — All Products: $958.62
  • HUMANA — Managed Medicaid: $815.03
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/> YRS 4/> PARAM Not listed in the file Not listed in the file $405.56 – $1,603.37
Sleep study (overnight, in a sleep lab): 10 of 18 insurance plan rates
  • Aetna — Managed Medicare: $943.16
  • Anthem — All Products: $943.16
  • Anthem — Managed Medicare: $943.16
  • Buckeye — ACA Exchange: $1,273.27
  • Buckeye — Managed Medicare: $943.16
  • CareSource — Managed Medicare: $1,603.37
  • Cigna — All Products: $1,559.87
  • CommuniCare I-SNP — Managed Medicare: $943.16
  • Devoted — Managed Medicare: $943.16
  • Humana — Managed Medicare: $943.16

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXER EA 15 M $194 $145.50 $11.74 – $53.09
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 34 insurance plan rates
  • Aetna — All Products: $53.09
  • Aetna — Managed Medicare: $27.31
  • Anthem — All Products: $27.31
  • Anthem — Managed Medicare: $27.31
  • Aultcare — Managed Medicare: $104.76
  • Buckeye — ACA Exchange: $36.87
  • Buckeye — Managed Medicare: $27.31
  • CareSource — Managed Medicare: $46.43
  • Cigna — All Products: $119
  • Clarity Health — All Products: $77.60
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AR OT THERE EX(EA.15 M) $194 $145.50 $11.74 – $53.09
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 34 insurance plan rates
  • Aetna — All Products: $53.09
  • Aetna — Managed Medicare: $27.31
  • Anthem — All Products: $27.31
  • Anthem — Managed Medicare: $27.31
  • Aultcare — Managed Medicare: $104.76
  • Buckeye — ACA Exchange: $36.87
  • Buckeye — Managed Medicare: $27.31
  • CareSource — Managed Medicare: $46.43
  • Cigna — All Products: $119
  • Clarity Health — All Products: $77.60
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THERAPEUTIC EXER EA 15 M $194 $145.50 $62.08 – $194
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 18 insurance plan rates
  • Aetna — All Products: $113.35
  • Aultcare — Managed Medicare: $104.76
  • Cigna — All Products: $119
  • Clarity Health — All Products: $77.60
  • Coventry — All Products: $133.86
  • First Health — All Products: $133.86
  • Health Design Plus — All Products: $71.78
  • HealthSmart — All Products: $62.08
  • HealthSmart Preferred — All Products: $87.30
  • HealthSpan — All Products: $77.60
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVAL LOW COMPLEXITY $223 $167.25 $40 – $180.85
Physical therapy evaluation (low complexity): 10 of 34 insurance plan rates
  • Aetna — All Products: $180.85
  • Aetna — Managed Medicare: $93.03
  • Anthem — All Products: $93.03
  • Anthem — Managed Medicare: $93.03
  • Aultcare — Managed Medicare: $120.42
  • Buckeye — ACA Exchange: $125.59
  • Buckeye — Managed Medicare: $93.03
  • CareSource — Managed Medicare: $158.15
  • Cigna — All Products: $119
  • Clarity Health — All Products: $89.20
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVAL LOW COMPLEXITY $247 $185.25 $79.04 – $247
Physical therapy evaluation (low complexity): 10 of 18 insurance plan rates
  • Aetna — All Products: $144.32
  • Aultcare — Managed Medicare: $133.38
  • Cigna — All Products: $119
  • Clarity Health — All Products: $98.80
  • Coventry — All Products: $170.43
  • First Health — All Products: $170.43
  • Health Design Plus — All Products: $91.39
  • HealthSmart — All Products: $79.04
  • HealthSmart Preferred — All Products: $111.15
  • HealthSpan — All Products: $98.80
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PED EVAL LOW COMPLEXITY $247 $185.25 $79.04 – $247
Physical therapy evaluation (low complexity): 10 of 18 insurance plan rates
  • Aetna — All Products: $144.32
  • Aultcare — Managed Medicare: $133.38
  • Cigna — All Products: $119
  • Clarity Health — All Products: $98.80
  • Coventry — All Products: $170.43
  • First Health — All Products: $170.43
  • Health Design Plus — All Products: $91.39
  • HealthSmart — All Products: $79.04
  • HealthSmart Preferred — All Products: $111.15
  • HealthSpan — All Products: $98.80
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVAL MODERATE COMPLEXITY $285 $213.75 $40 – $180.85
Physical therapy evaluation (moderate complexity): 10 of 34 insurance plan rates
  • Aetna — All Products: $180.85
  • Aetna — Managed Medicare: $93.03
  • Anthem — All Products: $93.03
  • Anthem — Managed Medicare: $93.03
  • Aultcare — Managed Medicare: $153.90
  • Buckeye — ACA Exchange: $125.59
  • Buckeye — Managed Medicare: $93.03
  • CareSource — Managed Medicare: $158.15
  • Cigna — All Products: $119
  • Clarity Health — All Products: $114
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVAL MODERATE COMPLEXITY $316 $237 $101.12 – $316
Physical therapy evaluation (moderate complexity): 10 of 18 insurance plan rates
  • Aetna — All Products: $184.64
  • Aultcare — Managed Medicare: $170.64
  • Cigna — All Products: $119
  • Clarity Health — All Products: $126.40
  • Coventry — All Products: $218.04
  • First Health — All Products: $218.04
  • Health Design Plus — All Products: $116.92
  • HealthSmart — All Products: $101.12
  • HealthSmart Preferred — All Products: $142.20
  • HealthSpan — All Products: $126.40
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PED EVAL MOD COMPLEXITY $316 $237 $101.12 – $316
Physical therapy evaluation (moderate complexity): 10 of 18 insurance plan rates
  • Aetna — All Products: $184.64
  • Aultcare — Managed Medicare: $170.64
  • Cigna — All Products: $119
  • Clarity Health — All Products: $126.40
  • Coventry — All Products: $218.04
  • First Health — All Products: $218.04
  • Health Design Plus — All Products: $116.92
  • HealthSmart — All Products: $101.12
  • HealthSmart Preferred — All Products: $142.20
  • HealthSpan — All Products: $126.40
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVAL HIGH COMPLEXITY $372 $279 $40 – $180.85
Physical therapy evaluation (high complexity): 10 of 34 insurance plan rates
  • Aetna — All Products: $180.85
  • Aetna — Managed Medicare: $93.03
  • Anthem — All Products: $93.03
  • Anthem — Managed Medicare: $93.03
  • Aultcare — Managed Medicare: $200.88
  • Buckeye — ACA Exchange: $125.59
  • Buckeye — Managed Medicare: $93.03
  • CareSource — Managed Medicare: $158.15
  • Cigna — All Products: $119
  • Clarity Health — All Products: $148.80
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVAL HIGH COMPLEXITY $413 $309.75 $132.16 – $413
Physical therapy evaluation (high complexity): 10 of 18 insurance plan rates
  • Aetna — All Products: $241.32
  • Aultcare — Managed Medicare: $223.02
  • Cigna — All Products: $119
  • Clarity Health — All Products: $165.20
  • Coventry — All Products: $284.97
  • First Health — All Products: $284.97
  • Health Design Plus — All Products: $152.81
  • HealthSmart — All Products: $132.16
  • HealthSmart Preferred — All Products: $185.85
  • HealthSpan — All Products: $165.20
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PED EVAL HIGH COMPLEXITY $413 $309.75 $132.16 – $413
Physical therapy evaluation (high complexity): 10 of 18 insurance plan rates
  • Aetna — All Products: $241.32
  • Aultcare — Managed Medicare: $223.02
  • Cigna — All Products: $119
  • Clarity Health — All Products: $165.20
  • Coventry — All Products: $284.97
  • First Health — All Products: $284.97
  • Health Design Plus — All Products: $152.81
  • HealthSmart — All Products: $132.16
  • HealthSmart Preferred — All Products: $185.85
  • HealthSpan — All Products: $165.20
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT PSYTX 16-37 MIN $422 $316.50 $64.05 – $253.21
Psychotherapy, 30 minutes: 10 of 34 insurance plan rates
  • Aetna — All Products: $130.75
  • Aetna — Managed Medicare: $148.95
  • Anthem — All Products: $148.95
  • Anthem — Managed Medicare: $148.95
  • Aultcare — Managed Medicare: $227.88
  • Buckeye — ACA Exchange: $201.08
  • Buckeye — Managed Medicare: $148.95
  • CareSource — Managed Medicare: $253.21
  • Cigna — All Products: $464.19
  • Clarity Health — All Products: $168.80
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY, 30 MINS $150 $112.50 $720
Psychotherapy, 30 minutes: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY, 30 MINS $150 Not listed in the file $67.26 – $90.80
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $69.10
  • Anthem — Blue Access OH 1 & 2: $71.56
  • ANTHEM — Managed Medicare: $67.26
  • Anthem BCBS — All Products: $89.46
  • Buckeye — Managed Medicaid: $35.58
  • CARESOURCE — Managed Medicaid: $35.58
  • CIGNA — All Products: $90.80
  • HEALTH DESIGN PLUS — All Products: $84.08
  • HEALTHSPAN — All Products: $73.99
  • HUMANA — Managed Medicaid: $35.58
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT PSYTX 38-52 MIN $486 $364.50 $64.05 – $253.21
Psychotherapy, 45 minutes: 10 of 34 insurance plan rates
  • Aetna — All Products: $172.45
  • Aetna — Managed Medicare: $148.95
  • Anthem — All Products: $148.95
  • Anthem — Managed Medicare: $148.95
  • Aultcare — Managed Medicare: $262.44
  • Buckeye — ACA Exchange: $201.08
  • Buckeye — Managed Medicare: $148.95
  • CareSource — Managed Medicare: $253.21
  • Cigna — All Products: $464.19
  • Clarity Health — All Products: $194.40
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY 45 MINS $185 $138.75 $720
Psychotherapy, 45 minutes: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY 45 MINS $185 Not listed in the file $88.71 – $119.76
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $91.36
  • Anthem — Blue Access OH 1 & 2: $94.39
  • ANTHEM — Managed Medicare: $88.71
  • Anthem BCBS — All Products: $117.98
  • Buckeye — Managed Medicaid: $49.43
  • CARESOURCE — Managed Medicaid: $49.43
  • CIGNA — All Products: $119.76
  • HEALTH DESIGN PLUS — All Products: $110.89
  • HEALTHSPAN — All Products: $97.58
  • HUMANA — Managed Medicaid: $49.43
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT PSYTX 53+ MIN $559 $419.25 $64.05 – $255.36
Psychotherapy, 60 minutes: 10 of 34 insurance plan rates
  • Aetna — All Products: $255.36
  • Aetna — Managed Medicare: $148.95
  • Anthem — All Products: $148.95
  • Anthem — Managed Medicare: $148.95
  • Aultcare — Managed Medicare: $301.86
  • Buckeye — ACA Exchange: $201.08
  • Buckeye — Managed Medicare: $148.95
  • CareSource — Managed Medicare: $253.21
  • Cigna — All Products: $464.19
  • Clarity Health — All Products: $223.60
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY 60 MINS $240 $180 $720
Psychotherapy, 60 minutes: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY 60 MINS $240 Not listed in the file $131.36 – $177.34
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $134.55
  • Anthem — Blue Access OH 1 & 2: $139.77
  • ANTHEM — Managed Medicare: $131.36
  • Anthem BCBS — All Products: $174.71
  • Buckeye — Managed Medicaid: $75.77
  • CARESOURCE — Managed Medicaid: $75.77
  • CIGNA — All Products: $177.34
  • HEALTH DESIGN PLUS — All Products: $164.20
  • HEALTHSPAN — All Products: $144.50
  • HUMANA — Managed Medicaid: $75.77
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAM PSYTX WO PT 26+ MIN $320 $240 $64.05 – $253.21
Family psychotherapy, without the patient: 10 of 34 insurance plan rates
  • Aetna — All Products: $186.51
  • Aetna — Managed Medicare: $148.95
  • Anthem — All Products: $148.95
  • Anthem — Managed Medicare: $148.95
  • Aultcare — Managed Medicare: $172.80
  • Buckeye — ACA Exchange: $201.08
  • Buckeye — Managed Medicare: $148.95
  • CareSource — Managed Medicare: $253.21
  • Cigna — All Products: $464.19
  • Clarity Health — All Products: $128
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY (W/O PATIENT PRESEN $165 $123.75 $720
Family psychotherapy, without the patient: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY (W/O PATIENT PRESEN $165 Not listed in the file $95.94 – $129.52
Family psychotherapy, without the patient: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $98.63
  • Anthem — Blue Access OH 1 & 2: $102.08
  • ANTHEM — Managed Medicare: $95.94
  • Anthem BCBS — All Products: $127.60
  • Buckeye — Managed Medicaid: $57.66
  • CARESOURCE — Managed Medicaid: $57.66
  • CIGNA — All Products: $129.52
  • HEALTH DESIGN PLUS — All Products: $119.93
  • HEALTHSPAN — All Products: $105.53
  • HUMANA — Managed Medicaid: $57.66
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAM PSYTX W PT 26+ MIN $320 $240 $64.05 – $253.21
Family psychotherapy, with the patient: 10 of 34 insurance plan rates
  • Aetna — All Products: $194.46
  • Aetna — Managed Medicare: $148.95
  • Anthem — All Products: $148.95
  • Anthem — Managed Medicare: $148.95
  • Aultcare — Managed Medicare: $172.80
  • Buckeye — ACA Exchange: $201.08
  • Buckeye — Managed Medicare: $148.95
  • CareSource — Managed Medicare: $253.21
  • Cigna — All Products: $464.19
  • Clarity Health — All Products: $128
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHE $170 $127.50 $720
Family psychotherapy, with the patient: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHE $170 Not listed in the file $100.03 – $135.04
Family psychotherapy, with the patient: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $102.30
  • Anthem — Blue Access OH 1 & 2: $106.43
  • ANTHEM — Managed Medicare: $100.03
  • Anthem BCBS — All Products: $133.04
  • Buckeye — Managed Medicaid: $67.71
  • CARESOURCE — Managed Medicaid: $67.71
  • CIGNA — All Products: $135.04
  • HEALTH DESIGN PLUS — All Products: $125.04
  • HEALTHSPAN — All Products: $110.03
  • HUMANA — Managed Medicaid: $67.71
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IOP COGNITIVE THERPY 1HR $321 $240.75 $36.87 – $145.78
Group psychotherapy: 10 of 34 insurance plan rates
  • Aetna — All Products: $46.05
  • Aetna — Managed Medicare: $85.75
  • Anthem — All Products: $85.75
  • Anthem — Managed Medicare: $85.75
  • Aultcare — Managed Medicare: $173.34
  • Buckeye — ACA Exchange: $115.76
  • Buckeye — Managed Medicare: $85.75
  • CareSource — Managed Medicare: $145.78
  • Cigna — All Products: $265.68
  • Clarity Health — All Products: $128.40
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IOP PSYCHOEDUCATION 1 HR $246 $184.50 $36.87 – $145.78
Group psychotherapy: 10 of 34 insurance plan rates
  • Aetna — All Products: $46.05
  • Aetna — Managed Medicare: $85.75
  • Anthem — All Products: $85.75
  • Anthem — Managed Medicare: $85.75
  • Aultcare — Managed Medicare: $132.84
  • Buckeye — ACA Exchange: $115.76
  • Buckeye — Managed Medicare: $85.75
  • CareSource — Managed Medicare: $145.78
  • Cigna — All Products: $265.68
  • Clarity Health — All Products: $98.40
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MH CONTINUE CARE ADULT $321 $240.75 $36.87 – $145.78
Group psychotherapy: 10 of 34 insurance plan rates
  • Aetna — All Products: $46.05
  • Aetna — Managed Medicare: $85.75
  • Anthem — All Products: $85.75
  • Anthem — Managed Medicare: $85.75
  • Aultcare — Managed Medicare: $173.34
  • Buckeye — ACA Exchange: $115.76
  • Buckeye — Managed Medicare: $85.75
  • CareSource — Managed Medicare: $145.78
  • Cigna — All Products: $265.68
  • Clarity Health — All Products: $128.40

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EXCISION, BREAST LESION, MALE/FEMALE; 1+ $700 $525 $720
Removal of breast growth (open surgery): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EXCISION, BREAST LESION, MALE/FEMALE; 1+ $700 Not listed in the file $393.71 – $534.01
Removal of breast growth (open surgery): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $393.71
  • Anthem — Blue Access OH 1 & 2: $420.88
  • ANTHEM — Managed Medicare: $395.56
  • Anthem BCBS — All Products: $526.09
  • Buckeye — Managed Medicaid: $215.08
  • CARESOURCE — Managed Medicaid: $215.08
  • CIGNA — All Products: $534.01
  • HEALTH DESIGN PLUS — All Products: $494.45
  • HEALTHSPAN — All Products: $435.12
  • HUMANA — Managed Medicaid: $215.08
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ARTHROPLASTY, ACETABULAR/PROXIMAL FEMORA $4,500 $3,375 $720
Total hip replacement: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHROPLASTY, ACETABULAR/PROXIMAL FEMORA $4,500 Not listed in the file $1,129.30 – $1,631.57
Total hip replacement: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $1,129.30
  • Anthem — Blue Access OH 1 & 2: $1,285.92
  • ANTHEM — Managed Medicare: $1,208.57
  • Anthem BCBS — All Products: $1,607.40
  • Buckeye — Managed Medicaid: $1,154.31
  • CARESOURCE — Managed Medicaid: $1,154.31
  • CIGNA — All Products: $1,631.57
  • HEALTH DESIGN PLUS — All Products: $1,510.71
  • HEALTHSPAN — All Products: $1,329.43
  • HUMANA — Managed Medicaid: $1,154.31
Total knee replacement CPT 27447 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ARTHROPLASTY, KNEE/CONDYLE/PLATEAU; MEDI $3,500 $2,625 $720
Total knee replacement: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHROPLASTY, KNEE/CONDYLE/PLATEAU; MEDI $3,500 Not listed in the file $1,126.77 – $1,629.53
Total knee replacement: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $1,126.77
  • Anthem — Blue Access OH 1 & 2: $1,284.31
  • ANTHEM — Managed Medicare: $1,207.06
  • Anthem BCBS — All Products: $1,605.39
  • Buckeye — Managed Medicaid: $1,228.01
  • CARESOURCE — Managed Medicaid: $1,228.01
  • CIGNA — All Products: $1,629.53
  • HEALTH DESIGN PLUS — All Products: $1,508.83
  • HEALTHSPAN — All Products: $1,327.77
  • HUMANA — Managed Medicaid: $1,228.01
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPR $920 $690 $720
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ARTHROSCOPY, KNEE, SURGICAL; W/ MENISCEC $1,800 $1,350 $720
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHROSCOPY, KNEE, SURGICAL; W/ MENISCEC $1,800 Not listed in the file $495.19 – $691.47
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $495.19
  • Anthem — Blue Access OH 1 & 2: $544.98
  • ANTHEM — Managed Medicare: $512.20
  • Anthem BCBS — All Products: $681.23
  • Buckeye — Managed Medicaid: $453.93
  • CARESOURCE — Managed Medicaid: $453.93
  • CIGNA — All Products: $691.47
  • HEALTH DESIGN PLUS — All Products: $640.25
  • HEALTHSPAN — All Products: $563.42
  • HUMANA — Managed Medicaid: $453.93
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TONSILLECTOMY & ADENOIDECTOMY; < AGE 12 $500 $375 $720
Removal of tonsils and adenoids (under age 12): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: TONSILLECTOMY & ADENOIDECTOMY; < AGE 12 $500 Not listed in the file $251.98 – $370.17
Removal of tonsils and adenoids (under age 12): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $251.98
  • Anthem — Blue Access OH 1 & 2: $291.75
  • ANTHEM — Managed Medicare: $274.20
  • Anthem BCBS — All Products: $364.69
  • Buckeye — Managed Medicaid: $194.83
  • CARESOURCE — Managed Medicaid: $194.83
  • CIGNA — All Products: $370.17
  • HEALTH DESIGN PLUS — All Products: $342.75
  • HEALTHSPAN — All Products: $301.62
  • HUMANA — Managed Medicaid: $194.83
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UPPER GI ENDOSCOPY; DX (SEP PROC) $450 $337.50 $720
Upper GI endoscopy (diagnostic): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: UPPER GI ENDOSCOPY; DX (SEP PROC) $450 Not listed in the file $107.63 – $153.21
Upper GI endoscopy (diagnostic): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $107.63
  • Anthem — Blue Access OH 1 & 2: $120.75
  • ANTHEM — Managed Medicare: $113.49
  • Anthem BCBS — All Products: $150.94
  • Buckeye — Managed Medicaid: $124.24
  • CARESOURCE — Managed Medicaid: $124.24
  • CIGNA — All Products: $153.21
  • HEALTH DESIGN PLUS — All Products: $141.86
  • HEALTHSPAN — All Products: $124.84
  • HUMANA — Managed Medicaid: $124.24
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UPPER GI ENDOSCOPY; W/ BX, SINGLE/MULTIP $450 $337.50 $720
Upper GI endoscopy with biopsy: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: UPPER GI ENDOSCOPY; W/ BX, SINGLE/MULTIP $450 Not listed in the file $120.46 – $172.17
Upper GI endoscopy with biopsy: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $120.46
  • Anthem — Blue Access OH 1 & 2: $135.69
  • ANTHEM — Managed Medicare: $127.53
  • Anthem BCBS — All Products: $169.61
  • Buckeye — Managed Medicaid: $139.81
  • CARESOURCE — Managed Medicaid: $139.81
  • CIGNA — All Products: $172.17
  • HEALTH DESIGN PLUS — All Products: $159.41
  • HEALTHSPAN — All Products: $140.28
  • HUMANA — Managed Medicaid: $139.81
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLEN $350 $262.50 $720
Colonoscopy (diagnostic): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLEN $350 Not listed in the file $160.88 – $230.54
Colonoscopy (diagnostic): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $160.88
  • Anthem — Blue Access OH 1 & 2: $181.70
  • ANTHEM — Managed Medicare: $170.77
  • Anthem BCBS — All Products: $227.12
  • Buckeye — Managed Medicaid: $93.44
  • CARESOURCE — Managed Medicaid: $93.44
  • CIGNA — All Products: $230.54
  • HEALTH DESIGN PLUS — All Products: $213.46
  • HEALTHSPAN — All Products: $187.85
  • HUMANA — Managed Medicaid: $93.44
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLEN $650 $487.50 $720
Colonoscopy with biopsy: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLEN $650 Not listed in the file $173.65 – $250.79
Colonoscopy with biopsy: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $173.65
  • Anthem — Blue Access OH 1 & 2: $197.66
  • ANTHEM — Managed Medicare: $185.77
  • Anthem BCBS — All Products: $247.07
  • Buckeye — Managed Medicaid: $202.79
  • CARESOURCE — Managed Medicaid: $202.79
  • CIGNA — All Products: $250.79
  • HEALTH DESIGN PLUS — All Products: $232.21
  • HEALTHSPAN — All Products: $204.35
  • HUMANA — Managed Medicaid: $202.79
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE; W/ REMOVAL, LESIO $725 $543.75 $720
Colonoscopy with removal of polyps (snare): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY, FLEXIBLE; W/ REMOVAL, LESIO $725 Not listed in the file $218.59 – $316.12
Colonoscopy with removal of polyps (snare): 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $218.59
  • Anthem — Blue Access OH 1 & 2: $249.15
  • ANTHEM — Managed Medicare: $234.16
  • Anthem BCBS — All Products: $311.43
  • Buckeye — Managed Medicaid: $257.82
  • CARESOURCE — Managed Medicaid: $257.82
  • CIGNA — All Products: $316.12
  • HEALTH DESIGN PLUS — All Products: $292.70
  • HEALTHSPAN — All Products: $257.58
  • HUMANA — Managed Medicaid: $257.82
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US Not listed in the file Not listed in the file $470.01 – $3,027
Ultrasound of the lower bowel by endoscope: 10 of 21 insurance plan rates
  • Aetna — All Products: $3,027
  • Aetna — Managed Medicare: $1,093.05
  • Anthem — All Products: $1,093.05
  • Anthem — Managed Medicare: $1,093.05
  • Buckeye — ACA Exchange: $1,475.62
  • Buckeye — Managed Medicare: $1,093.05
  • CareSource — Managed Medicare: $1,858.19
  • Cigna — All Products: $2,173.66
  • CommuniCare I-SNP — Managed Medicare: $1,093.05
  • Devoted — Managed Medicare: $1,093.05
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLOREC CNCR SCR;COLNSCPY NO HI RSK $745 $558.75 $720
Screening colonoscopy (not high risk): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLOREC CNCR SCR;COLNSCPY NO HI RSK $745 Not listed in the file $161.22 – $231
Screening colonoscopy (not high risk): rates for 10 insurance plans
  • AETNA — Managed Medicare: $161.22
  • Anthem — Blue Access OH 1 & 2: $182.06
  • ANTHEM — Managed Medicare: $171.11
  • Anthem BCBS — All Products: $227.58
  • CIGNA — All Products: $231
  • HEALTH DESIGN PLUS — All Products: $213.89
  • HEALTHSPAN — All Products: $188.22
  • HUMANA — Managed Medicare: $171.11
  • Medical Mutual-Ohio — Managed Medicare: $171.11
  • VALOR HEALTH — Managed Medicare: $171.11
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY $1,250 $937.50 $720
Gallbladder removal by laparoscope: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY $1,250 Not listed in the file $615.11 – $844.88
Gallbladder removal by laparoscope: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $615.11
  • Anthem — Blue Access OH 1 & 2: $665.89
  • ANTHEM — Managed Medicare: $625.84
  • Anthem BCBS — All Products: $832.37
  • Buckeye — Managed Medicaid: $515.68
  • CARESOURCE — Managed Medicaid: $515.68
  • CIGNA — All Products: $844.88
  • HEALTH DESIGN PLUS — All Products: $782.30
  • HEALTHSPAN — All Products: $688.42
  • HUMANA — Managed Medicaid: $515.68
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Hospital (facility) fee In the file: REPAIR, INITIAL INGUINAL HERNIA, AGE 5+; $985 $738.75 $720
Groin (inguinal) hernia repair, age 5 or older: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: REPAIR, INITIAL INGUINAL HERNIA, AGE 5+; $985 Not listed in the file $492.88 – $669.75
Groin (inguinal) hernia repair, age 5 or older: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $492.88
  • Anthem — Blue Access OH 1 & 2: $527.86
  • ANTHEM — Managed Medicare: $496.11
  • Anthem BCBS — All Products: $659.83
  • Buckeye — Managed Medicaid: $313.69
  • CARESOURCE — Managed Medicaid: $313.69
  • CIGNA — All Products: $669.75
  • HEALTH DESIGN PLUS — All Products: $620.14
  • HEALTHSPAN — All Products: $545.72
  • HUMANA — Managed Medicaid: $313.69
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE Not listed in the file Not listed in the file $816.59 – $3,228.39
Prostate biopsy: 10 of 20 insurance plan rates
  • Aetna — All Products: $3,027
  • Aetna — Managed Medicare: $1,899.05
  • Anthem — All Products: $1,899.05
  • Anthem — Managed Medicare: $1,899.05
  • Buckeye — ACA Exchange: $2,563.72
  • Buckeye — Managed Medicare: $1,899.05
  • CareSource — Managed Medicare: $3,228.39
  • CommuniCare I-SNP — Managed Medicare: $1,899.05
  • Devoted — Managed Medicare: $1,899.05
  • Humana — Managed Medicare: $1,899.05
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAPAROSCOPY, SURGICAL PROSTATECTOMY, RET $2,650 $1,987.50 $720
Prostate removal by laparoscope (radical prostatectomy): rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HYSTEROSCOPY, SURGICAL; W/ ENDOMETRIAL B $2,230 $1,672.50 $720
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: HYSTEROSCOPY, SURGICAL; W/ ENDOMETRIAL B $2,230 Not listed in the file $200.74 – $292.98
Hysteroscopy with biopsy of the uterus lining: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $200.74
  • Anthem — Blue Access OH 1 & 2: $230.91
  • ANTHEM — Managed Medicare: $217.02
  • Anthem BCBS — All Products: $288.64
  • Buckeye — Managed Medicaid: $117.66
  • CARESOURCE — Managed Medicaid: $117.66
  • CIGNA — All Products: $292.98
  • HEALTH DESIGN PLUS — All Products: $271.28
  • HEALTHSPAN — All Products: $238.72
  • HUMANA — Managed Medicaid: $117.66
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INTRLMR EPI INJ L/S CTGD $2,653 $1,989.75 $276.06 – $2,485
Spinal injection, lower back (epidural), with imaging guidance: 10 of 34 insurance plan rates
  • Aetna — All Products: $2,485
  • Aetna — Managed Medicare: $641.99
  • Anthem — All Products: $641.99
  • Anthem — Managed Medicare: $641.99
  • Aultcare — Managed Medicare: $1,432.62
  • Buckeye — ACA Exchange: $866.69
  • Buckeye — Managed Medicare: $641.99
  • CareSource — Managed Medicare: $1,091.39
  • Cigna — All Products: $1,846.03
  • Clarity Health — All Products: $1,061.20
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJECTION LUMBAR OR SACRAL W/GUIDANCE $185 $138.75 $720
Spinal injection, lower back (epidural), with imaging guidance: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: INJECTION LUMBAR OR SACRAL W/GUIDANCE $185 Not listed in the file $87.08 – $124.71
Spinal injection, lower back (epidural), with imaging guidance: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $87.08
  • Anthem — Blue Access OH 1 & 2: $98.29
  • ANTHEM — Managed Medicare: $92.38
  • Anthem BCBS — All Products: $122.87
  • Buckeye — Managed Medicaid: $80.87
  • CARESOURCE — Managed Medicaid: $80.87
  • CIGNA — All Products: $124.71
  • HEALTH DESIGN PLUS — All Products: $115.48
  • HEALTHSPAN — All Products: $101.62
  • HUMANA — Managed Medicaid: $80.87
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NRV BLK LUMB OR SAC SGL $2,523 $1,892.25 $354.89 – $2,485
Nerve root injection, lower back, with imaging guidance: 10 of 34 insurance plan rates
  • Aetna — All Products: $2,485
  • Aetna — Managed Medicare: $825.33
  • Anthem — All Products: $825.33
  • Anthem — Managed Medicare: $825.33
  • Aultcare — Managed Medicare: $1,362.42
  • Buckeye — ACA Exchange: $1,114.20
  • Buckeye — Managed Medicare: $825.33
  • CareSource — Managed Medicare: $1,403.07
  • Cigna — All Products: $2,313.07
  • Clarity Health — All Products: $1,009.20
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRFM EPI INJ L/S SGL LVL $2,523 $1,892.25 $354.89 – $2,485
Nerve root injection, lower back, with imaging guidance: 10 of 34 insurance plan rates
  • Aetna — All Products: $2,485
  • Aetna — Managed Medicare: $825.33
  • Anthem — All Products: $825.33
  • Anthem — Managed Medicare: $825.33
  • Aultcare — Managed Medicare: $1,362.42
  • Buckeye — ACA Exchange: $1,114.20
  • Buckeye — Managed Medicare: $825.33
  • CareSource — Managed Medicare: $1,403.07
  • Cigna — All Products: $2,313.07
  • Clarity Health — All Products: $1,009.20
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJECTION, ANESTHETIC/STEROID, TRANSFORA $350 $262.50 $720
Nerve root injection, lower back, with imaging guidance: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NEUROPLASTY &/OR TRANSPOSITION; MEDIAN N $1,000 $750 $720
Carpal tunnel release: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY Not listed in the file Not listed in the file $218.69 – $3,027
Laser treatment of clouding after cataract surgery: 10 of 21 insurance plan rates
  • Aetna — All Products: $3,027
  • Aetna — Managed Medicare: $508.57
  • Anthem — All Products: $508.57
  • Anthem — Managed Medicare: $508.57
  • Buckeye — ACA Exchange: $686.58
  • Buckeye — Managed Medicare: $508.57
  • CareSource — Managed Medicare: $864.58
  • Cigna — All Products: $999.05
  • CommuniCare I-SNP — Managed Medicare: $508.57
  • Devoted — Managed Medicare: $508.57
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP Not listed in the file Not listed in the file $909.16 – $6,804
Cataract removal with lens implant: 10 of 21 insurance plan rates
  • Aetna — All Products: $6,804
  • Aetna — Managed Medicare: $2,114.33
  • Anthem — All Products: $2,114.33
  • Anthem — Managed Medicare: $2,114.33
  • Buckeye — ACA Exchange: $2,854.34
  • Buckeye — Managed Medicare: $2,114.33
  • CareSource — Managed Medicare: $3,594.36
  • Cigna — All Products: $4,192.09
  • CommuniCare I-SNP — Managed Medicare: $2,114.33
  • Devoted — Managed Medicare: $2,114.33

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ROUTINE OBSTETRIC CARE, ANTEPARTUM CARE, $4,000 $3,000 $720
Vaginal delivery, with care before and after: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ROUTINE OBSTETRIC CARE, ANTEPARTUM CARE, $4,000 Not listed in the file $2,162.78 – $3,066.81
Vaginal delivery, with care before and after: 10 of 15 insurance plan rates
  • AETNA — Managed Medicare: $2,162.78
  • Anthem — Blue Access OH 1 & 2: $2,417.10
  • ANTHEM — Managed Medicare: $2,271.71
  • Anthem BCBS — All Products: $3,021.37
  • Buckeye — Managed Medicaid: $1,234.04
  • CARESOURCE — Managed Medicaid: $1,234.04
  • CIGNA — All Products: $3,066.81
  • HEALTH DESIGN PLUS — All Products: $2,839.64
  • HEALTHSPAN — All Products: $2,498.88
  • HUMANA — Managed Medicaid: $1,234.04
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ROUTINE OBSTETRIC CARE W/ ANTEPARTUM CAR $4,950 $3,712.50 $720
Cesarean delivery (C-section), with care before and after: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ROUTINE OBSTETRIC CARE W/ ANTEPARTUM CAR $4,950 Not listed in the file $2,418.69 – $3,412.50
Cesarean delivery (C-section), with care before and after: rates for 10 insurance plans
  • AETNA — Managed Medicare: $2,418.69
  • Anthem — Blue Access OH 1 & 2: $2,689.56
  • ANTHEM — Managed Medicare: $2,527.78
  • Anthem BCBS — All Products: $3,361.95
  • CIGNA — All Products: $3,412.50
  • HEALTH DESIGN PLUS — All Products: $3,159.73
  • HEALTHSPAN — All Products: $2,780.56
  • HUMANA — Managed Medicare: $2,527.78
  • Medical Mutual-Ohio — Managed Medicare: $2,527.78
  • VALOR HEALTH — Managed Medicare: $2,527.78
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ROUTINE OBSTETRIC CARE, VAGINAL DELIVERY $4,675 $3,506.25 $720
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan
  • SummaCare — Managed Medicare: $720
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ROUTINE OBSTETRIC CARE, VAGINAL DELIVERY $4,675 Not listed in the file $2,279.90 – $3,218.78
Vaginal delivery after a previous C-section, with care before and after: rates for 10 insurance plans
  • AETNA — Managed Medicare: $2,279.90
  • Anthem — Blue Access OH 1 & 2: $2,536.87
  • ANTHEM — Managed Medicare: $2,384.28
  • Anthem BCBS — All Products: $3,171.09
  • CIGNA — All Products: $3,218.78
  • HEALTH DESIGN PLUS — All Products: $2,980.35
  • HEALTHSPAN — All Products: $2,622.71
  • HUMANA — Managed Medicare: $2,384.28
  • Medical Mutual-Ohio — Managed Medicare: $2,384.28
  • VALOR HEALTH — Managed Medicare: $2,384.28

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · 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 $24,519.82 – $139,434.25
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 33 insurance plan rates
  • Aetna — All Products: $134,709.16
  • Aetna — Managed Medicare: $66,269.78
  • Anthem — All Products: $127,645.97
  • Anthem — Managed Medicare: $66,269.78
  • Aultcare — Managed Medicare: $66,269.78
  • Buckeye — ACA Exchange: $89,464.20
  • Buckeye — Managed Medicare: $66,269.78
  • CareSource — Managed Medicare: $106,031.65
  • Cigna — All Products: $124,075.25
  • CommuniCare I-SNP — Managed Medicare: $66,269.78
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 HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $4,837.75 – $27,492.61
Hip or knee replacement (major joint of the leg), without major complications: 10 of 18 insurance plan rates
  • Aetna — Managed Medicare: $13,074.99
  • Anthem — Managed Medicare: $13,074.99
  • Aultcare — Managed Medicare: $13,074.99
  • Buckeye — ACA Exchange: $17,651.24
  • Buckeye — Managed Medicare: $13,074.99
  • CareSource — Managed Medicare: $20,919.98
  • CommuniCare I-SNP — Managed Medicare: $13,074.99
  • Devoted — Managed Medicare: $13,074.99
  • Health Design Plus — All Products: $4,837.75
  • HealthSpan — All Products: $5,230
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 $4,837.75 – $27,492.61
Hip or knee replacement (major joint of the leg), without major complications: 10 of 15 insurance plan rates
  • Aetna — All Products: $26,560.95
  • Anthem — All Products: $25,168.29
  • Cigna — All Products: $24,464.24
  • Coventry — All Products: $12,335.32
  • First Health — All Products: $12,335.32
  • HealthSmart — All Products: $18,600.38
  • HealthSmart Preferred — All Products: $20,907.35
  • Medical Mutual — ACA Exchange: $24,743.35
  • Medical Mutual — All Products: $27,492.61
  • MEDICAL MUTUAL-OHIO — All Products: $24,743.35
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 $6,121.84 – $34,795.85
Neck (cervical) spinal fusion, without complications: 10 of 33 insurance plan rates
  • Aetna — All Products: $33,616.70
  • Aetna — Managed Medicare: $16,545.50
  • Anthem — All Products: $31,854.08
  • Anthem — Managed Medicare: $16,545.50
  • Aultcare — Managed Medicare: $16,545.50
  • Buckeye — ACA Exchange: $22,336.43
  • Buckeye — Managed Medicare: $16,545.50
  • CareSource — Managed Medicare: $26,472.80
  • Cigna — All Products: $30,963.01
  • CommuniCare I-SNP — Managed Medicare: $16,545.50
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 $3,113.10 – $17,683.70
Uterus and ovary surgery (not for cancer), without complications: 10 of 33 insurance plan rates
  • Aetna — All Products: $17,084.44
  • Aetna — Managed Medicare: $8,413.79
  • Anthem — All Products: $16,188.65
  • Anthem — Managed Medicare: $8,413.79
  • Aultcare — Managed Medicare: $8,413.79
  • Buckeye — ACA Exchange: $11,358.62
  • Buckeye — Managed Medicare: $8,413.79
  • CareSource — Managed Medicare: $13,462.06
  • Cigna — All Products: $15,735.80
  • CommuniCare I-SNP — Managed Medicare: $8,413.79

Source: Southwest General Health Center’s standard charges file (southwestgeneral.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on July 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address18697 Bagley Road, Middleburg Heights, OH 44130
CountyCuyahoga County
StateOhio
Phone(440) 816‑8000
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating4 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number360155
Name in Medicare recordsSOUTHWEST GENERAL HEALTH CENTER
Profile levelMedicare data + hospital website
Official websiteswgeneral.com
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. About Us - Southwest General Health Center — swgeneral.com
  2. Emergency Services — swgeneral.com
  3. Heart & Vascular — swgeneral.com
  4. Orthopedics — swgeneral.com
  5. Cancer Care — swgeneral.com
  6. Neurosciences — swgeneral.com
  7. Women's Health — swgeneral.com
  8. Behavioral Health — swgeneral.com
  9. Visitor Information — swgeneral.com