Does SSM Health Saint Louis University Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at SSM Health Saint Louis University Hospital. In a medical emergency, call 911.

Where is SSM Health Saint Louis University Hospital?

1201 S Grand Blvd, Saint Louis, MO 63104, in St. Louis City, Missouri.

What is the phone number of SSM Health Saint Louis University Hospital?

(314) 257-8000, as listed by Medicare (CMS).

What is the Medicare star rating of SSM Health Saint Louis University Hospital?

1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

SSM Health Saint Louis University Hospital

Quick answers

Does SSM Health Saint Louis University Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at SSM Health Saint Louis University Hospital. In a medical emergency, call 911.
Where is SSM Health Saint Louis University Hospital?: 1201 S Grand Blvd, Saint Louis, MO 63104, in St. Louis City, Missouri.
What is the phone number of SSM Health Saint Louis University Hospital?: (314) 257-8000, as listed by Medicare (CMS).
What is the Medicare star rating of SSM Health Saint Louis University Hospital?: 1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5][6][7]

Conditions treated^[5][7]

Stroke
STEMI (heart attack)
Traumatic injury

Procedures^[7]

Complex spine surgery

Programs and centers^[4][5][7]

Level 1 Time Critical Diagnosis hospital (stroke, trauma, STEMI)
Level I Trauma Center
Level 1 Stroke Center

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level I

Visiting and practical information

Visiting	Visiting hours 8 a.m.-8 p.m.; compassionate care exceptions may be made with the nursing leader's permission^[7]
Parking	Separate ER entrance and parking on Lasalle Street, north side of the hospital^[4]

Recognition^[5]

Level 1 trauma center verified by the American College of Surgeons Committee on Trauma

Doctors and clinicians (831)

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

Main specialties

And 807 more: the button below opens the full list.

Other emergency rooms nearby

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

St Louis-John Cochran VA Medical Center1.3 mi · St. Louis, MO · Federal/VA Acute Care Hospital
Barnes Jewish Hospital1.6 mi · Saint Louis, MO · Acute Care Hospital
St Louis Childrens Hospital1.8 mi · Saint Louis, MO · Children's Hospital
SSM Health St Mary's Hospital - St Louis4.0 mi · Saint Louis, MO · Acute Care Hospital
Gateway Regional Medical Center7.3 mi · Granite City, IL · Acute Care Hospital

Other hospitals nearby

Shriners Hospitals for Children1.2 mi · Saint Louis, MO · Children's Hospital
The Rehabilitation Institute of St. Louis, An Affi…1.5 mi · Saint Louis, MO · Inpatient Rehabilitation Hospital
St Louis Forensic Treatment Center2.6 mi · Saint Louis, MO · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Life Care Center of St Louis0.3 mi · Saint Louis, MO · 4 of 5 stars
Beauvais Rehab and Healthcare Center1.1 mi · Saint Louis, MO · 1 of 5 stars
Bernard Care Center1.4 mi · Saint Louis, MO · 1 of 5 stars

All nursing homes in the state →

Hospice providers

ACG Hospice1.6 mi · Saint Louis, MO
Medi-Plex Hospice, LLC1.6 mi · Saint Louis, MO
St Croix Hospice2.5 mi · Arnold, MO

All hospice providers in the state →

Home health agencies

Cooperative Home Care, Inc1.6 mi · Saint Louis, MO · 4 of 5 stars
Medi-Plex Healthcare Professionals, LLC1.6 mi · Saint Louis, MO · 2 of 5 stars
Aw Health Care5.5 mi · Saint Louis, MO

All home health agencies in the state →

Dialysis facilities

DaVita St. Louis Dialysis Center1.2 mi · Saint Louis, MO · 3 of 5 stars
Cardinal Glennon Childrens Hospital Dialysis1.5 mi · Saint Louis, MO
FMC - Chouteau1.6 mi · Saint Louis, MO · 1 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

314 Surgery Center, LLC1.2 mi · St. Louis, MO
Gateway Surgery Center10 mi · St. Louis, MO
Kirkwood Vascular and Surgical Institute, LLC10 mi · Kirkwood, MO

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

Forest Park Southeast1.1 mi · Saint Louis, MO · Community health center
Salvation Army Midtown Service and Treatment Center1.2 mi · Saint Louis, MO · Community health center
Family Care Health Centers at RUNG1.3 mi · Saint Louis, MO · Community health center

Clinics and urgent care

Veterans Advantage Urgent Care, Inc1.2 mi · Saint Louis, MO · Urgent care center
American Current Care P.A.1.5 mi · St Louis, MO · Urgent care center
Total Access Urgent Care, PC2.2 mi · Saint Louis, MO · Urgent care center

Pharmacies

Amc Pharmacy LLC1.2 mi · Saint Louis, MO · Community/retail pharmacy
Missouri CVS Pharmacy LLC1.2 mi · Saint Louis, MO · Pharmacy
Walgreen Co1.2 mi · Saint Louis, MO · Pharmacy

Assisted living nearby

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

Benedict Joseph Labre Center1.6 mi · Saint Louis, MO
Akins Health Care, Inc1.7 mi · Saint Louis, MO
Care Network at Waterman1.7 mi · Saint Louis, MO
Cooper House1.7 mi · Saint Louis, MO

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	2 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	2 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	2 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	63%National average: 72%
Would definitely recommend the hospital	65%National average: 71%
Nurses “always” communicated well	74%National average: 80%
Doctors “always” communicated well	75%National average: 80%
Staff “always” explained medicines before giving them	57%National average: 62%
Were given information about recovery at home	83%National average: 86%
Room and bathroom “always” clean	60%National average: 74%
Area around the room “always” quiet at night	62%National average: 60%
Completed surveys	846Response rate: 17%

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)	0.964No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.393Better than the national benchmark
Surgical site infections after colon surgery	0.68No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	1.122No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.234Better 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 patients	12.8%
Deaths within 30 days: heart failure patients	11.5%
Deaths within 30 days: pneumonia patients	14.1%
Deaths within 30 days: COPD patients	7.4%
Deaths within 30 days: stroke patients	11.3%
Deaths within 30 days: coronary bypass surgery (CABG)	2.2%
Serious complications (patient safety indicator PSI-90)	1.14No different from the national rate
Complications after hip or knee replacement	Not reported to Medicare

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	15%
Readmitted within 30 days: heart failure	21%
Readmitted within 30 days: pneumonia	17.7%
Readmitted within 30 days: COPD	19.1%
Readmitted within 30 days: coronary bypass surgery	12.4%
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	335 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)	39%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 Saint Louis Best hospitals in Saint Louis

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 87 common services exactly as SSM Health Saint Louis University Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new	Not listed in the file	Not listed in the file	$92.50 – $318.22
New patient office visit (about 30–44 minutes): rates for 4 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $94.47 BCBS — Anthem Blue Access PPO: $272.76 BCBS — Anthem Blue Preferred HMO/POS: $185.58 BCBS — Anthem Pathway Exchange: $92.50
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Faclty Op New Level 3	$397	$218.35	Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new	Not listed in the file	Not listed in the file	$156.39 – $538.01
New patient office visit (about 45–59 minutes): rates for 4 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $159.73 BCBS — Anthem Blue Access PPO: $461.15 BCBS — Anthem Blue Preferred HMO/POS: $313.76 BCBS — Anthem Pathway Exchange: $156.39
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Faclty Op New Level 4	$670	$368.50	Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new	Not listed in the file	Not listed in the file	$203.31 – $699.43
New patient office visit (about 60–74 minutes): rates for 4 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $207.65 BCBS — Anthem Blue Access PPO: $599.51 BCBS — Anthem Blue Preferred HMO/POS: $407.90 BCBS — Anthem Pathway Exchange: $203.31
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Faclty Op New Level 5	$764	$420.20	Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est	Not listed in the file	Not listed in the file	$60.90 – $3,851
Established patient office visit (about 20–29 minutes): rates for 6 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $62.20 BCBS — Anthem Blue Access PPO: $179.59 BCBS — Anthem Blue Preferred HMO/POS: $122.19 BCBS — Anthem Pathway Exchange: $60.90 Healthlink — HMO: $2,496 Healthlink — PPO: $3,851
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Faclty Op Est Pt Level 3	$382	$210.10	Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est	Not listed in the file	Not listed in the file	$94.15 – $4,616
Established patient office visit (about 30–39 minutes): rates for 6 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $96.16 BCBS — Anthem Blue Access PPO: $277.64 BCBS — Anthem Blue Preferred HMO/POS: $188.90 BCBS — Anthem Pathway Exchange: $94.15 Healthlink — HMO: $3,085 Healthlink — PPO: $4,616
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Faclty Op Est Pt Level 4	$560	$308	Not listed in the file
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office consultation	Not listed in the file	Not listed in the file	$117.73 – $405.01
Office consultation with a specialist (moderate): rates for 4 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $120.24 BCBS — Anthem Blue Access PPO: $347.15 BCBS — Anthem Blue Preferred HMO/POS: $236.20 BCBS — Anthem Pathway Exchange: $117.73
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office consultation	Not listed in the file	Not listed in the file	$186.30 – $640.93
Office consultation with a specialist (moderate to high): rates for 4 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $190.28 BCBS — Anthem Blue Access PPO: $549.37 BCBS — Anthem Blue Preferred HMO/POS: $373.79 BCBS — Anthem Pathway Exchange: $186.30
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 18-39	Not listed in the file	Not listed in the file	$118.95 – $409.22
Preventive checkup, new patient, age 18–39: rates for 4 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $121.49 BCBS — Anthem Blue Access PPO: $350.76 BCBS — Anthem Blue Preferred HMO/POS: $238.66 BCBS — Anthem Pathway Exchange: $118.95
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Preventive Visit New Age 18-39	$75	$41.25	Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 40-64	Not listed in the file	Not listed in the file	$144.08 – $495.68
Preventive checkup, new patient, age 40–64: rates for 4 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $147.16 BCBS — Anthem Blue Access PPO: $424.87 BCBS — Anthem Blue Preferred HMO/POS: $289.08 BCBS — Anthem Pathway Exchange: $144.08
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$74.97 – $328.10
Emergency room visit (moderate): 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $278.89 Aetna — Medicare Managed Care Plan: $273.42 BCBS — Anthem Blue Access Choice All Commercial Plans: $76.57 BCBS — Anthem Blue Access PPO: $221.06 BCBS — Anthem Blue Preferred HMO/POS: $150.41 BCBS — Anthem Medicare Managed Care Plan: $267.95 BCBS — Anthem Pathway Exchange: $74.97 Centene — Wellcare Medicare Managed Care - PPO: $276.15 Essence — Medicare Managed Care Plan: $281.62 Humana — Medicare Managed Care Plan: $278.07
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level Iii	$1,887	$1,037.85	Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$142.72 – $501.52
Emergency room visit (moderately high): 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $426.29 Aetna — Medicare Managed Care Plan: $417.94 BCBS — Anthem Blue Access Choice All Commercial Plans: $145.76 BCBS — Anthem Blue Access PPO: $420.84 BCBS — Anthem Blue Preferred HMO/POS: $286.34 BCBS — Anthem Medicare Managed Care Plan: $409.58 BCBS — Anthem Pathway Exchange: $142.72 Centene — Wellcare Medicare Managed Care - PPO: $422.12 Essence — Medicare Managed Care Plan: $430.47 Humana — Medicare Managed Care Plan: $425.04
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level Iv	$3,048	$1,676.40	Not listed in the file
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$211.38 – $727.19
Emergency room visit (high): 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $608.42 Aetna — Medicare Managed Care Plan: $596.49 BCBS — Anthem Blue Access Choice All Commercial Plans: $215.89 BCBS — Anthem Blue Access PPO: $623.31 BCBS — Anthem Blue Preferred HMO/POS: $424.09 BCBS — Anthem Medicare Managed Care Plan: $584.56 BCBS — Anthem Pathway Exchange: $211.38 Centene — Wellcare Medicare Managed Care - PPO: $602.46 Essence — Medicare Managed Care Plan: $614.39 Humana — Medicare Managed Care Plan: $606.63
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level V	$4,500	$2,475	Not listed in the file

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca	Not listed in the file	Not listed in the file	$8.29 – $47.48
Basic metabolic panel (blood test): 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $8.63 BCBS — Anthem Blue Access Choice All Commercial Plans: $23.28 BCBS — Anthem Blue Access PPO: $40.70 BCBS — Anthem Blue Preferred HMO/POS: $14.10 BCBS — Anthem Medicare Managed Care Plan: $8.29 BCBS — Anthem Pathway Exchange: $13.80 Centene — Wellcare Medicare Managed Care - PPO: $8.54 Cigna — All Commercial Plans: $14.29 Essence — Medicare Managed Care Plan: $8.71 Healthlink — HMO: $18.06
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Basic Metabolic Panel (Ca Total)	$230	$126.50	Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel	Not listed in the file	Not listed in the file	$10.35 – $59.28
Comprehensive metabolic panel (blood test): 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $10.77 BCBS — Anthem Blue Access Choice All Commercial Plans: $29.07 BCBS — Anthem Blue Access PPO: $50.81 BCBS — Anthem Blue Preferred HMO/POS: $29.07 BCBS — Anthem Medicare Managed Care Plan: $10.35 BCBS — Anthem Pathway Exchange: $28.46 Centene — Wellcare Medicare Managed Care - PPO: $10.67 Cigna — All Commercial Plans: $17.72 Essence — Medicare Managed Care Plan: $10.88 Healthlink — HMO: $22.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Comprehensive Metabolic Panel	$300	$165	Not listed in the file
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel	Not listed in the file	Not listed in the file	$46.85 – $268.63
Obstetric blood test panel: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $48.77 BCBS — Anthem Blue Access Choice All Commercial Plans: $131.74 BCBS — Anthem Blue Access PPO: $230.26 BCBS — Anthem Blue Preferred HMO/POS: $131.74 BCBS — Anthem Medicare Managed Care Plan: $46.85 BCBS — Anthem Pathway Exchange: $128.98 Centene — Wellcare Medicare Managed Care - PPO: $48.29 Cigna — All Commercial Plans: $80.61 Essence — Medicare Managed Care Plan: $49.24 Healthlink — HMO: $102.10
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel	Not listed in the file	Not listed in the file	$13.12 – $75.16
Cholesterol panel (lipid panel): 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $13.66 BCBS — Anthem Blue Access Choice All Commercial Plans: $36.86 BCBS — Anthem Blue Access PPO: $64.42 BCBS — Anthem Blue Preferred HMO/POS: $36.86 BCBS — Anthem Medicare Managed Care Plan: $13.12 BCBS — Anthem Pathway Exchange: $36.09 Centene — Wellcare Medicare Managed Care - PPO: $13.52 Cigna — All Commercial Plans: $22.87 Essence — Medicare Managed Care Plan: $13.79 Healthlink — HMO: $28.60
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Lipid Profile	$110	$60.50	Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Lipid Profile I	$93	$51.15	Not listed in the file
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel	Not listed in the file	Not listed in the file	$8.51 – $48.76
Kidney function panel: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $8.85 BCBS — Anthem Blue Access Choice All Commercial Plans: $23.91 BCBS — Anthem Blue Access PPO: $41.79 BCBS — Anthem Blue Preferred HMO/POS: $23.91 BCBS — Anthem Medicare Managed Care Plan: $8.51 BCBS — Anthem Pathway Exchange: $14.17 Centene — Wellcare Medicare Managed Care - PPO: $8.77 Cigna — All Commercial Plans: $14.86 Essence — Medicare Managed Care Plan: $8.94 Healthlink — HMO: $18.55
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Renal Function Panel	$130	$71.50	Not listed in the file
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel	Not listed in the file	Not listed in the file	$8.01 – $45.83
Liver function panel: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $8.33 BCBS — Anthem Blue Access Choice All Commercial Plans: $22.48 BCBS — Anthem Blue Access PPO: $39.28 BCBS — Anthem Blue Preferred HMO/POS: $13.61 BCBS — Anthem Medicare Managed Care Plan: $8.01 BCBS — Anthem Pathway Exchange: $13.32 Centene — Wellcare Medicare Managed Care - PPO: $8.25 Cigna — All Commercial Plans: $13.72 Essence — Medicare Managed Care Plan: $8.42 Healthlink — HMO: $17.46
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Hepatic Function Panel	$247	$135.85	Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope	Not listed in the file	Not listed in the file	$3.11 – $17.78
Urine test (automated, with microscope): 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $3.23 BCBS — Anthem Blue Access Choice All Commercial Plans: $8.72 BCBS — Anthem Blue Access PPO: $15.24 BCBS — Anthem Blue Preferred HMO/POS: $5.28 BCBS — Anthem Medicare Managed Care Plan: $3.11 BCBS — Anthem Pathway Exchange: $8.54 Centene — Wellcare Medicare Managed Care - PPO: $3.20 Cigna — All Commercial Plans: $5.15 Essence — Medicare Managed Care Plan: $3.27 Healthlink — HMO: $6.78
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Urinalysis Routine Auto W Microscopic	$60	$33	Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope	Not listed in the file	Not listed in the file	$3.41 – $11.72
Urine test (manual, without microscope): 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $3.55 BCBS — Anthem Blue Access Choice All Commercial Plans: $5.75 BCBS — Anthem Blue Access PPO: $10.04 BCBS — Anthem Blue Preferred HMO/POS: $3.48 BCBS — Anthem Medicare Managed Care Plan: $3.41 BCBS — Anthem Pathway Exchange: $5.62 Centene — Wellcare Medicare Managed Care - PPO: $3.51 Cigna — All Commercial Plans: $5.72 Essence — Medicare Managed Care Plan: $3.58 Healthlink — HMO: $6.02
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$19.20	$10.56	Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Lab Urinalysis Poct (Ip) Beaker	$40	$22	Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/o scope	Not listed in the file	Not listed in the file	$2.20 – $11.72
Urine test (automated, without microscope): 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $2.30 BCBS — Anthem Blue Access Choice All Commercial Plans: $5.75 BCBS — Anthem Blue Access PPO: $10.04 BCBS — Anthem Blue Preferred HMO/POS: $5.75 BCBS — Anthem Medicare Managed Care Plan: $2.20 BCBS — Anthem Pathway Exchange: $5.62 Centene — Wellcare Medicare Managed Care - PPO: $2.27 Cigna — All Commercial Plans: $4 Essence — Medicare Managed Care Plan: $2.32 Healthlink — HMO: $4.79
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Ketones Qualitative Urine Auto	$39	$21.45	Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Specific Gravity Urine Auto	$32	$17.60	Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay of psa total	Not listed in the file	Not listed in the file	$18.02 – $103.25
PSA (prostate specific antigen) blood test: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $18.76 BCBS — Anthem Blue Access Choice All Commercial Plans: $50.64 BCBS — Anthem Blue Access PPO: $88.50 BCBS — Anthem Blue Preferred HMO/POS: $60.22 BCBS — Anthem Medicare Managed Care Plan: $18.02 BCBS — Anthem Pathway Exchange: $30.01 Centene — Wellcare Medicare Managed Care - PPO: $18.57 Cigna — All Commercial Plans: $30.87 Essence — Medicare Managed Care Plan: $18.94 Healthlink — HMO: $39.29
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Psa Total	$140	$77	Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay thyroid stim hormone	Not listed in the file	Not listed in the file	$16.46 – $94.34
Thyroid stimulating hormone (TSH) test: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $17.14 BCBS — Anthem Blue Access Choice All Commercial Plans: $46.27 BCBS — Anthem Blue Access PPO: $80.87 BCBS — Anthem Blue Preferred HMO/POS: $55.02 BCBS — Anthem Medicare Managed Care Plan: $16.46 BCBS — Anthem Pathway Exchange: $27.42 Centene — Wellcare Medicare Managed Care - PPO: $16.97 Cigna — All Commercial Plans: $28.58 Essence — Medicare Managed Care Plan: $17.30 Healthlink — HMO: $35.90
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Tsh	$150	$82.50	Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Tsh Neonatal	$47	$25.85	Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc	Not listed in the file	Not listed in the file	$7.61 – $43.64
Complete blood count (CBC) with differential: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $7.93 BCBS — Anthem Blue Access Choice All Commercial Plans: $21.40 BCBS — Anthem Blue Access PPO: $37.41 BCBS — Anthem Blue Preferred HMO/POS: $25.45 BCBS — Anthem Medicare Managed Care Plan: $7.61 BCBS — Anthem Pathway Exchange: $12.69 Centene — Wellcare Medicare Managed Care - PPO: $7.85 Cigna — All Commercial Plans: $13.15 Essence — Medicare Managed Care Plan: $8 Healthlink — HMO: $16.59
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Cbc W Auto Differential	$130	$71.50	Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated	Not listed in the file	Not listed in the file	$6.34 – $36.34
Complete blood count (CBC), automated: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $6.60 BCBS — Anthem Blue Access Choice All Commercial Plans: $17.82 BCBS — Anthem Blue Access PPO: $31.15 BCBS — Anthem Blue Preferred HMO/POS: $21.20 BCBS — Anthem Medicare Managed Care Plan: $6.34 BCBS — Anthem Pathway Exchange: $10.56 Centene — Wellcare Medicare Managed Care - PPO: $6.53 Cigna — All Commercial Plans: $10.86 Essence — Medicare Managed Care Plan: $6.66 Healthlink — HMO: $13.81
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Cbc W/O Auto Differential	$110	$60.50	Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time	Not listed in the file	Not listed in the file	$4.20 – $22.07
Blood clotting time test (prothrombin time, PT): 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $4.38 BCBS — Anthem Blue Access Choice All Commercial Plans: $10.82 BCBS — Anthem Blue Access PPO: $18.92 BCBS — Anthem Blue Preferred HMO/POS: $12.87 BCBS — Anthem Medicare Managed Care Plan: $4.20 BCBS — Anthem Pathway Exchange: $6.42 Centene — Wellcare Medicare Managed Care - PPO: $4.33 Cigna — All Commercial Plans: $7.43 Essence — Medicare Managed Care Plan: $4.42 Healthlink — HMO: $8.39
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Pt-Inr	$41	$22.55	Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Pt I	$45	$24.75	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time partial	Not listed in the file	Not listed in the file	$5.89 – $33.70
Blood clotting test (partial thromboplastin time, PTT): 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $6.13 BCBS — Anthem Blue Access Choice All Commercial Plans: $16.53 BCBS — Anthem Blue Access PPO: $28.89 BCBS — Anthem Blue Preferred HMO/POS: $19.66 BCBS — Anthem Medicare Managed Care Plan: $5.89 BCBS — Anthem Pathway Exchange: $9.80 Centene — Wellcare Medicare Managed Care - PPO: $6.07 Cigna — All Commercial Plans: $10.29 Essence — Medicare Managed Care Plan: $6.19 Healthlink — HMO: $12.84
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Ptt Inhibitor 1Hr	$125	$68.75	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Ptt	$90	$49.50	Not listed in the file

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye	Not listed in the file	Not listed in the file	$83.97 – $358.93
CT scan of the head or brain, without contrast: 10 of 14 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $106.81 Aetna — Medicare Managed Care Plan: $104.71 BCBS — Anthem Blue Access Choice All Commercial Plans: $141.67 BCBS — Anthem Blue Access PPO: $247.62 BCBS — Anthem Blue Preferred HMO/POS: $141.67 BCBS — Anthem Medicare Managed Care Plan: $102.62 BCBS — Anthem Pathway Exchange: $138.70 Centene — Wellcare Medicare Managed Care - PPO: $105.76 Essence — Medicare Managed Care Plan: $107.86 Healthlink — HMO: $358.93
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ct Head Non Contrast	$1,800	$990	Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye	Not listed in the file	Not listed in the file	$301.27 – $1,200.46
MRI of the brain, before and after contrast: 10 of 14 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $356.43 Aetna — Medicare Managed Care Plan: $349.44 BCBS — Anthem Blue Access Choice All Commercial Plans: $508.28 BCBS — Anthem Blue Access PPO: $888.39 BCBS — Anthem Blue Preferred HMO/POS: $508.28 BCBS — Anthem Medicare Managed Care Plan: $342.45 BCBS — Anthem Pathway Exchange: $497.63 Centene — Wellcare Medicare Managed Care - PPO: $352.93 Essence — Medicare Managed Care Plan: $359.92 Healthlink — HMO: $1,200.46
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mri Brain With & Without Contrast	$4,100	$2,255	Not listed in the file
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views	Not listed in the file	Not listed in the file	$22.81 – $173.94
Chest X-ray, 2 views: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $88.91 Aetna — Medicare Managed Care Plan: $87.17 BCBS — Anthem Blue Access Choice All Commercial Plans: $38.48 BCBS — Anthem Blue Access PPO: $67.25 BCBS — Anthem Blue Preferred HMO/POS: $38.48 BCBS — Anthem Medicare Managed Care Plan: $85.42 BCBS — Anthem Pathway Exchange: $37.67 Centene — Wellcare Medicare Managed Care - PPO: $88.04 Cigna — All Commercial Plans: $40 Essence — Medicare Managed Care Plan: $89.78
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Xray Chest 2 Views	$512	$281.60	Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws	Not listed in the file	Not listed in the file	$37.47 – $234.29
X-ray of the lower spine, at least 4 views: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $106.81 Aetna — Medicare Managed Care Plan: $104.71 BCBS — Anthem Blue Access Choice All Commercial Plans: $63.22 BCBS — Anthem Blue Access PPO: $110.50 BCBS — Anthem Blue Preferred HMO/POS: $63.22 BCBS — Anthem Medicare Managed Care Plan: $102.62 BCBS — Anthem Pathway Exchange: $61.89 Centene — Wellcare Medicare Managed Care - PPO: $105.76 Cigna — All Commercial Plans: $66.87 Essence — Medicare Managed Care Plan: $107.86
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Lumbar Spine 4+ Vw	$760	$418	Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye	Not listed in the file	Not listed in the file	$169.16 – $683.90
MRI of the lower back (lumbar spine), without contrast: 10 of 14 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $243.77 Aetna — Medicare Managed Care Plan: $238.99 BCBS — Anthem Blue Access Choice All Commercial Plans: $285.38 BCBS — Anthem Blue Access PPO: $498.81 BCBS — Anthem Blue Preferred HMO/POS: $285.38 BCBS — Anthem Medicare Managed Care Plan: $234.21 BCBS — Anthem Pathway Exchange: $279.40 Centene — Wellcare Medicare Managed Care - PPO: $241.38 Essence — Medicare Managed Care Plan: $246.16 Healthlink — HMO: $683.90
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mri Spine Lumbar Non Contrast	$2,500	$1,375	Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye	Not listed in the file	Not listed in the file	$172.17 – $819.92
CT scan of the pelvis, with contrast: 10 of 14 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $179.20 Aetna — Medicare Managed Care Plan: $175.68 BCBS — Anthem Blue Access Choice All Commercial Plans: $324.25 BCBS — Anthem Blue Access PPO: $566.73 BCBS — Anthem Blue Preferred HMO/POS: $324.25 BCBS — Anthem Medicare Managed Care Plan: $172.17 BCBS — Anthem Pathway Exchange: $317.45 Centene — Wellcare Medicare Managed Care - PPO: $177.44 Essence — Medicare Managed Care Plan: $180.95 Healthlink — HMO: $819.92
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ct Pelvis With Iv Contrast	$2,500	$1,375	Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye	Not listed in the file	Not listed in the file	$191.78 – $770.95
MRI of a leg joint (such as the knee), without contrast: 10 of 14 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $243.77 Aetna — Medicare Managed Care Plan: $238.99 BCBS — Anthem Blue Access Choice All Commercial Plans: $323.56 BCBS — Anthem Blue Access PPO: $565.53 BCBS — Anthem Blue Preferred HMO/POS: $323.56 BCBS — Anthem Medicare Managed Care Plan: $234.21 BCBS — Anthem Pathway Exchange: $191.78 Centene — Wellcare Medicare Managed Care - PPO: $241.38 Essence — Medicare Managed Care Plan: $246.16 Healthlink — HMO: $770.95
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mri Lower Ext Any Joint Non Contrast	$2,444	$1,344.20	Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelv w/contrast	Not listed in the file	Not listed in the file	$252.28 – $1,078.15
CT scan of the abdomen and pelvis, with contrast: 10 of 14 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $356.43 Aetna — Medicare Managed Care Plan: $349.44 BCBS — Anthem Blue Access Choice All Commercial Plans: $425.62 BCBS — Anthem Blue Access PPO: $743.92 BCBS — Anthem Blue Preferred HMO/POS: $425.62 BCBS — Anthem Medicare Managed Care Plan: $342.45 BCBS — Anthem Pathway Exchange: $416.70 Centene — Wellcare Medicare Managed Care - PPO: $352.93 Essence — Medicare Managed Care Plan: $359.92 Healthlink — HMO: $1,078.15
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ct Abdomen Pelvis W Contrast	$3,750	$2,062.50	Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete	Not listed in the file	Not listed in the file	$95.50 – $328.53
Ultrasound of the abdomen, complete: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $106.81 Aetna — Medicare Managed Care Plan: $104.71 BCBS — Anthem Blue Access Choice All Commercial Plans: $161.11 BCBS — Anthem Blue Access PPO: $281.60 BCBS — Anthem Blue Preferred HMO/POS: $161.11 BCBS — Anthem Medicare Managed Care Plan: $102.62 BCBS — Anthem Pathway Exchange: $95.50 Centene — Wellcare Medicare Managed Care - PPO: $105.76 Cigna — All Commercial Plans: $135.47 Essence — Medicare Managed Care Plan: $107.86
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Abdomen Complete	$1,012	$556.60	Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us >/= 14 wks sngl fetus	Not listed in the file	Not listed in the file	$102.62 – $365.33
Pregnancy ultrasound (after the first trimester): 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $106.81 Aetna — Medicare Managed Care Plan: $104.71 BCBS — Anthem Blue Access Choice All Commercial Plans: $179.16 BCBS — Anthem Blue Access PPO: $313.14 BCBS — Anthem Blue Preferred HMO/POS: $108.46 BCBS — Anthem Medicare Managed Care Plan: $102.62 BCBS — Anthem Pathway Exchange: $106.19 Centene — Wellcare Medicare Managed Care - PPO: $105.76 Cigna — All Commercial Plans: $152.61 Essence — Medicare Managed Care Plan: $107.86
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Ob 14+ Wks Single Gest	$523	$287.65	Not listed in the file
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob	Not listed in the file	Not listed in the file	$101.25 – $348.33
Transvaginal ultrasound: 10 of 15 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $106.81 Aetna — Medicare Managed Care Plan: $104.71 BCBS — Anthem Blue Access Choice All Commercial Plans: $170.82 BCBS — Anthem Blue Access PPO: $298.57 BCBS — Anthem Blue Preferred HMO/POS: $103.41 BCBS — Anthem Medicare Managed Care Plan: $102.62 BCBS — Anthem Pathway Exchange: $167.24 Centene — Wellcare Medicare Managed Care - PPO: $105.76 Cigna — All Commercial Plans: $149.77 Essence — Medicare Managed Care Plan: $107.86
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Transvaginal Non Ob	$950	$522.50	Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$109.17 – $375.56
Diagnostic mammogram, one breast: rates for 8 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $184.17 BCBS — Anthem Blue Access PPO: $321.91 BCBS — Anthem Blue Preferred HMO/POS: $184.17 BCBS — Anthem Pathway Exchange: $180.31 Cigna — All Commercial Plans: $149.77 Healthlink — HMO: $232.37 UnitedHealthCare — Non-PPO Other Commercial Plan: $116.10 UnitedHealthCare — Options PPO: $196.55
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Dx Unilateral Includes Cad/Ai	$300	$165	Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$72.83 – $89.18
Diagnostic mammogram, one breast: rates for 7 insurance plans Aetna — Advantra Medicare Managed Care Plan: $75.81 Aetna — Medicare Managed Care Plan: $74.32 BCBS — Anthem Medicare Managed Care Plan: $72.83 Centene — Wellcare Medicare Managed Care - PPO: $75.06 Essence — Medicare Managed Care Plan: $76.55 Humana — Medicare Managed Care Plan: $75.58 Oscar — Exchange: $89.18
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi	Not listed in the file	Not listed in the file	$139.65 – $480.42
Diagnostic mammogram, both breasts: rates for 8 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $235.60 BCBS — Anthem Blue Access PPO: $411.79 BCBS — Anthem Blue Preferred HMO/POS: $235.60 BCBS — Anthem Pathway Exchange: $139.65 Cigna — All Commercial Plans: $190.93 Healthlink — HMO: $296.76 UnitedHealthCare — Non-PPO Other Commercial Plan: $148.45 UnitedHealthCare — Options PPO: $251.31
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Dx Bilateral Includes Cad/Ai	$580	$319	Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Dx mammo incl cad bi	Not listed in the file	Not listed in the file	$101.76 – $124.61
Diagnostic mammogram, both breasts: rates for 7 insurance plans Aetna — Advantra Medicare Managed Care Plan: $105.92 Aetna — Medicare Managed Care Plan: $103.84 BCBS — Anthem Medicare Managed Care Plan: $101.76 Centene — Wellcare Medicare Managed Care - PPO: $104.88 Essence — Medicare Managed Care Plan: $106.96 Humana — Medicare Managed Care Plan: $105.61 Oscar — Exchange: $124.61
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad	Not listed in the file	Not listed in the file	$115.35 – $396.84
Screening mammogram, both breasts: rates for 8 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $194.61 BCBS — Anthem Blue Access PPO: $340.15 BCBS — Anthem Blue Preferred HMO/POS: $194.61 BCBS — Anthem Pathway Exchange: $115.35 Cigna — All Commercial Plans: $158.34 Healthlink — HMO: $245.42 UnitedHealthCare — Non-PPO Other Commercial Plan: $122.75 UnitedHealthCare — Options PPO: $207.80
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Screen Bilat Includes Cad/Ai	$400	$220	Not listed in the file
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Screen Unilat Includes Cad/Ai	$200	$110	Not listed in the file

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrocardiogram complete	Not listed in the file	Not listed in the file	$20.14 – $69.30
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans BCBS — Anthem Blue Access Choice All Commercial Plans: $33.99 BCBS — Anthem Blue Access PPO: $59.40 BCBS — Anthem Blue Preferred HMO/POS: $40.42 BCBS — Anthem Pathway Exchange: $20.14
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left hrt cath w/ventrclgrphy	Not listed in the file	Not listed in the file	$730.92 – $16,495
Left heart catheterization (diagnostic): 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $3,312.11 Aetna — All Commercial Plans: $8,579 Aetna — Carelink All Commercial Plans: $5,554 Aetna — Medicare Managed Care Plan: $3,247.17 BCBS — Anthem Blue Access Choice All Commercial Plans: $1,233.14 BCBS — Anthem Blue Access PPO: $2,155.34 BCBS — Anthem Blue Preferred HMO/POS: $1,466.48 BCBS — Anthem Medicare Managed Care Plan: $3,182.22 BCBS — Anthem Pathway Exchange: $730.92 Centene — Ambetter Exchange: $9,640
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Lhc W Lt Vent W S+I	$8,200	$4,510	Not listed in the file
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrophysiology evaluation	Not listed in the file	Not listed in the file	$403.23 – $13,104
Heart rhythm study (electrophysiology evaluation): 10 of 19 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $7,968.50 Aetna — All Commercial Plans: $13,104 Aetna — Carelink All Commercial Plans: $8,484 Aetna — Medicare Managed Care Plan: $7,812.26 BCBS — Anthem Blue Access Choice All Commercial Plans: $680.29 BCBS — Anthem Blue Access PPO: $1,189.05 BCBS — Anthem Blue Preferred HMO/POS: $809.02 BCBS — Anthem Medicare Managed Care Plan: $7,656.01 BCBS — Anthem Pathway Exchange: $403.23 Centene — Ambetter Exchange: $9,640
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ep Eval W/O Induction Right A/V	$22,896	$12,592.80	Not listed in the file
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tx atrial fib pulm vein isol	Not listed in the file	Not listed in the file	$1,403.97 – $40,705
Heart rhythm study with ablation for atrial fibrillation: 10 of 19 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $26,703.66 Aetna — All Commercial Plans: $20,254 Aetna — Carelink All Commercial Plans: $13,116 Aetna — Medicare Managed Care Plan: $26,180.06 BCBS — Anthem Blue Access Choice All Commercial Plans: $2,368.63 BCBS — Anthem Blue Access PPO: $4,140.01 BCBS — Anthem Blue Preferred HMO/POS: $2,816.83 BCBS — Anthem Medicare Managed Care Plan: $25,656.46 BCBS — Anthem Pathway Exchange: $1,403.97 Centene — Ambetter Exchange: $9,640
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ep Eval Ablation Afib By Pulm Vein Iso	$59,000	$32,450	Not listed in the file
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	$578.83 – $1,991.32
Sleep study (overnight, in a sleep lab): 10 of 13 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $877.33 Aetna — All Commercial Plans: $1,314.67 Aetna — Carelink All Commercial Plans: $1,046.63 Aetna — Medicare Managed Care Plan: $860.13 BCBS — Anthem Blue Access Choice All Commercial Plans: $591.19 BCBS — Anthem Blue Access PPO: $1,706.85 BCBS — Anthem Blue Preferred HMO/POS: $1,161.33 BCBS — Anthem Medicare Managed Care Plan: $842.92 BCBS — Anthem Pathway Exchange: $578.83 Centene — Wellcare Medicare Managed Care - PPO: $868.73

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic exercises	Not listed in the file	Not listed in the file	$26.62 – $132.05
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $27.70 Aetna — Medicare Managed Care Plan: $27.16 BCBS — Anthem Blue Access Choice All Commercial Plans: $39.20 BCBS — Anthem Blue Access PPO: $113.18 BCBS — Anthem Blue Preferred HMO/POS: $77.01 BCBS — Anthem Medicare Managed Care Plan: $26.62 BCBS — Anthem Pathway Exchange: $38.38 Centene — Wellcare Medicare Managed Care - PPO: $27.43 Essence — Medicare Managed Care Plan: $27.97 Humana — Medicare Managed Care Plan: $27.62
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ther Exercise Ea 15 Min Pt	$160	$88	Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ther Exercise Ea 15 Min Ot	$160	$88	Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min	Not listed in the file	Not listed in the file	$89.67 – $331.87
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $93.33 Aetna — Medicare Managed Care Plan: $91.50 BCBS — Anthem Blue Access Choice All Commercial Plans: $98.53 BCBS — Anthem Blue Access PPO: $284.46 BCBS — Anthem Blue Preferred HMO/POS: $193.55 BCBS — Anthem Medicare Managed Care Plan: $89.67 BCBS — Anthem Pathway Exchange: $96.47 Centene — Wellcare Medicare Managed Care - PPO: $92.42 Essence — Medicare Managed Care Plan: $94.24 Humana — Medicare Managed Care Plan: $93.06
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval Low Complexity 1 Rvu	$409	$224.95	Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval Low Complexity 2 Rvu	$409	$224.95	Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min	Not listed in the file	Not listed in the file	$93.74 – $331.87
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $97.56 Aetna — Medicare Managed Care Plan: $95.65 BCBS — Anthem Blue Access Choice All Commercial Plans: $98.53 BCBS — Anthem Blue Access PPO: $284.46 BCBS — Anthem Blue Preferred HMO/POS: $193.55 BCBS — Anthem Medicare Managed Care Plan: $93.74 BCBS — Anthem Pathway Exchange: $96.47 Centene — Wellcare Medicare Managed Care - PPO: $96.61 Essence — Medicare Managed Care Plan: $98.52 Humana — Medicare Managed Care Plan: $97.28
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$193.20	$106.26	Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval Mod Complexity 2 Rvu	$390	$214.50	Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min	Not listed in the file	Not listed in the file	$89.67 – $331.87
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $93.33 Aetna — Medicare Managed Care Plan: $91.50 BCBS — Anthem Blue Access Choice All Commercial Plans: $98.53 BCBS — Anthem Blue Access PPO: $284.46 BCBS — Anthem Blue Preferred HMO/POS: $193.55 BCBS — Anthem Medicare Managed Care Plan: $89.67 BCBS — Anthem Pathway Exchange: $96.47 Centene — Wellcare Medicare Managed Care - PPO: $92.42 Essence — Medicare Managed Care Plan: $94.24 Humana — Medicare Managed Care Plan: $93.06
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval High Complexity 3 Rvu	$410	$225.50	Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval High Complexity 4 Rvu	$410	$225.50	Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 30 minutes	Not listed in the file	Not listed in the file	$75.89 – $261.08
Psychotherapy, 30 minutes: 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $181.34 Aetna — Medicare Managed Care Plan: $177.78 BCBS — Anthem Blue Access Choice All Commercial Plans: $128.04 BCBS — Anthem Blue Access PPO: $223.79 BCBS — Anthem Blue Preferred HMO/POS: $152.26 BCBS — Anthem Medicare Managed Care Plan: $174.23 BCBS — Anthem Pathway Exchange: $75.89 Centene — Wellcare Medicare Managed Care - PPO: $179.56 Essence — Medicare Managed Care Plan: $183.12 Humana — Medicare Managed Care Plan: $180.80
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 45 minutes	Not listed in the file	Not listed in the file	$100.76 – $346.64
Psychotherapy, 45 minutes: 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $181.34 Aetna — Medicare Managed Care Plan: $177.78 BCBS — Anthem Blue Access Choice All Commercial Plans: $169.99 BCBS — Anthem Blue Access PPO: $297.12 BCBS — Anthem Blue Preferred HMO/POS: $202.16 BCBS — Anthem Medicare Managed Care Plan: $174.23 BCBS — Anthem Pathway Exchange: $100.76 Centene — Wellcare Medicare Managed Care - PPO: $179.56 Essence — Medicare Managed Care Plan: $183.12 Humana — Medicare Managed Care Plan: $180.80
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 60 minutes	Not listed in the file	Not listed in the file	$151.78 – $522.17
Psychotherapy, 60 minutes: 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $181.34 Aetna — Medicare Managed Care Plan: $177.78 BCBS — Anthem Blue Access Choice All Commercial Plans: $256.07 BCBS — Anthem Blue Access PPO: $447.57 BCBS — Anthem Blue Preferred HMO/POS: $304.53 BCBS — Anthem Medicare Managed Care Plan: $174.23 BCBS — Anthem Pathway Exchange: $151.78 Centene — Wellcare Medicare Managed Care - PPO: $179.56 Essence — Medicare Managed Care Plan: $183.12 Humana — Medicare Managed Care Plan: $180.80
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/o pt 50 min	Not listed in the file	Not listed in the file	$122.14 – $420.19
Family psychotherapy, without the patient: 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $181.34 Aetna — Medicare Managed Care Plan: $177.78 BCBS — Anthem Blue Access Choice All Commercial Plans: $206.06 BCBS — Anthem Blue Access PPO: $360.17 BCBS — Anthem Blue Preferred HMO/POS: $245.05 BCBS — Anthem Medicare Managed Care Plan: $174.23 BCBS — Anthem Pathway Exchange: $122.14 Centene — Wellcare Medicare Managed Care - PPO: $179.56 Essence — Medicare Managed Care Plan: $183.12 Humana — Medicare Managed Care Plan: $180.80
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/pt 50 min	Not listed in the file	Not listed in the file	$127.33 – $438.05
Family psychotherapy, with the patient: 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $181.34 Aetna — Medicare Managed Care Plan: $177.78 BCBS — Anthem Blue Access Choice All Commercial Plans: $214.82 BCBS — Anthem Blue Access PPO: $375.48 BCBS — Anthem Blue Preferred HMO/POS: $255.47 BCBS — Anthem Medicare Managed Care Plan: $174.23 BCBS — Anthem Pathway Exchange: $127.33 Centene — Wellcare Medicare Managed Care - PPO: $179.56 Essence — Medicare Managed Care Plan: $183.12 Humana — Medicare Managed Care Plan: $180.80
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group psychotherapy	Not listed in the file	Not listed in the file	$30.42 – $122.10
Group psychotherapy: 10 of 11 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $103.79 Aetna — Medicare Managed Care Plan: $101.75 BCBS — Anthem Blue Access Choice All Commercial Plans: $51.32 BCBS — Anthem Blue Access PPO: $89.71 BCBS — Anthem Blue Preferred HMO/POS: $61.04 BCBS — Anthem Medicare Managed Care Plan: $99.72 BCBS — Anthem Pathway Exchange: $30.42 Centene — Wellcare Medicare Managed Care - PPO: $102.77 Essence — Medicare Managed Care Plan: $104.81 Humana — Medicare Managed Care Plan: $103.48

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$502.82 – $4,706.11
Removal of breast growth (open surgery): 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $4,000.19 Aetna — All Commercial Plans: $2,918 Aetna — Carelink All Commercial Plans: $1,889 Aetna — Medicare Managed Care Plan: $3,921.76 BCBS — Anthem Blue Access Choice All Commercial Plans: $848.30 BCBS — Anthem Blue Access PPO: $1,482.71 BCBS — Anthem Blue Preferred HMO/POS: $513.55 BCBS — Anthem Medicare Managed Care Plan: $3,843.32 BCBS — Anthem Pathway Exchange: $830.52 Centene — Ambetter Exchange: $3,148
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$1,664.76 – $17,361
Total hip replacement: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $13,116.60 Aetna — All Commercial Plans: $10,038 Aetna — Carelink All Commercial Plans: $2,628 Aetna — Medicare Managed Care Plan: $12,859.41 BCBS — Anthem Blue Access Choice All Commercial Plans: $2,808.61 BCBS — Anthem Blue Access PPO: $4,909.03 BCBS — Anthem Blue Preferred HMO/POS: $2,808.61 BCBS — Anthem Medicare Managed Care Plan: $12,602.22 BCBS — Anthem Pathway Exchange: $2,749.75 Centene — Ambetter Exchange: $3,148
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$1,664.34 – $17,361
Total knee replacement: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $13,116.60 Aetna — All Commercial Plans: $10,038 Aetna — Carelink All Commercial Plans: $2,628 Aetna — Medicare Managed Care Plan: $12,859.41 BCBS — Anthem Blue Access Choice All Commercial Plans: $2,807.90 BCBS — Anthem Blue Access PPO: $4,907.79 BCBS — Anthem Blue Preferred HMO/POS: $1,699.87 BCBS — Anthem Medicare Managed Care Plan: $12,602.22 BCBS — Anthem Pathway Exchange: $1,664.34 Centene — Ambetter Exchange: $3,148
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Shoulder arthroscopy/surgery	Not listed in the file	Not listed in the file	$217.46 – $7,503
Shoulder arthroscopy: shaving of shoulder bone: 10 of 13 insurance plan rates Aetna — All Commercial Plans: $5,701 Aetna — Carelink All Commercial Plans: $3,690 BCBS — Anthem Blue Access Choice All Commercial Plans: $366.87 BCBS — Anthem Blue Access PPO: $641.24 BCBS — Anthem Blue Preferred HMO/POS: $366.87 BCBS — Anthem Pathway Exchange: $217.46 Cigna — All Commercial Plans: $1,833 Healthlink — HMO: $2,496 Healthlink — PPO: $3,851 Oscar — Exchange: $3,886
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$659.30 – $7,503
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $3,342.83 Aetna — All Commercial Plans: $5,701 Aetna — Carelink All Commercial Plans: $3,690 Aetna — Medicare Managed Care Plan: $3,277.28 BCBS — Anthem Blue Access Choice All Commercial Plans: $1,112.31 BCBS — Anthem Blue Access PPO: $1,944.14 BCBS — Anthem Blue Preferred HMO/POS: $673.38 BCBS — Anthem Medicare Managed Care Plan: $3,211.74 BCBS — Anthem Pathway Exchange: $659.30 Centene — Ambetter Exchange: $3,148
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$355.70 – $7,115.26
Removal of tonsils and adenoids (under age 12): 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $6,047.98 Aetna — All Commercial Plans: $2,918 Aetna — Carelink All Commercial Plans: $1,889 Aetna — Medicare Managed Care Plan: $5,929.39 BCBS — Anthem Blue Access Choice All Commercial Plans: $600.10 BCBS — Anthem Blue Access PPO: $1,048.89 BCBS — Anthem Blue Preferred HMO/POS: $363.30 BCBS — Anthem Medicare Managed Care Plan: $5,810.80 BCBS — Anthem Pathway Exchange: $355.70 Centene — Ambetter Exchange: $3,148
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash	Not listed in the file	Not listed in the file	$162.43 – $3,886
Upper GI endoscopy (diagnostic): 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $926.62 Aetna — All Commercial Plans: $1,907 Aetna — Carelink All Commercial Plans: $1,234 Aetna — Medicare Managed Care Plan: $908.45 BCBS — Anthem Blue Access Choice All Commercial Plans: $274.04 BCBS — Anthem Blue Access PPO: $478.97 BCBS — Anthem Blue Preferred HMO/POS: $165.90 BCBS — Anthem Medicare Managed Care Plan: $890.28 BCBS — Anthem Pathway Exchange: $162.43 Centene — Ambetter Exchange: $2,073
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Egd Flex Transoral Dx	$2,144	$1,179.20	Not listed in the file
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Egd Flex Transoral Dx	$1,864	$1,025.20	Not listed in the file
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple	Not listed in the file	Not listed in the file	$182.44 – $3,886
Upper GI endoscopy with biopsy: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $926.62 Aetna — All Commercial Plans: $2,535 Aetna — Carelink All Commercial Plans: $1,642 Aetna — Medicare Managed Care Plan: $908.45 BCBS — Anthem Blue Access Choice All Commercial Plans: $307.80 BCBS — Anthem Blue Access PPO: $537.99 BCBS — Anthem Blue Preferred HMO/POS: $186.34 BCBS — Anthem Medicare Managed Care Plan: $890.28 BCBS — Anthem Pathway Exchange: $182.44 Centene — Ambetter Exchange: $2,073
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Egd Flex Transoral W Bx Sngl Or Mult	$2,475	$1,361.25	Not listed in the file
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy	Not listed in the file	Not listed in the file	$263.55 – $3,886
Colonoscopy (diagnostic): 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $950.09 Aetna — All Commercial Plans: $2,535 Aetna — Carelink All Commercial Plans: $1,642 Aetna — Medicare Managed Care Plan: $931.46 BCBS — Anthem Blue Access Choice All Commercial Plans: $444.64 BCBS — Anthem Blue Access PPO: $777.16 BCBS — Anthem Blue Preferred HMO/POS: $444.64 BCBS — Anthem Medicare Managed Care Plan: $912.83 BCBS — Anthem Pathway Exchange: $263.55 Centene — Ambetter Exchange: $2,073
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy	Not listed in the file	Not listed in the file	$315.09 – $3,886
Colonoscopy with biopsy: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $1,222.54 Aetna — All Commercial Plans: $2,535 Aetna — Carelink All Commercial Plans: $1,642 Aetna — Medicare Managed Care Plan: $1,198.57 BCBS — Anthem Blue Access Choice All Commercial Plans: $531.58 BCBS — Anthem Blue Access PPO: $929.13 BCBS — Anthem Blue Preferred HMO/POS: $531.58 BCBS — Anthem Medicare Managed Care Plan: $1,174.60 BCBS — Anthem Pathway Exchange: $315.09 Centene — Ambetter Exchange: $2,073
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal	Not listed in the file	Not listed in the file	$373.95 – $3,886
Colonoscopy with removal of polyps (snare): 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $1,222.54 Aetna — All Commercial Plans: $2,535 Aetna — Carelink All Commercial Plans: $1,642 Aetna — Medicare Managed Care Plan: $1,198.57 BCBS — Anthem Blue Access Choice All Commercial Plans: $630.89 BCBS — Anthem Blue Access PPO: $1,102.71 BCBS — Anthem Blue Preferred HMO/POS: $630.89 BCBS — Anthem Medicare Managed Care Plan: $1,174.60 BCBS — Anthem Pathway Exchange: $373.95 Centene — Ambetter Exchange: $2,073
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	$358.93 – $3,886
Ultrasound of the lower bowel by endoscope: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $1,222.54 Aetna — All Commercial Plans: $2,535 Aetna — Carelink All Commercial Plans: $1,642 Aetna — Medicare Managed Care Plan: $1,198.57 BCBS — Anthem Blue Access Choice All Commercial Plans: $605.54 BCBS — Anthem Blue Access PPO: $1,058.40 BCBS — Anthem Blue Preferred HMO/POS: $366.59 BCBS — Anthem Medicare Managed Care Plan: $1,174.60 BCBS — Anthem Pathway Exchange: $358.93 Centene — Ambetter Exchange: $3,148
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$249.34 – $3,886
Screening colonoscopy (not high risk): 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $950.09 Aetna — All Commercial Plans: $2,535 Aetna — Carelink All Commercial Plans: $1,642 Aetna — Medicare Managed Care Plan: $931.46 BCBS — Anthem Blue Access Choice All Commercial Plans: $254.66 BCBS — Anthem Blue Access PPO: $735.26 BCBS — Anthem Blue Preferred HMO/POS: $500.26 BCBS — Anthem Medicare Managed Care Plan: $912.83 BCBS — Anthem Pathway Exchange: $249.34 Centene — Ambetter Exchange: $3,148
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$809.49 – $10,998
Gallbladder removal by laparoscope: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $6,176.39 Aetna — All Commercial Plans: $7,148 Aetna — Carelink All Commercial Plans: $4,627 Aetna — Medicare Managed Care Plan: $6,055.29 BCBS — Anthem Blue Access Choice All Commercial Plans: $1,365.69 BCBS — Anthem Blue Access PPO: $2,387.02 BCBS — Anthem Blue Preferred HMO/POS: $826.77 BCBS — Anthem Medicare Managed Care Plan: $5,934.18 BCBS — Anthem Pathway Exchange: $809.49 Centene — Ambetter Exchange: $6,611
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$638.66 – $5,698
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $3,657.90 Aetna — All Commercial Plans: $3,551 Aetna — Carelink All Commercial Plans: $2,298 Aetna — Medicare Managed Care Plan: $3,586.18 BCBS — Anthem Blue Access Choice All Commercial Plans: $1,077.49 BCBS — Anthem Blue Access PPO: $1,883.29 BCBS — Anthem Blue Preferred HMO/POS: $652.30 BCBS — Anthem Medicare Managed Care Plan: $3,514.46 BCBS — Anthem Pathway Exchange: $638.66 Centene — Ambetter Exchange: $3,148
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	$170.88 – $3,886
Prostate biopsy: 10 of 14 insurance plan rates Aetna — All Commercial Plans: $2,535 Aetna — Carelink All Commercial Plans: $1,642 BCBS — Anthem Blue Access Choice All Commercial Plans: $288.30 BCBS — Anthem Blue Access PPO: $503.90 BCBS — Anthem Blue Preferred HMO/POS: $174.53 BCBS — Anthem Pathway Exchange: $282.26 Centene — Ambetter Exchange: $3,148 Cigna — All Commercial Plans: $1,719 Healthlink — HMO: $2,187 Healthlink — PPO: $3,406
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Biopsy Prostate	$5,132	$2,822.60	Not listed in the file
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparo radical prostatectomy	Not listed in the file	Not listed in the file	$2,120.82 – $20,006
Prostate removal by laparoscope (radical prostatectomy): 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $10,859.94 Aetna — All Commercial Plans: $7,148 Aetna — Carelink All Commercial Plans: $4,627 Aetna — Medicare Managed Care Plan: $10,647 BCBS — Anthem Blue Access Choice All Commercial Plans: $3,578.04 BCBS — Anthem Blue Access PPO: $6,253.88 BCBS — Anthem Blue Preferred HMO/POS: $2,166.10 BCBS — Anthem Medicare Managed Care Plan: $10,434.06 BCBS — Anthem Pathway Exchange: $3,503.05 Centene — Ambetter Exchange: $18,226
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$323.79 – $7,863
Hysteroscopy with biopsy of the uterus lining: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $3,307.20 Aetna — All Commercial Plans: $7,863 Aetna — Carelink All Commercial Plans: $5,092 Aetna — Medicare Managed Care Plan: $3,242.35 BCBS — Anthem Blue Access Choice All Commercial Plans: $546.27 BCBS — Anthem Blue Access PPO: $954.80 BCBS — Anthem Blue Preferred HMO/POS: $546.27 BCBS — Anthem Medicare Managed Care Plan: $3,177.50 BCBS — Anthem Pathway Exchange: $534.82 Centene — Ambetter Exchange: $6,611
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac	Not listed in the file	Not listed in the file	$123.05 – $3,406
Spinal injection, lower back (epidural), with imaging guidance: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $721.16 Aetna — All Commercial Plans: $1,907 Aetna — Carelink All Commercial Plans: $1,234 Aetna — Medicare Managed Care Plan: $707.02 BCBS — Anthem Blue Access Choice All Commercial Plans: $207.60 BCBS — Anthem Blue Access PPO: $362.85 BCBS — Anthem Blue Preferred HMO/POS: $207.60 BCBS — Anthem Medicare Managed Care Plan: $692.88 BCBS — Anthem Pathway Exchange: $203.25 Centene — Ambetter Exchange: $3,148
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Inj Epidural Lumbar Sacral W Img	$3,542	$1,948.10	Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj foramen epidural l/s	Not listed in the file	Not listed in the file	$137.90 – $3,886
Nerve root injection, lower back, with imaging guidance: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $903.62 Aetna — All Commercial Plans: $1,907 Aetna — Carelink All Commercial Plans: $1,234 Aetna — Medicare Managed Care Plan: $885.90 BCBS — Anthem Blue Access Choice All Commercial Plans: $232.65 BCBS — Anthem Blue Access PPO: $406.63 BCBS — Anthem Blue Preferred HMO/POS: $140.84 BCBS — Anthem Medicare Managed Care Plan: $868.18 BCBS — Anthem Pathway Exchange: $227.77 Centene — Ambetter Exchange: $3,148
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Inj Transforam Nerve L/S Sngl	$3,245	$1,784.75	Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Inj Trans Nerve L/S Sngl Bilat	$5,080	$2,794	Not listed in the file
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$516.40 – $4,332
Carpal tunnel release: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $1,995 Aetna — All Commercial Plans: $2,535 Aetna — Carelink All Commercial Plans: $1,642 Aetna — Medicare Managed Care Plan: $1,955.88 BCBS — Anthem Blue Access Choice All Commercial Plans: $871.23 BCBS — Anthem Blue Access PPO: $1,522.77 BCBS — Anthem Blue Preferred HMO/POS: $871.23 BCBS — Anthem Medicare Managed Care Plan: $1,916.76 BCBS — Anthem Pathway Exchange: $852.97 Centene — Ambetter Exchange: $3,148
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Carpal Tunnel Release Unilat	$5,189	$2,853.95	Not listed in the file
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	$369.53 – $3,886
Laser treatment of clouding after cataract surgery: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $561.90 Aetna — All Commercial Plans: $2,535 Aetna — Carelink All Commercial Plans: $1,642 Aetna — Medicare Managed Care Plan: $550.89 BCBS — Anthem Blue Access Choice All Commercial Plans: $623.43 BCBS — Anthem Blue Access PPO: $1,089.66 BCBS — Anthem Blue Preferred HMO/POS: $623.43 BCBS — Anthem Medicare Managed Care Plan: $539.87 BCBS — Anthem Pathway Exchange: $610.36 Centene — Ambetter Exchange: $3,148
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record	$539.60	$296.78	Not listed in the file
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cataract surg w/iol 1 stage	Not listed in the file	Not listed in the file	$763.16 – $6,817
Cataract removal with lens implant: 10 of 20 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $2,357.78 Aetna — All Commercial Plans: $4,059 Aetna — Carelink All Commercial Plans: $2,628 Aetna — Medicare Managed Care Plan: $2,311.55 BCBS — Anthem Blue Access Choice All Commercial Plans: $1,287.52 BCBS — Anthem Blue Access PPO: $2,250.39 BCBS — Anthem Blue Preferred HMO/POS: $779.45 BCBS — Anthem Medicare Managed Care Plan: $2,265.32 BCBS — Anthem Pathway Exchange: $763.16 Centene — Ambetter Exchange: $3,148

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care	Not listed in the file	Not listed in the file	$2,176 – $8,881.64
Vaginal delivery, with care before and after: rates for 10 insurance plans Aetna — All Commercial Plans: $3,362 Aetna — Carelink All Commercial Plans: $2,176 BCBS — Anthem Blue Access Choice All Commercial Plans: $4,355.56 BCBS — Anthem Blue Access PPO: $7,612.86 BCBS — Anthem Blue Preferred HMO/POS: $4,355.56 BCBS — Anthem Pathway Exchange: $4,264.27 Centene — Ambetter Exchange: $3,148 Cigna — All Commercial Plans: $2,979 Healthlink — HMO: $3,085 Healthlink — PPO: $4,616
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery	Not listed in the file	Not listed in the file	$2,176 – $9,814.88
Cesarean delivery (C-section), with care before and after: rates for 10 insurance plans Aetna — All Commercial Plans: $3,362 Aetna — Carelink All Commercial Plans: $2,176 BCBS — Anthem Blue Access Choice All Commercial Plans: $4,813.22 BCBS — Anthem Blue Access PPO: $8,412.79 BCBS — Anthem Blue Preferred HMO/POS: $4,813.22 BCBS — Anthem Pathway Exchange: $4,712.34 Centene — Ambetter Exchange: $3,148 Cigna — All Commercial Plans: $2,979 Healthlink — HMO: $3,085 Healthlink — PPO: $4,616
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery	Not listed in the file	Not listed in the file	$2,176 – $9,309.42
Vaginal delivery after a previous C-section, with care before and after: rates for 10 insurance plans Aetna — All Commercial Plans: $3,362 Aetna — Carelink All Commercial Plans: $2,176 BCBS — Anthem Blue Access Choice All Commercial Plans: $4,565.34 BCBS — Anthem Blue Access PPO: $7,979.54 BCBS — Anthem Blue Preferred HMO/POS: $4,565.34 BCBS — Anthem Pathway Exchange: $2,706.03 Centene — Ambetter Exchange: $3,148 Cigna — All Commercial Plans: $2,979 Healthlink — HMO: $3,085 Healthlink — PPO: $4,616

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc	Not listed in the file	Not listed in the file	$88,201.72 – $231,342
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 33 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $101,833.91 Aetna — Gold Advantage Medicare Managed Care Plan: $101,833.91 Aetna — Medicare Managed Care Plan: $99,837.17 Aetna — Total Care Medicare Managed Care Plan: $99,837.17 BCBS — Anthem Medicare Managed Care Plan: $97,840.43 Centene — Ambetter Exchange: $117,882.74 Centene — Wellcare Medicare Managed Care - HMO: $99,837.17 Centene — Wellcare Medicare Managed Care - PPO: $100,835.54 Cigna — All Commercial Plans: $130,238.42 Essence — Medicare Managed Care Plan: $102,832.29
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal Fusion Except Cervical Without Mcc	Not listed in the file	Not listed in the file	Not listed in the file
Spinal fusion (not neck), without major complications: rates for 5 insurance plans Aetna — NAP Other Commercial Plan: 85% (a percentage in the contract, not a dollar amount) BCBS — Anthem Traditional: 50% (a percentage in the contract, not a dollar amount) Health Alliance — All Commercial Plans: 30% (a percentage in the contract, not a dollar amount) Humana — All Commercial Plans: 53% (a percentage in the contract, not a dollar amount) SmartHealth — All Commercial Plans: 30% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc	Not listed in the file	Not listed in the file	$17,390.96 – $58,129
Hip or knee replacement (major joint of the leg), without major complications: 10 of 33 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $22,357.92 Aetna — Gold Advantage Medicare Managed Care Plan: $22,357.92 Aetna — Medicare Managed Care Plan: $21,919.53 Aetna — Total Care Medicare Managed Care Plan: $21,919.53 BCBS — Anthem Medicare Managed Care Plan: $21,481.14 Centene — Ambetter Exchange: $23,243.25 Centene — Wellcare Medicare Managed Care - HMO: $21,919.53 Centene — Wellcare Medicare Managed Care - PPO: $22,138.73 Cigna — All Commercial Plans: $25,679.45 Essence — Medicare Managed Care Plan: $22,577.12
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	$22,010.76 – $46,387.14
Neck (cervical) spinal fusion, without complications: 10 of 33 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $27,543.06 Aetna — Gold Advantage Medicare Managed Care Plan: $27,543.06 Aetna — Medicare Managed Care Plan: $27,003 Aetna — Total Care Medicare Managed Care Plan: $27,003 BCBS — Anthem Medicare Managed Care Plan: $26,462.94 Centene — Ambetter Exchange: $29,417.67 Centene — Wellcare Medicare Managed Care - HMO: $27,003 Centene — Wellcare Medicare Managed Care - PPO: $27,273.03 Cigna — All Commercial Plans: $32,501.03 Essence — Medicare Managed Care Plan: $27,813.09
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	$11,186.15 – $23,574.54
Uterus and ovary surgery (not for cancer), without complications: 10 of 31 insurance plan rates Aetna — Advantra Medicare Managed Care Plan: $15,393.82 Aetna — Gold Advantage Medicare Managed Care Plan: $15,393.82 Aetna — Medicare Managed Care Plan: $15,091.98 Aetna — Total Care Medicare Managed Care Plan: $15,091.98 BCBS — Anthem Medicare Managed Care Plan: $14,790.14 Centene — Ambetter Exchange: $14,950.44 Centene — Wellcare Medicare Managed Care - HMO: $15,091.98 Centene — Wellcare Medicare Managed Care - PPO: $15,242.90 Cigna — All Commercial Plans: $16,517.44 Essence — Medicare Managed Care Plan: $15,544.74

Source: SSM Health Saint Louis University Hospital’s standard charges file (hospitalpricedisclosure.com, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 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 type	Acute Care Hospital
Address	1201 S Grand Blvd, Saint Louis, MO 63104
County	St. Louis City
State	Missouri
Phone	(314) 257‑8000
Emergency services	Yes
Ownership	Voluntary non-profit - Church
Medicare overall rating	1 of 5 stars
CMS Certification Number	260105
Name in Medicare records	SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL
Profile level	Medicare data + hospital website
Official website	ssmhealth.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Emergency Room at Saint Louis University Hospital — ssmhealth.com
Emergency & Trauma Services (SLUCare) — ssmhealth.com
Grand New SSM Health Saint Louis University Hospital — ssmhealth.com
Saint Louis University Hospital — ssmhealth.com