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Acute Care Hospital

SSM Health St Mary's Hospital - St Louis

Saint Louis, Missouri · St. Louis County · Emergency services listed

Summary

SSM Health St Mary's Hospital - St Louis is an acute care hospital in Saint Louis, Missouri. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 26 services, specialties and programs. Medicare lists 725 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(314) 768‑8000 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
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
725Doctors and clinicians
26Services listed

Quick answers

Does SSM Health St Mary's Hospital - St Louis have an emergency room?
Yes. Medicare (CMS) data lists emergency services at SSM Health St Mary's Hospital - St Louis. In a medical emergency, call 911.
Where is SSM Health St Mary's Hospital - St Louis?
6420 Clayton Rd, Saint Louis, MO 63117, in St. Louis County, Missouri.
What is the phone number of SSM Health St Mary's Hospital - St Louis?
(314) 768-8000, as listed by Medicare (CMS).
What is the Medicare star rating of SSM Health St Mary's Hospital - St Louis?
3 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[4][5][8]

Treatments[5][8]

Procedures[6][7]

Programs and centers[4][8]

  • Chest pain center
  • Level III NICU
  • Internal medicine residency
  • Level III Neonatal ICU
  • Perinatal Center
  • Satellite of SSM Health Cardinal Glennon Fetal Care Institute
  • WISH (Women and Infant Substance Help) Center
  • Saint Louis University OB/GYN and Family Practice residency site
  • Certified stroke center

Emergency care (hospital website)[4]

Emergency roomYes
Stroke designationCertified stroke center

Visiting and practical information

VisitingVisiting hours 8 a.m.-8 p.m.; exceptions possible with nursing leader permission[4]
ParkingHospital garage off DeMun Avenue or west garage off Bellevue Avenue; max daily fee $5; valet at main entrance[4]

Recognition[4]

  • Level III Time Critical Diagnosis STEMI Center
  • Joint Commission Gold Seal: Acute Heart Attack Ready Certification
  • Premier Award for Quality (two-time winner)

Doctors and clinicians (725)

725 doctors and other clinicians list SSM Health St Mary's Hospital - St Louis 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 (725)

And 701 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 SSM Health St Mary's Hospital - St Louis 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 hospital2 of 5 stars
Would recommend the hospital2 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 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 1062%National average: 72%
Would definitely recommend the hospital63%National average: 71%
Nurses “always” communicated well76%National average: 80%
Doctors “always” communicated well76%National average: 80%
Staff “always” explained medicines before giving them57%National average: 62%
Were given information about recovery at home83%National average: 86%
Room and bathroom “always” clean62%National average: 74%
Area around the room “always” quiet at night60%National average: 60%
Completed surveys920Response rate: 15%

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)0.49Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.183Better than the national benchmark
Surgical site infections after colon surgery0.255No different from the national benchmark
Surgical site infections after abdominal hysterectomy0.419No different from the national benchmark
MRSA bloodstream infections1.147No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.3Better 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 patients11.8%
Deaths within 30 days: heart failure patients8.7%
Deaths within 30 days: pneumonia patients14.5%
Deaths within 30 days: COPD patients8.5%
Deaths within 30 days: stroke patients9.6%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)1.15No different from the national rate
Complications after hip or knee replacement3.8%

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%
Readmitted within 30 days: heart failure21.8%
Readmitted within 30 days: pneumonia16.4%
Readmitted within 30 days: COPD19.6%
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacement6.4%

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)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)166 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)53%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 LouisBest hospitals in Saint Louis

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 85 common services exactly as SSM Health St Mary's Hospital - St Louis 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 or outpatient · Hospital (facility) fee In the file: Hc Faclty Op New Level 3 $275 $151.25 Not listed in the file
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: Hp Office/Outpt Visit New Level Iii $240 $132 Not listed in the file
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 $456 $250.80 Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: Hp Office/Outpt Visit New Level Iv $520 $286 Not listed in the file
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 $587 $322.85 Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: Hp Office/Outpt Visit New Level V $547 $300.85 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 $1,865 – $3,102
Established patient office visit (about 20–29 minutes): rates for 2 insurance plans
  • Healthlink — Employers Choice All Commercial Plans: $1,865
  • Healthlink — HMO: $3,102
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 $210 $115.50 Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Hp Office Outpt Visit Est Levl Iii $160 $88 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 $2,302 – $3,829
Established patient office visit (about 30–39 minutes): rates for 2 insurance plans
  • Healthlink — Employers Choice All Commercial Plans: $2,302
  • Healthlink — HMO: $3,829
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 $307 $168.85 Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: Hp Office/Outpt Visit Est Level Iv $240 $132 Not listed in the file
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 $56 $30.80 Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Preventive Visit New Age 40-64 $56 $30.80 Not listed in the file
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 $273.42 – $328.10
Emergency room visit (moderate): rates for 6 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $276.15
  • Aetna — Medicare Managed Care Plan: $273.42
  • BCBS — Anthem Medicare Managed Care Plan: $277.52
  • Humana — Medicare Managed Care Plan: $278.07
  • Oscar — Exchange: $328.10
  • UnitedHealthCare — Medicare Managed Care Plan: $277.46
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level Iii $1,743 $958.65 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 $417.94 – $501.52
Emergency room visit (moderately high): rates for 6 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $422.12
  • Aetna — Medicare Managed Care Plan: $417.94
  • BCBS — Anthem Medicare Managed Care Plan: $424.21
  • Humana — Medicare Managed Care Plan: $425.04
  • Oscar — Exchange: $501.52
  • UnitedHealthCare — Medicare Managed Care Plan: $424.12
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level Iv $2,323 $1,277.65 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 $596.49 – $715.79
Emergency room visit (high): rates for 6 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $602.46
  • Aetna — Medicare Managed Care Plan: $596.49
  • BCBS — Anthem Medicare Managed Care Plan: $605.44
  • Humana — Medicare Managed Care Plan: $606.63
  • Oscar — Exchange: $715.79
  • UnitedHealthCare — Medicare Managed Care Plan: $605.32
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Emergent Level V $3,341 $1,837.55 Not listed in the file

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: Metabolic panel total ca Not listed in the file Not listed in the file $8.46 – $66.25
Basic metabolic panel (blood test): 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $8.54
  • BCBS — Anthem Blue Access Choice PPO: $17.91
  • BCBS — Anthem Blue Access PPO: $62.24
  • BCBS — Anthem Blue Preferred HMO/POS: $61.43
  • BCBS — Anthem Medicare Managed Care Plan: $8.59
  • BCBS — Anthem Pathway Exchange: $12.02
  • Cigna — OAP Other Commercial Plan: $14.29
  • Healthlink — Employers Choice All Commercial Plans: $34.87
  • Healthlink — HMO: $34.87
  • Humana — Medicare Managed Care Plan: $8.60
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Basic Metabolic Panel (Ca Total) $143 $78.65 Not listed in the file
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Basic Metabolic Panel Poct $213 $117.15 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 $10.56 – $82.72
Comprehensive metabolic panel (blood test): 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $10.67
  • BCBS — Anthem Blue Access Choice PPO: $22.36
  • BCBS — Anthem Blue Access PPO: $77.70
  • BCBS — Anthem Blue Preferred HMO/POS: $76.69
  • BCBS — Anthem Medicare Managed Care Plan: $10.72
  • BCBS — Anthem Pathway Exchange: $15.01
  • Cigna — OAP Other Commercial Plan: $17.72
  • Healthlink — Employers Choice All Commercial Plans: $43.55
  • Healthlink — HMO: $43.55
  • Humana — Medicare Managed Care Plan: $10.74
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Comprehensive Metabolic Panel $171 $94.05 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 $47.81 – $374.84
Obstetric blood test panel: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $48.29
  • BCBS — Anthem Blue Access Choice PPO: $101.33
  • BCBS — Anthem Blue Access PPO: $352.13
  • BCBS — Anthem Blue Preferred HMO/POS: $347.55
  • BCBS — Anthem Medicare Managed Care Plan: $48.53
  • BCBS — Anthem Pathway Exchange: $68
  • Cigna — OAP Other Commercial Plan: $80.61
  • Healthlink — Employers Choice All Commercial Plans: $197.13
  • Healthlink — HMO: $197.13
  • Humana — Medicare Managed Care Plan: $48.62
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Obstetric Panel $295 $162.25 Not listed in the file
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 $13.39 – $104.88
Cholesterol panel (lipid panel): 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $13.52
  • BCBS — Anthem Blue Access Choice PPO: $28.35
  • BCBS — Anthem Blue Access PPO: $98.52
  • BCBS — Anthem Blue Preferred HMO/POS: $97.24
  • BCBS — Anthem Medicare Managed Care Plan: $13.59
  • BCBS — Anthem Pathway Exchange: $19.03
  • Cigna — OAP Other Commercial Plan: $22.87
  • Healthlink — Employers Choice All Commercial Plans: $55.21
  • Healthlink — HMO: $55.21
  • Humana — Medicare Managed Care Plan: $13.62
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 $59 $32.45 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 $8.68 – $68.04
Kidney function panel: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $8.77
  • BCBS — Anthem Blue Access Choice PPO: $18.39
  • BCBS — Anthem Blue Access PPO: $63.92
  • BCBS — Anthem Blue Preferred HMO/POS: $63.08
  • BCBS — Anthem Medicare Managed Care Plan: $8.81
  • BCBS — Anthem Pathway Exchange: $12.34
  • Cigna — OAP Other Commercial Plan: $14.86
  • Healthlink — Employers Choice All Commercial Plans: $35.80
  • Healthlink — HMO: $35.80
  • Humana — Medicare Managed Care Plan: $8.83
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Renal Function Panel $100 $55 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 $8.17 – $63.95
Liver function panel: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $8.25
  • BCBS — Anthem Blue Access Choice PPO: $17.29
  • BCBS — Anthem Blue Access PPO: $60.08
  • BCBS — Anthem Blue Preferred HMO/POS: $59.30
  • BCBS — Anthem Medicare Managed Care Plan: $8.29
  • BCBS — Anthem Pathway Exchange: $11.60
  • Cigna — OAP Other Commercial Plan: $13.72
  • Healthlink — Employers Choice All Commercial Plans: $33.70
  • Healthlink — HMO: $33.70
  • Humana — Medicare Managed Care Plan: $8.31
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Hepatic Function Panel $143 $78.65 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 $3.17 – $24.81
Urine test (automated, with microscope): 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $3.20
  • BCBS — Anthem Blue Access Choice PPO: $6.71
  • BCBS — Anthem Blue Access PPO: $23.31
  • BCBS — Anthem Blue Preferred HMO/POS: $23
  • BCBS — Anthem Medicare Managed Care Plan: $3.22
  • BCBS — Anthem Pathway Exchange: $4.50
  • Cigna — OAP Other Commercial Plan: $5.15
  • Healthlink — Employers Choice All Commercial Plans: $13.09
  • Healthlink — HMO: $13.09
  • Humana — Medicare Managed Care Plan: $3.22
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Urinalysis Routine Auto W Microscopic $71 $39.05 Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Urinalysis Routine Auto W Microscopic I $67 $36.85 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 $2.97 – $16.35
Urine test (manual, without microscope): 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $3.51
  • BCBS — Anthem Blue Access Choice PPO: $4.42
  • BCBS — Anthem Blue Access PPO: $15.36
  • BCBS — Anthem Blue Preferred HMO/POS: $15.16
  • BCBS — Anthem Medicare Managed Care Plan: $3.53
  • BCBS — Anthem Pathway Exchange: $2.97
  • Cigna — OAP Other Commercial Plan: $5.72
  • Healthlink — Employers Choice All Commercial Plans: $11.62
  • Healthlink — HMO: $11.62
  • Humana — Medicare Managed Care Plan: $3.54
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Reducing Substance Urine $34 $18.70 Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Urinalysis Dipstick Poct $34 $18.70 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 $2.25 – $16.35
Urine test (automated, without microscope): 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $2.27
  • BCBS — Anthem Blue Access Choice PPO: $4.42
  • BCBS — Anthem Blue Access PPO: $15.36
  • BCBS — Anthem Blue Preferred HMO/POS: $15.16
  • BCBS — Anthem Medicare Managed Care Plan: $2.28
  • BCBS — Anthem Pathway Exchange: $2.97
  • Cigna — OAP Other Commercial Plan: $4
  • Healthlink — Employers Choice All Commercial Plans: $9.25
  • Healthlink — HMO: $9.25
  • Humana — Medicare Managed Care Plan: $2.29
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Leukocyte Esterase Fluid $42 $23.10 Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Ketones Qualitative Urine Auto $42 $23.10 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 $18.39 – $144.08
PSA (prostate specific antigen) blood test: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $18.57
  • BCBS — Anthem Blue Access Choice PPO: $38.95
  • BCBS — Anthem Blue Access PPO: $135.35
  • BCBS — Anthem Blue Preferred HMO/POS: $133.59
  • BCBS — Anthem Medicare Managed Care Plan: $18.67
  • BCBS — Anthem Pathway Exchange: $26.14
  • Cigna — OAP Other Commercial Plan: $30.87
  • Healthlink — Employers Choice All Commercial Plans: $75.85
  • Healthlink — HMO: $75.85
  • Humana — Medicare Managed Care Plan: $18.70
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Psa Total $105 $57.75 Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Prostate Specific Antigen Diag $105 $57.75 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 $16.80 – $131.64
Thyroid stimulating hormone (TSH) test: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $16.97
  • BCBS — Anthem Blue Access Choice PPO: $35.59
  • BCBS — Anthem Blue Access PPO: $123.67
  • BCBS — Anthem Blue Preferred HMO/POS: $122.06
  • BCBS — Anthem Medicare Managed Care Plan: $17.05
  • BCBS — Anthem Pathway Exchange: $23.88
  • Cigna — OAP Other Commercial Plan: $28.58
  • Healthlink — Employers Choice All Commercial Plans: $69.31
  • Healthlink — HMO: $69.31
  • Humana — Medicare Managed Care Plan: $17.09
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Tsh $110 $60.50 Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Tsh I $110 $60.50 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 $7.77 – $60.90
Complete blood count (CBC) with differential: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $7.85
  • BCBS — Anthem Blue Access Choice PPO: $16.46
  • BCBS — Anthem Blue Access PPO: $57.21
  • BCBS — Anthem Blue Preferred HMO/POS: $56.47
  • BCBS — Anthem Medicare Managed Care Plan: $7.89
  • BCBS — Anthem Pathway Exchange: $11.05
  • Cigna — OAP Other Commercial Plan: $13.15
  • Healthlink — Employers Choice All Commercial Plans: $32.03
  • Healthlink — HMO: $32.03
  • Humana — Medicare Managed Care Plan: $7.90
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Cbc W Auto Differential $81 $44.55 Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Cbc W Auto Differential I $81 $44.55 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 $6.47 – $50.71
Complete blood count (CBC), automated: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $6.53
  • BCBS — Anthem Blue Access Choice PPO: $13.71
  • BCBS — Anthem Blue Access PPO: $47.64
  • BCBS — Anthem Blue Preferred HMO/POS: $47.02
  • BCBS — Anthem Medicare Managed Care Plan: $6.57
  • BCBS — Anthem Pathway Exchange: $9.20
  • Cigna — OAP Other Commercial Plan: $10.86
  • Healthlink — Employers Choice All Commercial Plans: $26.65
  • Healthlink — HMO: $26.65
  • Humana — Medicare Managed Care Plan: $6.58
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Cbc W/O Auto Differential $64 $35.20 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 $4.29 – $30.80
Blood clotting time test (prothrombin time, PT): 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $4.33
  • BCBS — Anthem Blue Access Choice PPO: $8.32
  • BCBS — Anthem Blue Access PPO: $28.93
  • BCBS — Anthem Blue Preferred HMO/POS: $28.55
  • BCBS — Anthem Medicare Managed Care Plan: $4.35
  • BCBS — Anthem Pathway Exchange: $6.70
  • Cigna — OAP Other Commercial Plan: $7.43
  • Healthlink — Employers Choice All Commercial Plans: $16.20
  • Healthlink — HMO: $16.20
  • Humana — Medicare Managed Care Plan: $4.36
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Istat Pt $45 $24.75 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 Poct $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 $6.01 – $47.03
Blood clotting test (partial thromboplastin time, PTT): 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $6.07
  • BCBS — Anthem Blue Access Choice PPO: $12.71
  • BCBS — Anthem Blue Access PPO: $44.18
  • BCBS — Anthem Blue Preferred HMO/POS: $43.60
  • BCBS — Anthem Medicare Managed Care Plan: $6.10
  • BCBS — Anthem Pathway Exchange: $8.53
  • Cigna — OAP Other Commercial Plan: $10.29
  • Healthlink — Employers Choice All Commercial Plans: $24.78
  • Healthlink — HMO: $24.78
  • Humana — Medicare Managed Care Plan: $6.11
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Lchg Ptt Inhibitor 1Hr $38 $20.90 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 Inhibitor 1Hr I $53 $29.15 Not listed in the file

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 head/brain w/o dye Not listed in the file Not listed in the file $73.13 – $403.11
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $105.76
  • Aetna — Medicare Managed Care Plan: $104.71
  • BCBS — Anthem Blue Access Choice PPO: $108.97
  • BCBS — Anthem Blue Access PPO: $211.74
  • BCBS — Anthem Blue Preferred HMO/POS: $373.76
  • BCBS — Anthem Medicare Managed Care Plan: $106.29
  • BCBS — Anthem Pathway Exchange: $73.13
  • Healthlink — Employers Choice All Commercial Plans: $287.43
  • Healthlink — HMO: $287.43
  • Humana — Medicare Managed Care Plan: $106.49
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 $1,852 $1,018.60 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 $262.38 – $1,446.25
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $352.93
  • Aetna — Medicare Managed Care Plan: $349.44
  • BCBS — Anthem Blue Access Choice PPO: $390.95
  • BCBS — Anthem Blue Access PPO: $759.65
  • BCBS — Anthem Blue Preferred HMO/POS: $1,340.95
  • BCBS — Anthem Medicare Managed Care Plan: $354.68
  • BCBS — Anthem Pathway Exchange: $262.38
  • Healthlink — Employers Choice All Commercial Plans: $1,244.26
  • Healthlink — HMO: $1,244.26
  • Humana — Medicare Managed Care Plan: $355.38
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 $4,289 $2,358.95 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 $19.86 – $165.85
Chest X-ray, 2 views: 10 of 16 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $88.04
  • Aetna — Medicare Managed Care Plan: $87.17
  • BCBS — Anthem Blue Access Choice PPO: $29.60
  • BCBS — Anthem Blue Access PPO: $57.51
  • BCBS — Anthem Blue Preferred HMO/POS: $101.51
  • BCBS — Anthem Medicare Managed Care Plan: $88.47
  • BCBS — Anthem Pathway Exchange: $19.86
  • Cigna — OAP Other Commercial Plan: $40
  • Healthlink — Employers Choice All Commercial Plans: $59.72
  • Healthlink — HMO: $59.72
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Xray Chest 2 Views $367 $201.85 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 $32.63 – $223.39
X-ray of the lower spine, at least 4 views: 10 of 16 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $105.76
  • Aetna — Medicare Managed Care Plan: $104.71
  • BCBS — Anthem Blue Access Choice PPO: $48.63
  • BCBS — Anthem Blue Access PPO: $94.48
  • BCBS — Anthem Blue Preferred HMO/POS: $166.78
  • BCBS — Anthem Medicare Managed Care Plan: $106.29
  • BCBS — Anthem Pathway Exchange: $32.63
  • Cigna — OAP Other Commercial Plan: $66.87
  • Healthlink — Employers Choice All Commercial Plans: $100.92
  • Healthlink — HMO: $100.92
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 $651 $358.05 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 $147.32 – $812.03
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $241.38
  • Aetna — Medicare Managed Care Plan: $238.99
  • BCBS — Anthem Blue Access Choice PPO: $219.50
  • BCBS — Anthem Blue Access PPO: $426.53
  • BCBS — Anthem Blue Preferred HMO/POS: $752.90
  • BCBS — Anthem Medicare Managed Care Plan: $242.57
  • BCBS — Anthem Pathway Exchange: $147.32
  • Healthlink — Employers Choice All Commercial Plans: $708.85
  • Healthlink — HMO: $708.85
  • Humana — Medicare Managed Care Plan: $243.05
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 $2,933 $1,613.15 Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mri L-Spine Limited $2,933 $1,613.15 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 $167.38 – $922.60
CT scan of the pelvis, with contrast: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $177.44
  • Aetna — Medicare Managed Care Plan: $175.68
  • BCBS — Anthem Blue Access Choice PPO: $249.40
  • BCBS — Anthem Blue Access PPO: $866.70
  • BCBS — Anthem Blue Preferred HMO/POS: $855.43
  • BCBS — Anthem Medicare Managed Care Plan: $178.32
  • BCBS — Anthem Pathway Exchange: $167.38
  • Healthlink — Employers Choice All Commercial Plans: $656.59
  • Healthlink — HMO: $656.59
  • Humana — Medicare Managed Care Plan: $178.67
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ct Pelvis With Iv Contrast $1,852 $1,018.60 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 $167.03 – $920.65
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $241.38
  • Aetna — Medicare Managed Care Plan: $238.99
  • BCBS — Anthem Blue Access Choice PPO: $248.87
  • BCBS — Anthem Blue Access PPO: $864.86
  • BCBS — Anthem Blue Preferred HMO/POS: $853.62
  • BCBS — Anthem Medicare Managed Care Plan: $242.57
  • BCBS — Anthem Pathway Exchange: $167.03
  • Healthlink — Employers Choice All Commercial Plans: $799.08
  • Healthlink — HMO: $799.08
  • Humana — Medicare Managed Care Plan: $243.05
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 $3,082 $1,695.10 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 $219.71 – $1,211.05
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $352.93
  • Aetna — Medicare Managed Care Plan: $349.44
  • BCBS — Anthem Blue Access Choice PPO: $327.37
  • BCBS — Anthem Blue Access PPO: $1,137.66
  • BCBS — Anthem Blue Preferred HMO/POS: $1,122.87
  • BCBS — Anthem Medicare Managed Care Plan: $354.68
  • BCBS — Anthem Pathway Exchange: $219.71
  • Healthlink — Employers Choice All Commercial Plans: $863.38
  • Healthlink — HMO: $863.38
  • Humana — Medicare Managed Care Plan: $355.38
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 $4,199 $2,309.45 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 $83.17 – $458.42
Ultrasound of the abdomen, complete: 10 of 16 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $105.76
  • Aetna — Medicare Managed Care Plan: $104.71
  • BCBS — Anthem Blue Access Choice PPO: $123.92
  • BCBS — Anthem Blue Access PPO: $430.65
  • BCBS — Anthem Blue Preferred HMO/POS: $425.05
  • BCBS — Anthem Medicare Managed Care Plan: $106.29
  • BCBS — Anthem Pathway Exchange: $83.17
  • Cigna — OAP Other Commercial Plan: $135.47
  • Healthlink — Employers Choice All Commercial Plans: $253.77
  • Healthlink — HMO: $253.77
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Abdomen Complete $1,157 $636.35 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 $92.48 – $509.77
Pregnancy ultrasound (after the first trimester): 10 of 16 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $105.76
  • Aetna — Medicare Managed Care Plan: $104.71
  • BCBS — Anthem Blue Access Choice PPO: $137.80
  • BCBS — Anthem Blue Access PPO: $478.88
  • BCBS — Anthem Blue Preferred HMO/POS: $472.65
  • BCBS — Anthem Medicare Managed Care Plan: $106.29
  • BCBS — Anthem Pathway Exchange: $92.48
  • Cigna — OAP Other Commercial Plan: $152.61
  • Healthlink — Employers Choice All Commercial Plans: $284.14
  • Healthlink — HMO: $284.14
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Ob 14+ Wks Single Gest $946 $520.30 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 $88.18 – $486.05
Transvaginal ultrasound: 10 of 16 insurance plan rates
  • Aetna — Gold Advantage Medicare Managed Care Plan: $105.76
  • Aetna — Medicare Managed Care Plan: $104.71
  • BCBS — Anthem Blue Access Choice PPO: $131.39
  • BCBS — Anthem Blue Access PPO: $456.60
  • BCBS — Anthem Blue Preferred HMO/POS: $450.66
  • BCBS — Anthem Medicare Managed Care Plan: $106.29
  • BCBS — Anthem Pathway Exchange: $88.18
  • Cigna — OAP Other Commercial Plan: $149.77
  • Healthlink — Employers Choice All Commercial Plans: $270.04
  • Healthlink — HMO: $270.04
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Us Transvaginal Non Ob $832 $457.60 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 $95.07 – $524.04
Diagnostic mammogram, one breast: rates for 10 insurance plans
  • BCBS — Anthem Blue Access Choice PPO: $141.66
  • BCBS — Anthem Blue Access PPO: $492.29
  • BCBS — Anthem Blue Preferred HMO/POS: $485.89
  • BCBS — Anthem Pathway Exchange: $95.07
  • Cigna — OAP Other Commercial Plan: $149.77
  • Healthlink — Employers Choice All Commercial Plans: $289.54
  • Healthlink — HMO: $289.54
  • UnitedHealthCare — All Commercial Plans: $187.41
  • UnitedHealthCare — Options PPO: $182.84
  • UnitedHealthCare — St. Louis University Employee: $187.41
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Dx Unilateral Includes Cad/Ai $422 $232.10 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 $74.32 – $89.18
Diagnostic mammogram, one breast: rates for 6 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $75.06
  • Aetna — Medicare Managed Care Plan: $74.32
  • BCBS — Anthem Medicare Managed Care Plan: $75.43
  • Humana — Medicare Managed Care Plan: $75.58
  • Oscar — Exchange: $89.18
  • UnitedHealthCare — Medicare Managed Care Plan: $75.42
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 $121.62 – $670.37
Diagnostic mammogram, both breasts: rates for 10 insurance plans
  • BCBS — Anthem Blue Access Choice PPO: $181.21
  • BCBS — Anthem Blue Access PPO: $629.75
  • BCBS — Anthem Blue Preferred HMO/POS: $621.56
  • BCBS — Anthem Pathway Exchange: $121.62
  • Cigna — OAP Other Commercial Plan: $190.93
  • Healthlink — Employers Choice All Commercial Plans: $369.77
  • Healthlink — HMO: $369.77
  • UnitedHealthCare — All Commercial Plans: $239.62
  • UnitedHealthCare — Options PPO: $233.78
  • UnitedHealthCare — St. Louis University Employee: $239.62
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Dx Bilateral Includes Cad/Ai $650 $357.50 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 $103.84 – $124.61
Diagnostic mammogram, both breasts: rates for 6 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $104.88
  • Aetna — Medicare Managed Care Plan: $103.84
  • BCBS — Anthem Medicare Managed Care Plan: $105.40
  • Humana — Medicare Managed Care Plan: $105.61
  • Oscar — Exchange: $124.61
  • UnitedHealthCare — Medicare Managed Care Plan: $105.38
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 $100.46 – $553.75
Screening mammogram, both breasts: rates for 10 insurance plans
  • BCBS — Anthem Blue Access Choice PPO: $149.69
  • BCBS — Anthem Blue Access PPO: $520.19
  • BCBS — Anthem Blue Preferred HMO/POS: $513.43
  • BCBS — Anthem Pathway Exchange: $100.46
  • Cigna — OAP Other Commercial Plan: $158.34
  • Healthlink — Employers Choice All Commercial Plans: $305.80
  • Healthlink — HMO: $305.80
  • UnitedHealthCare — All Commercial Plans: $198.13
  • UnitedHealthCare — Options PPO: $193.30
  • UnitedHealthCare — St. Louis University Employee: $198.13
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Mamm Screen Bilat Includes Cad/Ai $432 $237.60 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 $217 $119.35 Not listed in the file

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance 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 $17.54 – $96.70
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans
  • BCBS — Anthem Blue Access Choice PPO: $26.14
  • BCBS — Anthem Blue Access PPO: $90.84
  • BCBS — Anthem Blue Preferred HMO/POS: $89.66
  • BCBS — Anthem Pathway Exchange: $17.54
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 $636.56 – $27,154
Left heart catheterization (diagnostic): 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $8,050
  • Aetna — Carelink Other Commercial Plan: $5,773
  • Aetna — Gold Advantage Medicare Managed Care Plan: $3,279.64
  • Aetna — Medicare Managed Care Plan: $3,247.17
  • Aetna — NBD Other Commercial Plan: $7,104
  • Ambetter — Exchange: $7,297
  • BCBS — Anthem Blue Access Choice PPO: $948.48
  • BCBS — Anthem Blue Access PPO: $3,296.13
  • BCBS — Anthem Blue Preferred HMO/POS: $3,253.28
  • BCBS — Anthem Medicare Managed Care Plan: $3,295.87
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Lhc W Lt Vent W S+I $9,592 $5,275.60 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 $351.18 – $10,423
Heart rhythm study (electrophysiology evaluation): 10 of 19 insurance plan rates
  • Aetna — All Commercial Plans: $7,154
  • Aetna — Carelink Other Commercial Plan: $4,223
  • Aetna — Gold Advantage Medicare Managed Care Plan: $7,890.38
  • Aetna — Medicare Managed Care Plan: $7,812.26
  • Aetna — NBD Other Commercial Plan: $6,314
  • Ambetter — Exchange: $7,297
  • BCBS — Anthem Blue Access Choice PPO: $523.25
  • BCBS — Anthem Blue Access PPO: $1,818.40
  • BCBS — Anthem Blue Preferred HMO/POS: $1,794.76
  • BCBS — Anthem Medicare Managed Care Plan: $7,929.44
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 $8,635 $4,749.25 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 $1,222.72 – $31,416.07
Heart rhythm study with ablation for atrial fibrillation: 10 of 17 insurance plan rates
  • Aetna — All Commercial Plans: $21,841
  • Aetna — Carelink Other Commercial Plan: $4,223
  • Aetna — Gold Advantage Medicare Managed Care Plan: $26,441.86
  • Aetna — Medicare Managed Care Plan: $26,180.06
  • Aetna — NBD Other Commercial Plan: $19,274
  • Ambetter — Exchange: $7,297
  • BCBS — Anthem Blue Access Choice PPO: $1,821.84
  • BCBS — Anthem Blue Access PPO: $6,331.25
  • BCBS — Anthem Blue Preferred HMO/POS: $6,248.94
  • BCBS — Anthem Medicare Managed Care Plan: $26,572.76
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 $29,075 $15,991.25 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 $504.10 – $2,778.63
Sleep study (overnight, in a sleep lab): rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $868.73
  • Aetna — Medicare Managed Care Plan: $860.13
  • BCBS — Anthem Blue Access Choice PPO: $751.11
  • BCBS — Anthem Blue Access PPO: $2,610.26
  • BCBS — Anthem Blue Preferred HMO/POS: $2,576.32
  • BCBS — Anthem Medicare Managed Care Plan: $873.03
  • BCBS — Anthem Pathway Exchange: $504.10
  • Humana — Medicare Managed Care Plan: $874.75
  • Oscar — Exchange: $1,032.15
  • UnitedHealthCare — Medicare Managed Care Plan: $872.86
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Polysomn 4 Or More >=6Yrs $7,050 $3,877.50 Not listed in the file

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 exercises Not listed in the file Not listed in the file $27.16 – $184.26
Physical therapy: therapeutic exercise (each 15 minutes): rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $27.43
  • Aetna — Medicare Managed Care Plan: $27.16
  • BCBS — Anthem Blue Access Choice PPO: $49.81
  • BCBS — Anthem Blue Access PPO: $173.09
  • BCBS — Anthem Blue Preferred HMO/POS: $170.84
  • BCBS — Anthem Medicare Managed Care Plan: $27.57
  • BCBS — Anthem Pathway Exchange: $33.43
  • Humana — Medicare Managed Care Plan: $27.62
  • Oscar — Exchange: $32.59
  • UnitedHealthCare — Medicare Managed Care Plan: $27.56
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 $173 $95.15 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 $173 $95.15 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 $84.01 – $463.09
Physical therapy evaluation (low complexity): rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $92.42
  • Aetna — Medicare Managed Care Plan: $91.50
  • BCBS — Anthem Blue Access Choice PPO: $125.18
  • BCBS — Anthem Blue Access PPO: $435.03
  • BCBS — Anthem Blue Preferred HMO/POS: $429.37
  • BCBS — Anthem Medicare Managed Care Plan: $92.87
  • BCBS — Anthem Pathway Exchange: $84.01
  • Humana — Medicare Managed Care Plan: $93.06
  • Oscar — Exchange: $109.80
  • UnitedHealthCare — Medicare Managed Care Plan: $92.85
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval Low Complexity $306 $168.30 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 1 Rvu $306 $168.30 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 $84.01 – $463.09
Physical therapy evaluation (moderate complexity): rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $96.61
  • Aetna — Medicare Managed Care Plan: $95.65
  • BCBS — Anthem Blue Access Choice PPO: $125.18
  • BCBS — Anthem Blue Access PPO: $435.03
  • BCBS — Anthem Blue Preferred HMO/POS: $429.37
  • BCBS — Anthem Medicare Managed Care Plan: $97.08
  • BCBS — Anthem Pathway Exchange: $84.01
  • Humana — Medicare Managed Care Plan: $97.28
  • Oscar — Exchange: $114.78
  • UnitedHealthCare — Medicare Managed Care Plan: $97.07
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval Mod Complexity $333 $183.15 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 $349 $191.95 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 $84.01 – $463.09
Physical therapy evaluation (high complexity): rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $92.42
  • Aetna — Medicare Managed Care Plan: $91.50
  • BCBS — Anthem Blue Access Choice PPO: $125.18
  • BCBS — Anthem Blue Access PPO: $435.03
  • BCBS — Anthem Blue Preferred HMO/POS: $429.37
  • BCBS — Anthem Medicare Managed Care Plan: $92.87
  • BCBS — Anthem Pathway Exchange: $84.01
  • Humana — Medicare Managed Care Plan: $93.06
  • Oscar — Exchange: $109.80
  • UnitedHealthCare — Medicare Managed Care Plan: $92.85
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Pt Eval High Complexity $388 $213.40 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 3 Rvu $642 $353.10 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 $66.09 – $364.31
Psychotherapy, 30 minutes: rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $179.56
  • Aetna — Medicare Managed Care Plan: $177.78
  • BCBS — Anthem Blue Access Choice PPO: $98.48
  • BCBS — Anthem Blue Access PPO: $342.23
  • BCBS — Anthem Blue Preferred HMO/POS: $337.79
  • BCBS — Anthem Medicare Managed Care Plan: $180.45
  • BCBS — Anthem Pathway Exchange: $66.09
  • Humana — Medicare Managed Care Plan: $180.80
  • Oscar — Exchange: $213.34
  • UnitedHealthCare — Medicare Managed Care Plan: $180.41
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Php Psychotherapy W Pt 30 Min $325 $178.75 Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Psychotherapy W Pt 30 Min $325 $178.75 Not listed in the file
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 $87.75 – $483.69
Psychotherapy, 45 minutes: rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $179.56
  • Aetna — Medicare Managed Care Plan: $177.78
  • BCBS — Anthem Blue Access Choice PPO: $130.75
  • BCBS — Anthem Blue Access PPO: $454.38
  • BCBS — Anthem Blue Preferred HMO/POS: $448.48
  • BCBS — Anthem Medicare Managed Care Plan: $180.45
  • BCBS — Anthem Pathway Exchange: $105.31
  • Humana — Medicare Managed Care Plan: $180.80
  • Oscar — Exchange: $213.34
  • UnitedHealthCare — Medicare Managed Care Plan: $180.41
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Php Psychotherapy W Pt 45 Min $274 $150.70 Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Op Psychotherapy W Pt 45 Min $305 $167.75 Not listed in the file
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 $132.19 – $728.62
Psychotherapy, 60 minutes: rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $179.56
  • Aetna — Medicare Managed Care Plan: $177.78
  • BCBS — Anthem Blue Access Choice PPO: $196.96
  • BCBS — Anthem Blue Access PPO: $684.47
  • BCBS — Anthem Blue Preferred HMO/POS: $675.57
  • BCBS — Anthem Medicare Managed Care Plan: $180.45
  • BCBS — Anthem Pathway Exchange: $132.19
  • Humana — Medicare Managed Care Plan: $180.80
  • Oscar — Exchange: $213.34
  • UnitedHealthCare — Medicare Managed Care Plan: $180.41
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Op Psychotherapy W Pt 60 Min $427 $234.85 Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Psychotherapy W Pt 60 Min $427 $234.85 Not listed in the file
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 $106.37 – $586.33
Family psychotherapy, without the patient: rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $179.56
  • Aetna — Medicare Managed Care Plan: $177.78
  • BCBS — Anthem Blue Access Choice PPO: $158.49
  • BCBS — Anthem Blue Access PPO: $550.80
  • BCBS — Anthem Blue Preferred HMO/POS: $543.64
  • BCBS — Anthem Medicare Managed Care Plan: $180.45
  • BCBS — Anthem Pathway Exchange: $106.37
  • Humana — Medicare Managed Care Plan: $180.80
  • Oscar — Exchange: $213.34
  • UnitedHealthCare — Medicare Managed Care Plan: $180.41
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Op Family Psychotherapy Wo Pt 50Min $455 $250.25 Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Family Psychotherapy Wo Pt 50 Min $455 $250.25 Not listed in the file
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 $110.89 – $611.25
Family psychotherapy, with the patient: rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $179.56
  • Aetna — Medicare Managed Care Plan: $177.78
  • BCBS — Anthem Blue Access Choice PPO: $165.23
  • BCBS — Anthem Blue Access PPO: $574.21
  • BCBS — Anthem Blue Preferred HMO/POS: $566.75
  • BCBS — Anthem Medicare Managed Care Plan: $180.45
  • BCBS — Anthem Pathway Exchange: $133.08
  • Humana — Medicare Managed Care Plan: $180.80
  • Oscar — Exchange: $213.34
  • UnitedHealthCare — Medicare Managed Care Plan: $180.41
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Family Psychotherapy W Pt 50 Min $455 $250.25 Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Op Family Psychotherapy W Pt 50 Min $455 $250.25 Not listed in the file
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 $26.49 – $146.03
Group psychotherapy: rates for 10 insurance plans
  • Aetna — Gold Advantage Medicare Managed Care Plan: $102.77
  • Aetna — Medicare Managed Care Plan: $101.75
  • BCBS — Anthem Blue Access Choice PPO: $39.48
  • BCBS — Anthem Blue Access PPO: $137.19
  • BCBS — Anthem Blue Preferred HMO/POS: $135.40
  • BCBS — Anthem Medicare Managed Care Plan: $103.28
  • BCBS — Anthem Pathway Exchange: $26.49
  • Humana — Medicare Managed Care Plan: $103.48
  • Oscar — Exchange: $122.10
  • UnitedHealthCare — Medicare Managed Care Plan: $103.26
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record $223 $122.65 Not listed in the file
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc 1 Hr Psych Therapy Group $238 $130.90 Not listed in the file

Procedures and surgery

ServiceHospital chargeCash priceInsurance 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 $437.91 – $4,706.11
Removal of breast growth (open surgery): 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $3,697
  • Aetna — Carelink Other Commercial Plan: $2,224
  • Aetna — Gold Advantage Medicare Managed Care Plan: $3,960.97
  • Aetna — Medicare Managed Care Plan: $3,921.76
  • Aetna — NBD Other Commercial Plan: $3,262
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $697.47
  • BCBS — Anthem Blue Access PPO: $1,267.84
  • BCBS — Anthem Blue Preferred HMO/POS: $678.18
  • BCBS — Anthem Medicare Managed Care Plan: $3,980.58
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Breast Mass Biopsy/Excision $6,368 $3,502.40 Not listed in the file
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 $1,449.84 – $15,478
Total hip replacement: 10 of 21 insurance plan rates
  • Aetna — All Commercial Plans: $9,317
  • Aetna — Carelink Other Commercial Plan: $3,112
  • Aetna — Gold Advantage Medicare Managed Care Plan: $12,988
  • Aetna — Medicare Managed Care Plan: $12,859.41
  • Aetna — NBD Other Commercial Plan: $4,539
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $2,309.23
  • BCBS — Anthem Blue Access PPO: $7,507.31
  • BCBS — Anthem Blue Preferred HMO/POS: $2,245.36
  • BCBS — Anthem Medicare Managed Care Plan: $13,052.30
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 $1,449.48 – $15,478
Total knee replacement: 10 of 21 insurance plan rates
  • Aetna — All Commercial Plans: $9,317
  • Aetna — Carelink Other Commercial Plan: $3,112
  • Aetna — Gold Advantage Medicare Managed Care Plan: $12,988
  • Aetna — Medicare Managed Care Plan: $12,859.41
  • Aetna — NBD Other Commercial Plan: $4,539
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $2,308.64
  • BCBS — Anthem Blue Access PPO: $7,505.42
  • BCBS — Anthem Blue Preferred HMO/POS: $2,244.80
  • BCBS — Anthem Medicare Managed Care Plan: $13,052.30
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 $189.38 – $7,994
Shoulder arthroscopy: shaving of shoulder bone: 10 of 15 insurance plan rates
  • Aetna — All Commercial Plans: $3,697
  • Aetna — Carelink Other Commercial Plan: $2,224
  • Aetna — NBD Other Commercial Plan: $3,262
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $282.18
  • BCBS — Anthem Blue Access PPO: $980.63
  • BCBS — Anthem Blue Preferred HMO/POS: $293.30
  • BCBS — Anthem Pathway Exchange: $189.38
  • Cigna — OAP Other Commercial Plan: $7,994
  • Healthlink — Employers Choice All Commercial Plans: $1,865
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 $574.19 – $7,994
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $4,498
  • Aetna — Carelink Other Commercial Plan: $2,666
  • Aetna — Gold Advantage Medicare Managed Care Plan: $3,310.06
  • Aetna — Medicare Managed Care Plan: $3,277.28
  • Aetna — NBD Other Commercial Plan: $3,969
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $855.54
  • BCBS — Anthem Blue Access PPO: $2,973.15
  • BCBS — Anthem Blue Preferred HMO/POS: $889.24
  • BCBS — Anthem Medicare Managed Care Plan: $3,326.44
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 $309.78 – $7,115.26
Removal of tonsils and adenoids (under age 12): 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $3,697
  • Aetna — Carelink Other Commercial Plan: $2,224
  • Aetna — Gold Advantage Medicare Managed Care Plan: $5,988.68
  • Aetna — Medicare Managed Care Plan: $5,929.39
  • Aetna — NBD Other Commercial Plan: $3,262
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $461.57
  • BCBS — Anthem Blue Access PPO: $1,604.05
  • BCBS — Anthem Blue Preferred HMO/POS: $1,583.20
  • BCBS — Anthem Medicare Managed Care Plan: $6,018.33
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 $141.46 – $2,783
Upper GI endoscopy (diagnostic): 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $2,414
  • Aetna — Carelink Other Commercial Plan: $1,444
  • Aetna — Gold Advantage Medicare Managed Care Plan: $917.53
  • Aetna — Medicare Managed Care Plan: $908.45
  • Aetna — NBD Other Commercial Plan: $2,131
  • Ambetter — Exchange: $1,568
  • BCBS — Anthem Blue Access Choice PPO: $210.78
  • BCBS — Anthem Blue Access PPO: $732.49
  • BCBS — Anthem Blue Preferred HMO/POS: $722.96
  • BCBS — Anthem Medicare Managed Care Plan: $922.08
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Egd Flex Transoral Dx $2,360 $1,298 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 $2,052 $1,128.60 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 $158.89 – $3,213
Upper GI endoscopy with biopsy: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $3,213
  • Aetna — Carelink Other Commercial Plan: $1,944
  • Aetna — Gold Advantage Medicare Managed Care Plan: $917.53
  • Aetna — Medicare Managed Care Plan: $908.45
  • Aetna — NBD Other Commercial Plan: $2,835
  • Ambetter — Exchange: $1,568
  • BCBS — Anthem Blue Access Choice PPO: $236.75
  • BCBS — Anthem Blue Access PPO: $822.74
  • BCBS — Anthem Blue Preferred HMO/POS: $812.04
  • BCBS — Anthem Medicare Managed Care Plan: $922.08
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 $2,491 $1,370.05 Not listed in the file
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: Noncdm Charge Record $899 $494.45 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 $229.53 – $3,213
Colonoscopy (diagnostic): 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $3,213
  • Aetna — Carelink Other Commercial Plan: $1,944
  • Aetna — Gold Advantage Medicare Managed Care Plan: $940.77
  • Aetna — Medicare Managed Care Plan: $931.46
  • Aetna — NBD Other Commercial Plan: $2,835
  • Ambetter — Exchange: $1,568
  • BCBS — Anthem Blue Access Choice PPO: $341.99
  • BCBS — Anthem Blue Access PPO: $1,188.49
  • BCBS — Anthem Blue Preferred HMO/POS: $1,173.04
  • BCBS — Anthem Medicare Managed Care Plan: $945.43
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 $274.41 – $3,213
Colonoscopy with biopsy: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $3,213
  • Aetna — Carelink Other Commercial Plan: $1,944
  • Aetna — Gold Advantage Medicare Managed Care Plan: $1,210.56
  • Aetna — Medicare Managed Care Plan: $1,198.57
  • Aetna — NBD Other Commercial Plan: $2,835
  • Ambetter — Exchange: $1,568
  • BCBS — Anthem Blue Access Choice PPO: $408.87
  • BCBS — Anthem Blue Access PPO: $1,420.90
  • BCBS — Anthem Blue Preferred HMO/POS: $1,402.43
  • BCBS — Anthem Medicare Managed Care Plan: $1,216.55
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 $325.68 – $3,213
Colonoscopy with removal of polyps (snare): 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $3,213
  • Aetna — Carelink Other Commercial Plan: $1,944
  • Aetna — Gold Advantage Medicare Managed Care Plan: $1,210.56
  • Aetna — Medicare Managed Care Plan: $1,198.57
  • Aetna — NBD Other Commercial Plan: $2,835
  • Ambetter — Exchange: $1,568
  • BCBS — Anthem Blue Access Choice PPO: $485.25
  • BCBS — Anthem Blue Access PPO: $1,686.35
  • BCBS — Anthem Blue Preferred HMO/POS: $1,664.43
  • BCBS — Anthem Medicare Managed Care Plan: $1,216.55
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Colonoscopy Flex W Remv Les Snare $2,529 $1,390.95 Not listed in the file
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 $312.59 – $3,886
Ultrasound of the lower bowel by endoscope: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $3,213
  • Aetna — Carelink Other Commercial Plan: $1,944
  • Aetna — Gold Advantage Medicare Managed Care Plan: $1,210.56
  • Aetna — Medicare Managed Care Plan: $1,198.57
  • Aetna — NBD Other Commercial Plan: $2,835
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $465.76
  • BCBS — Anthem Blue Access PPO: $1,618.60
  • BCBS — Anthem Blue Preferred HMO/POS: $1,597.55
  • BCBS — Anthem Medicare Managed Care Plan: $1,216.55
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 $217.15 – $3,213
Screening colonoscopy (not high risk): 10 of 19 insurance plan rates
  • Aetna — All Commercial Plans: $3,213
  • Aetna — Carelink Other Commercial Plan: $1,944
  • Aetna — Gold Advantage Medicare Managed Care Plan: $940.77
  • Aetna — Medicare Managed Care Plan: $931.46
  • Aetna — NBD Other Commercial Plan: $2,835
  • BCBS — Anthem Blue Access Choice PPO: $323.55
  • BCBS — Anthem Blue Access PPO: $1,124.41
  • BCBS — Anthem Blue Preferred HMO/POS: $1,109.80
  • BCBS — Anthem Medicare Managed Care Plan: $945.43
  • BCBS — Anthem Pathway Exchange: $217.15
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 $704.99 – $10,806
Gallbladder removal by laparoscope: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $7,370
  • Aetna — Carelink Other Commercial Plan: $5,286
  • Aetna — Gold Advantage Medicare Managed Care Plan: $6,115.84
  • Aetna — Medicare Managed Care Plan: $6,055.29
  • Aetna — NBD Other Commercial Plan: $6,504
  • Ambetter — Exchange: $5,004
  • BCBS — Anthem Blue Access Choice PPO: $1,050.42
  • BCBS — Anthem Blue Access PPO: $3,650.43
  • BCBS — Anthem Blue Preferred HMO/POS: $3,602.97
  • BCBS — Anthem Medicare Managed Care Plan: $6,146.12
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 $556.22 – $4,553
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $4,498
  • Aetna — Carelink Other Commercial Plan: $2,666
  • Aetna — Gold Advantage Medicare Managed Care Plan: $3,622.04
  • Aetna — Medicare Managed Care Plan: $3,586.18
  • Aetna — NBD Other Commercial Plan: $3,969
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $828.76
  • BCBS — Anthem Blue Access PPO: $2,880.09
  • BCBS — Anthem Blue Preferred HMO/POS: $2,842.65
  • BCBS — Anthem Medicare Managed Care Plan: $3,639.97
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 $148.82 – $3,886
Prostate biopsy: 10 of 15 insurance plan rates
  • Aetna — All Commercial Plans: $3,213
  • Aetna — Carelink Other Commercial Plan: $1,944
  • Aetna — NBD Other Commercial Plan: $2,835
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $221.75
  • BCBS — Anthem Blue Access PPO: $770.61
  • BCBS — Anthem Blue Preferred HMO/POS: $760.59
  • BCBS — Anthem Pathway Exchange: $148.82
  • Cigna — OAP Other Commercial Plan: $2,680
  • Healthlink — Employers Choice All Commercial Plans: $1,628
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Biopsy Prostate $5,216 $2,868.80 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 $1,847.03 – $20,033
Prostate removal by laparoscope (radical prostatectomy): 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $7,370
  • Aetna — Carelink Other Commercial Plan: $5,286
  • Aetna — Gold Advantage Medicare Managed Care Plan: $10,753.47
  • Aetna — Medicare Managed Care Plan: $10,647
  • Aetna — NBD Other Commercial Plan: $6,504
  • Ambetter — Exchange: $13,793
  • BCBS — Anthem Blue Access Choice PPO: $2,752.07
  • BCBS — Anthem Blue Access PPO: $9,563.96
  • BCBS — Anthem Blue Preferred HMO/POS: $9,439.62
  • BCBS — Anthem Medicare Managed Care Plan: $10,806.70
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 $281.99 – $10,806
Hysteroscopy with biopsy of the uterus lining: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $7,370
  • Aetna — Carelink Other Commercial Plan: $5,286
  • Aetna — Gold Advantage Medicare Managed Care Plan: $3,274.78
  • Aetna — Medicare Managed Care Plan: $3,242.35
  • Aetna — NBD Other Commercial Plan: $6,504
  • Ambetter — Exchange: $5,004
  • BCBS — Anthem Blue Access Choice PPO: $420.17
  • BCBS — Anthem Blue Access PPO: $1,460.16
  • BCBS — Anthem Blue Preferred HMO/POS: $1,441.18
  • BCBS — Anthem Medicare Managed Care Plan: $3,290.99
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Hysterocopy W Endo Bx $8,396 $4,617.80 Not listed in the file
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee In the file: Hc Ed Hysteroscopy W Endo Bx $6,915 $3,803.25 Not listed in the file
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 $107.17 – $2,709
Spinal injection, lower back (epidural), with imaging guidance: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $2,414
  • Aetna — Carelink Other Commercial Plan: $1,444
  • Aetna — Gold Advantage Medicare Managed Care Plan: $714.09
  • Aetna — Medicare Managed Care Plan: $707.02
  • Aetna — NBD Other Commercial Plan: $2,131
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $159.68
  • BCBS — Anthem Blue Access PPO: $554.91
  • BCBS — Anthem Blue Preferred HMO/POS: $547.69
  • BCBS — Anthem Medicare Managed Care Plan: $717.63
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 $3,594 $1,976.70 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 $120.09 – $3,886
Nerve root injection, lower back, with imaging guidance: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $2,414
  • Aetna — Carelink Other Commercial Plan: $1,444
  • Aetna — Gold Advantage Medicare Managed Care Plan: $894.76
  • Aetna — Medicare Managed Care Plan: $885.90
  • Aetna — NBD Other Commercial Plan: $2,131
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $178.94
  • BCBS — Anthem Blue Access PPO: $621.85
  • BCBS — Anthem Blue Preferred HMO/POS: $613.77
  • BCBS — Anthem Medicare Managed Care Plan: $899.19
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 $3,577 $1,967.35 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 $5,962 $3,279.10 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 $449.74 – $3,886
Carpal tunnel release: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $3,213
  • Aetna — Carelink Other Commercial Plan: $1,944
  • Aetna — Gold Advantage Medicare Managed Care Plan: $1,975.44
  • Aetna — Medicare Managed Care Plan: $1,955.88
  • Aetna — NBD Other Commercial Plan: $2,835
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $670.11
  • BCBS — Anthem Blue Access PPO: $1,302.10
  • BCBS — Anthem Blue Preferred HMO/POS: $2,298.48
  • BCBS — Anthem Medicare Managed Care Plan: $1,985.22
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 $321.82 – $3,886
Laser treatment of clouding after cataract surgery: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $3,213
  • Aetna — Carelink Other Commercial Plan: $1,944
  • Aetna — Gold Advantage Medicare Managed Care Plan: $556.39
  • Aetna — Medicare Managed Care Plan: $550.89
  • Aetna — NBD Other Commercial Plan: $2,835
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $479.51
  • BCBS — Anthem Blue Access PPO: $931.75
  • BCBS — Anthem Blue Preferred HMO/POS: $1,644.73
  • BCBS — Anthem Medicare Managed Care Plan: $559.15
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 $664.63 – $5,982
Cataract removal with lens implant: 10 of 20 insurance plan rates
  • Aetna — All Commercial Plans: $5,144
  • Aetna — Carelink Other Commercial Plan: $3,112
  • Aetna — Gold Advantage Medicare Managed Care Plan: $2,334.67
  • Aetna — Medicare Managed Care Plan: $2,311.55
  • Aetna — NBD Other Commercial Plan: $4,539
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $990.30
  • BCBS — Anthem Blue Access PPO: $3,441.49
  • BCBS — Anthem Blue Preferred HMO/POS: $3,396.74
  • BCBS — Anthem Medicare Managed Care Plan: $2,346.22

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance 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 $2,167 – $12,393.21
Vaginal delivery, with care before and after: 10 of 11 insurance plan rates
  • Aetna — All Commercial Plans: $4,261
  • Aetna — Carelink Other Commercial Plan: $2,444
  • Aetna — NBD Other Commercial Plan: $3,760
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $3,350.10
  • BCBS — Anthem Blue Access PPO: $11,642.24
  • BCBS — Anthem Blue Preferred HMO/POS: $11,490.88
  • BCBS — Anthem Pathway Exchange: $2,248.40
  • Cigna — OAP Other Commercial Plan: $3,071
  • Healthlink — Employers Choice All Commercial Plans: $2,302
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 $2,167 – $13,695.44
Cesarean delivery (C-section), with care before and after: 10 of 11 insurance plan rates
  • Aetna — All Commercial Plans: $4,261
  • Aetna — Carelink Other Commercial Plan: $2,444
  • Aetna — NBD Other Commercial Plan: $3,760
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $3,702.11
  • BCBS — Anthem Blue Access PPO: $12,865.56
  • BCBS — Anthem Blue Preferred HMO/POS: $12,698.30
  • BCBS — Anthem Pathway Exchange: $2,484.65
  • Cigna — OAP Other Commercial Plan: $3,071
  • Healthlink — Employers Choice All Commercial Plans: $2,302
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 $2,167 – $12,990.13
Vaginal delivery after a previous C-section, with care before and after: 10 of 11 insurance plan rates
  • Aetna — All Commercial Plans: $4,261
  • Aetna — Carelink Other Commercial Plan: $2,444
  • Aetna — NBD Other Commercial Plan: $3,760
  • Ambetter — Exchange: $2,167
  • BCBS — Anthem Blue Access Choice PPO: $3,511.46
  • BCBS — Anthem Blue Access PPO: $12,202.99
  • BCBS — Anthem Blue Preferred HMO/POS: $12,044.34
  • BCBS — Anthem Pathway Exchange: $2,356.69
  • Cigna — OAP Other Commercial Plan: $3,071
  • Healthlink — Employers Choice All Commercial Plans: $2,302

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 $69,927.45 – $189,788.89
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 42 insurance plan rates
  • Aetna — All Commercial Plans: $115,045.73
  • Aetna — Carelink Other Commercial Plan: $78,272.18
  • Aetna — Gold Advantage Medicare Managed Care Plan: $93,045.98
  • Aetna — Medicare Managed Care Plan: $92,124.73
  • Aetna — NBD Other Commercial Plan: $101,467.20
  • Aetna — Total Care Medicare Managed Care Plan: $92,124.73
  • Ambetter — Exchange: $91,312.66
  • BCBS — Anthem Blue Access Choice PPO: $104,157.47
  • BCBS — Anthem Blue Access PPO: $172,666.42
  • BCBS — Anthem Blue Preferred HMO/POS: $98,639.97
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 $29,705.81 – $78,024.69
Spinal fusion (not neck), without major complications: 10 of 15 insurance plan rates
  • Ambetter — Exchange: $34,142.84
  • BCBS — Anthem Blue Access Choice PPO: $38,945.66
  • BCBS — Anthem Blue Access PPO: $64,561.94
  • BCBS — Anthem Pathway Exchange: $29,705.81
  • Cigna — OAP Other Commercial Plan: $45,507.93
  • Healthlink — HMO: $46,612.94
  • Healthlink — PPO: $78,024.69
  • Aetna — First Health Other Commercial Plan: 56.4% (a percentage in the contract, not a dollar amount)
  • Aetna — NAP Other Commercial Plan: 85% (a percentage in the contract, not a dollar amount)
  • BCBS — Anthem Traditional: 76.7% (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 $13,787.78 – $38,452.89
Hip or knee replacement (major joint of the leg), without major complications: 10 of 42 insurance plan rates
  • Aetna — All Commercial Plans: $22,683.86
  • Aetna — Carelink Other Commercial Plan: $15,433.13
  • Aetna — Gold Advantage Medicare Managed Care Plan: $20,437.17
  • Aetna — Medicare Managed Care Plan: $20,234.82
  • Aetna — NBD Other Commercial Plan: $20,006.55
  • Aetna — Total Care Medicare Managed Care Plan: $20,234.82
  • Ambetter — Exchange: $18,004.35
  • BCBS — Anthem Blue Access Choice PPO: $20,537
  • BCBS — Anthem Blue Access PPO: $34,045.09
  • BCBS — Anthem Blue Preferred HMO/POS: $19,449.10
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 $17,450.41 – $45,856.29
Neck (cervical) spinal fusion, without complications: 10 of 42 insurance plan rates
  • Aetna — All Commercial Plans: $28,709.69
  • Aetna — Carelink Other Commercial Plan: $19,532.84
  • Aetna — Gold Advantage Medicare Managed Care Plan: $25,174.27
  • Aetna — Medicare Managed Care Plan: $24,925.02
  • Aetna — NBD Other Commercial Plan: $25,321.16
  • Aetna — Total Care Medicare Managed Care Plan: $24,925.02
  • Ambetter — Exchange: $22,787.09
  • BCBS — Anthem Blue Access Choice PPO: $25,992.52
  • BCBS — Anthem Blue Access PPO: $43,088.95
  • BCBS — Anthem Blue Preferred HMO/POS: $24,615.63
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 $8,868.52 – $21,898.36
Uterus and ovary surgery (not for cancer), without complications: 10 of 42 insurance plan rates
  • Aetna — All Commercial Plans: $14,590.63
  • Aetna — Carelink Other Commercial Plan: $9,926.84
  • Aetna — Gold Advantage Medicare Managed Care Plan: $14,074.80
  • Aetna — Medicare Managed Care Plan: $13,935.45
  • Aetna — NBD Other Commercial Plan: $12,868.54
  • Aetna — Total Care Medicare Managed Care Plan: $13,935.45
  • Ambetter — Exchange: $11,580.69
  • BCBS — Anthem Blue Access Choice PPO: $13,209.73
  • BCBS — Anthem Blue Access PPO: $21,898.36
  • BCBS — Anthem Blue Preferred HMO/POS: $12,509.98

Source: SSM Health St Mary's Hospital - St Louis’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 typeAcute Care Hospital
Address6420 Clayton Rd, Saint Louis, MO 63117
CountySt. Louis County
StateMissouri
Phone(314) 768‑8000
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number260091
Name in Medicare recordsSSM HEALTH ST MARY'S HOSPITAL - ST LOUIS
Profile levelMedicare data + hospital website
Official websitessmhealth.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. St. Mary's Hospital - St. Louis — ssmhealth.com
  2. Pain Care — ssmhealth.com
  3. Breast Care — ssmhealth.com
  4. Imaging Services — ssmhealth.com
  5. WISH Center at St. Mary's Hospital — ssmhealth.com