Quick answers
- Does St Anthonys Memorial Hospital have an emergency room?
- Yes. Medicare (CMS) data lists emergency services at St Anthonys Memorial Hospital. In a medical emergency, call 911.
- Where is St Anthonys Memorial Hospital?
- 503 N Maple Street, Effingham, IL 62401, in Effingham County, Illinois.
- What is the phone number of St Anthonys Memorial Hospital?
- (217) 342-2121, as listed by Medicare (CMS).
- What is the Medicare star rating of St Anthonys Memorial Hospital?
- 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
- Does Medicare reduce its payments to St Anthonys Memorial Hospital for hospital-acquired conditions?
- No. For fiscal year 2026, CMS lists no Medicare payment reduction for St Anthonys Memorial Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.2081; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).
Specialties and care areas[5]
- Cancer care
- Emergency care
- Diabetes and endocrinology
- Foot and ankle
- Gastroenterology
- Heart care
- Orthopedics
- Pain management
- Plastic surgery
- Women's health
- Rehabilitation
- Surgery
- Wound care
- Imaging and laboratory
- Home health and hospice
Treatments[5]
- Dietitian services
Procedures[5]
- Mammogram
Programs and centers[5]
- Pregnancy and birth
- Inpatient care
Emergency care (hospital website)[5]
| Emergency room | Yes |
|---|
Visiting and practical information
| Patient portal | MyHSHS |
|---|
Doctors and clinicians (412)
412 doctors and other clinicians list St Anthonys Memorial 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
- Nurse Practitioner103
- Family Practice39
- Internal Medicine38
- Diagnostic Radiology28
- Physician Assistant21
- Emergency Medicine17
- Hospitalist15
- Certified Registered Nurse Anesthetist (CRNA)14
- General Surgery13
- Cardiovascular Disease (Cardiology)13
- Orthopedic Surgery12
- Pathology11
Doctors with a page on this site (412)
- Abbie C. Massengill, MDObstetrics/Gynecology
- Abdur Rahman Ahmad, MDCardiac Electrophysiology
- Abdur Shakir, MDHematology/Oncology
- Abubaker Kallan, MDInternal Medicine
- Adam Held, MDDiagnostic Radiology
- Adebunmi Ojulari, MDHospitalist
- Adree B. Venatta, MDFamily Practice
- Ahmad H. Rimawi, MDInternal Medicine
- Aja A. Lystila, MDFamily Practice
- Alecia SteeleNurse Practitioner
- Alex G. NiebruggeNurse Practitioner
- Alex You, MDEmergency Medicine
- Alexander Fitzthum, MDPathology
- Alexis D. King, CNACertified Registered Nurse Anesthetist (CRNA)
- Ali H. Warda, MDInternal Medicine
- Alison GryczewskiPhysician Assistant
- Amanda Fuson, NPNurse Practitioner
- Amanda StroudNurse Practitioner
- Amber D. Willis, NPNurse Practitioner
- Amit S. Dande, MDInterventional Cardiology
- Andrea BushnellNurse Practitioner
- Andrew Batey, MDGastroenterology
- Andrew Mahtani, MDFamily Practice
- Andrew Mills, MDOrthopedic Surgery
And 388 more: the button below opens the full list.
Names link to the doctor’s page on this site when there is one, otherwise to the official NPI Registry record (U.S. Department of Health and Human Services). Find a doctor · Source: CMS Facility Affiliation Data
Other emergency rooms nearby
Hospitals that list emergency services, by straight-line distance (not driving distance).
- HSHS Good Shepherd Hospital Inc24 mi · Shelbyville, IL · Critical Access Hospital
- Sarah Bush Lincoln Health Center29 mi · Mattoon, IL · Acute Care Hospital
- Clay County Hospital31 mi · Flora, IL · Critical Access Hospital
- Fayette County Hospital31 mi · Vandalia, IL · Critical Access Hospital
- Pana Community Hospital34 mi · Pana, IL · Critical Access Hospital
Find the closest emergency room to where you are → · Compare ER wait times
Other hospitals near Effingham
- Carle Richland Memorial Hospital37 mi · Olney, IL · Critical Access Hospital
Nursing homes, hospice, home health and dialysis nearby
Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.
Nursing homes
- Lakeland Rehab & Healthcare Center0.2 mi · Effingham, IL · 4 of 5 stars
- Effingham Healthcare & Senior Living0.8 mi · Effingham, IL · 1 of 5 stars
- Evergreen Nursing & Rehab Center0.8 mi · Effingham, IL · 3 of 5 stars
All nursing homes in the state →
Hospice providers
- HSHS Hospice Illinois0.9 mi · Effingham, IL · 3 of 5 stars
All hospice providers in the state →
Home health agencies
- HSHS Home Care Illinois0.9 mi · Effingham, IL · 3 of 5 stars
All home health agencies in the state →
Dialysis facilities
- DaVita Effingham Dialysis0.9 mi · Effingham, IL · 3 of 5 stars
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
- SIHF Healthcare - Effingham0.3 mi · Effingham, IL · Community health center
- SIHF Healthcare - Greenup22 mi · Greenup, IL · Community health center
Clinics and urgent care
- Effingham Express Care0.9 mi · Effingham, IL · Rural health clinic
- Effingham Obstetrics and Gynecology Associates PLLC0.9 mi · Effingham, IL · Rural health clinic
- Family Care Associates of Effingham SC0.9 mi · Effingham, IL · Rural health clinic
Pharmacies
- G M Andes Ltd0.9 mi · Effingham, IL · Community/retail pharmacy
- Kirby Foods Inc0.9 mi · Effingham, IL · Community/retail pharmacy
- Moore Family Stores Inc.0.9 mi · Effingham, IL · Community/retail pharmacy
About the Medicare star rating
CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →
Medicare quality data
What St Anthonys Memorial 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) | 4 of 5 stars |
|---|---|
| Overall rating of the hospital | 4 of 5 stars |
| Would recommend the hospital | 4 of 5 stars |
| Nurses communicated well | 5 of 5 stars |
| Doctors communicated well | 4 of 5 stars |
| Patients got help quickly from staff | 4 of 5 stars |
| Staff explained medicines | 4 of 5 stars |
| Information about recovery at home | 4 of 5 stars |
| Room and bathroom kept clean | 4 of 5 stars |
| Restfulness of Environment | 4 of 5 stars |
| Care Coordination | 4 of 5 stars |
| Symptoms After Stay | 4 of 5 stars |
| Rated the hospital 9 or 10 out of 10 | 74%National average: 72% |
| Would definitely recommend the hospital | 67%National average: 71% |
| Nurses “always” communicated well | 84%National average: 80% |
| Doctors “always” communicated well | 82%National average: 80% |
| “Always” got help as soon as they wanted | 69%National average: 64% |
| Staff “always” explained medicines before giving them | 64%National average: 62% |
| Were given information about recovery at home | 90%National average: 86% |
| Room and bathroom “always” clean | 74%National average: 73% |
| Completed surveys | 457Response rate: 25% |
Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 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.
| Clostridioides difficile (C. diff) intestinal infections | 0.908No different from the national benchmark |
|---|---|
| Not reported to Medicare | Central line bloodstream infections (CLABSI); Catheter-associated urinary tract infections (CAUTI); Surgical site infections after colon surgery; Surgical site infections after abdominal hysterectomy; MRSA bloodstream infections |
Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.
Complications and deaths
What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.
| Deaths within 30 days: heart failure patients | 12.9% |
|---|---|
| Deaths within 30 days: pneumonia patients | 16.3% |
| Deaths within 30 days: COPD patients | 7.9% |
| Deaths within 30 days: stroke patients | 13.9% |
| Serious complications (patient safety indicator PSI-90) | 1.06No different from the national rate |
| Not reported to Medicare | Deaths within 30 days: coronary bypass surgery (CABG) |
| Too few cases to report | Deaths within 30 days: heart attack patients; Complications after hip or knee replacement |
Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.
Return visits to the hospital (readmissions)
What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.
| Returned to any hospital within 30 days (all patients) | 17.4% |
|---|---|
| Readmitted within 30 days: heart failure | 21.4% |
| Readmitted within 30 days: pneumonia | 18.2% |
| Readmitted within 30 days: COPD | 19% |
| Not reported to Medicare | Readmitted within 30 days: coronary bypass surgery |
| Too few cases to report | Readmitted within 30 days: heart attack; Readmitted within 30 days: hip or knee replacement |
Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.
Emergency room times and sepsis care
What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.
| Emergency room volume (patients per year) | Medium (20,000–39,999) |
|---|---|
| Average (median) time patients spent in the emergency room before leaving (OP-18b) | 136 minutesNational average: 162 minutes |
| Patients who left the emergency room before being seen (OP-22) | 0%National average: 2% |
| Sepsis patients who got all the recommended early care (SEP-1) | 77%National average: 66% |
Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.
Medicare payment programs
Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for St Anthonys Memorial Hospital, fiscal year 2026 (October 2025 to September 2026).
Show the Medicare payment program results
Hospital-Acquired Condition Reduction Program
What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.
CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.
| Medicare payment reduction, fiscal year 2026 | NoCMS lists no payment reduction for this hospital. |
|---|---|
| Total HAC Score | 0.2081Lower is better. Hospitals above the 75th percentile of all scores get the reduction. |
Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.
Hospital Readmissions Reduction Program
What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.
CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).
| Heart failure | 1.0540More readmissions than expected |
|---|---|
| Pneumonia | 1.0118More readmissions than expected |
| COPD (chronic lung disease) | 0.9277Fewer readmissions than expected |
| No result published | Heart attack; Hip or knee replacement; Coronary bypass surgery (CABG) (not reported, or too few cases) |
Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.
Hospital Value-Based Purchasing Program
What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.
CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.
| Total Performance Score | 37.00 out of 100Median of the 2,455 hospitals in the program: 29.50 |
|---|---|
| Clinical outcomes (deaths and complications) | 12.50 out of 100 |
| Person and community engagement (patient survey) | 58.00 out of 100 |
| Safety (infections and sepsis care) | 37.50 out of 100 |
| Efficiency and cost reduction (Medicare spending) | 40.00 out of 100 |
Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.
Medicare spending per patient (MSPB)
What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.
CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.
| Medicare spending per patient, ratio | 0.94Below the national median hospital (1.00): Medicare spent less |
|---|
Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.
ER wait times and Medicare ratings nearby
How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.
Prices
Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 66 common services exactly as St Anthonys Memorial 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 →
Show the prices of 66 common services
Office and emergency visits
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: HC CLINIC VISIT INTERM NEW | $431 | $310.32 | $115.84 – $431 |
New patient office visit (about 30–44 minutes): 10 of 37 insurance plan rates
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| New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · modifier 25 In the file: HC CLINIC VISIT INTERM NEW -25 | $431 | $310.32 | $115.84 – $431 |
New patient office visit (about 30–44 minutes): 10 of 37 insurance plan rates
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| New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: HC CLINIC VISIT COMPLEX NEW | $546 | $393.12 | $152.88 – $546 |
New patient office visit (about 45–59 minutes): 10 of 37 insurance plan rates
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| New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · modifier 25 In the file: HC CLINIC VISIT COMPLEX NEW -25 | $546 | $393.12 | $152.88 – $546 |
New patient office visit (about 45–59 minutes): 10 of 37 insurance plan rates
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| New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: HC CLINIC VISIT COMPREH NEW | $778 | $560.16 | $217.84 – $778 |
New patient office visit (about 60–74 minutes): 10 of 37 insurance plan rates
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| New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · modifier 25 In the file: HC CLINIC VISIT COMPREH NEW -25 | $778 | $560.16 | $217.84 – $778 |
New patient office visit (about 60–74 minutes): 10 of 37 insurance plan rates
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| Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: HC CLINIC VISIT INTERM EST | $343 | $246.96 | $93.54 – $343 |
Established patient office visit (about 20–29 minutes): 10 of 37 insurance plan rates
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| Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · modifier 25 In the file: HC CLINIC VISIT INTERM EST -25 | $343 | $246.96 | $93.54 – $343 |
Established patient office visit (about 20–29 minutes): 10 of 37 insurance plan rates
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| Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · modifier 27 In the file: HC CLINIC VISIT INTERM EST | $343 | $246.96 | $93.54 – $343 |
Established patient office visit (about 20–29 minutes): 10 of 37 insurance plan rates
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| Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: HC CLINIC VISIT COMPLX EST | $431 | $310.32 | $120.68 – $431 |
Established patient office visit (about 30–39 minutes): 10 of 37 insurance plan rates
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| Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · modifier 25 In the file: HC CLINIC VISIT COMPLEX EST -25 | $431 | $310.32 | $120.68 – $431 |
Established patient office visit (about 30–39 minutes): 10 of 37 insurance plan rates
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| Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · modifier XU In the file: HC CLINIC VISIT COMPLX EST | $431 | $310.32 | $120.68 – $431 |
Established patient office visit (about 30–39 minutes): 10 of 37 insurance plan rates
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| Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: HC ER LEVEL 3 | $1,026 | $738.72 | $287.28 – $1,026 |
Emergency room visit (moderate): 10 of 51 insurance plan rates
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| Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier XU In the file: HC ER LEVEL 3 | $1,026 | $738.72 | $287.28 – $1,026 |
Emergency room visit (moderate): 10 of 51 insurance plan rates
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| Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier G0 In the file: HC ER LEVEL 3 | $1,026 | $738.72 | $287.28 – $1,026 |
Emergency room visit (moderate): 10 of 51 insurance plan rates
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| Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: HC ER LEVEL 4 | $1,589 | $1,144.08 | $444.92 – $1,589 |
Emergency room visit (moderately high): 10 of 51 insurance plan rates
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| Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · modifier 27 In the file: HC ER LEVEL 4 | $1,589 | $1,144.08 | $444.92 – $1,589 |
Emergency room visit (moderately high): 10 of 51 insurance plan rates
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| Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · modifier XU In the file: HC ER LEVEL 4 | $1,589 | $1,144.08 | $444.92 – $1,589 |
Emergency room visit (moderately high): 10 of 51 insurance plan rates
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| Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC ER LEVEL 5 | $2,050 | $1,476 | $574 – $2,050 |
Emergency room visit (high): 10 of 51 insurance plan rates
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| Emergency room visit (high) CPT 99285 · Inpatient or outpatient · modifier XU In the file: HC ER LEVEL 5 | $2,050 | $1,476 | $574 – $2,050 |
Emergency room visit (high): 10 of 51 insurance plan rates
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| Emergency room visit (high) CPT 99285 · Inpatient or outpatient · modifier 27 In the file: HC ER LEVEL 5 | $2,050 | $1,476 | $574 – $2,050 |
Emergency room visit (high): 10 of 51 insurance plan rates
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Lab tests
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: HC BASIC METABOLIC PANEL | $150 | $108 | $6.67 – $150 |
Basic metabolic panel (blood test): 10 of 53 insurance plan rates
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| Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier XS In the file: HC BASIC METABOLIC PANEL | $150 | $108 | $6.67 – $150 |
Basic metabolic panel (blood test): 10 of 53 insurance plan rates
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| Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier SE In the file: HC BASIC METABOLIC PANEL | $150 | $108 | $6.67 – $150 |
Basic metabolic panel (blood test): 10 of 53 insurance plan rates
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| Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: HC COMPREHENSIVE METABOL PANEL | $161 | $115.92 | $6.67 – $161 |
Comprehensive metabolic panel (blood test): 10 of 53 insurance plan rates
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| Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier XE In the file: HC COMPREHENSIVE METABOL PANEL | $161 | $115.92 | $6.67 – $161 |
Comprehensive metabolic panel (blood test): 10 of 53 insurance plan rates
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| Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier XP In the file: HC COMPREHENSIVE METABOL PANEL | $161 | $115.92 | $6.67 – $161 |
Comprehensive metabolic panel (blood test): 10 of 53 insurance plan rates
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| Obstetric blood test panel CPT 80055 · Inpatient or outpatient In the file: HC PRENATAL PANEL | $662 | $476.64 | $6.67 – $662 |
Obstetric blood test panel: 10 of 53 insurance plan rates
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| Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: HC LIPID PANEL | $236 | $169.92 | $6.67 – $236 |
Cholesterol panel (lipid panel): 10 of 53 insurance plan rates
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| Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · modifier 90 In the file: HC LIPID PANEL - 90 | $236 | $169.92 | $6.67 – $236 |
Cholesterol panel (lipid panel): 10 of 53 insurance plan rates
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| Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · modifier 91 In the file: HC LIPID PANEL | $236 | $169.92 | $6.67 – $236 |
Cholesterol panel (lipid panel): 10 of 53 insurance plan rates
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| Kidney function panel CPT 80069 · Inpatient or outpatient In the file: HC RENAL PANEL | $305 | $219.60 | $6.67 – $305 |
Kidney function panel: 10 of 53 insurance plan rates
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| Kidney function panel CPT 80069 · Inpatient or outpatient · modifier 59 In the file: HC RENAL PANEL | $305 | $219.60 | $6.67 – $305 |
Kidney function panel: 10 of 53 insurance plan rates
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| Kidney function panel CPT 80069 · Inpatient or outpatient · modifier PN In the file: HC RENAL PANEL | $305 | $219.60 | $6.67 – $305 |
Kidney function panel: 10 of 53 insurance plan rates
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| Liver function panel CPT 80076 · Inpatient or outpatient In the file: HC LIVER (HEPATIC) PANEL | $233 | $167.76 | $6.67 – $233 |
Liver function panel: 10 of 53 insurance plan rates
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| Liver function panel CPT 80076 · Inpatient or outpatient · modifier 59 In the file: HC LIVER (HEPATIC) PANEL | $233 | $167.76 | $6.67 – $233 |
Liver function panel: 10 of 53 insurance plan rates
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| Liver function panel CPT 80076 · Inpatient or outpatient · modifier XU In the file: HC LIVER (HEPATIC) PANEL | $233 | $167.76 | $6.67 – $233 |
Liver function panel: 10 of 53 insurance plan rates
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| Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: HC URINALYSIS AUTO W/MICRO | $103 | $74.16 | $2.22 – $103 |
Urine test (automated, with microscope): 10 of 53 insurance plan rates
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| Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · modifier XU In the file: HC URINALYSIS AUTO W/MICRO | $103 | $74.16 | $2.22 – $103 |
Urine test (automated, with microscope): 10 of 53 insurance plan rates
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| Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · modifier 91 In the file: HC URINALYSIS AUTO W/MICRO | $103 | $74.16 | $2.22 – $103 |
Urine test (automated, with microscope): 10 of 53 insurance plan rates
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| Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · modifier QW In the file: HC URINALYSIS NON AUTO W/O MICRO-QW | $60 | $43.20 | $2.22 – $60 |
Urine test (manual, without microscope): 10 of 53 insurance plan rates
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| Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier QW In the file: HC URINALYSIS AUTO W/O MICRO | $64 | $46.08 | $2.22 – $64 |
Urine test (automated, without microscope): 10 of 53 insurance plan rates
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| PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: ASSAY OF PSA TOTAL | $216 | $155.52 | $8.82 – $216 |
PSA (prostate specific antigen) blood test: 10 of 53 insurance plan rates
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| PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · modifier 91 In the file: ASSAY OF PSA TOTAL | $216 | $155.52 | $8.82 – $216 |
PSA (prostate specific antigen) blood test: 10 of 53 insurance plan rates
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| PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · modifier Q1 In the file: ASSAY OF PSA TOTAL | $216 | $155.52 | $8.82 – $216 |
PSA (prostate specific antigen) blood test: 10 of 53 insurance plan rates
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| Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: HC THYROID STIMULATING HORM | $191 | $137.52 | $9.74 – $191 |
Thyroid stimulating hormone (TSH) test: 10 of 53 insurance plan rates
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| Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier 90 In the file: HC THYROID STIMULATING HORM-90 | $191 | $137.52 | $9.74 – $191 |
Thyroid stimulating hormone (TSH) test: 10 of 53 insurance plan rates
| |||
| Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier 91 In the file: HC THYROID STIMULATING HORM | $191 | $137.52 | $9.74 – $191 |
Thyroid stimulating hormone (TSH) test: 10 of 53 insurance plan rates
| |||
| Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: HC CBC AUTO W/AUTO DIFF | $54 | $38.88 | $4.38 – $54 |
Complete blood count (CBC) with differential: 10 of 53 insurance plan rates
| |||
| Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier GZ In the file: HC CBC AUTO W/AUTO DIFF | $54 | $38.88 | $4.38 – $54 |
Complete blood count (CBC) with differential: 10 of 53 insurance plan rates
| |||
| Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier 59 In the file: HC CBC AUTO W/AUTO DIFF | $54 | $38.88 | $4.38 – $54 |
Complete blood count (CBC) with differential: 10 of 53 insurance plan rates
| |||
| Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HC CBC W/O DIFF | $44 | $31.68 | $4.38 – $44 |
Complete blood count (CBC), automated: 10 of 53 insurance plan rates
| |||
| Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier 91 In the file: HC CBC W/O DIFF | $44 | $31.68 | $4.38 – $44 |
Complete blood count (CBC), automated: 10 of 53 insurance plan rates
| |||
| Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier Q1 In the file: HC CBC W/O DIFF | $44 | $31.68 | $4.38 – $44 |
Complete blood count (CBC), automated: 10 of 53 insurance plan rates
| |||
| Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC PROTHROMBIN TIME (PT) | $66 | $47.52 | $3.27 – $66 |
Blood clotting time test (prothrombin time, PT): 10 of 53 insurance plan rates
| |||
| Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · modifier QW In the file: HC PROTHROMBIN TIME (PT)-QW | $66 | $47.52 | $3.27 – $66 |
Blood clotting time test (prothrombin time, PT): 10 of 53 insurance plan rates
| |||
| Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · modifier 91 In the file: HC PROTHROMBIN TIME (PT) | $66 | $47.52 | $3.27 – $66 |
Blood clotting time test (prothrombin time, PT): 10 of 53 insurance plan rates
| |||
| Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HC PTT | $58 | $41.76 | $3.27 – $58 |
Blood clotting test (partial thromboplastin time, PTT): 10 of 53 insurance plan rates
| |||
| Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · modifier 90 In the file: HC PTT-90 | $58 | $41.76 | $3.27 – $58 |
Blood clotting test (partial thromboplastin time, PTT): 10 of 53 insurance plan rates
| |||
| Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · modifier GZ In the file: HC PTT | $58 | $41.76 | $3.27 – $58 |
Blood clotting test (partial thromboplastin time, PTT): 10 of 53 insurance plan rates
| |||
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 · Inpatient or outpatient In the file: HC CT HEAD/BRAIN W/O CONTRAST | $2,936 | $2,113.92 | $119.99 – $2,936 |
CT scan of the head or brain, without contrast: 10 of 53 insurance plan rates
| |||
| CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier XU In the file: HC CT HEAD/BRAIN W/O CONTRAST | $2,936 | $2,113.92 | $119.99 – $2,936 |
CT scan of the head or brain, without contrast: 10 of 53 insurance plan rates
| |||
| CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier MG In the file: HC CT HEAD/BRAIN W/O CONTRAST | $2,936 | $2,113.92 | $119.99 – $2,936 |
CT scan of the head or brain, without contrast: 10 of 53 insurance plan rates
| |||
| MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN STEM W/O & W/DYE | $6,684 | $4,812.48 | $370.49 – $6,684 |
MRI of the brain, before and after contrast: 10 of 53 insurance plan rates
| |||
| MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier XU In the file: MRI BRAIN STEM W/O & W/DYE | $6,684 | $4,812.48 | $370.49 – $6,684 |
MRI of the brain, before and after contrast: 10 of 53 insurance plan rates
| |||
| MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier PO In the file: MRI BRAIN STEM W/O & W/DYE | $6,684 | $4,812.48 | $370.49 – $6,684 |
MRI of the brain, before and after contrast: 10 of 53 insurance plan rates
| |||
| Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-RAY EXAM CHEST 2 VIEWS | $610 | $439.20 | $23.49 – $610 |
Chest X-ray, 2 views: 10 of 53 insurance plan rates
| |||
| Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier XS In the file: X-RAY EXAM CHEST 2 VIEWS | $610 | $439.20 | $23.49 – $610 |
Chest X-ray, 2 views: 10 of 53 insurance plan rates
| |||
| Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier Q1 In the file: X-RAY EXAM CHEST 2 VIEWS | $610 | $439.20 | $23.49 – $610 |
Chest X-ray, 2 views: 10 of 53 insurance plan rates
| |||
| X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: HC XR L-SPINE 4+V | $1,264 | $910.08 | $51.11 – $1,264 |
X-ray of the lower spine, at least 4 views: 10 of 53 insurance plan rates
| |||
| X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier XU In the file: HC XR L-SPINE 4+V | $1,264 | $910.08 | $51.11 – $1,264 |
X-ray of the lower spine, at least 4 views: 10 of 53 insurance plan rates
| |||
| X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier XS In the file: HC XR L-SPINE 4+V | $1,264 | $910.08 | $51.11 – $1,264 |
X-ray of the lower spine, at least 4 views: 10 of 53 insurance plan rates
| |||
| MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: HC MRI L-SPINE W/O CONTRAST | $5,046 | $3,633.12 | $219.59 – $5,046 |
MRI of the lower back (lumbar spine), without contrast: 10 of 53 insurance plan rates
| |||
| MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier PN In the file: HC MRI L-SPINE W/O CONTRAST | $5,046 | $3,633.12 | $102.28 – $5,046 |
MRI of the lower back (lumbar spine), without contrast: 10 of 53 insurance plan rates
| |||
| MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier UA In the file: HC MRI L-SPINE W/O CONTRAST | $5,046 | $3,633.12 | $219.59 – $5,046 |
MRI of the lower back (lumbar spine), without contrast: 10 of 53 insurance plan rates
| |||
| CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: HC CT PELVIS W/CONTRAST | $3,921 | $2,823.12 | $201.31 – $3,921 |
CT scan of the pelvis, with contrast: 10 of 53 insurance plan rates
| |||
| CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · modifier UA In the file: HC CT PELVIS W/CONTRAST | $3,921 | $2,823.12 | $201.31 – $3,921 |
CT scan of the pelvis, with contrast: 10 of 53 insurance plan rates
| |||
| MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: HC MRI LWR EXT JOINT W/O CONTRAST | $4,813 | $3,465.36 | $219.59 – $4,813 |
MRI of a leg joint (such as the knee), without contrast: 10 of 53 insurance plan rates
| |||
| CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: HC CT ABDOMEN/PELVIS W/CONTRAST | $7,784 | $5,604.48 | $276.64 – $7,784 |
CT scan of the abdomen and pelvis, with contrast: 10 of 53 insurance plan rates
| |||
| CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier XU In the file: HC CT ABDOMEN/PELVIS W/CONTRAST | $7,784 | $5,604.48 | $276.64 – $7,784 |
CT scan of the abdomen and pelvis, with contrast: 10 of 53 insurance plan rates
| |||
| CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier MA In the file: HC CT ABDOMEN/PELVIS W/CONTRAST | $7,784 | $5,604.48 | $276.64 – $7,784 |
CT scan of the abdomen and pelvis, with contrast: 10 of 53 insurance plan rates
| |||
| Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: HC US ABDOMEN CMPL | $1,807 | $1,301.04 | $119.99 – $1,807 |
Ultrasound of the abdomen, complete: 10 of 53 insurance plan rates
| |||
| Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier PN In the file: HC US ABDOMEN CMPL | $1,807 | $1,301.04 | $44.81 – $1,807 |
Ultrasound of the abdomen, complete: 10 of 53 insurance plan rates
| |||
| Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier PO In the file: HC US ABDOMEN CMPL | $1,807 | $1,301.04 | $119.99 – $1,807 |
Ultrasound of the abdomen, complete: 10 of 53 insurance plan rates
| |||
| Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: HC US PREGNANCY >14 WEEKS SGL | $1,448 | $1,042.56 | $91.63 – $1,448 |
Pregnancy ultrasound (after the first trimester): 10 of 53 insurance plan rates
| |||
| Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · modifier 59 In the file: HC US PREGNANCY >14 WEEKS SGL | $1,448 | $1,042.56 | $91.63 – $1,448 |
Pregnancy ultrasound (after the first trimester): 10 of 53 insurance plan rates
| |||
| Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: HC US TRANSVAGINAL | $1,281 | $922.32 | $99.47 – $1,281 |
Transvaginal ultrasound: 10 of 53 insurance plan rates
| |||
| Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier PN In the file: HC US TRANSVAGINAL | $1,281 | $922.32 | $44.81 – $1,281 |
Transvaginal ultrasound: 10 of 53 insurance plan rates
| |||
| Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier PO In the file: HC US TRANSVAGINAL | $1,281 | $922.32 | $99.47 – $1,281 |
Transvaginal ultrasound: 10 of 53 insurance plan rates
| |||
| Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: DX MAMMO INCL CAD UNI | $662 | $476.64 | $43.46 – $662 |
Diagnostic mammogram, one breast: 10 of 53 insurance plan rates
| |||
| Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier FY In the file: DX MAMMO INCL CAD UNI | $662 | $476.64 | $43.46 – $662 |
Diagnostic mammogram, one breast: 10 of 53 insurance plan rates
| |||
| Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier GG In the file: DX MAMMO INCL CAD UNI | $662 | $476.64 | $43.46 – $662 |
Diagnostic mammogram, one breast: 10 of 53 insurance plan rates
| |||
| Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: DX MAMMO INCL CAD BI | $781 | $562.32 | $43.46 – $781 |
Diagnostic mammogram, both breasts: 10 of 53 insurance plan rates
| |||
| Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier FY In the file: DX MAMMO INCL CAD BI | $781 | $562.32 | $43.46 – $781 |
Diagnostic mammogram, both breasts: 10 of 53 insurance plan rates
| |||
| Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier GZ In the file: DX MAMMO INCL CAD BI | $781 | $562.32 | $43.46 – $781 |
Diagnostic mammogram, both breasts: 10 of 53 insurance plan rates
| |||
| Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC MAMMOGRAM SCREEN DIGI W/CAD | $678 | $488.16 | $43.46 – $678 |
Screening mammogram, both breasts: 10 of 53 insurance plan rates
| |||
| Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC MAMMOGRAM SCREEN W/CAD IMPLANT | $414 | $298.08 | $43.46 – $414 |
Screening mammogram, both breasts: 10 of 53 insurance plan rates
| |||
| Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier FY In the file: HC MAMMOGRAM SCREEN DIGI W/CAD | $678 | $488.16 | $43.46 – $678 |
Screening mammogram, both breasts: 10 of 53 insurance plan rates
| |||
Heart tests and sleep study
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: HC LHC ONLY NO COROS 93452 | $11,432 | $8,231.04 | $2,195.44 – $11,432 |
Left heart catheterization (diagnostic): 10 of 53 insurance plan rates
| |||
| Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: HC SLEEP STUDY | $5,667 | $4,080.24 | $719.35 – $5,667 |
Sleep study (overnight, in a sleep lab): 10 of 53 insurance plan rates
| |||
| Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · modifier 52 In the file: HC SLEEP STUDY PSG 4+ PARAMETERS >6YRS -52 | $5,667 | $4,080.24 | $359.68 – $5,667 |
Sleep study (overnight, in a sleep lab): 10 of 53 insurance plan rates
| |||
| Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · modifier PO In the file: HC SLEEP STUDY | $5,667 | $4,080.24 | $719.35 – $5,667 |
Sleep study (overnight, in a sleep lab): 10 of 53 insurance plan rates
| |||
Physical therapy and mental health
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: HC THERA EXER; EA 15 MIN | $116 | $83.52 | $28.06 – $116 |
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 53 insurance plan rates
| |||
| Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GO In the file: HC THERA EXER; EA 15 MIN | $116 | $83.52 | $28.06 – $116 |
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 53 insurance plan rates
| |||
| Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GP In the file: HC THERA EXER; EA 15 MIN | $116 | $83.52 | $28.06 – $116 |
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 53 insurance plan rates
| |||
| Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: PT EVAL LOW COMPLEX 20 MIN | $613 | $441.36 | $94.04 – $613 |
Physical therapy evaluation (low complexity): 10 of 53 insurance plan rates
| |||
| Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier GP In the file: PT EVAL LOW COMPLEX 20 MIN | $613 | $441.36 | $94.04 – $613 |
Physical therapy evaluation (low complexity): 10 of 53 insurance plan rates
| |||
| Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: PT EVAL MOD COMPLEX 30 MIN | $713 | $513.36 | $94.04 – $713 |
Physical therapy evaluation (moderate complexity): 10 of 53 insurance plan rates
| |||
| Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier GP In the file: PT EVAL MOD COMPLEX 30 MIN | $713 | $513.36 | $94.04 – $713 |
Physical therapy evaluation (moderate complexity): 10 of 53 insurance plan rates
| |||
| Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier KX In the file: PT EVAL MOD COMPLEX 30 MIN | $713 | $513.36 | $94.04 – $713 |
Physical therapy evaluation (moderate complexity): 10 of 53 insurance plan rates
| |||
| Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: PT EVAL HIGH COMPLEX 45 MIN | $996 | $717.12 | $94.04 – $996 |
Physical therapy evaluation (high complexity): 10 of 53 insurance plan rates
| |||
| Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier GP In the file: PT EVAL HIGH COMPLEX 45 MIN | $996 | $717.12 | $94.04 – $996 |
Physical therapy evaluation (high complexity): 10 of 53 insurance plan rates
| |||
Procedures and surgery
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: REMOVAL OF BREAST LESION | Not listed in the file | Not listed in the file | $566.09 – $10,142.02 |
Removal of breast growth (open surgery): 10 of 36 insurance plan rates
| |||
| Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier 50 In the file: REMOVAL OF BREAST LESION | Not listed in the file | Not listed in the file | $566.09 – $10,142.02 |
Removal of breast growth (open surgery): 10 of 36 insurance plan rates
| |||
| Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: TOTAL HIP ARTHROPLASTY | Not listed in the file | Not listed in the file | $5,330.27 – $31,932.71 |
Total hip replacement: 10 of 36 insurance plan rates
| |||
| Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: TOTAL KNEE ARTHROPLASTY | Not listed in the file | Not listed in the file | $4,929.51 – $31,932.71 |
Total knee replacement: 10 of 36 insurance plan rates
| |||
| Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier 50 In the file: TOTAL KNEE ARTHROPLASTY | Not listed in the file | Not listed in the file | $4,929.51 – $31,932.71 |
Total knee replacement: 10 of 36 insurance plan rates
| |||
| Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: SHO ARTHRS SRG DECOMPRESSION | Not listed in the file | Not listed in the file | $1,540.88 – $5,503.15 |
Shoulder arthroscopy: shaving of shoulder bone: 10 of 36 insurance plan rates
| |||
| Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier XU In the file: SHO ARTHRS SRG DECOMPRESSION | Not listed in the file | Not listed in the file | $1,540.88 – $5,503.15 |
Shoulder arthroscopy: shaving of shoulder bone: 10 of 36 insurance plan rates
| |||
| Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier XS In the file: SHO ARTHRS SRG DECOMPRESSION | Not listed in the file | Not listed in the file | $1,540.88 – $5,503.15 |
Shoulder arthroscopy: shaving of shoulder bone: 10 of 36 insurance plan rates
| |||
| Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: ARTHRS KNE SRG MNISECTMY M/L | Not listed in the file | Not listed in the file | $1,946.64 – $8,138.21 |
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 36 insurance plan rates
| |||
| Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier XS In the file: ARTHRS KNE SRG MNISECTMY M/L | Not listed in the file | Not listed in the file | $1,946.64 – $8,138.21 |
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 36 insurance plan rates
| |||
| Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 50 In the file: ARTHRS KNE SRG MNISECTMY M/L | Not listed in the file | Not listed in the file | $2,177.18 – $8,138.21 |
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 36 insurance plan rates
| |||
| Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: REMOVE TONSILS AND ADENOIDS | Not listed in the file | Not listed in the file | $1,641.28 – $14,723.96 |
Removal of tonsils and adenoids (under age 12): 10 of 36 insurance plan rates
| |||
| Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: EGD DIAGNOSTIC BRUSH WASH | Not listed in the file | Not listed in the file | $877.71 – $3,971.34 |
Upper GI endoscopy (diagnostic): 10 of 36 insurance plan rates
| |||
| Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier XU In the file: EGD DIAGNOSTIC BRUSH WASH | Not listed in the file | Not listed in the file | $740.36 – $2,644.13 |
Upper GI endoscopy (diagnostic): 10 of 36 insurance plan rates
| |||
| Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier XS In the file: EGD DIAGNOSTIC BRUSH WASH | Not listed in the file | Not listed in the file | $740.36 – $2,644.13 |
Upper GI endoscopy (diagnostic): 10 of 36 insurance plan rates
| |||
| Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: EGD BIOPSY SINGLE/MULTIPLE | Not listed in the file | Not listed in the file | $787.03 – $2,810.82 |
Upper GI endoscopy with biopsy: 10 of 36 insurance plan rates
| |||
| Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier XU In the file: EGD BIOPSY SINGLE/MULTIPLE | Not listed in the file | Not listed in the file | $823.20 – $2,940 |
Upper GI endoscopy with biopsy: 10 of 36 insurance plan rates
| |||
| Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier XP In the file: EGD BIOPSY SINGLE/MULTIPLE | Not listed in the file | Not listed in the file | $787.03 – $2,810.82 |
Upper GI endoscopy with biopsy: 10 of 36 insurance plan rates
| |||
| Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: DIAGNOSTIC COLONOSCOPY | Not listed in the file | Not listed in the file | $896.85 – $3,347.29 |
Colonoscopy (diagnostic): 10 of 36 insurance plan rates
| |||
| Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 74 In the file: DIAGNOSTIC COLONOSCOPY | Not listed in the file | Not listed in the file | $896.85 – $3,347.29 |
Colonoscopy (diagnostic): 10 of 36 insurance plan rates
| |||
| Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 52 In the file: DIAGNOSTIC COLONOSCOPY | Not listed in the file | Not listed in the file | $448.43 – $2,927.33 |
Colonoscopy (diagnostic): 10 of 36 insurance plan rates
| |||
| Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY AND BIOPSY | Not listed in the file | Not listed in the file | $775.62 – $2,976.32 |
Colonoscopy with biopsy: 10 of 36 insurance plan rates
| |||
| Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier XP In the file: COLONOSCOPY AND BIOPSY | Not listed in the file | Not listed in the file | $775.62 – $2,976.32 |
Colonoscopy with biopsy: 10 of 36 insurance plan rates
| |||
| Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier PT In the file: COLONOSCOPY AND BIOPSY | Not listed in the file | Not listed in the file | $775.62 – $2,976.32 |
Colonoscopy with biopsy: 10 of 36 insurance plan rates
| |||
| Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/LESION REMOVAL | Not listed in the file | Not listed in the file | $847.70 – $3,027.50 |
Colonoscopy with removal of polyps (snare): 10 of 36 insurance plan rates
| |||
| Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier XS In the file: COLONOSCOPY W/LESION REMOVAL | Not listed in the file | Not listed in the file | $847.70 – $3,027.50 |
Colonoscopy with removal of polyps (snare): 10 of 36 insurance plan rates
| |||
| Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier PT In the file: COLONOSCOPY W/LESION REMOVAL | Not listed in the file | Not listed in the file | $847.70 – $3,027.50 |
Colonoscopy with removal of polyps (snare): 10 of 36 insurance plan rates
| |||
| Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLON CA SCRN NOT HI RSK IND | Not listed in the file | Not listed in the file | $823.20 – $2,940 |
Screening colonoscopy (not high risk): 10 of 36 insurance plan rates
| |||
| Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier 52 In the file: COLON CA SCRN NOT HI RSK IND | Not listed in the file | Not listed in the file | $448.43 – $2,925.71 |
Screening colonoscopy (not high risk): 10 of 36 insurance plan rates
| |||
| Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier 73 In the file: COLON CA SCRN NOT HI RSK IND | Not listed in the file | Not listed in the file | $448.43 – $2,925.71 |
Screening colonoscopy (not high risk): 10 of 36 insurance plan rates
| |||
| Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAPAROSCOPIC CHOLECYSTECTOMY | Not listed in the file | Not listed in the file | $3,124.64 – $15,036.60 |
Gallbladder removal by laparoscope: 10 of 36 insurance plan rates
| |||
| Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 50 In the file: LAPAROSCOPIC CHOLECYSTECTOMY | Not listed in the file | Not listed in the file | $3,898.62 – $15,036.60 |
Gallbladder removal by laparoscope: 10 of 36 insurance plan rates
| |||
| Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PRP I/HERN INIT REDUC >5 YR | Not listed in the file | Not listed in the file | $2,917.97 – $10,421.33 |
Groin (inguinal) hernia repair, age 5 or older: 10 of 36 insurance plan rates
| |||
| Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 50 In the file: PRP I/HERN INIT REDUC >5 YR | Not listed in the file | Not listed in the file | $2,917.97 – $15,099.70 |
Groin (inguinal) hernia repair, age 5 or older: 10 of 36 insurance plan rates
| |||
| Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: BIOPSY OF PROSTATE | Not listed in the file | Not listed in the file | $914.26 – $3,265.23 |
Prostate biopsy: 10 of 36 insurance plan rates
| |||
| Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier XS In the file: BIOPSY OF PROSTATE | Not listed in the file | Not listed in the file | $914.26 – $3,265.23 |
Prostate biopsy: 10 of 36 insurance plan rates
| |||
| Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier 59 In the file: BIOPSY OF PROSTATE | Not listed in the file | Not listed in the file | $914.26 – $3,265.23 |
Prostate biopsy: 10 of 36 insurance plan rates
| |||
| Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY BIOPSY | Not listed in the file | Not listed in the file | $1,255.63 – $8,051.47 |
Hysteroscopy with biopsy of the uterus lining: 10 of 36 insurance plan rates
| |||
| Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 74 In the file: HYSTEROSCOPY BIOPSY | Not listed in the file | Not listed in the file | $1,255.63 – $8,051.47 |
Hysteroscopy with biopsy of the uterus lining: 10 of 36 insurance plan rates
| |||
| Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier XP In the file: HYSTEROSCOPY BIOPSY | Not listed in the file | Not listed in the file | $1,255.63 – $8,051.47 |
Hysteroscopy with biopsy of the uterus lining: 10 of 36 insurance plan rates
| |||
| Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: HC INJ INTRLAMNR LUM/SAC W/GUIDE | $3,816 | $2,747.52 | $695.24 – $3,816 |
Spinal injection, lower back (epidural), with imaging guidance: 10 of 53 insurance plan rates
| |||
| Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier GZ In the file: HC INJ INTRLAMNR LUM/SAC W/GUIDE | $3,816 | $2,747.52 | $695.24 – $3,816 |
Spinal injection, lower back (epidural), with imaging guidance: 10 of 53 insurance plan rates
| |||
| Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier 50 In the file: HC INJ INTRLAMNR LUM/SAC W/GUIDE | $3,816 | $2,747.52 | $695.24 – $3,816 |
Spinal injection, lower back (epidural), with imaging guidance: 10 of 53 insurance plan rates
| |||
| Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier 50 In the file: HC INJ EPID LUMBAR/SACRAL SGL-BI | $6,716 | $4,835.52 | $1,042.86 – $6,716 |
Nerve root injection, lower back, with imaging guidance: 10 of 53 insurance plan rates
| |||
| Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier LT In the file: HC INJ EPID LUMBAR/SACRAL SGL-LT | $4,477 | $3,223.44 | $695.24 – $4,477 |
Nerve root injection, lower back, with imaging guidance: 10 of 53 insurance plan rates
| |||
| Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier RT In the file: HC INJ EPID LUMBAR/SACRAL SGL-RT | $4,477 | $3,223.44 | $695.24 – $4,477 |
Nerve root injection, lower back, with imaging guidance: 10 of 53 insurance plan rates
| |||
| Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: CARPAL TUNNEL SURGERY | Not listed in the file | Not listed in the file | $1,225.32 – $4,856.87 |
Carpal tunnel release: 10 of 36 insurance plan rates
| |||
| Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier XS In the file: CARPAL TUNNEL SURGERY | Not listed in the file | Not listed in the file | $1,225.32 – $4,856.87 |
Carpal tunnel release: 10 of 36 insurance plan rates
| |||
| Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 50 In the file: CARPAL TUNNEL SURGERY | Not listed in the file | Not listed in the file | $1,280.95 – $4,856.87 |
Carpal tunnel release: 10 of 36 insurance plan rates
| |||
| Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: HC LASER (YAG) POST CATARACT | $2,002 | $1,441.44 | $517.87 – $2,002 |
Laser treatment of clouding after cataract surgery: 10 of 53 insurance plan rates
| |||
| Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · modifier 50 In the file: HC LASER (YAG) POST CATARACT | $2,002 | $1,441.44 | $560.56 – $2,051.95 |
Laser treatment of clouding after cataract surgery: 10 of 53 insurance plan rates
| |||
| Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · modifier 53 In the file: HC LASER (YAG) POST CATARACT | $2,002 | $1,441.44 | $517.87 – $2,002 |
Laser treatment of clouding after cataract surgery: 10 of 53 insurance plan rates
| |||
| Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: XCAPSL CTRC RMVL W/O ECP | Not listed in the file | Not listed in the file | $814.53 – $5,740.08 |
Cataract removal with lens implant: 10 of 36 insurance plan rates
| |||
| Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · modifier PO In the file: XCAPSL CTRC RMVL W/O ECP | Not listed in the file | Not listed in the file | $814.53 – $5,740.08 |
Cataract removal with lens implant: 10 of 36 insurance plan rates
| |||
| Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · modifier 50 In the file: XCAPSL CTRC RMVL W/O ECP | Not listed in the file | Not listed in the file | $814.53 – $5,740.08 |
Cataract removal with lens implant: 10 of 36 insurance plan rates
| |||
Hospital stays (whole stay, MS-DRG)
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) 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 | $16,481.91 – $58,863.95 |
Hip or knee replacement (major joint of the leg), without major complications: 10 of 34 insurance plan rates
| |||
| Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | Not listed in the file | Not listed in the file | $10,441.37 – $37,290.61 |
Uterus and ovary surgery (not for cancer), without complications: 10 of 34 insurance plan rates
| |||
Source: St Anthonys Memorial Hospital’s standard charges file (hshs.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 24, 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 | 503 N Maple Street, Effingham, IL 62401 |
| County | Effingham County |
| State | Illinois |
| Phone | (217) 342‑2121 |
| Emergency services | Yes |
| Ownership | Voluntary non-profit - Church |
| Medicare overall rating | 3 of 5 stars |
| Birthing-friendly designation | Yes (meets CMS criteria) |
| CMS Certification Number | 140032 |
| Name in Medicare records | ST ANTHONYS MEMORIAL HOSPITAL |
| Profile level | Medicare data + hospital website |
| Name on the hospital’s website | HSHS St. Anthony's Memorial Hospital |
| Official website | hshs.org |
| Corrections | Report an error or suggest an update → |
Sources
- Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
- Medicare Care Compare — official Medicare profile of this hospital
- U.S. Census Bureau Geocoder — map position used for distances
From the hospital’s website
Numbers match the citations above. Checked 2026-10-30.
- Services — hshs.org