Does Stonewall Jackson Memorial Hospital Company have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Stonewall Jackson Memorial Hospital Company. In a medical emergency, call 911.

Where is Stonewall Jackson Memorial Hospital Company?

230 Hospital Plaza, Weston, WV 26452, in Lewis County, West Virginia.

What is the phone number of Stonewall Jackson Memorial Hospital Company?

(304) 269-8000, as listed by Medicare (CMS).

What is the Medicare star rating of Stonewall Jackson Memorial Hospital Company?

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

Stonewall Jackson Memorial Hospital Company

Quick answers

Does Stonewall Jackson Memorial Hospital Company have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Stonewall Jackson Memorial Hospital Company. In a medical emergency, call 911.
Where is Stonewall Jackson Memorial Hospital Company?: 230 Hospital Plaza, Weston, WV 26452, in Lewis County, West Virginia.
What is the phone number of Stonewall Jackson Memorial Hospital Company?: (304) 269-8000, as listed by Medicare (CMS).
What is the Medicare star rating of Stonewall Jackson Memorial Hospital Company?: 1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[5][6]

Procedures^[6]

Hernia repair
Colonoscopy
Endoscopy
Thyroidectomy and parathyroidectomy
Laparoscopic gallbladder surgery
Arthroscopic surgery
Rotator cuff repair
Knee, hip and joint replacement
Cesarean section
Hysterectomy
Endometrial ablation
Colposcopy
Uterine fibroid embolization
Prostate surgery
Vasectomy and reversal
Kidney biopsy

Emergency care (hospital website)^[5]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV
Stroke designation	DNV Acute Stroke Ready Certified

Visiting and practical information

Visiting	No set visiting hours; visitors asked to respect patient privacy, clinical restrictions may apply^[7]

Doctors and clinicians (102)

102 doctors and other clinicians list Stonewall Jackson Memorial Hospital Company 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 (102)

Aaron Vaslow, MDOrthopedic Surgery
Abdulmalek Sabbagh, MDCardiovascular Disease (Cardiology)
Abid Rizvi, MDPsychiatry
Abigail L. Strait, PAPhysician Assistant
Adnan Alghadban, MDNeurology
Ahmed S. Aboraya, MDPsychiatry
Alexis N. Hernandez Abrego, MDEmergency Medicine
Allison G. Bardes, MDOphthalmology
Amanda E. Dawson, PAPhysician Assistant
Amy B. Pearson, MDFamily Practice
Angela M. Mills, DOFamily Practice
Anthony Roda-Renzelli, MDInterventional Cardiology
Antoine Naim, MDObstetrics/Gynecology
Benjamin M. Blick, CNACertified Registered Nurse Anesthetist (CRNA)
Brittany L. GregoryNurse Practitioner
Carey F. Swisher, DOFamily Practice
Carolyn M. Moyers, DOObstetrics/Gynecology
Chad J. Micucci, MDOrthopedic Surgery
Christopher Courtney, DOOrthopedic Surgery
Christopher S. Chen, MDOrthopedic Surgery
Clara R. LarewNurse Practitioner
Clyde Ellis Jr., MDGeneral Surgery
Colin Fee, MDInternal Medicine
Crystal CoricaNurse Practitioner

And 78 more: the button below opens the full list.

Other emergency rooms nearby

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

St Joseph's Hospital of Buckhannon, Inc14 mi · Buckhannon, WV · Critical Access Hospital
Clarksburg VA Medical Center17 mi · Clarksburg, WV · Federal/VA Acute Care Hospital
Highland-Clarksburg Hospital, Inc18 mi · Clarksburg, WV · Psychiatric Hospital
United Hospital Center, Inc23 mi · Bridgeport, WV · Acute Care Hospital
Vandalia Health Broaddus Hospital26 mi · Philippi, WV · Critical Access Hospital

Other hospitals nearby

William R Sharpe, Jr Hospital0.6 mi · Weston, WV · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Crestview Manor Healthcare6.7 mi · Jane Lew, WV · 4 of 5 stars
St. Joseph's Hospital15 mi · Buckhannon, WV · 5 of 5 stars
Holbrook Healthcare Center16 mi · Buckhannon, WV · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Adoration Hospice16 mi · Buckhannon, WV
Wvuhs Home Care18 mi · Clarksburg, WV · 4 of 5 stars

All hospice providers in the state →

Home health agencies

West Virginia Home Health16 mi · Buckhannon, WV · 3 of 5 stars
Wvuhs Home Care18 mi · Clarksburg, WV

All home health agencies in the state →

Dialysis facilities

Fresenius Medical Care Upshur County16 mi · Buckhannon, WV · 1 of 5 stars
DaVita Harrison County Dialysis18 mi · Clarksburg, WV · 3 of 5 stars
Fresenius Medical Care Clarksburg22 mi · Bridgeport, WV · 2 of 5 stars

All dialysis facilities 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

Robert Bland Middle School Wellness Center1.7 mi · Weston, WV · Community health center
Camden Family Health2.0 mi · Weston, WV · Community health center
Robert L Bland Middle School Wellness Center Temporary Site2.3 mi · Jane Lew, WV · Community health center

Clinics and urgent care

Brushy Fork Clinic, a Rural Health Clinic of St. Joseph's Hospital16 mi · Buckhannon, WV · Rural health clinic
St Joseph's Hospital of Buckhannon Inc16 mi · Buckhannon, WV · Rural health clinic
Burnsville Medical Center PLLC18 mi · Burnsville, WV · Rural health clinic

Pharmacies

Community Care of West Virginia, Inc.2.1 mi · Weston, WV · Pharmacy
Fast & Friendly Pharmacy RC LLC2.1 mi · Weston, WV · Pharmacy
Wal-Mart Stores East LP2.1 mi · Weston, WV · 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 Stonewall Jackson Memorial Hospital Company reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	69%National average: 72%
Would definitely recommend the hospital	67%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	82%National average: 80%
Staff “always” explained medicines before giving them	60%National average: 62%
Were given information about recovery at home	84%National average: 86%
Room and bathroom “always” clean	78%National average: 74%
Area around the room “always” quiet at night	51%National average: 60%
Completed surveys	179Response rate: 21%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	20.3%
Deaths within 30 days: COPD patients	8.2%
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.07No different from the national rate
Complications after hip or knee replacement	3.4%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	21.7%
Readmitted within 30 days: pneumonia	18.3%
Readmitted within 30 days: COPD	19%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	5.1%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	98 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	81%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 West Virginia Best hospitals in West Virginia

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 43 common services exactly as Stonewall Jackson Memorial Hospital Company lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: 99203 Office visit - new patient, level 3	$245.09	$122.55	$58.25 – $240.19
New patient office visit (about 30–44 minutes): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $240.19 AETNA — COMMERCIAL: $196.07 AETNA_AUTO — COMMERCIAL: $196.07 AETNA_BETTER_HEALTH — MEDICARE: $98.55 AETNA_MEDICAL_RENTAL — COMMERCIAL: $196.07 AETNA_WORK_COMP — COMMERCIAL: $196.07 ALLIANCE_PPO — COMMERCIAL: $232.84 CARESOURCE_MEDICAID — MEDICAID: $59.42 CCN — COMMERCIAL: $232.84 CIGNA — COMMERCIAL: $221.07
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: 99204 Office visit - new patient, level 4	$245.09	$122.55	$94.39 – $240.19
New patient office visit (about 45–59 minutes): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $240.19 AETNA — COMMERCIAL: $196.07 AETNA_AUTO — COMMERCIAL: $196.07 AETNA_BETTER_HEALTH — MEDICARE: $150.90 AETNA_MEDICAL_RENTAL — COMMERCIAL: $196.07 AETNA_WORK_COMP — COMMERCIAL: $196.07 ALLIANCE_PPO — COMMERCIAL: $232.84 CARESOURCE_MEDICAID — MEDICAID: $96.28 CCN — COMMERCIAL: $232.84 CIGNA — COMMERCIAL: $221.07
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: 99205 Office visit - new patient, level 5	$245.09	$122.55	$127.82 – $240.19
New patient office visit (about 60–74 minutes): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $240.19 AETNA — COMMERCIAL: $196.07 AETNA_AUTO — COMMERCIAL: $196.07 AETNA_BETTER_HEALTH — MEDICARE: $158.95 AETNA_MEDICAL_RENTAL — COMMERCIAL: $196.07 AETNA_WORK_COMP — COMMERCIAL: $196.07 ALLIANCE_PPO — COMMERCIAL: $232.84 CARESOURCE_MEDICAID — MEDICAID: $130.38 CCN — COMMERCIAL: $232.84 CIGNA — COMMERCIAL: $221.07
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: 99213 Office visit - established patient, level 3	$245.09	$122.55	$46.46 – $240.19
Established patient office visit (about 20–29 minutes): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $240.19 AETNA — COMMERCIAL: $196.07 AETNA_AUTO — COMMERCIAL: $196.07 AETNA_BETTER_HEALTH — MEDICARE: $67.12 AETNA_MEDICAL_RENTAL — COMMERCIAL: $196.07 AETNA_WORK_COMP — COMMERCIAL: $196.07 ALLIANCE_PPO — COMMERCIAL: $232.84 CARESOURCE_MEDICAID — MEDICAID: $47.39 CCN — COMMERCIAL: $232.84 CIGNA — COMMERCIAL: $221.07
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: 99214 Office visit - established patient, level 4	$245.09	$122.55	$67.84 – $240.19
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $240.19 AETNA — COMMERCIAL: $196.07 AETNA_AUTO — COMMERCIAL: $196.07 AETNA_BETTER_HEALTH — MEDICARE: $98.63 AETNA_MEDICAL_RENTAL — COMMERCIAL: $196.07 AETNA_WORK_COMP — COMMERCIAL: $196.07 ALLIANCE_PPO — COMMERCIAL: $232.84 CARESOURCE_MEDICAID — MEDICAID: $69.20 CCN — COMMERCIAL: $232.84 CIGNA — COMMERCIAL: $221.07
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: 99283 Level 3 FCT Charge	$1,571.39	$785.70	$59.71 – $1,539.96
Emergency room visit (moderate): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $1,539.96 AETNA — COMMERCIAL: $1,257.11 AETNA_AUTO — COMMERCIAL: $1,257.11 AETNA_BETTER_HEALTH — MEDICARE: $59.71 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,257.11 AETNA_WORK_COMP — COMMERCIAL: $1,257.11 ALLIANCE_PPO — COMMERCIAL: $1,492.82 CARESOURCE_MEDICAID — MEDICAID: $152.36 CCN — COMMERCIAL: $1,492.82 CIGNA — COMMERCIAL: $1,417.39
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: 99283 Exam Plus Treat Iii	$1,571.39	$785.70	$59.71 – $1,539.96
Emergency room visit (moderate): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $1,539.96 AETNA — COMMERCIAL: $1,257.11 AETNA_AUTO — COMMERCIAL: $1,257.11 AETNA_BETTER_HEALTH — MEDICARE: $59.71 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,257.11 AETNA_WORK_COMP — COMMERCIAL: $1,257.11 ALLIANCE_PPO — COMMERCIAL: $1,492.82 CARESOURCE_MEDICAID — MEDICAID: $152.36 CCN — COMMERCIAL: $1,492.82 CIGNA — COMMERCIAL: $1,417.39
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: 99284 Level 4 FCT Charge	$2,439.30	$1,219.65	$113.40 – $2,390.51
Emergency room visit (moderately high): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $2,390.51 AETNA — COMMERCIAL: $1,951.44 AETNA_AUTO — COMMERCIAL: $1,951.44 AETNA_BETTER_HEALTH — MEDICARE: $113.40 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,951.44 AETNA_WORK_COMP — COMMERCIAL: $1,951.44 ALLIANCE_PPO — COMMERCIAL: $2,317.34 CARESOURCE_MEDICAID — MEDICAID: $284.39 CCN — COMMERCIAL: $2,317.34 CIGNA — COMMERCIAL: $2,200.25
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: 99284 Exam Plus Treatment Iv	$2,439.30	$1,219.65	$113.40 – $2,390.51
Emergency room visit (moderately high): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $2,390.51 AETNA — COMMERCIAL: $1,951.44 AETNA_AUTO — COMMERCIAL: $1,951.44 AETNA_BETTER_HEALTH — MEDICARE: $113.40 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,951.44 AETNA_WORK_COMP — COMMERCIAL: $1,951.44 ALLIANCE_PPO — COMMERCIAL: $2,317.34 CARESOURCE_MEDICAID — MEDICAID: $284.39 CCN — COMMERCIAL: $2,317.34 CIGNA — COMMERCIAL: $2,200.25
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: 99285 Level 5 FCT Charge	$3,537.51	$1,768.76	$167.34 – $3,466.76
Emergency room visit (high): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $3,466.76 AETNA — COMMERCIAL: $2,830.01 AETNA_AUTO — COMMERCIAL: $2,830.01 AETNA_BETTER_HEALTH — MEDICARE: $167.34 AETNA_MEDICAL_RENTAL — COMMERCIAL: $2,830.01 AETNA_WORK_COMP — COMMERCIAL: $2,830.01 ALLIANCE_PPO — COMMERCIAL: $3,360.63 CARESOURCE_MEDICAID — MEDICAID: $720.78 CCN — COMMERCIAL: $3,360.63 CIGNA — COMMERCIAL: $3,190.83
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: 99285 Exam Plus Treat-V	$3,537.51	$1,768.76	$167.34 – $3,466.76
Emergency room visit (high): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $3,466.76 AETNA — COMMERCIAL: $2,830.01 AETNA_AUTO — COMMERCIAL: $2,830.01 AETNA_BETTER_HEALTH — MEDICARE: $167.34 AETNA_MEDICAL_RENTAL — COMMERCIAL: $2,830.01 AETNA_WORK_COMP — COMMERCIAL: $2,830.01 ALLIANCE_PPO — COMMERCIAL: $3,360.63 CARESOURCE_MEDICAID — MEDICAID: $720.78 CCN — COMMERCIAL: $3,360.63 CIGNA — COMMERCIAL: $3,190.83

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP Standard	$65.34	$32.67	$7.33 – $64.03
Basic metabolic panel (blood test): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $64.03 AETNA — COMMERCIAL: $8.48 AETNA_AUTO — COMMERCIAL: $52.27 AETNA_BETTER_HEALTH — MEDICARE: $7.33 AETNA_MEDICAL_RENTAL — COMMERCIAL: $52.27 AETNA_WORK_COMP — COMMERCIAL: $52.27 ALLIANCE_PPO — COMMERCIAL: $62.07 CARESOURCE_MEDICAID — MEDICAID: $7.76 CCN — COMMERCIAL: $62.07 CIGNA — COMMERCIAL: $58.94
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: CMP Standard	$70.39	$35.20	$9.16 – $68.98
Comprehensive metabolic panel (blood test): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $68.98 AETNA — COMMERCIAL: $10.60 AETNA_AUTO — COMMERCIAL: $56.31 AETNA_BETTER_HEALTH — MEDICARE: $9.16 AETNA_MEDICAL_RENTAL — COMMERCIAL: $56.31 AETNA_WORK_COMP — COMMERCIAL: $56.31 ALLIANCE_PPO — COMMERCIAL: $66.87 CARESOURCE_MEDICAID — MEDICAID: $9.69 CCN — COMMERCIAL: $66.87 CIGNA — COMMERCIAL: $63.49
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Lipid Panel Standard	$89.25	$44.63	$9.83 – $87.47
Cholesterol panel (lipid panel): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $87.47 AETNA — COMMERCIAL: $9.83 AETNA_AUTO — COMMERCIAL: $71.40 AETNA_BETTER_HEALTH — MEDICARE: $11.61 AETNA_MEDICAL_RENTAL — COMMERCIAL: $71.40 AETNA_WORK_COMP — COMMERCIAL: $71.40 ALLIANCE_PPO — COMMERCIAL: $84.79 CARESOURCE_MEDICAID — MEDICAID: $12.29 CCN — COMMERCIAL: $84.79 CIGNA — COMMERCIAL: $80.50
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: NMR Lipo Profile LC	$89.25	$44.63	$9.83 – $87.47
Cholesterol panel (lipid panel): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $87.47 AETNA — COMMERCIAL: $9.83 AETNA_AUTO — COMMERCIAL: $71.40 AETNA_BETTER_HEALTH — MEDICARE: $11.61 AETNA_MEDICAL_RENTAL — COMMERCIAL: $71.40 AETNA_WORK_COMP — COMMERCIAL: $71.40 ALLIANCE_PPO — COMMERCIAL: $84.79 CARESOURCE_MEDICAID — MEDICAID: $12.29 CCN — COMMERCIAL: $84.79 CIGNA — COMMERCIAL: $80.50
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal Panel Standard	$57.86	$28.93	$7.53 – $56.70
Kidney function panel: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $56.70 AETNA — COMMERCIAL: $46.29 AETNA_AUTO — COMMERCIAL: $46.29 AETNA_BETTER_HEALTH — MEDICARE: $7.53 AETNA_MEDICAL_RENTAL — COMMERCIAL: $46.29 AETNA_WORK_COMP — COMMERCIAL: $46.29 ALLIANCE_PPO — COMMERCIAL: $54.97 CARESOURCE_MEDICAID — MEDICAID: $7.97 CCN — COMMERCIAL: $54.97 CIGNA — COMMERCIAL: $52.19
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic Panel Standard	$54.46	$27.23	$7.08 – $53.37
Liver function panel: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $53.37 AETNA — COMMERCIAL: $8.19 AETNA_AUTO — COMMERCIAL: $43.57 AETNA_BETTER_HEALTH — MEDICARE: $7.08 AETNA_MEDICAL_RENTAL — COMMERCIAL: $43.57 AETNA_WORK_COMP — COMMERCIAL: $43.57 ALLIANCE_PPO — COMMERCIAL: $51.74 CARESOURCE_MEDICAID — MEDICAID: $7.50 CCN — COMMERCIAL: $51.74 CIGNA — COMMERCIAL: $49.12
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis Microscopic Standard	$34.67	$17.34	$2.75 – $33.98
Urine test (automated, with microscope): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $33.98 AETNA — COMMERCIAL: $3.18 AETNA_AUTO — COMMERCIAL: $27.74 AETNA_BETTER_HEALTH — MEDICARE: $2.75 AETNA_MEDICAL_RENTAL — COMMERCIAL: $27.74 AETNA_WORK_COMP — COMMERCIAL: $27.74 ALLIANCE_PPO — COMMERCIAL: $32.94 CARESOURCE_MEDICAID — MEDICAID: $2.91 CCN — COMMERCIAL: $32.94 CIGNA — COMMERCIAL: $31.27
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: pH, 24 Hr Urine	$14.99	$7.50	$1.94 – $14.69
Urine test (automated, without microscope): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $14.69 AETNA — COMMERCIAL: $2.25 AETNA_AUTO — COMMERCIAL: $11.99 AETNA_BETTER_HEALTH — MEDICARE: $1.94 AETNA_MEDICAL_RENTAL — COMMERCIAL: $11.99 AETNA_WORK_COMP — COMMERCIAL: $11.99 ALLIANCE_PPO — COMMERCIAL: $14.24 CARESOURCE_MEDICAID — MEDICAID: $2.07 CCN — COMMERCIAL: $14.24 CIGNA — COMMERCIAL: $13.52
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Bill Urinalysis Macroscopic	$24	$12	$1.94 – $23.52
Urine test (automated, without microscope): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $23.52 AETNA — COMMERCIAL: $2.25 AETNA_AUTO — COMMERCIAL: $19.20 AETNA_BETTER_HEALTH — MEDICARE: $1.94 AETNA_MEDICAL_RENTAL — COMMERCIAL: $19.20 AETNA_WORK_COMP — COMMERCIAL: $19.20 ALLIANCE_PPO — COMMERCIAL: $22.80 CARESOURCE_MEDICAID — MEDICAID: $2.07 CCN — COMMERCIAL: $22.80 CIGNA — COMMERCIAL: $21.65
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urinalysis Dipstick Standard	$24	$12	$1.94 – $23.52
Urine test (automated, without microscope): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $23.52 AETNA — COMMERCIAL: $2.25 AETNA_AUTO — COMMERCIAL: $19.20 AETNA_BETTER_HEALTH — MEDICARE: $1.94 AETNA_MEDICAL_RENTAL — COMMERCIAL: $19.20 AETNA_WORK_COMP — COMMERCIAL: $19.20 ALLIANCE_PPO — COMMERCIAL: $22.80 CARESOURCE_MEDICAID — MEDICAID: $2.07 CCN — COMMERCIAL: $22.80 CIGNA — COMMERCIAL: $21.65
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: % Free PSA	$122.59	$61.30	$15.94 – $120.14
PSA (prostate specific antigen) blood test: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $120.14 AETNA — COMMERCIAL: $18.44 AETNA_AUTO — COMMERCIAL: $98.07 AETNA_BETTER_HEALTH — MEDICARE: $15.94 AETNA_MEDICAL_RENTAL — COMMERCIAL: $98.07 AETNA_WORK_COMP — COMMERCIAL: $98.07 ALLIANCE_PPO — COMMERCIAL: $116.46 CARESOURCE_MEDICAID — MEDICAID: $16.88 CCN — COMMERCIAL: $116.46 CIGNA — COMMERCIAL: $110.58
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA Screen	$122.59	$61.30	$15.94 – $120.14
PSA (prostate specific antigen) blood test: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $120.14 AETNA — COMMERCIAL: $18.44 AETNA_AUTO — COMMERCIAL: $98.07 AETNA_BETTER_HEALTH — MEDICARE: $15.94 AETNA_MEDICAL_RENTAL — COMMERCIAL: $98.07 AETNA_WORK_COMP — COMMERCIAL: $98.07 ALLIANCE_PPO — COMMERCIAL: $116.46 CARESOURCE_MEDICAID — MEDICAID: $16.88 CCN — COMMERCIAL: $116.46 CIGNA — COMMERCIAL: $110.58
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate Specific Antigen Diagnostic	$122.59	$61.30	$15.94 – $120.14
PSA (prostate specific antigen) blood test: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $120.14 AETNA — COMMERCIAL: $18.44 AETNA_AUTO — COMMERCIAL: $98.07 AETNA_BETTER_HEALTH — MEDICARE: $15.94 AETNA_MEDICAL_RENTAL — COMMERCIAL: $98.07 AETNA_WORK_COMP — COMMERCIAL: $98.07 ALLIANCE_PPO — COMMERCIAL: $116.46 CARESOURCE_MEDICAID — MEDICAID: $16.88 CCN — COMMERCIAL: $116.46 CIGNA — COMMERCIAL: $110.58
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid Panel 1	$111.98	$55.99	$14.56 – $109.74
Thyroid stimulating hormone (TSH) test: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $109.74 AETNA — COMMERCIAL: $16.84 AETNA_AUTO — COMMERCIAL: $89.58 AETNA_BETTER_HEALTH — MEDICARE: $14.56 AETNA_MEDICAL_RENTAL — COMMERCIAL: $89.58 AETNA_WORK_COMP — COMMERCIAL: $89.58 ALLIANCE_PPO — COMMERCIAL: $106.38 CARESOURCE_MEDICAID — MEDICAID: $15.42 CCN — COMMERCIAL: $106.38 CIGNA — COMMERCIAL: $101.01
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid Stimulating Hormone Cascade	$111.98	$55.99	$14.56 – $109.74
Thyroid stimulating hormone (TSH) test: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $109.74 AETNA — COMMERCIAL: $16.84 AETNA_AUTO — COMMERCIAL: $89.58 AETNA_BETTER_HEALTH — MEDICARE: $14.56 AETNA_MEDICAL_RENTAL — COMMERCIAL: $89.58 AETNA_WORK_COMP — COMMERCIAL: $89.58 ALLIANCE_PPO — COMMERCIAL: $106.38 CARESOURCE_MEDICAID — MEDICAID: $15.42 CCN — COMMERCIAL: $106.38 CIGNA — COMMERCIAL: $101.01
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH 3rd Gen	$111.98	$55.99	$14.56 – $109.74
Thyroid stimulating hormone (TSH) test: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $109.74 AETNA — COMMERCIAL: $16.84 AETNA_AUTO — COMMERCIAL: $89.58 AETNA_BETTER_HEALTH — MEDICARE: $14.56 AETNA_MEDICAL_RENTAL — COMMERCIAL: $89.58 AETNA_WORK_COMP — COMMERCIAL: $89.58 ALLIANCE_PPO — COMMERCIAL: $106.38 CARESOURCE_MEDICAID — MEDICAID: $15.42 CCN — COMMERCIAL: $106.38 CIGNA — COMMERCIAL: $101.01
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Neutrophil Automated	$51.80	$25.90	$6.73 – $50.76
Complete blood count (CBC) with differential: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $50.76 AETNA — COMMERCIAL: $7.80 AETNA_AUTO — COMMERCIAL: $41.44 AETNA_BETTER_HEALTH — MEDICARE: $6.73 AETNA_MEDICAL_RENTAL — COMMERCIAL: $41.44 AETNA_WORK_COMP — COMMERCIAL: $41.44 ALLIANCE_PPO — COMMERCIAL: $49.21 CARESOURCE_MEDICAID — MEDICAID: $7.13 CCN — COMMERCIAL: $49.21 CIGNA — COMMERCIAL: $46.72
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Bill Neutrophil Automated	$51.80	$25.90	$6.73 – $50.76
Complete blood count (CBC) with differential: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $50.76 AETNA — COMMERCIAL: $7.80 AETNA_AUTO — COMMERCIAL: $41.44 AETNA_BETTER_HEALTH — MEDICARE: $6.73 AETNA_MEDICAL_RENTAL — COMMERCIAL: $41.44 AETNA_WORK_COMP — COMMERCIAL: $41.44 ALLIANCE_PPO — COMMERCIAL: $49.21 CARESOURCE_MEDICAID — MEDICAID: $7.13 CCN — COMMERCIAL: $49.21 CIGNA — COMMERCIAL: $46.72
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC/Hemogram	$43.13	$21.57	$5.60 – $42.27
Complete blood count (CBC), automated: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $42.27 AETNA — COMMERCIAL: $6.49 AETNA_AUTO — COMMERCIAL: $34.50 AETNA_BETTER_HEALTH — MEDICARE: $5.60 AETNA_MEDICAL_RENTAL — COMMERCIAL: $34.50 AETNA_WORK_COMP — COMMERCIAL: $34.50 ALLIANCE_PPO — COMMERCIAL: $40.97 CARESOURCE_MEDICAID — MEDICAID: $5.94 CCN — COMMERCIAL: $40.97 CIGNA — COMMERCIAL: $38.90
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: 85027 CBC	$43.13	$21.57	$5.60 – $42.27
Complete blood count (CBC), automated: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $42.27 AETNA — COMMERCIAL: $6.49 AETNA_AUTO — COMMERCIAL: $34.50 AETNA_BETTER_HEALTH — MEDICARE: $5.60 AETNA_MEDICAL_RENTAL — COMMERCIAL: $34.50 AETNA_WORK_COMP — COMMERCIAL: $34.50 ALLIANCE_PPO — COMMERCIAL: $40.97 CARESOURCE_MEDICAID — MEDICAID: $5.94 CCN — COMMERCIAL: $40.97 CIGNA — COMMERCIAL: $38.90
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PT	$28.59	$14.30	$3.41 – $28.02
Blood clotting time test (prothrombin time, PT): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $28.02 AETNA — COMMERCIAL: $3.93 AETNA_AUTO — COMMERCIAL: $22.87 AETNA_BETTER_HEALTH — MEDICARE: $3.41 AETNA_MEDICAL_RENTAL — COMMERCIAL: $22.87 AETNA_WORK_COMP — COMMERCIAL: $22.87 ALLIANCE_PPO — COMMERCIAL: $27.16 CARESOURCE_MEDICAID — MEDICAID: $3.94 CCN — COMMERCIAL: $27.16 CIGNA — COMMERCIAL: $25.79
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT	$40.06	$20.03	$5.20 – $39.26
Blood clotting test (partial thromboplastin time, PTT): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $39.26 AETNA — COMMERCIAL: $6.02 AETNA_AUTO — COMMERCIAL: $32.05 AETNA_BETTER_HEALTH — MEDICARE: $5.20 AETNA_MEDICAL_RENTAL — COMMERCIAL: $32.05 AETNA_WORK_COMP — COMMERCIAL: $32.05 ALLIANCE_PPO — COMMERCIAL: $38.06 CARESOURCE_MEDICAID — MEDICAID: $5.52 CCN — COMMERCIAL: $38.06 CIGNA — COMMERCIAL: $36.13
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Lupus Anticoagulant VH	$200.20	$100.10	$5.20 – $196.20
Blood clotting test (partial thromboplastin time, PTT): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $196.20 AETNA — COMMERCIAL: $6.02 AETNA_AUTO — COMMERCIAL: $160.16 AETNA_BETTER_HEALTH — MEDICARE: $5.20 AETNA_MEDICAL_RENTAL — COMMERCIAL: $160.16 AETNA_WORK_COMP — COMMERCIAL: $160.16 ALLIANCE_PPO — COMMERCIAL: $190.19 CARESOURCE_MEDICAID — MEDICAID: $5.52 CCN — COMMERCIAL: $190.19 CIGNA — COMMERCIAL: $180.58

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · modifier TC In the file: CT Head or Brain w/o Contrast	$605.49	$302.75	$72.27 – $593.38
CT scan of the head or brain, without contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $593.38 AETNA — COMMERCIAL: $484.39 AETNA_AUTO — COMMERCIAL: $484.39 AETNA_BETTER_HEALTH — MEDICARE: $102.84 AETNA_MEDICAL_RENTAL — COMMERCIAL: $484.39 AETNA_WORK_COMP — COMMERCIAL: $484.39 ALLIANCE_PPO — COMMERCIAL: $575.22 CARESOURCE_MEDICAID — MEDICAID: $73.72 CCN — COMMERCIAL: $575.22 CIGNA — COMMERCIAL: $546.15
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · modifier TC In the file: CT Brain for Stroke	$605.49	$302.75	$72.27 – $593.38
CT scan of the head or brain, without contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $593.38 AETNA — COMMERCIAL: $484.39 AETNA_AUTO — COMMERCIAL: $484.39 AETNA_BETTER_HEALTH — MEDICARE: $102.84 AETNA_MEDICAL_RENTAL — COMMERCIAL: $484.39 AETNA_WORK_COMP — COMMERCIAL: $484.39 ALLIANCE_PPO — COMMERCIAL: $575.22 CARESOURCE_MEDICAID — MEDICAID: $73.72 CCN — COMMERCIAL: $575.22 CIGNA — COMMERCIAL: $546.15
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · modifier TC In the file: 70450 CT Head or Brain w/o Contrast	$605.49	$302.75	$72.27 – $593.38
CT scan of the head or brain, without contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $593.38 AETNA — COMMERCIAL: $484.39 AETNA_AUTO — COMMERCIAL: $484.39 AETNA_BETTER_HEALTH — MEDICARE: $102.84 AETNA_MEDICAL_RENTAL — COMMERCIAL: $484.39 AETNA_WORK_COMP — COMMERCIAL: $484.39 ALLIANCE_PPO — COMMERCIAL: $575.22 CARESOURCE_MEDICAID — MEDICAID: $73.72 CCN — COMMERCIAL: $575.22 CIGNA — COMMERCIAL: $546.15
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · modifier TC In the file: MRI Brain w/ + w/o Contrast	$2,118.03	$1,059.02	$220.48 – $2,075.67
MRI of the brain, before and after contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $2,075.67 AETNA — COMMERCIAL: $1,694.42 AETNA_AUTO — COMMERCIAL: $1,694.42 AETNA_BETTER_HEALTH — MEDICARE: $326.82 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,694.42 AETNA_WORK_COMP — COMMERCIAL: $1,694.42 ALLIANCE_PPO — COMMERCIAL: $2,012.13 CARESOURCE_MEDICAID — MEDICAID: $224.89 CCN — COMMERCIAL: $2,012.13 CIGNA — COMMERCIAL: $1,910.46
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier TC In the file: XR Chest 2 Views	$500.47	$250.24	$21.88 – $490.46
Chest X-ray, 2 views: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $490.46 AETNA — COMMERCIAL: $400.38 AETNA_AUTO — COMMERCIAL: $400.38 AETNA_BETTER_HEALTH — MEDICARE: $28.07 AETNA_MEDICAL_RENTAL — COMMERCIAL: $400.38 AETNA_WORK_COMP — COMMERCIAL: $400.38 ALLIANCE_PPO — COMMERCIAL: $475.45 CARESOURCE_MEDICAID — MEDICAID: $22.32 CCN — COMMERCIAL: $475.45 CIGNA — COMMERCIAL: $451.42
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier TC In the file: XR Spine Lumbosacral Minimum 4 Views	$605.49	$302.75	$33.18 – $593.38
X-ray of the lower spine, at least 4 views: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $593.38 AETNA — COMMERCIAL: $484.39 AETNA_AUTO — COMMERCIAL: $484.39 AETNA_BETTER_HEALTH — MEDICARE: $45.15 AETNA_MEDICAL_RENTAL — COMMERCIAL: $484.39 AETNA_WORK_COMP — COMMERCIAL: $484.39 ALLIANCE_PPO — COMMERCIAL: $575.22 CARESOURCE_MEDICAID — MEDICAID: $33.84 CCN — COMMERCIAL: $575.22 CIGNA — COMMERCIAL: $546.15
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · modifier TC In the file: MRI Spine Lumbar w/o Contrast	$1,349.53	$674.77	$132.49 – $1,322.54
MRI of the lower back (lumbar spine), without contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $1,322.54 AETNA — COMMERCIAL: $1,079.62 AETNA_AUTO — COMMERCIAL: $1,079.62 AETNA_BETTER_HEALTH — MEDICARE: $195.58 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,079.62 AETNA_WORK_COMP — COMMERCIAL: $1,079.62 ALLIANCE_PPO — COMMERCIAL: $1,282.05 CARESOURCE_MEDICAID — MEDICAID: $135.14 CCN — COMMERCIAL: $1,282.05 CIGNA — COMMERCIAL: $1,217.28
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · modifier TC In the file: CT Pelvis w/ Contrast	$1,011.91	$505.96	$150.07 – $991.67
CT scan of the pelvis, with contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $991.67 AETNA — COMMERCIAL: $809.53 AETNA_AUTO — COMMERCIAL: $809.53 AETNA_BETTER_HEALTH — MEDICARE: $204.46 AETNA_MEDICAL_RENTAL — COMMERCIAL: $809.53 AETNA_WORK_COMP — COMMERCIAL: $809.53 ALLIANCE_PPO — COMMERCIAL: $961.31 CARESOURCE_MEDICAID — MEDICAID: $153.07 CCN — COMMERCIAL: $961.31 CIGNA — COMMERCIAL: $912.74
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier TC\|LT In the file: MRI LE Joint w/o Contrast Left	$1,349.53	$674.77	$139.12 – $1,322.54
MRI of a leg joint (such as the knee), without contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $1,322.54 AETNA — COMMERCIAL: $1,079.62 AETNA_AUTO — COMMERCIAL: $1,079.62 AETNA_BETTER_HEALTH — MEDICARE: $205.11 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,079.62 AETNA_WORK_COMP — COMMERCIAL: $1,079.62 ALLIANCE_PPO — COMMERCIAL: $1,282.05 CARESOURCE_MEDICAID — MEDICAID: $141.90 CCN — COMMERCIAL: $1,282.05 CIGNA — COMMERCIAL: $1,217.28
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier TC\|RT In the file: MRI LE Joint w/o Contrast Right	$1,349.53	$674.77	$139.12 – $1,322.54
MRI of a leg joint (such as the knee), without contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $1,322.54 AETNA — COMMERCIAL: $1,079.62 AETNA_AUTO — COMMERCIAL: $1,079.62 AETNA_BETTER_HEALTH — MEDICARE: $205.11 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,079.62 AETNA_WORK_COMP — COMMERCIAL: $1,079.62 ALLIANCE_PPO — COMMERCIAL: $1,282.05 CARESOURCE_MEDICAID — MEDICAID: $141.90 CCN — COMMERCIAL: $1,282.05 CIGNA — COMMERCIAL: $1,217.28
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT Abdomen and Pelvis w/ Contrast	$2,118.03	$1,059.02	$210.40 – $2,075.67
CT scan of the abdomen and pelvis, with contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $2,075.67 AETNA — COMMERCIAL: $1,694.42 AETNA_AUTO — COMMERCIAL: $1,694.42 AETNA_BETTER_HEALTH — MEDICARE: $280.12 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,694.42 AETNA_WORK_COMP — COMMERCIAL: $1,694.42 ALLIANCE_PPO — COMMERCIAL: $2,012.13 CARESOURCE_MEDICAID — MEDICAID: $214.61 CCN — COMMERCIAL: $2,012.13 CIGNA — COMMERCIAL: $1,910.46
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: 74177 CT Abdomen Pelvis with Contrast	$2,118.03	$1,059.02	$210.40 – $2,075.67
CT scan of the abdomen and pelvis, with contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $2,075.67 AETNA — COMMERCIAL: $1,694.42 AETNA_AUTO — COMMERCIAL: $1,694.42 AETNA_BETTER_HEALTH — MEDICARE: $280.12 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,694.42 AETNA_WORK_COMP — COMMERCIAL: $1,694.42 ALLIANCE_PPO — COMMERCIAL: $2,012.13 CARESOURCE_MEDICAID — MEDICAID: $214.61 CCN — COMMERCIAL: $2,012.13 CIGNA — COMMERCIAL: $1,910.46
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: SJMH CT Abdomen Pelvis with Contrast	$2,118.03	$1,059.02	$210.40 – $2,075.67
CT scan of the abdomen and pelvis, with contrast: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $2,075.67 AETNA — COMMERCIAL: $1,694.42 AETNA_AUTO — COMMERCIAL: $1,694.42 AETNA_BETTER_HEALTH — MEDICARE: $280.12 AETNA_MEDICAL_RENTAL — COMMERCIAL: $1,694.42 AETNA_WORK_COMP — COMMERCIAL: $1,694.42 ALLIANCE_PPO — COMMERCIAL: $2,012.13 CARESOURCE_MEDICAID — MEDICAID: $214.61 CCN — COMMERCIAL: $2,012.13 CIGNA — COMMERCIAL: $1,910.46
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier TC In the file: US Abdomen Complete	$605.49	$302.75	$77.67 – $593.38
Ultrasound of the abdomen, complete: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $593.38 AETNA — COMMERCIAL: $484.39 AETNA_AUTO — COMMERCIAL: $484.39 AETNA_BETTER_HEALTH — MEDICARE: $107.58 AETNA_MEDICAL_RENTAL — COMMERCIAL: $484.39 AETNA_WORK_COMP — COMMERCIAL: $484.39 ALLIANCE_PPO — COMMERCIAL: $575.22 CARESOURCE_MEDICAID — MEDICAID: $79.22 CCN — COMMERCIAL: $575.22 CIGNA — COMMERCIAL: $546.15
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US OB Complete	$605.49	$302.75	$89.23 – $593.38
Pregnancy ultrasound (after the first trimester): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $593.38 AETNA — COMMERCIAL: $484.39 AETNA_AUTO — COMMERCIAL: $484.39 AETNA_BETTER_HEALTH — MEDICARE: $125.11 AETNA_MEDICAL_RENTAL — COMMERCIAL: $484.39 AETNA_WORK_COMP — COMMERCIAL: $484.39 ALLIANCE_PPO — COMMERCIAL: $575.22 CARESOURCE_MEDICAID — MEDICAID: $91.01 CCN — COMMERCIAL: $575.22 CIGNA — COMMERCIAL: $546.15
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier TC In the file: US OB Complete	$605.49	$302.75	$89.23 – $593.38
Pregnancy ultrasound (after the first trimester): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $593.38 AETNA — COMMERCIAL: $484.39 AETNA_AUTO — COMMERCIAL: $484.39 AETNA_BETTER_HEALTH — MEDICARE: $125.11 AETNA_MEDICAL_RENTAL — COMMERCIAL: $484.39 AETNA_WORK_COMP — COMMERCIAL: $484.39 ALLIANCE_PPO — COMMERCIAL: $575.22 CARESOURCE_MEDICAID — MEDICAID: $91.01 CCN — COMMERCIAL: $575.22 CIGNA — COMMERCIAL: $546.15
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier TC In the file: US Transvaginal Non-OB	$605.49	$302.75	$78.90 – $593.38
Transvaginal ultrasound: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $593.38 AETNA — COMMERCIAL: $484.39 AETNA_AUTO — COMMERCIAL: $484.39 AETNA_BETTER_HEALTH — MEDICARE: $107.28 AETNA_MEDICAL_RENTAL — COMMERCIAL: $484.39 AETNA_WORK_COMP — COMMERCIAL: $484.39 ALLIANCE_PPO — COMMERCIAL: $575.22 CARESOURCE_MEDICAID — MEDICAID: $80.48 CCN — COMMERCIAL: $575.22 CIGNA — COMMERCIAL: $546.15
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier TC\|LT In the file: MA Mammogram Digital Diagnostic Left.	$557.99	$279	$82.59 – $546.83
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $546.83 AETNA — COMMERCIAL: $446.39 AETNA_AUTO — COMMERCIAL: $446.39 AETNA_BETTER_HEALTH — MEDICARE: $117.92 AETNA_MEDICAL_RENTAL — COMMERCIAL: $446.39 AETNA_WORK_COMP — COMMERCIAL: $446.39 ALLIANCE_PPO — COMMERCIAL: $530.09 CARESOURCE_MEDICAID — MEDICAID: $84.24 CCN — COMMERCIAL: $530.09 CIGNA — COMMERCIAL: $503.31
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier TC\|RT In the file: MA Mammogram Digital Diagnostic Right.	$557.99	$279	$82.59 – $546.83
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $546.83 AETNA — COMMERCIAL: $446.39 AETNA_AUTO — COMMERCIAL: $446.39 AETNA_BETTER_HEALTH — MEDICARE: $117.92 AETNA_MEDICAL_RENTAL — COMMERCIAL: $446.39 AETNA_WORK_COMP — COMMERCIAL: $446.39 ALLIANCE_PPO — COMMERCIAL: $530.09 CARESOURCE_MEDICAID — MEDICAID: $84.24 CCN — COMMERCIAL: $530.09 CIGNA — COMMERCIAL: $503.31
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier TC\|LT In the file: MA Mammogram Diagnostic Left w/ Tomo	$557.99	$279	$82.59 – $546.83
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $546.83 AETNA — COMMERCIAL: $446.39 AETNA_AUTO — COMMERCIAL: $446.39 AETNA_BETTER_HEALTH — MEDICARE: $117.92 AETNA_MEDICAL_RENTAL — COMMERCIAL: $446.39 AETNA_WORK_COMP — COMMERCIAL: $446.39 ALLIANCE_PPO — COMMERCIAL: $530.09 CARESOURCE_MEDICAID — MEDICAID: $84.24 CCN — COMMERCIAL: $530.09 CIGNA — COMMERCIAL: $503.31
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier TC In the file: MA Mammogram Digital Diagnostic Bilat.	$713.17	$356.59	$104.22 – $698.91
Diagnostic mammogram, both breasts: 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $698.91 AETNA — COMMERCIAL: $570.54 AETNA_AUTO — COMMERCIAL: $570.54 AETNA_BETTER_HEALTH — MEDICARE: $148.98 AETNA_MEDICAL_RENTAL — COMMERCIAL: $570.54 AETNA_WORK_COMP — COMMERCIAL: $570.54 ALLIANCE_PPO — COMMERCIAL: $677.51 CARESOURCE_MEDICAID — MEDICAID: $106.30 CCN — COMMERCIAL: $677.51 CIGNA — COMMERCIAL: $643.28
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier TC In the file: MA Mammogram Diagnostic Bilat w/ Tomo	$713.17	$356.59	$104.22 – $698.91
Diagnostic mammogram, both breasts: 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $698.91 AETNA — COMMERCIAL: $570.54 AETNA_AUTO — COMMERCIAL: $570.54 AETNA_BETTER_HEALTH — MEDICARE: $148.98 AETNA_MEDICAL_RENTAL — COMMERCIAL: $570.54 AETNA_WORK_COMP — COMMERCIAL: $570.54 ALLIANCE_PPO — COMMERCIAL: $677.51 CARESOURCE_MEDICAID — MEDICAID: $106.30 CCN — COMMERCIAL: $677.51 CIGNA — COMMERCIAL: $643.28
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: 77067 Computer Aided Detect. Screen	$589.86	$294.93	$83.82 – $578.06
Screening mammogram, both breasts: 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $578.06 AETNA — COMMERCIAL: $471.89 AETNA_AUTO — COMMERCIAL: $471.89 AETNA_BETTER_HEALTH — MEDICARE: $119.61 AETNA_MEDICAL_RENTAL — COMMERCIAL: $471.89 AETNA_WORK_COMP — COMMERCIAL: $471.89 ALLIANCE_PPO — COMMERCIAL: $560.37 CARESOURCE_MEDICAID — MEDICAID: $85.50 CCN — COMMERCIAL: $560.37 CIGNA — COMMERCIAL: $532.05
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier TC In the file: MA Mammogram Digital Screening.	$589.86	$294.93	$83.82 – $578.06
Screening mammogram, both breasts: 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $578.06 AETNA — COMMERCIAL: $471.89 AETNA_AUTO — COMMERCIAL: $471.89 AETNA_BETTER_HEALTH — MEDICARE: $119.61 AETNA_MEDICAL_RENTAL — COMMERCIAL: $471.89 AETNA_WORK_COMP — COMMERCIAL: $471.89 ALLIANCE_PPO — COMMERCIAL: $560.37 CARESOURCE_MEDICAID — MEDICAID: $85.50 CCN — COMMERCIAL: $560.37 CIGNA — COMMERCIAL: $532.05
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier TC In the file: MA Routine Screen Bil w/ Cad.	$589.86	$294.93	$83.82 – $578.06
Screening mammogram, both breasts: 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $578.06 AETNA — COMMERCIAL: $471.89 AETNA_AUTO — COMMERCIAL: $471.89 AETNA_BETTER_HEALTH — MEDICARE: $119.61 AETNA_MEDICAL_RENTAL — COMMERCIAL: $471.89 AETNA_WORK_COMP — COMMERCIAL: $471.89 ALLIANCE_PPO — COMMERCIAL: $560.37 CARESOURCE_MEDICAID — MEDICAID: $85.50 CCN — COMMERCIAL: $560.37 CIGNA — COMMERCIAL: $532.05

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: 93000 Bl EKG CHARGE	$380.42	$190.21	$9.59 – $372.81
Electrocardiogram (ECG/EKG) with reading: 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $372.81 AETNA — COMMERCIAL: $304.34 AETNA_AUTO — COMMERCIAL: $304.34 AETNA_BETTER_HEALTH — MEDICARE: $15.70 AETNA_MEDICAL_RENTAL — COMMERCIAL: $304.34 AETNA_WORK_COMP — COMMERCIAL: $304.34 ALLIANCE_PPO — COMMERCIAL: $361.40 CARESOURCE_MEDICAID — MEDICAID: $9.78 CCN — COMMERCIAL: $361.40 CIGNA — COMMERCIAL: $343.14
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · modifier TC In the file: Polysomniagram - 4	$5,758.26	$2,879.13	$389.35 – $5,643.09
Sleep study (overnight, in a sleep lab): 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $5,643.09 AETNA — COMMERCIAL: $4,606.61 AETNA_AUTO — COMMERCIAL: $4,606.61 AETNA_BETTER_HEALTH — MEDICARE: $540.87 AETNA_MEDICAL_RENTAL — COMMERCIAL: $4,606.61 AETNA_WORK_COMP — COMMERCIAL: $4,606.61 ALLIANCE_PPO — COMMERCIAL: $5,470.35 CARESOURCE_MEDICAID — MEDICAID: $397.14 CCN — COMMERCIAL: $5,470.35 CIGNA — COMMERCIAL: $5,193.95

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: 97110 Therapeutic Exercise	$202.49	$101.25	$19.91 – $198.44
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $198.44 AETNA — COMMERCIAL: $161.99 AETNA_AUTO — COMMERCIAL: $161.99 AETNA_BETTER_HEALTH — MEDICARE: $28.03 AETNA_MEDICAL_RENTAL — COMMERCIAL: $161.99 AETNA_WORK_COMP — COMMERCIAL: $161.99 ALLIANCE_PPO — COMMERCIAL: $150 CARESOURCE_MEDICAID — MEDICAID: $20.31 CCN — COMMERCIAL: $192.37 CIGNA — COMMERCIAL: $182.65
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: Therapeutic Exercise Charges	$202.49	$101.25	$19.91 – $198.44
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $198.44 AETNA — COMMERCIAL: $161.99 AETNA_AUTO — COMMERCIAL: $161.99 AETNA_BETTER_HEALTH — MEDICARE: $28.03 AETNA_MEDICAL_RENTAL — COMMERCIAL: $161.99 AETNA_WORK_COMP — COMMERCIAL: $161.99 ALLIANCE_PPO — COMMERCIAL: $150 CARESOURCE_MEDICAID — MEDICAID: $20.31 CCN — COMMERCIAL: $192.37 CIGNA — COMMERCIAL: $182.65
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: 97161 PT Eval Low Complex 20 Min	$679.30	$339.65	$68.33 – $665.71
Physical therapy evaluation (low complexity): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $665.71 AETNA — COMMERCIAL: $543.44 AETNA_AUTO — COMMERCIAL: $543.44 AETNA_BETTER_HEALTH — MEDICARE: $77.05 AETNA_MEDICAL_RENTAL — COMMERCIAL: $543.44 AETNA_WORK_COMP — COMMERCIAL: $543.44 ALLIANCE_PPO — COMMERCIAL: $645.34 CARESOURCE_MEDICAID — MEDICAID: $69.70 CCN — COMMERCIAL: $645.34 CIGNA — COMMERCIAL: $612.73
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: PT Low Complex Units	$679.30	$339.65	$68.33 – $665.71
Physical therapy evaluation (low complexity): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $665.71 AETNA — COMMERCIAL: $543.44 AETNA_AUTO — COMMERCIAL: $543.44 AETNA_BETTER_HEALTH — MEDICARE: $77.05 AETNA_MEDICAL_RENTAL — COMMERCIAL: $543.44 AETNA_WORK_COMP — COMMERCIAL: $543.44 ALLIANCE_PPO — COMMERCIAL: $645.34 CARESOURCE_MEDICAID — MEDICAID: $69.70 CCN — COMMERCIAL: $645.34 CIGNA — COMMERCIAL: $612.73
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: 97162 PT Eval Mod Complex 30 Min	$679.30	$339.65	$68.33 – $665.71
Physical therapy evaluation (moderate complexity): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $665.71 AETNA — COMMERCIAL: $543.44 AETNA_AUTO — COMMERCIAL: $543.44 AETNA_BETTER_HEALTH — MEDICARE: $77.05 AETNA_MEDICAL_RENTAL — COMMERCIAL: $543.44 AETNA_WORK_COMP — COMMERCIAL: $543.44 ALLIANCE_PPO — COMMERCIAL: $645.34 CARESOURCE_MEDICAID — MEDICAID: $69.70 CCN — COMMERCIAL: $645.34 CIGNA — COMMERCIAL: $612.73
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: PT Moderate Complex Units	$679.30	$339.65	$68.33 – $665.71
Physical therapy evaluation (moderate complexity): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $665.71 AETNA — COMMERCIAL: $543.44 AETNA_AUTO — COMMERCIAL: $543.44 AETNA_BETTER_HEALTH — MEDICARE: $77.05 AETNA_MEDICAL_RENTAL — COMMERCIAL: $543.44 AETNA_WORK_COMP — COMMERCIAL: $543.44 ALLIANCE_PPO — COMMERCIAL: $645.34 CARESOURCE_MEDICAID — MEDICAID: $69.70 CCN — COMMERCIAL: $645.34 CIGNA — COMMERCIAL: $612.73
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: 97163 PT Eval High Complex 45 Min	$679.30	$339.65	$68.33 – $665.71
Physical therapy evaluation (high complexity): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $665.71 AETNA — COMMERCIAL: $543.44 AETNA_AUTO — COMMERCIAL: $543.44 AETNA_BETTER_HEALTH — MEDICARE: $77.05 AETNA_MEDICAL_RENTAL — COMMERCIAL: $543.44 AETNA_WORK_COMP — COMMERCIAL: $543.44 ALLIANCE_PPO — COMMERCIAL: $645.34 CARESOURCE_MEDICAID — MEDICAID: $69.70 CCN — COMMERCIAL: $645.34 CIGNA — COMMERCIAL: $612.73
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: PT High Complex Units	$679.30	$339.65	$68.33 – $665.71
Physical therapy evaluation (high complexity): 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $665.71 AETNA — COMMERCIAL: $543.44 AETNA_AUTO — COMMERCIAL: $543.44 AETNA_BETTER_HEALTH — MEDICARE: $77.05 AETNA_MEDICAL_RENTAL — COMMERCIAL: $543.44 AETNA_WORK_COMP — COMMERCIAL: $543.44 ALLIANCE_PPO — COMMERCIAL: $645.34 CARESOURCE_MEDICAID — MEDICAID: $69.70 CCN — COMMERCIAL: $645.34 CIGNA — COMMERCIAL: $612.73

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: 66821 Post-Cataract Laser Surgery	$2,571.32	$1,285.66	$196 – $2,519.89
Laser treatment of clouding after cataract surgery: 10 of 29 insurance plan rates 4_MOST — COMMERCIAL: $2,519.89 AETNA — COMMERCIAL: $2,057.06 AETNA_AUTO — COMMERCIAL: $2,057.06 AETNA_BETTER_HEALTH — MEDICARE: $306.27 AETNA_MEDICAL_RENTAL — COMMERCIAL: $2,057.06 AETNA_WORK_COMP — COMMERCIAL: $2,057.06 ALLIANCE_PPO — COMMERCIAL: $2,442.75 CARESOURCE_MEDICAID — MEDICAID: $199.92 CCN — COMMERCIAL: $2,442.75 CIGNA — COMMERCIAL: $2,319.33
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: 66984 Xcapsl Ctrc Rmvl Ins IO Lens Prosth wo ECP	$12,834.37	$6,417.19	$196 – $12,577.68
Cataract removal with lens implant: 10 of 22 insurance plan rates 4_MOST — COMMERCIAL: $12,577.68 AETNA — COMMERCIAL: $10,267.50 AETNA_AUTO — COMMERCIAL: $10,267.50 AETNA_BETTER_HEALTH — MEDICARE: $602 AETNA_MEDICAL_RENTAL — COMMERCIAL: $10,267.50 AETNA_WORK_COMP — COMMERCIAL: $10,267.50 ALLIANCE_PPO — COMMERCIAL: $12,192.65 CARESOURCE_MEDICAID — MEDICAID: $199.92 CCN — COMMERCIAL: $12,192.65 CIGNA — COMMERCIAL: $11,576.60

Source: Stonewall Jackson Memorial Hospital Company’s standard charges file (stonewalljacksonhospital.pg.quadax.revenuemasters.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on May 19, 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	230 Hospital Plaza, Weston, WV 26452
County	Lewis County
State	West Virginia
Phone	(304) 269‑8000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	1 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	510038
Name in Medicare records	STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY
Profile level	Medicare data + hospital website
Name on the hospital’s website	Mon Health Stonewall Jackson Memorial Hospital
Official website	monhealth.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Emergency Services — monhealth.com
Surgical Services — monhealth.com
Visitor Information — monhealth.com