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Acute Care Hospital

The East Alabama Healthcare Authority

Opelika, Alabama · Lee County · Emergency services listed

Summary

The East Alabama Healthcare Authority is an acute care hospital in Opelika, Alabama. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 12 services, specialties and programs. Medicare lists 518 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

Call(334) 528‑1300 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
518Doctors and clinicians
12Services listed

Quick answers

Does The East Alabama Healthcare Authority have an emergency room?
Yes. Medicare (CMS) data lists emergency services at The East Alabama Healthcare Authority. In a medical emergency, call 911.
Where is The East Alabama Healthcare Authority?
2000 Pepperell Parkway, Opelika, AL 36801, in Lee County, Alabama.
What is the phone number of The East Alabama Healthcare Authority?
(334) 528-1300, as listed by Medicare (CMS).
What is the Medicare star rating of The East Alabama Healthcare Authority?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][5][6][9]

Procedures[10]

  • Robotic surgery (da Vinci)

Programs and centers[4][11]

  • Internal medicine residency
  • Transitional year residency
  • Pharmacy residency
  • Level III NICU
  • Cardiovascular intensive care unit (10 beds)
  • Maternity care

Emergency care (hospital website)[4][6][7][9]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel III
Stroke designationJoint Commission Primary Stroke Center; described as a Level II Stroke Center

Visiting and practical information

VisitingGeneral visiting 6 a.m.-9 p.m. daily; pediatric unit has set hours; ED is the only open entrance after 9 p.m.; photo ID required[5]
ParkingParking deck with 609 spaces near the Main Lobby; patient and visitor parking open 24/7[8]

Recognition[4][7][9]

  • Level III Trauma Center
  • Joint Commission Gold Seal, Primary Stroke Center certification

Doctors and clinicians (518)

518 doctors and other clinicians list The East Alabama Healthcare Authority 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 (518)

And 494 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

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 The East Alabama Healthcare Authority 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 hospital4 of 5 stars
Would recommend the hospital4 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well4 of 5 stars
Staff explained medicines3 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean3 of 5 stars
Quiet at night4 of 5 stars
Rated the hospital 9 or 10 out of 1071%National average: 72%
Would definitely recommend the hospital70%National average: 71%
Nurses “always” communicated well80%National average: 80%
Doctors “always” communicated well83%National average: 80%
Staff “always” explained medicines before giving them66%National average: 62%
Were given information about recovery at home86%National average: 86%
Room and bathroom “always” clean70%National average: 74%
Area around the room “always” quiet at night63%National average: 60%
Completed surveys416Response rate: 18%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.386No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.328Better than the national benchmark
Surgical site infections after colon surgery1.299No different from the national benchmark
Surgical site infections after abdominal hysterectomy1.751No different from the national benchmark
MRSA bloodstream infections0.541No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.711Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients13.4%
Deaths within 30 days: heart failure patients12.1%
Deaths within 30 days: pneumonia patients17.5%
Deaths within 30 days: COPD patients11.6%
Deaths within 30 days: stroke patients13.6%
Deaths within 30 days: coronary bypass surgery (CABG)2.6%
Serious complications (patient safety indicator PSI-90)0.99No different from the national rate
Complications after hip or knee replacement3.1%

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 attack13.6%
Readmitted within 30 days: heart failure19.5%
Readmitted within 30 days: pneumonia17%
Readmitted within 30 days: COPD19%
Readmitted within 30 days: coronary bypass surgery10.9%
Readmitted within 30 days: hip or knee replacement5.3%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)200 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)5%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)71%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 AlabamaBest hospitals in Alabama

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 78 common services exactly as The East Alabama Healthcare Authority lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHEUM FAC OP NEW PATIENT LEVEL 3 $131 $72.05 $19.65 – $117.90
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MC 99203 FAC OFFICE VISIT NEW PATIENT LEVEL 3 $131 $72.05 $19.65 – $117.90
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ROP FAC NEW PT DETAILED LEVEL 3 $131 $72.05 $19.65 – $117.90
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHEUM FAC OP NEW PATIENT LEVEL 4 $131 $72.05 $19.65 – $117.90
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: zAMB WTC Level 4 99204 81-161 points $131 $72.05 $19.65 – $117.90
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MC 99204 FAC OFFICE VISIT NEW PATIENT LEVEL 4 $131 $72.05 $19.65 – $117.90
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHEUM FAC OP NEW PATIENT LEVEL 5 $131 $72.05 $19.65 – $117.90
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Level 5 99205 162 - FC Leveling Code $131 $72.05 $19.65 – $117.90
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: zAMB WTC Level 5 99205 162 points $131 $72.05 $19.65 – $117.90
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHEUM FAC OP ESTABLISHED LEVEL 3 $131 $72.05 $19.65 – $117.90
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MC 99213 FAC OFFICE VISIT EST PATIENT LEVEL 3 $131 $72.05 $19.65 – $117.90
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Level 3 99213 9-80 - FC Leveling Code $135 $74.25 $20.25 – $121.50
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $81
  • BeechStreet — PHCS: $114.75
  • Coventry First Health — Commercial: $114.75
  • GEHA — Commercial: $114.75
  • Humana — Commercial: $94.50
  • MCM Maxcare — Commercial: $108
  • Mega Life — Commercial: $108
  • Multiplan — PHCS: $114.75
  • Novanet — Commercial: $20.25
  • TRPN — Commercial: $121.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHEUM FAC OP ESTABLISHED LEVEL 4 $131 $72.05 $19.65 – $117.90
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MC 99214 FAC OFFICE VISIT EST PATIENT LEVEL 4 $131 $72.05 $19.65 – $117.90
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PC FAC OFFICE OUTPATIENT VISIT 25 MINUTES $131 $72.05 $19.65 – $117.90
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78.60
  • BeechStreet — PHCS: $111.35
  • Coventry First Health — Commercial: $111.35
  • GEHA — Commercial: $111.35
  • Humana — Commercial: $91.70
  • MCM Maxcare — Commercial: $104.80
  • Mega Life — Commercial: $104.80
  • Multiplan — PHCS: $111.35
  • Novanet — Commercial: $19.65
  • TRPN — Commercial: $117.90
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Intermediate $507 $278.85 $76.05 – $456.30
Emergency room visit (moderate): 10 of 12 insurance plan rates
  • Aetna — Commercial: $304.20
  • BeechStreet — PHCS: $430.95
  • Coventry First Health — Commercial: $430.95
  • GEHA — Commercial: $430.95
  • Humana — Commercial: $354.90
  • MCM Maxcare — Commercial: $405.60
  • Mega Life — Commercial: $405.60
  • Multiplan — PHCS: $430.95
  • Novanet — Commercial: $76.05
  • TRPN — Commercial: $456.30
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED Intermediate $507 $278.85 $76.05 – $507
Emergency room visit (moderate): rates for 8 insurance plans
  • Aetna — Commercial: $507
  • Alabama Crime Victims — Commercial: $253.50
  • Coventry First Health — Commercial: $430.95
  • GEHA — Commercial: $430.95
  • MCM Maxcare — Commercial: $405.60
  • Mega Life — Commercial: $405.60
  • Novanet — Commercial: $76.05
  • TRPN — Commercial: $456.30
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit low mdm Not listed in the file Not listed in the file $250.94 – $623.51
Emergency room visit (moderate): rates for 10 insurance plans
  • Aetna — Commercial: $524.46
  • Blue Cross — Commercial: $304.09
  • Blue Cross — Medicare Advantage: $250.94
  • Blue Cross Lanier — Commercial: $304.09
  • Cigna — Commercial: $493.73
  • Humana — Commercial: $505.79
  • Humana — Medicare Advantage: $250.94
  • Simpra — Medicare Advantage: $250.94
  • Viva — Commercial: $623.51
  • Viva — Medicare Advantage: $250.94
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ER Extensive $780 $429 $117 – $702
Emergency room visit (moderately high): 10 of 12 insurance plan rates
  • Aetna — Commercial: $468
  • BeechStreet — PHCS: $663
  • Coventry First Health — Commercial: $663
  • GEHA — Commercial: $663
  • Humana — Commercial: $546
  • MCM Maxcare — Commercial: $624
  • Mega Life — Commercial: $624
  • Multiplan — PHCS: $663
  • Novanet — Commercial: $117
  • TRPN — Commercial: $702
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ER Extensive $780 $429 $117 – $780
Emergency room visit (moderately high): rates for 8 insurance plans
  • Aetna — Commercial: $780
  • Alabama Crime Victims — Commercial: $390
  • Coventry First Health — Commercial: $663
  • GEHA — Commercial: $663
  • MCM Maxcare — Commercial: $624
  • Mega Life — Commercial: $624
  • Novanet — Commercial: $117
  • TRPN — Commercial: $702
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit mod mdm Not listed in the file Not listed in the file $304.09 – $958.88
Emergency room visit (moderately high): rates for 10 insurance plans
  • Aetna — Commercial: $806.55
  • Blue Cross — Commercial: $304.09
  • Blue Cross — Medicare Advantage: $385.91
  • Blue Cross Lanier — Commercial: $304.09
  • Cigna — Commercial: $759.29
  • Humana — Commercial: $785.15
  • Humana — Medicare Advantage: $385.91
  • Simpra — Medicare Advantage: $385.91
  • Viva — Commercial: $958.88
  • Viva — Medicare Advantage: $385.91
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Critical Care $1,123 $617.65 $168.45 – $1,010.70
Emergency room visit (high): 10 of 12 insurance plan rates
  • Aetna — Commercial: $673.80
  • BeechStreet — PHCS: $954.55
  • Coventry First Health — Commercial: $954.55
  • GEHA — Commercial: $954.55
  • Humana — Commercial: $786.10
  • MCM Maxcare — Commercial: $898.40
  • Mega Life — Commercial: $898.40
  • Multiplan — PHCS: $954.55
  • Novanet — Commercial: $168.45
  • TRPN — Commercial: $1,010.70
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED Critical Care $1,123 $617.65 $168.45 – $1,123
Emergency room visit (high): rates for 8 insurance plans
  • Aetna — Commercial: $1,123
  • Alabama Crime Victims — Commercial: $561.50
  • Coventry First Health — Commercial: $954.55
  • GEHA — Commercial: $954.55
  • MCM Maxcare — Commercial: $898.40
  • Mega Life — Commercial: $898.40
  • Novanet — Commercial: $168.45
  • TRPN — Commercial: $1,010.70
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit hi mdm Not listed in the file Not listed in the file $304.09 – $1,380.61
Emergency room visit (high): rates for 10 insurance plans
  • Aetna — Commercial: $1,161.29
  • Blue Cross — Commercial: $304.09
  • Blue Cross — Medicare Advantage: $555.64
  • Blue Cross Lanier — Commercial: $304.09
  • Cigna — Commercial: $1,093.24
  • Humana — Commercial: $1,138.62
  • Humana — Medicare Advantage: $555.64
  • Simpra — Medicare Advantage: $555.64
  • Viva — Commercial: $1,380.61
  • Viva — Medicare Advantage: $555.64

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic Metabolic Panel $115 $63.25 $17.25 – $103.50
Basic metabolic panel (blood test): 10 of 12 insurance plan rates
  • Aetna — Commercial: $69
  • BeechStreet — PHCS: $97.75
  • Coventry First Health — Commercial: $97.75
  • GEHA — Commercial: $97.75
  • Humana — Commercial: $80.50
  • MCM Maxcare — Commercial: $92
  • Mega Life — Commercial: $92
  • Multiplan — PHCS: $97.75
  • Novanet — Commercial: $17.25
  • TRPN — Commercial: $103.50
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Basic Metabolic Panel $115 $63.25 $17.25 – $115
Basic metabolic panel (blood test): rates for 8 insurance plans
  • Aetna — Commercial: $115
  • Alabama Crime Victims — Commercial: $57.50
  • Coventry First Health — Commercial: $97.75
  • GEHA — Commercial: $97.75
  • MCM Maxcare — Commercial: $92
  • Mega Life — Commercial: $92
  • Novanet — Commercial: $17.25
  • TRPN — Commercial: $103.50
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca Not listed in the file Not listed in the file $8.46 – $19.63
Basic metabolic panel (blood test): rates for 10 insurance plans
  • Aetna — Commercial: $17.68
  • Blue Cross — Commercial: $15.72
  • Blue Cross — Medicare Advantage: $8.46
  • Blue Cross Lanier — Commercial: $15.72
  • Cigna — Commercial: $16.07
  • Humana — Commercial: $17.86
  • Humana — Medicare Advantage: $8.46
  • Simpra — Medicare Advantage: $8.46
  • Viva — Commercial: $19.63
  • Viva — Medicare Advantage: $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Profile 1 (CMP) $130 $71.50 $19.50 – $117
Comprehensive metabolic panel (blood test): 10 of 12 insurance plan rates
  • Aetna — Commercial: $78
  • BeechStreet — PHCS: $110.50
  • Coventry First Health — Commercial: $110.50
  • GEHA — Commercial: $110.50
  • Humana — Commercial: $91
  • MCM Maxcare — Commercial: $104
  • Mega Life — Commercial: $104
  • Multiplan — PHCS: $110.50
  • Novanet — Commercial: $19.50
  • TRPN — Commercial: $117
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Profile 1 (CMP) $130 $71.50 $19.50 – $130
Comprehensive metabolic panel (blood test): rates for 8 insurance plans
  • Aetna — Commercial: $130
  • Alabama Crime Victims — Commercial: $65
  • Coventry First Health — Commercial: $110.50
  • GEHA — Commercial: $110.50
  • MCM Maxcare — Commercial: $104
  • Mega Life — Commercial: $104
  • Novanet — Commercial: $19.50
  • TRPN — Commercial: $117
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel Not listed in the file Not listed in the file $10.56 – $24.50
Comprehensive metabolic panel (blood test): rates for 10 insurance plans
  • Aetna — Commercial: $22.07
  • Blue Cross — Commercial: $15.72
  • Blue Cross — Medicare Advantage: $10.56
  • Blue Cross Lanier — Commercial: $15.72
  • Cigna — Commercial: $20.06
  • Humana — Commercial: $22.30
  • Humana — Medicare Advantage: $10.56
  • Simpra — Medicare Advantage: $10.56
  • Viva — Commercial: $24.50
  • Viva — Medicare Advantage: $10.56
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prenatal1 $447 $245.85 $67.05 – $402.30
Obstetric blood test panel: 10 of 12 insurance plan rates
  • Aetna — Commercial: $268.20
  • BeechStreet — PHCS: $379.95
  • Coventry First Health — Commercial: $379.95
  • GEHA — Commercial: $379.95
  • Humana — Commercial: $312.90
  • MCM Maxcare — Commercial: $357.60
  • Mega Life — Commercial: $357.60
  • Multiplan — PHCS: $379.95
  • Novanet — Commercial: $67.05
  • TRPN — Commercial: $402.30
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prenatal2 $447 $245.85 $67.05 – $402.30
Obstetric blood test panel: 10 of 12 insurance plan rates
  • Aetna — Commercial: $268.20
  • BeechStreet — PHCS: $379.95
  • Coventry First Health — Commercial: $379.95
  • GEHA — Commercial: $379.95
  • Humana — Commercial: $312.90
  • MCM Maxcare — Commercial: $357.60
  • Mega Life — Commercial: $357.60
  • Multiplan — PHCS: $379.95
  • Novanet — Commercial: $67.05
  • TRPN — Commercial: $402.30
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Prenatal1 $447 $245.85 $67.05 – $447
Obstetric blood test panel: rates for 8 insurance plans
  • Aetna — Commercial: $447
  • Alabama Crime Victims — Commercial: $223.50
  • Coventry First Health — Commercial: $379.95
  • GEHA — Commercial: $379.95
  • MCM Maxcare — Commercial: $357.60
  • Mega Life — Commercial: $357.60
  • Novanet — Commercial: $67.05
  • TRPN — Commercial: $402.30
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB LIPID PANEL WITH TRIG/HDL-CHOL $95 $52.25 $14.25 – $85.50
Cholesterol panel (lipid panel): 10 of 12 insurance plan rates
  • Aetna — Commercial: $57
  • BeechStreet — PHCS: $80.75
  • Coventry First Health — Commercial: $80.75
  • GEHA — Commercial: $80.75
  • Humana — Commercial: $66.50
  • MCM Maxcare — Commercial: $76
  • Mega Life — Commercial: $76
  • Multiplan — PHCS: $80.75
  • Novanet — Commercial: $14.25
  • TRPN — Commercial: $85.50
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB 80061 - LIPID PANEL $95 $52.25 $14.25 – $85.50
Cholesterol panel (lipid panel): 10 of 12 insurance plan rates
  • Aetna — Commercial: $57
  • BeechStreet — PHCS: $80.75
  • Coventry First Health — Commercial: $80.75
  • GEHA — Commercial: $80.75
  • Humana — Commercial: $66.50
  • MCM Maxcare — Commercial: $76
  • Mega Life — Commercial: $76
  • Multiplan — PHCS: $80.75
  • Novanet — Commercial: $14.25
  • TRPN — Commercial: $85.50
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Lipid Panel $95 $52.25 $14.25 – $85.50
Cholesterol panel (lipid panel): 10 of 12 insurance plan rates
  • Aetna — Commercial: $57
  • BeechStreet — PHCS: $80.75
  • Coventry First Health — Commercial: $80.75
  • GEHA — Commercial: $80.75
  • Humana — Commercial: $66.50
  • MCM Maxcare — Commercial: $76
  • Mega Life — Commercial: $76
  • Multiplan — PHCS: $80.75
  • Novanet — Commercial: $14.25
  • TRPN — Commercial: $85.50
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Profile III (Renal) $115 $63.25 $17.25 – $103.50
Kidney function panel: 10 of 12 insurance plan rates
  • Aetna — Commercial: $69
  • BeechStreet — PHCS: $97.75
  • Coventry First Health — Commercial: $97.75
  • GEHA — Commercial: $97.75
  • Humana — Commercial: $80.50
  • MCM Maxcare — Commercial: $92
  • Mega Life — Commercial: $92
  • Multiplan — PHCS: $97.75
  • Novanet — Commercial: $17.25
  • TRPN — Commercial: $103.50
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Profile III (Renal) $115 $63.25 $17.25 – $115
Kidney function panel: rates for 8 insurance plans
  • Aetna — Commercial: $115
  • Alabama Crime Victims — Commercial: $57.50
  • Coventry First Health — Commercial: $97.75
  • GEHA — Commercial: $97.75
  • MCM Maxcare — Commercial: $92
  • Mega Life — Commercial: $92
  • Novanet — Commercial: $17.25
  • TRPN — Commercial: $103.50
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel Not listed in the file Not listed in the file $8.68 – $20.14
Kidney function panel: rates for 10 insurance plans
  • Aetna — Commercial: $18.14
  • Blue Cross — Commercial: $15.72
  • Blue Cross — Medicare Advantage: $8.68
  • Blue Cross Lanier — Commercial: $15.72
  • Cigna — Commercial: $16.49
  • Humana — Commercial: $18.33
  • Humana — Medicare Advantage: $8.68
  • Simpra — Medicare Advantage: $8.68
  • Viva — Commercial: $20.14
  • Viva — Medicare Advantage: $8.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Profile IV (Liver) $115 $63.25 $17.25 – $103.50
Liver function panel: 10 of 12 insurance plan rates
  • Aetna — Commercial: $69
  • BeechStreet — PHCS: $97.75
  • Coventry First Health — Commercial: $97.75
  • GEHA — Commercial: $97.75
  • Humana — Commercial: $80.50
  • MCM Maxcare — Commercial: $92
  • Mega Life — Commercial: $92
  • Multiplan — PHCS: $97.75
  • Novanet — Commercial: $17.25
  • TRPN — Commercial: $103.50
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Profile IV (Liver) $115 $63.25 $17.25 – $115
Liver function panel: rates for 8 insurance plans
  • Aetna — Commercial: $115
  • Alabama Crime Victims — Commercial: $57.50
  • Coventry First Health — Commercial: $97.75
  • GEHA — Commercial: $97.75
  • MCM Maxcare — Commercial: $92
  • Mega Life — Commercial: $92
  • Novanet — Commercial: $17.25
  • TRPN — Commercial: $103.50
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel Not listed in the file Not listed in the file $8.17 – $18.95
Liver function panel: rates for 10 insurance plans
  • Aetna — Commercial: $17.08
  • Blue Cross — Commercial: $15.72
  • Blue Cross — Medicare Advantage: $8.17
  • Blue Cross Lanier — Commercial: $15.72
  • Cigna — Commercial: $15.52
  • Humana — Commercial: $17.25
  • Humana — Medicare Advantage: $8.17
  • Simpra — Medicare Advantage: $8.17
  • Viva — Commercial: $18.95
  • Viva — Medicare Advantage: $8.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis with Microscopic $44 $24.20 $6.60 – $39.60
Urine test (automated, with microscope): 10 of 12 insurance plan rates
  • Aetna — Commercial: $26.40
  • BeechStreet — PHCS: $37.40
  • Coventry First Health — Commercial: $37.40
  • GEHA — Commercial: $37.40
  • Humana — Commercial: $30.80
  • MCM Maxcare — Commercial: $35.20
  • Mega Life — Commercial: $35.20
  • Multiplan — PHCS: $37.40
  • Novanet — Commercial: $6.60
  • TRPN — Commercial: $39.60
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis with Microscopic $44 $24.20 $6.60 – $44
Urine test (automated, with microscope): rates for 8 insurance plans
  • Aetna — Commercial: $44
  • Alabama Crime Victims — Commercial: $22
  • Coventry First Health — Commercial: $37.40
  • GEHA — Commercial: $37.40
  • MCM Maxcare — Commercial: $35.20
  • Mega Life — Commercial: $35.20
  • Novanet — Commercial: $6.60
  • TRPN — Commercial: $39.60
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope Not listed in the file Not listed in the file $3.17 – $7.35
Urine test (automated, with microscope): rates for 10 insurance plans
  • Aetna — Commercial: $6.63
  • Blue Cross — Commercial: $5.12
  • Blue Cross — Medicare Advantage: $3.17
  • Blue Cross Lanier — Commercial: $5.12
  • Cigna — Commercial: $6.02
  • Humana — Commercial: $6.69
  • Humana — Medicare Advantage: $3.17
  • Simpra — Medicare Advantage: $3.17
  • Viva — Commercial: $7.35
  • Viva — Medicare Advantage: $3.17
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Strip (ED Charge) $33 $18.15 $4.95 – $29.70
Urine test (manual, without microscope): 10 of 12 insurance plan rates
  • Aetna — Commercial: $19.80
  • BeechStreet — PHCS: $28.05
  • Coventry First Health — Commercial: $28.05
  • GEHA — Commercial: $28.05
  • Humana — Commercial: $23.10
  • MCM Maxcare — Commercial: $26.40
  • Mega Life — Commercial: $26.40
  • Multiplan — PHCS: $28.05
  • Novanet — Commercial: $4.95
  • TRPN — Commercial: $29.70
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ketones Urine $34 $18.70 $5.10 – $30.60
Urine test (manual, without microscope): 10 of 12 insurance plan rates
  • Aetna — Commercial: $20.40
  • BeechStreet — PHCS: $28.90
  • Coventry First Health — Commercial: $28.90
  • GEHA — Commercial: $28.90
  • Humana — Commercial: $23.80
  • MCM Maxcare — Commercial: $27.20
  • Mega Life — Commercial: $27.20
  • Multiplan — PHCS: $28.90
  • Novanet — Commercial: $5.10
  • TRPN — Commercial: $30.60
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis Strip (ED Charge) $33 $18.15 $4.95 – $33
Urine test (manual, without microscope): rates for 8 insurance plans
  • Aetna — Commercial: $33
  • Alabama Crime Victims — Commercial: $16.50
  • Coventry First Health — Commercial: $28.05
  • GEHA — Commercial: $28.05
  • MCM Maxcare — Commercial: $26.40
  • Mega Life — Commercial: $26.40
  • Novanet — Commercial: $4.95
  • TRPN — Commercial: $29.70
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urine for Hemoglobin $37 $20.35 $5.55 – $33.30
Urine test (automated, without microscope): 10 of 12 insurance plan rates
  • Aetna — Commercial: $22.20
  • BeechStreet — PHCS: $31.45
  • Coventry First Health — Commercial: $31.45
  • GEHA — Commercial: $31.45
  • Humana — Commercial: $25.90
  • MCM Maxcare — Commercial: $29.60
  • Mega Life — Commercial: $29.60
  • Multiplan — PHCS: $31.45
  • Novanet — Commercial: $5.55
  • TRPN — Commercial: $33.30
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis $38 $20.90 $5.70 – $34.20
Urine test (automated, without microscope): 10 of 12 insurance plan rates
  • Aetna — Commercial: $22.80
  • BeechStreet — PHCS: $32.30
  • Coventry First Health — Commercial: $32.30
  • GEHA — Commercial: $32.30
  • Humana — Commercial: $26.60
  • MCM Maxcare — Commercial: $30.40
  • Mega Life — Commercial: $30.40
  • Multiplan — PHCS: $32.30
  • Novanet — Commercial: $5.70
  • TRPN — Commercial: $34.20
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urine for Hemoglobin $37 $20.35 $5.55 – $37
Urine test (automated, without microscope): rates for 8 insurance plans
  • Aetna — Commercial: $37
  • Alabama Crime Victims — Commercial: $18.50
  • Coventry First Health — Commercial: $31.45
  • GEHA — Commercial: $31.45
  • MCM Maxcare — Commercial: $29.60
  • Mega Life — Commercial: $29.60
  • Novanet — Commercial: $5.55
  • TRPN — Commercial: $33.30
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB PSA, TOTAL L $88 $48.40 $13.20 – $79.20
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates
  • Aetna — Commercial: $52.80
  • BeechStreet — PHCS: $74.80
  • Coventry First Health — Commercial: $74.80
  • GEHA — Commercial: $74.80
  • Humana — Commercial: $61.60
  • MCM Maxcare — Commercial: $70.40
  • Mega Life — Commercial: $70.40
  • Multiplan — PHCS: $74.80
  • Novanet — Commercial: $13.20
  • TRPN — Commercial: $79.20
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB 84153 - ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL $88 $48.40 $13.20 – $79.20
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates
  • Aetna — Commercial: $52.80
  • BeechStreet — PHCS: $74.80
  • Coventry First Health — Commercial: $74.80
  • GEHA — Commercial: $74.80
  • Humana — Commercial: $61.60
  • MCM Maxcare — Commercial: $70.40
  • Mega Life — Commercial: $70.40
  • Multiplan — PHCS: $74.80
  • Novanet — Commercial: $13.20
  • TRPN — Commercial: $79.20
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prostate Specific Antigen Diagnostic $88 $48.40 $13.20 – $79.20
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates
  • Aetna — Commercial: $52.80
  • BeechStreet — PHCS: $74.80
  • Coventry First Health — Commercial: $74.80
  • GEHA — Commercial: $74.80
  • Humana — Commercial: $61.60
  • MCM Maxcare — Commercial: $70.40
  • Mega Life — Commercial: $70.40
  • Multiplan — PHCS: $74.80
  • Novanet — Commercial: $13.20
  • TRPN — Commercial: $79.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB TSH $82 $45.10 $12.30 – $73.80
Thyroid stimulating hormone (TSH) test: 10 of 12 insurance plan rates
  • Aetna — Commercial: $49.20
  • BeechStreet — PHCS: $69.70
  • Coventry First Health — Commercial: $69.70
  • GEHA — Commercial: $69.70
  • Humana — Commercial: $57.40
  • MCM Maxcare — Commercial: $65.60
  • Mega Life — Commercial: $65.60
  • Multiplan — PHCS: $69.70
  • Novanet — Commercial: $12.30
  • TRPN — Commercial: $73.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB 84443 - ASSAY THYROID STIM HORMONE $82 $45.10 $12.30 – $73.80
Thyroid stimulating hormone (TSH) test: 10 of 12 insurance plan rates
  • Aetna — Commercial: $49.20
  • BeechStreet — PHCS: $69.70
  • Coventry First Health — Commercial: $69.70
  • GEHA — Commercial: $69.70
  • Humana — Commercial: $57.40
  • MCM Maxcare — Commercial: $65.60
  • Mega Life — Commercial: $65.60
  • Multiplan — PHCS: $69.70
  • Novanet — Commercial: $12.30
  • TRPN — Commercial: $73.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB TSH, PANEL (0162)- L $84 $46.20 $12.60 – $75.60
Thyroid stimulating hormone (TSH) test: 10 of 12 insurance plan rates
  • Aetna — Commercial: $50.40
  • BeechStreet — PHCS: $71.40
  • Coventry First Health — Commercial: $71.40
  • GEHA — Commercial: $71.40
  • Humana — Commercial: $58.80
  • MCM Maxcare — Commercial: $67.20
  • Mega Life — Commercial: $67.20
  • Multiplan — PHCS: $71.40
  • Novanet — Commercial: $12.60
  • TRPN — Commercial: $75.60
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB 85025 - COMPLETE CBC W/AUTO DIFF WBC $70 $38.50 $10.50 – $63
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates
  • Aetna — Commercial: $42
  • BeechStreet — PHCS: $59.50
  • Coventry First Health — Commercial: $59.50
  • GEHA — Commercial: $59.50
  • Humana — Commercial: $49
  • MCM Maxcare — Commercial: $56
  • Mega Life — Commercial: $56
  • Multiplan — PHCS: $59.50
  • Novanet — Commercial: $10.50
  • TRPN — Commercial: $63
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete Blood Count w/ Diff $70 $38.50 $10.50 – $63
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates
  • Aetna — Commercial: $42
  • BeechStreet — PHCS: $59.50
  • Coventry First Health — Commercial: $59.50
  • GEHA — Commercial: $59.50
  • Humana — Commercial: $49
  • MCM Maxcare — Commercial: $56
  • Mega Life — Commercial: $56
  • Multiplan — PHCS: $59.50
  • Novanet — Commercial: $10.50
  • TRPN — Commercial: $63
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED Complete Blood Count w/Diff $70 $38.50 $10.50 – $63
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates
  • Aetna — Commercial: $42
  • BeechStreet — PHCS: $59.50
  • Coventry First Health — Commercial: $59.50
  • GEHA — Commercial: $59.50
  • Humana — Commercial: $49
  • MCM Maxcare — Commercial: $56
  • Mega Life — Commercial: $56
  • Multiplan — PHCS: $59.50
  • Novanet — Commercial: $10.50
  • TRPN — Commercial: $63
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete Blood Count $46 $25.30 $6.90 – $41.40
Complete blood count (CBC), automated: 10 of 12 insurance plan rates
  • Aetna — Commercial: $27.60
  • BeechStreet — PHCS: $39.10
  • Coventry First Health — Commercial: $39.10
  • GEHA — Commercial: $39.10
  • Humana — Commercial: $32.20
  • MCM Maxcare — Commercial: $36.80
  • Mega Life — Commercial: $36.80
  • Multiplan — PHCS: $39.10
  • Novanet — Commercial: $6.90
  • TRPN — Commercial: $41.40
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Complete Blood Count $46 $25.30 $6.90 – $46
Complete blood count (CBC), automated: rates for 8 insurance plans
  • Aetna — Commercial: $46
  • Alabama Crime Victims — Commercial: $23
  • Coventry First Health — Commercial: $39.10
  • GEHA — Commercial: $39.10
  • MCM Maxcare — Commercial: $36.80
  • Mega Life — Commercial: $36.80
  • Novanet — Commercial: $6.90
  • TRPN — Commercial: $41.40
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated Not listed in the file Not listed in the file $6.47 – $15.01
Complete blood count (CBC), automated: rates for 10 insurance plans
  • Aetna — Commercial: $13.52
  • Blue Cross — Commercial: $10.15
  • Blue Cross — Medicare Advantage: $6.47
  • Blue Cross Lanier — Commercial: $10.15
  • Cigna — Commercial: $12.29
  • Humana — Commercial: $13.66
  • Humana — Medicare Advantage: $6.47
  • Simpra — Medicare Advantage: $6.47
  • Viva — Commercial: $15.01
  • Viva — Medicare Advantage: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB 85610 - PROTHROMBIN TIME $80 $44 $12 – $72
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates
  • Aetna — Commercial: $48
  • BeechStreet — PHCS: $68
  • Coventry First Health — Commercial: $68
  • GEHA — Commercial: $68
  • Humana — Commercial: $56
  • MCM Maxcare — Commercial: $64
  • Mega Life — Commercial: $64
  • Multiplan — PHCS: $68
  • Novanet — Commercial: $12
  • TRPN — Commercial: $72
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIC Screen $80 $44 $12 – $72
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates
  • Aetna — Commercial: $48
  • BeechStreet — PHCS: $68
  • Coventry First Health — Commercial: $68
  • GEHA — Commercial: $68
  • Humana — Commercial: $56
  • MCM Maxcare — Commercial: $64
  • Mega Life — Commercial: $64
  • Multiplan — PHCS: $68
  • Novanet — Commercial: $12
  • TRPN — Commercial: $72
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC PT+/INR END $80 $44 $12 – $72
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates
  • Aetna — Commercial: $48
  • BeechStreet — PHCS: $68
  • Coventry First Health — Commercial: $68
  • GEHA — Commercial: $68
  • Humana — Commercial: $56
  • MCM Maxcare — Commercial: $64
  • Mega Life — Commercial: $64
  • Multiplan — PHCS: $68
  • Novanet — Commercial: $12
  • TRPN — Commercial: $72
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB APTT $72 $39.60 $10.80 – $64.80
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates
  • Aetna — Commercial: $43.20
  • BeechStreet — PHCS: $61.20
  • Coventry First Health — Commercial: $61.20
  • GEHA — Commercial: $61.20
  • Humana — Commercial: $50.40
  • MCM Maxcare — Commercial: $57.60
  • Mega Life — Commercial: $57.60
  • Multiplan — PHCS: $61.20
  • Novanet — Commercial: $10.80
  • TRPN — Commercial: $64.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB HYPERCOAGULABLE PTT $72 $39.60 $10.80 – $64.80
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates
  • Aetna — Commercial: $43.20
  • BeechStreet — PHCS: $61.20
  • Coventry First Health — Commercial: $61.20
  • GEHA — Commercial: $61.20
  • Humana — Commercial: $50.40
  • MCM Maxcare — Commercial: $57.60
  • Mega Life — Commercial: $57.60
  • Multiplan — PHCS: $61.20
  • Novanet — Commercial: $10.80
  • TRPN — Commercial: $64.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ZAPTT Mix 1:1 $72 $39.60 $10.80 – $64.80
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates
  • Aetna — Commercial: $43.20
  • BeechStreet — PHCS: $61.20
  • Coventry First Health — Commercial: $61.20
  • GEHA — Commercial: $61.20
  • Humana — Commercial: $50.40
  • MCM Maxcare — Commercial: $57.60
  • Mega Life — Commercial: $57.60
  • Multiplan — PHCS: $61.20
  • Novanet — Commercial: $10.80
  • TRPN — Commercial: $64.80

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Exam 2 $628 $345.40 $94.20 – $565.20
CT scan of the head or brain, without contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial: $376.80
  • BeechStreet — PHCS: $533.80
  • Coventry First Health — Commercial: $533.80
  • GEHA — Commercial: $533.80
  • Humana — Commercial: $439.60
  • MCM Maxcare — Commercial: $502.40
  • Mega Life — Commercial: $502.40
  • Multiplan — PHCS: $533.80
  • Novanet — Commercial: $94.20
  • TRPN — Commercial: $565.20
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Exam 2 $628 $345.40 $94.20 – $628
CT scan of the head or brain, without contrast: rates for 8 insurance plans
  • Aetna — Commercial: $628
  • Alabama Crime Victims — Commercial: $314
  • Coventry First Health — Commercial: $533.80
  • GEHA — Commercial: $533.80
  • MCM Maxcare — Commercial: $502.40
  • Mega Life — Commercial: $502.40
  • Novanet — Commercial: $94.20
  • TRPN — Commercial: $565.20
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye Not listed in the file Not listed in the file $96.38 – $487.66
CT scan of the head or brain, without contrast: rates for 10 insurance plans
  • Aetna — Commercial: $201.43
  • Blue Cross — Commercial: $487.66
  • Blue Cross — Medicare Advantage: $96.38
  • Blue Cross Lanier — Commercial: $487.66
  • Cigna — Commercial: $189.62
  • Humana — Commercial: $194.90
  • Humana — Medicare Advantage: $96.38
  • Simpra — Medicare Advantage: $96.38
  • Viva — Commercial: $239.47
  • Viva — Medicare Advantage: $96.38
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Brain w/ + w/o contrast $861 $473.55 $129.15 – $774.90
MRI of the brain, before and after contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial: $516.60
  • BeechStreet — PHCS: $731.85
  • Coventry First Health — Commercial: $731.85
  • GEHA — Commercial: $731.85
  • Humana — Commercial: $602.70
  • MCM Maxcare — Commercial: $688.80
  • Mega Life — Commercial: $688.80
  • Multiplan — PHCS: $731.85
  • Novanet — Commercial: $129.15
  • TRPN — Commercial: $774.90
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Exam $887 $487.85 $133.05 – $798.30
MRI of the brain, before and after contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial: $532.20
  • BeechStreet — PHCS: $753.95
  • Coventry First Health — Commercial: $753.95
  • GEHA — Commercial: $753.95
  • Humana — Commercial: $620.90
  • MCM Maxcare — Commercial: $709.60
  • Mega Life — Commercial: $709.60
  • Multiplan — PHCS: $753.95
  • Novanet — Commercial: $133.05
  • TRPN — Commercial: $798.30
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Brain w/ + w/o contrast $861 $473.55 $129.15 – $861
MRI of the brain, before and after contrast: rates for 8 insurance plans
  • Aetna — Commercial: $861
  • Alabama Crime Victims — Commercial: $430.50
  • Coventry First Health — Commercial: $731.85
  • GEHA — Commercial: $731.85
  • MCM Maxcare — Commercial: $688.80
  • Mega Life — Commercial: $688.80
  • Novanet — Commercial: $129.15
  • TRPN — Commercial: $774.90
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Chest 2 Views 71046 AMB $157 $86.35 $23.55 – $141.30
Chest X-ray, 2 views: 10 of 12 insurance plan rates
  • Aetna — Commercial: $94.20
  • BeechStreet — PHCS: $133.45
  • Coventry First Health — Commercial: $133.45
  • GEHA — Commercial: $133.45
  • Humana — Commercial: $109.90
  • MCM Maxcare — Commercial: $125.60
  • Mega Life — Commercial: $125.60
  • Multiplan — PHCS: $133.45
  • Novanet — Commercial: $23.55
  • TRPN — Commercial: $141.30
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RAD XR CHEST 2 VIEWS $162 $89.10 $24.30 – $145.80
Chest X-ray, 2 views: 10 of 12 insurance plan rates
  • Aetna — Commercial: $97.20
  • BeechStreet — PHCS: $137.70
  • Coventry First Health — Commercial: $137.70
  • GEHA — Commercial: $137.70
  • Humana — Commercial: $113.40
  • MCM Maxcare — Commercial: $129.60
  • Mega Life — Commercial: $129.60
  • Multiplan — PHCS: $137.70
  • Novanet — Commercial: $24.30
  • TRPN — Commercial: $145.80
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Exam $162 $89.10 $24.30 – $145.80
Chest X-ray, 2 views: 10 of 12 insurance plan rates
  • Aetna — Commercial: $97.20
  • BeechStreet — PHCS: $137.70
  • Coventry First Health — Commercial: $137.70
  • GEHA — Commercial: $137.70
  • Humana — Commercial: $113.40
  • MCM Maxcare — Commercial: $129.60
  • Mega Life — Commercial: $129.60
  • Multiplan — PHCS: $137.70
  • Novanet — Commercial: $24.30
  • TRPN — Commercial: $145.80
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR L-S Spine 4 or more Views 72110 AMB $223 $122.65 $33.45 – $200.70
X-ray of the lower spine, at least 4 views: 10 of 12 insurance plan rates
  • Aetna — Commercial: $133.80
  • BeechStreet — PHCS: $189.55
  • Coventry First Health — Commercial: $189.55
  • GEHA — Commercial: $189.55
  • Humana — Commercial: $156.10
  • MCM Maxcare — Commercial: $178.40
  • Mega Life — Commercial: $178.40
  • Multiplan — PHCS: $189.55
  • Novanet — Commercial: $33.45
  • TRPN — Commercial: $200.70
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Exam $230 $126.50 $34.50 – $207
X-ray of the lower spine, at least 4 views: 10 of 12 insurance plan rates
  • Aetna — Commercial: $138
  • BeechStreet — PHCS: $195.50
  • Coventry First Health — Commercial: $195.50
  • GEHA — Commercial: $195.50
  • Humana — Commercial: $161
  • MCM Maxcare — Commercial: $184
  • Mega Life — Commercial: $184
  • Multiplan — PHCS: $195.50
  • Novanet — Commercial: $34.50
  • TRPN — Commercial: $207
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: XR L-S Spine 4 or more Views 72110 AMB $223 $122.65 $33.45 – $223
X-ray of the lower spine, at least 4 views: rates for 8 insurance plans
  • Aetna — Commercial: $223
  • Alabama Crime Victims — Commercial: $111.50
  • Coventry First Health — Commercial: $189.55
  • GEHA — Commercial: $189.55
  • MCM Maxcare — Commercial: $178.40
  • Mega Life — Commercial: $178.40
  • Novanet — Commercial: $33.45
  • TRPN — Commercial: $200.70
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Spine Lumbar Without Contrast $492 $270.60 $73.80 – $442.80
MRI of the lower back (lumbar spine), without contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial: $295.20
  • BeechStreet — PHCS: $418.20
  • Coventry First Health — Commercial: $418.20
  • GEHA — Commercial: $418.20
  • Humana — Commercial: $344.40
  • MCM Maxcare — Commercial: $393.60
  • Mega Life — Commercial: $393.60
  • Multiplan — PHCS: $418.20
  • Novanet — Commercial: $73.80
  • TRPN — Commercial: $442.80
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Exam $507 $278.85 $76.05 – $456.30
MRI of the lower back (lumbar spine), without contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial: $304.20
  • BeechStreet — PHCS: $430.95
  • Coventry First Health — Commercial: $430.95
  • GEHA — Commercial: $430.95
  • Humana — Commercial: $354.90
  • MCM Maxcare — Commercial: $405.60
  • Mega Life — Commercial: $405.60
  • Multiplan — PHCS: $430.95
  • Novanet — Commercial: $76.05
  • TRPN — Commercial: $456.30
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Spine Lumbar Without Contrast $492 $270.60 $73.80 – $492
MRI of the lower back (lumbar spine), without contrast: rates for 8 insurance plans
  • Aetna — Commercial: $492
  • Alabama Crime Victims — Commercial: $246
  • Coventry First Health — Commercial: $418.20
  • GEHA — Commercial: $418.20
  • MCM Maxcare — Commercial: $393.60
  • Mega Life — Commercial: $393.60
  • Novanet — Commercial: $73.80
  • TRPN — Commercial: $442.80
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Exam 2 $628 $345.40 $94.20 – $565.20
CT scan of the pelvis, with contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial: $376.80
  • BeechStreet — PHCS: $533.80
  • Coventry First Health — Commercial: $533.80
  • GEHA — Commercial: $533.80
  • Humana — Commercial: $439.60
  • MCM Maxcare — Commercial: $502.40
  • Mega Life — Commercial: $502.40
  • Multiplan — PHCS: $533.80
  • Novanet — Commercial: $94.20
  • TRPN — Commercial: $565.20
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis w/o contrast $628 $345.40 $94.20 – $565.20
CT scan of the pelvis, with contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial: $376.80
  • BeechStreet — PHCS: $533.80
  • Coventry First Health — Commercial: $533.80
  • GEHA — Commercial: $533.80
  • Humana — Commercial: $439.60
  • MCM Maxcare — Commercial: $502.40
  • Mega Life — Commercial: $502.40
  • Multiplan — PHCS: $533.80
  • Novanet — Commercial: $94.20
  • TRPN — Commercial: $565.20
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Exam 2 $628 $345.40 $94.20 – $628
CT scan of the pelvis, with contrast: rates for 8 insurance plans
  • Aetna — Commercial: $628
  • Alabama Crime Victims — Commercial: $314
  • Coventry First Health — Commercial: $533.80
  • GEHA — Commercial: $533.80
  • MCM Maxcare — Commercial: $502.40
  • Mega Life — Commercial: $502.40
  • Novanet — Commercial: $94.20
  • TRPN — Commercial: $565.20
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye Not listed in the file Not listed in the file $219.07 – $544.32
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans
  • Aetna — Commercial: $457.85
  • Blue Cross — Commercial: $397.04
  • Blue Cross — Medicare Advantage: $219.07
  • Blue Cross Lanier — Commercial: $397.04
  • Cigna — Commercial: $431.02
  • Humana — Commercial: $434.37
  • Humana — Medicare Advantage: $219.07
  • Simpra — Medicare Advantage: $219.07
  • Viva — Commercial: $544.32
  • Viva — Medicare Advantage: $219.07
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Mri jnt of lwr extre w/o dye Not listed in the file Not listed in the file $205.72 – $397.04
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans
  • BeechStreet — PHCS: $205.72
  • Blue Cross Lanier — Commercial: $397.04
  • Humana — Commercial: $205.72
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: RAD MRI JNT OF LWR EXTRE W/O DYE LT $492 $270.60 $73.80 – $442.80
MRI of a leg joint (such as the knee), without contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial: $295.20
  • BeechStreet — PHCS: $418.20
  • Coventry First Health — Commercial: $418.20
  • GEHA — Commercial: $418.20
  • Humana — Commercial: $344.40
  • MCM Maxcare — Commercial: $393.60
  • Mega Life — Commercial: $393.60
  • Multiplan — PHCS: $418.20
  • Novanet — Commercial: $73.80
  • TRPN — Commercial: $442.80
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Exam 2 $789 $433.95 $118.35 – $710.10
CT scan of the abdomen and pelvis, with contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial: $473.40
  • BeechStreet — PHCS: $670.65
  • Coventry First Health — Commercial: $670.65
  • GEHA — Commercial: $670.65
  • Humana — Commercial: $552.30
  • MCM Maxcare — Commercial: $631.20
  • Mega Life — Commercial: $631.20
  • Multiplan — PHCS: $670.65
  • Novanet — Commercial: $118.35
  • TRPN — Commercial: $710.10
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Exam 2 $789 $433.95 $118.35 – $789
CT scan of the abdomen and pelvis, with contrast: rates for 8 insurance plans
  • Aetna — Commercial: $789
  • Alabama Crime Victims — Commercial: $394.50
  • Coventry First Health — Commercial: $670.65
  • GEHA — Commercial: $670.65
  • MCM Maxcare — Commercial: $631.20
  • Mega Life — Commercial: $631.20
  • Novanet — Commercial: $118.35
  • TRPN — Commercial: $710.10
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelvis w/contrast Not listed in the file Not listed in the file $323.66 – $804.21
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans
  • Aetna — Commercial: $676.45
  • Blue Cross — Commercial: $487.66
  • Blue Cross — Medicare Advantage: $323.66
  • Blue Cross Lanier — Commercial: $487.66
  • Cigna — Commercial: $636.81
  • Humana — Commercial: $681.73
  • Humana — Medicare Advantage: $323.66
  • Simpra — Medicare Advantage: $323.66
  • Viva — Commercial: $804.21
  • Viva — Medicare Advantage: $323.66
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RAD US Abdomen Complete $329 $180.95 $49.35 – $296.10
Ultrasound of the abdomen, complete: 10 of 12 insurance plan rates
  • Aetna — Commercial: $197.40
  • BeechStreet — PHCS: $279.65
  • Coventry First Health — Commercial: $279.65
  • GEHA — Commercial: $279.65
  • Humana — Commercial: $230.30
  • MCM Maxcare — Commercial: $263.20
  • Mega Life — Commercial: $263.20
  • Multiplan — PHCS: $279.65
  • Novanet — Commercial: $49.35
  • TRPN — Commercial: $296.10
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Exam ADI/2 $339 $186.45 $50.85 – $305.10
Ultrasound of the abdomen, complete: 10 of 12 insurance plan rates
  • Aetna — Commercial: $203.40
  • BeechStreet — PHCS: $288.15
  • Coventry First Health — Commercial: $288.15
  • GEHA — Commercial: $288.15
  • Humana — Commercial: $237.30
  • MCM Maxcare — Commercial: $271.20
  • Mega Life — Commercial: $271.20
  • Multiplan — PHCS: $288.15
  • Novanet — Commercial: $50.85
  • TRPN — Commercial: $305.10
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RAD US Abdomen Complete $329 $180.95 $49.35 – $329
Ultrasound of the abdomen, complete: rates for 8 insurance plans
  • Aetna — Commercial: $329
  • Alabama Crime Victims — Commercial: $164.50
  • Coventry First Health — Commercial: $279.65
  • GEHA — Commercial: $279.65
  • MCM Maxcare — Commercial: $263.20
  • Mega Life — Commercial: $263.20
  • Novanet — Commercial: $49.35
  • TRPN — Commercial: $296.10
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Obstetrical Complete 76805 AMB $223 $122.65 $33.45 – $200.70
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates
  • Aetna — Commercial: $133.80
  • BeechStreet — PHCS: $189.55
  • Coventry First Health — Commercial: $189.55
  • GEHA — Commercial: $189.55
  • Humana — Commercial: $156.10
  • MCM Maxcare — Commercial: $178.40
  • Mega Life — Commercial: $178.40
  • Multiplan — PHCS: $189.55
  • Novanet — Commercial: $33.45
  • TRPN — Commercial: $200.70
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RAD US Obstetrical Pregnancy > 14 weeks $223 $122.65 $33.45 – $200.70
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates
  • Aetna — Commercial: $133.80
  • BeechStreet — PHCS: $189.55
  • Coventry First Health — Commercial: $189.55
  • GEHA — Commercial: $189.55
  • Humana — Commercial: $156.10
  • MCM Maxcare — Commercial: $178.40
  • Mega Life — Commercial: $178.40
  • Multiplan — PHCS: $189.55
  • Novanet — Commercial: $33.45
  • TRPN — Commercial: $200.70
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Exam ADI/2 $230 $126.50 $34.50 – $207
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates
  • Aetna — Commercial: $138
  • BeechStreet — PHCS: $195.50
  • Coventry First Health — Commercial: $195.50
  • GEHA — Commercial: $195.50
  • Humana — Commercial: $161
  • MCM Maxcare — Commercial: $184
  • Mega Life — Commercial: $184
  • Multiplan — PHCS: $195.50
  • Novanet — Commercial: $34.50
  • TRPN — Commercial: $207
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RAD US Transvaginal $254 $139.70 $38.10 – $228.60
Transvaginal ultrasound: 10 of 12 insurance plan rates
  • Aetna — Commercial: $152.40
  • BeechStreet — PHCS: $215.90
  • Coventry First Health — Commercial: $215.90
  • GEHA — Commercial: $215.90
  • Humana — Commercial: $177.80
  • MCM Maxcare — Commercial: $203.20
  • Mega Life — Commercial: $203.20
  • Multiplan — PHCS: $215.90
  • Novanet — Commercial: $38.10
  • TRPN — Commercial: $228.60
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Transvaginal Non-Obstetrical 76830 AMB $254 $139.70 $38.10 – $228.60
Transvaginal ultrasound: 10 of 12 insurance plan rates
  • Aetna — Commercial: $152.40
  • BeechStreet — PHCS: $215.90
  • Coventry First Health — Commercial: $215.90
  • GEHA — Commercial: $215.90
  • Humana — Commercial: $177.80
  • MCM Maxcare — Commercial: $203.20
  • Mega Life — Commercial: $203.20
  • Multiplan — PHCS: $215.90
  • Novanet — Commercial: $38.10
  • TRPN — Commercial: $228.60
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RAD US Transvaginal Non-Obstetrical $254 $139.70 $38.10 – $228.60
Transvaginal ultrasound: 10 of 12 insurance plan rates
  • Aetna — Commercial: $152.40
  • BeechStreet — PHCS: $215.90
  • Coventry First Health — Commercial: $215.90
  • GEHA — Commercial: $215.90
  • Humana — Commercial: $177.80
  • MCM Maxcare — Commercial: $203.20
  • Mega Life — Commercial: $203.20
  • Multiplan — PHCS: $215.90
  • Novanet — Commercial: $38.10
  • TRPN — Commercial: $228.60
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni Not listed in the file Not listed in the file $106.24 – $227.45
Diagnostic mammogram, one breast: rates for 10 insurance plans
  • Aetna — Commercial: $227.45
  • Blue Cross — Commercial: $106.24
  • Blue Cross — Medicare Advantage: $108.83
  • Blue Cross Lanier — Commercial: $106.24
  • Cigna — Commercial: $108.83
  • Humana — Commercial: $157.22
  • Humana — Medicare Advantage: $108.83
  • Simpra — Medicare Advantage: $108.83
  • Viva — Commercial: $171.08
  • Viva — Medicare Advantage: $108.83
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Dx mammo incl cad uni Not listed in the file Not listed in the file $74.46 – $106.24
Diagnostic mammogram, one breast: rates for 3 insurance plans
  • BeechStreet — PHCS: $74.46
  • Blue Cross Lanier — Commercial: $106.24
  • Humana — Commercial: $74.46
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MM Exam 1 $151 $83.05 $22.65 – $135.90
Diagnostic mammogram, one breast: 10 of 12 insurance plan rates
  • Aetna — Commercial: $90.60
  • BeechStreet — PHCS: $128.35
  • Coventry First Health — Commercial: $128.35
  • GEHA — Commercial: $128.35
  • Humana — Commercial: $105.70
  • MCM Maxcare — Commercial: $120.80
  • Mega Life — Commercial: $120.80
  • Multiplan — PHCS: $128.35
  • Novanet — Commercial: $22.65
  • TRPN — Commercial: $135.90
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MM Exam 1 $205 $112.75 $30.75 – $184.50
Diagnostic mammogram, both breasts: 10 of 12 insurance plan rates
  • Aetna — Commercial: $123
  • BeechStreet — PHCS: $174.25
  • Coventry First Health — Commercial: $174.25
  • GEHA — Commercial: $174.25
  • Humana — Commercial: $143.50
  • MCM Maxcare — Commercial: $164
  • Mega Life — Commercial: $164
  • Multiplan — PHCS: $174.25
  • Novanet — Commercial: $30.75
  • TRPN — Commercial: $184.50
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MM Exam 1 $205 $112.75 $30.75 – $205
Diagnostic mammogram, both breasts: rates for 8 insurance plans
  • Aetna — Commercial: $205
  • Alabama Crime Victims — Commercial: $102.50
  • Coventry First Health — Commercial: $174.25
  • GEHA — Commercial: $174.25
  • MCM Maxcare — Commercial: $164
  • Mega Life — Commercial: $164
  • Novanet — Commercial: $30.75
  • TRPN — Commercial: $184.50
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi Not listed in the file Not listed in the file $106.24 – $286.73
Diagnostic mammogram, both breasts: rates for 10 insurance plans
  • Aetna — Commercial: $286.73
  • Blue Cross — Commercial: $106.24
  • Blue Cross — Medicare Advantage: $137.19
  • Blue Cross Lanier — Commercial: $106.24
  • Cigna — Commercial: $137.19
  • Humana — Commercial: $201.48
  • Humana — Medicare Advantage: $137.19
  • Simpra — Medicare Advantage: $137.19
  • Viva — Commercial: $218.03
  • Viva — Medicare Advantage: $137.19
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MM Exam 1 $170 $93.50 $25.50 – $153
Screening mammogram, both breasts: 10 of 12 insurance plan rates
  • Aetna — Commercial: $102
  • BeechStreet — PHCS: $144.50
  • Coventry First Health — Commercial: $144.50
  • GEHA — Commercial: $144.50
  • Humana — Commercial: $119
  • MCM Maxcare — Commercial: $136
  • Mega Life — Commercial: $136
  • Multiplan — PHCS: $144.50
  • Novanet — Commercial: $25.50
  • TRPN — Commercial: $153
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MM Exam 1 $170 $93.50 $25.50 – $170
Screening mammogram, both breasts: rates for 8 insurance plans
  • Aetna — Commercial: $170
  • Alabama Crime Victims — Commercial: $85
  • Coventry First Health — Commercial: $144.50
  • GEHA — Commercial: $144.50
  • MCM Maxcare — Commercial: $136
  • Mega Life — Commercial: $136
  • Novanet — Commercial: $25.50
  • TRPN — Commercial: $153
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad Not listed in the file Not listed in the file $106.24 – $231.91
Screening mammogram, both breasts: rates for 10 insurance plans
  • Aetna — Commercial: $231.91
  • Blue Cross — Commercial: $106.24
  • Blue Cross — Medicare Advantage: $110.96
  • Blue Cross Lanier — Commercial: $106.24
  • Cigna — Commercial: $110.96
  • Humana — Commercial: $166.22
  • Humana — Medicare Advantage: $110.96
  • Simpra — Medicare Advantage: $110.96
  • Viva — Commercial: $180.43
  • Viva — Medicare Advantage: $110.96

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Electrocardiogram complete Not listed in the file Not listed in the file $12.62 – $42.21
Electrocardiogram (ECG/EKG) with reading: rates for 8 insurance plans
  • Aetna — Commercial: $12.62
  • Blue Cross — Medicare Advantage: $12.62
  • Blue Cross Lanier — Commercial: $42.21
  • Cigna — Commercial: $12.62
  • Humana — Medicare Advantage: $12.62
  • Simpra — Medicare Advantage: $12.62
  • Viva — Commercial: $12.62
  • Viva — Medicare Advantage: $12.62
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrocardiogram complete Not listed in the file Not listed in the file $42.21
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans
  • Blue Cross — Commercial: $42.21
  • Blue Cross Lanier — Commercial: $42.21
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 93452 Left Heart Cath (LHC) LV Only $5,885 $3,236.75 $882.75 – $5,296.50
Left heart catheterization (diagnostic): 10 of 12 insurance plan rates
  • Aetna — Commercial: $3,531
  • BeechStreet — PHCS: $5,002.25
  • Coventry First Health — Commercial: $5,002.25
  • GEHA — Commercial: $5,002.25
  • Humana — Commercial: $4,119.50
  • MCM Maxcare — Commercial: $4,708
  • Mega Life — Commercial: $4,708
  • Multiplan — PHCS: $5,002.25
  • Novanet — Commercial: $882.75
  • TRPN — Commercial: $5,296.50
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CTH LV $5,885 $3,236.75 $882.75 – $5,296.50
Left heart catheterization (diagnostic): 10 of 12 insurance plan rates
  • Aetna — Commercial: $3,531
  • BeechStreet — PHCS: $5,002.25
  • Coventry First Health — Commercial: $5,002.25
  • GEHA — Commercial: $5,002.25
  • Humana — Commercial: $4,119.50
  • MCM Maxcare — Commercial: $4,708
  • Mega Life — Commercial: $4,708
  • Multiplan — PHCS: $5,002.25
  • Novanet — Commercial: $882.75
  • TRPN — Commercial: $5,296.50
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 93452 Left Heart Cath (LHC) LV Only $5,885 $3,236.75 $882.75 – $5,885
Left heart catheterization (diagnostic): rates for 8 insurance plans
  • Aetna — Commercial: $5,885
  • Alabama Crime Victims — Commercial: $2,942.50
  • Coventry First Health — Commercial: $5,002.25
  • GEHA — Commercial: $5,002.25
  • MCM Maxcare — Commercial: $4,708
  • Mega Life — Commercial: $4,708
  • Novanet — Commercial: $882.75
  • TRPN — Commercial: $5,296.50
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 93619 Comp EP eval w/o ind of arrhythmia $32,480 $17,864 $4,872 – $29,232
Heart rhythm study (electrophysiology evaluation): 10 of 12 insurance plan rates
  • Aetna — Commercial: $19,488
  • BeechStreet — PHCS: $27,608
  • Coventry First Health — Commercial: $27,608
  • GEHA — Commercial: $27,608
  • Humana — Commercial: $22,736
  • MCM Maxcare — Commercial: $25,984
  • Mega Life — Commercial: $25,984
  • Multiplan — PHCS: $27,608
  • Novanet — Commercial: $4,872
  • TRPN — Commercial: $29,232
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CTH EP COMPREHENSIVE EP STUDY WITHOUT INDUCTION $32,480 $17,864 $4,872 – $29,232
Heart rhythm study (electrophysiology evaluation): 10 of 12 insurance plan rates
  • Aetna — Commercial: $19,488
  • BeechStreet — PHCS: $27,608
  • Coventry First Health — Commercial: $27,608
  • GEHA — Commercial: $27,608
  • Humana — Commercial: $22,736
  • MCM Maxcare — Commercial: $25,984
  • Mega Life — Commercial: $25,984
  • Multiplan — PHCS: $27,608
  • Novanet — Commercial: $4,872
  • TRPN — Commercial: $29,232
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 93619 Comp EP eval w/o ind of arrhythmia $32,480 $17,864 $4,872 – $32,480
Heart rhythm study (electrophysiology evaluation): rates for 8 insurance plans
  • Aetna — Commercial: $32,480
  • Alabama Crime Victims — Commercial: $16,240
  • Coventry First Health — Commercial: $27,608
  • GEHA — Commercial: $27,608
  • MCM Maxcare — Commercial: $25,984
  • Mega Life — Commercial: $25,984
  • Novanet — Commercial: $4,872
  • TRPN — Commercial: $29,232
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 93656 Comp EP/ Afib ablat/pul vein iso $44,884 $24,686.20 $6,732.60 – $40,395.60
Heart rhythm study with ablation for atrial fibrillation: 10 of 12 insurance plan rates
  • Aetna — Commercial: $26,930.40
  • BeechStreet — PHCS: $38,151.40
  • Coventry First Health — Commercial: $38,151.40
  • GEHA — Commercial: $38,151.40
  • Humana — Commercial: $31,418.80
  • MCM Maxcare — Commercial: $35,907.20
  • Mega Life — Commercial: $35,907.20
  • Multiplan — PHCS: $38,151.40
  • Novanet — Commercial: $6,732.60
  • TRPN — Commercial: $40,395.60
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CTH EP EVALUATION INCLUDING TRAN SEPTAL CATHETERIZATIONS $44,884 $24,686.20 $6,732.60 – $40,395.60
Heart rhythm study with ablation for atrial fibrillation: 10 of 12 insurance plan rates
  • Aetna — Commercial: $26,930.40
  • BeechStreet — PHCS: $38,151.40
  • Coventry First Health — Commercial: $38,151.40
  • GEHA — Commercial: $38,151.40
  • Humana — Commercial: $31,418.80
  • MCM Maxcare — Commercial: $35,907.20
  • Mega Life — Commercial: $35,907.20
  • Multiplan — PHCS: $38,151.40
  • Novanet — Commercial: $6,732.60
  • TRPN — Commercial: $40,395.60
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 93656 Comp EP/ Afib ablat/pul vein iso $44,884 $24,686.20 $6,732.60 – $44,884
Heart rhythm study with ablation for atrial fibrillation: rates for 8 insurance plans
  • Aetna — Commercial: $44,884
  • Alabama Crime Victims — Commercial: $22,442
  • Coventry First Health — Commercial: $38,151.40
  • GEHA — Commercial: $38,151.40
  • MCM Maxcare — Commercial: $35,907.20
  • Mega Life — Commercial: $35,907.20
  • Novanet — Commercial: $6,732.60
  • TRPN — Commercial: $40,395.60
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Nocturnal Polysomnogram (NPSG) - Sleep Lab Charges $4,085 $2,246.75 $612.75 – $3,676.50
Sleep study (overnight, in a sleep lab): 10 of 12 insurance plan rates
  • Aetna — Commercial: $2,451
  • BeechStreet — PHCS: $3,472.25
  • Coventry First Health — Commercial: $3,472.25
  • GEHA — Commercial: $3,472.25
  • Humana — Commercial: $2,859.50
  • MCM Maxcare — Commercial: $3,268
  • Mega Life — Commercial: $3,268
  • Multiplan — PHCS: $3,472.25
  • Novanet — Commercial: $612.75
  • TRPN — Commercial: $3,676.50
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Nocturnal Polysomnogram (NPSG) - Sleep Lab Charges $4,085 $2,246.75 $612.75 – $4,085
Sleep study (overnight, in a sleep lab): rates for 8 insurance plans
  • Aetna — Commercial: $4,085
  • Alabama Crime Victims — Commercial: $2,042.50
  • Coventry First Health — Commercial: $3,472.25
  • GEHA — Commercial: $3,472.25
  • MCM Maxcare — Commercial: $3,268
  • Mega Life — Commercial: $3,268
  • Novanet — Commercial: $612.75
  • TRPN — Commercial: $3,676.50
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param Not listed in the file Not listed in the file $922.04 – $2,291.02
Sleep study (overnight, in a sleep lab): rates for 10 insurance plans
  • Aetna — Commercial: $1,927.07
  • Blue Cross — Commercial: $1,232.44
  • Blue Cross — Medicare Advantage: $922.04
  • Blue Cross Lanier — Commercial: $1,232.44
  • Cigna — Commercial: $1,814.14
  • Humana — Commercial: $1,853.42
  • Humana — Medicare Advantage: $922.04
  • Simpra — Medicare Advantage: $922.04
  • Viva — Commercial: $2,291.02
  • Viva — Medicare Advantage: $922.04

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 97110 Therapeutic exercise/ea 15 min $84 $46.20 $12.60 – $75.60
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $50.40
  • BeechStreet — PHCS: $71.40
  • Coventry First Health — Commercial: $71.40
  • GEHA — Commercial: $71.40
  • Humana — Commercial: $58.80
  • MCM Maxcare — Commercial: $67.20
  • Mega Life — Commercial: $67.20
  • Multiplan — PHCS: $71.40
  • Novanet — Commercial: $12.60
  • TRPN — Commercial: $75.60
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RSA THERAPEUTIC EX 15 MIN $87 $47.85 $13.05 – $78.30
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial: $52.20
  • BeechStreet — PHCS: $73.95
  • Coventry First Health — Commercial: $73.95
  • GEHA — Commercial: $73.95
  • Humana — Commercial: $60.90
  • MCM Maxcare — Commercial: $69.60
  • Mega Life — Commercial: $69.60
  • Multiplan — PHCS: $73.95
  • Novanet — Commercial: $13.05
  • TRPN — Commercial: $78.30
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 97110 Therapeutic exercise/ea 15 min $84 $46.20 $12.60 – $84
Physical therapy: therapeutic exercise (each 15 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $84
  • Alabama Crime Victims — Commercial: $42
  • Coventry First Health — Commercial: $71.40
  • GEHA — Commercial: $71.40
  • MCM Maxcare — Commercial: $67.20
  • Mega Life — Commercial: $67.20
  • Novanet — Commercial: $12.60
  • TRPN — Commercial: $75.60
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RS PT EVAL LOW COMPLEXITY $193 $106.15 $28.95 – $173.70
Physical therapy evaluation (low complexity): 10 of 12 insurance plan rates
  • Aetna — Commercial: $115.80
  • BeechStreet — PHCS: $164.05
  • Coventry First Health — Commercial: $164.05
  • GEHA — Commercial: $164.05
  • Humana — Commercial: $135.10
  • MCM Maxcare — Commercial: $154.40
  • Mega Life — Commercial: $154.40
  • Multiplan — PHCS: $164.05
  • Novanet — Commercial: $28.95
  • TRPN — Commercial: $173.70
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RS PT EVAL LOW COMPLEXITY $193 $106.15 $28.95 – $193
Physical therapy evaluation (low complexity): rates for 8 insurance plans
  • Aetna — Commercial: $193
  • Alabama Crime Victims — Commercial: $96.50
  • Coventry First Health — Commercial: $164.05
  • GEHA — Commercial: $164.05
  • MCM Maxcare — Commercial: $154.40
  • Mega Life — Commercial: $154.40
  • Novanet — Commercial: $28.95
  • TRPN — Commercial: $173.70
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min Not listed in the file Not listed in the file $49.48 – $211.86
Physical therapy evaluation (low complexity): rates for 10 insurance plans
  • Aetna — Commercial: $190.86
  • Blue Cross — Commercial: $49.48
  • Blue Cross — Medicare Advantage: $91.32
  • Blue Cross Lanier — Commercial: $49.48
  • Cigna — Commercial: $91.32
  • Humana — Commercial: $192.82
  • Humana — Medicare Advantage: $91.32
  • Simpra — Medicare Advantage: $91.32
  • Viva — Commercial: $211.86
  • Viva — Medicare Advantage: $91.32
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RS PT EVAL MOD COMPLEXITY $193 $106.15 $28.95 – $173.70
Physical therapy evaluation (moderate complexity): 10 of 12 insurance plan rates
  • Aetna — Commercial: $115.80
  • BeechStreet — PHCS: $164.05
  • Coventry First Health — Commercial: $164.05
  • GEHA — Commercial: $164.05
  • Humana — Commercial: $135.10
  • MCM Maxcare — Commercial: $154.40
  • Mega Life — Commercial: $154.40
  • Multiplan — PHCS: $164.05
  • Novanet — Commercial: $28.95
  • TRPN — Commercial: $173.70
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RS PT EVAL MOD COMPLEXITY $193 $106.15 $28.95 – $193
Physical therapy evaluation (moderate complexity): rates for 8 insurance plans
  • Aetna — Commercial: $193
  • Alabama Crime Victims — Commercial: $96.50
  • Coventry First Health — Commercial: $164.05
  • GEHA — Commercial: $164.05
  • MCM Maxcare — Commercial: $154.40
  • Mega Life — Commercial: $154.40
  • Novanet — Commercial: $28.95
  • TRPN — Commercial: $173.70
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min Not listed in the file Not listed in the file $49.48 – $211.86
Physical therapy evaluation (moderate complexity): rates for 10 insurance plans
  • Aetna — Commercial: $190.86
  • Blue Cross — Commercial: $49.48
  • Blue Cross — Medicare Advantage: $91.32
  • Blue Cross Lanier — Commercial: $49.48
  • Cigna — Commercial: $91.32
  • Humana — Commercial: $192.82
  • Humana — Medicare Advantage: $91.32
  • Simpra — Medicare Advantage: $91.32
  • Viva — Commercial: $211.86
  • Viva — Medicare Advantage: $91.32
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RS PT EVAL HIGH COMPLEXITY $193 $106.15 $28.95 – $173.70
Physical therapy evaluation (high complexity): 10 of 12 insurance plan rates
  • Aetna — Commercial: $115.80
  • BeechStreet — PHCS: $164.05
  • Coventry First Health — Commercial: $164.05
  • GEHA — Commercial: $164.05
  • Humana — Commercial: $135.10
  • MCM Maxcare — Commercial: $154.40
  • Mega Life — Commercial: $154.40
  • Multiplan — PHCS: $164.05
  • Novanet — Commercial: $28.95
  • TRPN — Commercial: $173.70
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RS PT EVAL HIGH COMPLEXITY $193 $106.15 $28.95 – $193
Physical therapy evaluation (high complexity): rates for 8 insurance plans
  • Aetna — Commercial: $193
  • Alabama Crime Victims — Commercial: $96.50
  • Coventry First Health — Commercial: $164.05
  • GEHA — Commercial: $164.05
  • MCM Maxcare — Commercial: $154.40
  • Mega Life — Commercial: $154.40
  • Novanet — Commercial: $28.95
  • TRPN — Commercial: $173.70
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min Not listed in the file Not listed in the file $49.48 – $211.86
Physical therapy evaluation (high complexity): rates for 10 insurance plans
  • Aetna — Commercial: $190.86
  • Blue Cross — Commercial: $49.48
  • Blue Cross — Medicare Advantage: $91.32
  • Blue Cross Lanier — Commercial: $49.48
  • Cigna — Commercial: $91.32
  • Humana — Commercial: $192.82
  • Humana — Medicare Advantage: $91.32
  • Simpra — Medicare Advantage: $91.32
  • Viva — Commercial: $211.86
  • Viva — Medicare Advantage: $91.32
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY LTA ADOLESCENT INDIV THPY 30 MIN $286 $157.30 $42.90 – $257.40
Psychotherapy, 30 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial: $171.60
  • BeechStreet — PHCS: $243.10
  • Coventry First Health — Commercial: $243.10
  • GEHA — Commercial: $243.10
  • Humana — Commercial: $200.20
  • MCM Maxcare — Commercial: $228.80
  • Mega Life — Commercial: $228.80
  • Multiplan — PHCS: $243.10
  • Novanet — Commercial: $42.90
  • TRPN — Commercial: $257.40
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY INDIV THERAPY 30 MIN $286 $157.30 $42.90 – $257.40
Psychotherapy, 30 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial: $171.60
  • BeechStreet — PHCS: $243.10
  • Coventry First Health — Commercial: $243.10
  • GEHA — Commercial: $243.10
  • Humana — Commercial: $200.20
  • MCM Maxcare — Commercial: $228.80
  • Mega Life — Commercial: $228.80
  • Multiplan — PHCS: $243.10
  • Novanet — Commercial: $42.90
  • TRPN — Commercial: $257.40
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY Individual Therapy 30 min $295 $162.25 $44.25 – $265.50
Psychotherapy, 30 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial: $177
  • BeechStreet — PHCS: $250.75
  • Coventry First Health — Commercial: $250.75
  • GEHA — Commercial: $250.75
  • Humana — Commercial: $206.50
  • MCM Maxcare — Commercial: $236
  • Mega Life — Commercial: $236
  • Multiplan — PHCS: $250.75
  • Novanet — Commercial: $44.25
  • TRPN — Commercial: $265.50
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY LTA ADOLESCENT INDIV THPY 45 MIN $286 $157.30 $42.90 – $257.40
Psychotherapy, 45 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial: $171.60
  • BeechStreet — PHCS: $243.10
  • Coventry First Health — Commercial: $243.10
  • GEHA — Commercial: $243.10
  • Humana — Commercial: $200.20
  • MCM Maxcare — Commercial: $228.80
  • Mega Life — Commercial: $228.80
  • Multiplan — PHCS: $243.10
  • Novanet — Commercial: $42.90
  • TRPN — Commercial: $257.40
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY INDIV THERAPY 45 MIN $286 $157.30 $42.90 – $257.40
Psychotherapy, 45 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial: $171.60
  • BeechStreet — PHCS: $243.10
  • Coventry First Health — Commercial: $243.10
  • GEHA — Commercial: $243.10
  • Humana — Commercial: $200.20
  • MCM Maxcare — Commercial: $228.80
  • Mega Life — Commercial: $228.80
  • Multiplan — PHCS: $243.10
  • Novanet — Commercial: $42.90
  • TRPN — Commercial: $257.40
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY Individual Therapy 45 min $295 $162.25 $44.25 – $265.50
Psychotherapy, 45 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial: $177
  • BeechStreet — PHCS: $250.75
  • Coventry First Health — Commercial: $250.75
  • GEHA — Commercial: $250.75
  • Humana — Commercial: $206.50
  • MCM Maxcare — Commercial: $236
  • Mega Life — Commercial: $236
  • Multiplan — PHCS: $250.75
  • Novanet — Commercial: $44.25
  • TRPN — Commercial: $265.50
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY LTA ADOLESCENT INDV THPY 60 MIN $286 $157.30 $42.90 – $257.40
Psychotherapy, 60 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial: $171.60
  • BeechStreet — PHCS: $243.10
  • Coventry First Health — Commercial: $243.10
  • GEHA — Commercial: $243.10
  • Humana — Commercial: $200.20
  • MCM Maxcare — Commercial: $228.80
  • Mega Life — Commercial: $228.80
  • Multiplan — PHCS: $243.10
  • Novanet — Commercial: $42.90
  • TRPN — Commercial: $257.40
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY INDIV THERAPY 60 MIN $286 $157.30 $42.90 – $257.40
Psychotherapy, 60 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial: $171.60
  • BeechStreet — PHCS: $243.10
  • Coventry First Health — Commercial: $243.10
  • GEHA — Commercial: $243.10
  • Humana — Commercial: $200.20
  • MCM Maxcare — Commercial: $228.80
  • Mega Life — Commercial: $228.80
  • Multiplan — PHCS: $243.10
  • Novanet — Commercial: $42.90
  • TRPN — Commercial: $257.40
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY Individual Therapy 60 min $295 $162.25 $44.25 – $265.50
Psychotherapy, 60 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial: $177
  • BeechStreet — PHCS: $250.75
  • Coventry First Health — Commercial: $250.75
  • GEHA — Commercial: $250.75
  • Humana — Commercial: $206.50
  • MCM Maxcare — Commercial: $236
  • Mega Life — Commercial: $236
  • Multiplan — PHCS: $250.75
  • Novanet — Commercial: $44.25
  • TRPN — Commercial: $265.50
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY FAMILY THERAPY WO PT $286 $157.30 $42.90 – $257.40
Family psychotherapy, without the patient: 10 of 12 insurance plan rates
  • Aetna — Commercial: $171.60
  • BeechStreet — PHCS: $243.10
  • Coventry First Health — Commercial: $243.10
  • GEHA — Commercial: $243.10
  • Humana — Commercial: $200.20
  • MCM Maxcare — Commercial: $228.80
  • Mega Life — Commercial: $228.80
  • Multiplan — PHCS: $243.10
  • Novanet — Commercial: $42.90
  • TRPN — Commercial: $257.40
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY LTA ADOLESCENT FAMILY THPY WO PT $286 $157.30 $42.90 – $257.40
Family psychotherapy, without the patient: 10 of 12 insurance plan rates
  • Aetna — Commercial: $171.60
  • BeechStreet — PHCS: $243.10
  • Coventry First Health — Commercial: $243.10
  • GEHA — Commercial: $243.10
  • Humana — Commercial: $200.20
  • MCM Maxcare — Commercial: $228.80
  • Mega Life — Commercial: $228.80
  • Multiplan — PHCS: $243.10
  • Novanet — Commercial: $42.90
  • TRPN — Commercial: $257.40
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY Family Therapy w/o pt $295 $162.25 $44.25 – $265.50
Family psychotherapy, without the patient: 10 of 12 insurance plan rates
  • Aetna — Commercial: $177
  • BeechStreet — PHCS: $250.75
  • Coventry First Health — Commercial: $250.75
  • GEHA — Commercial: $250.75
  • Humana — Commercial: $206.50
  • MCM Maxcare — Commercial: $236
  • Mega Life — Commercial: $236
  • Multiplan — PHCS: $250.75
  • Novanet — Commercial: $44.25
  • TRPN — Commercial: $265.50
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY LTA ADOLESCENT FAMILY THERAPY $286 $157.30 $42.90 – $257.40
Family psychotherapy, with the patient: 10 of 12 insurance plan rates
  • Aetna — Commercial: $171.60
  • BeechStreet — PHCS: $243.10
  • Coventry First Health — Commercial: $243.10
  • GEHA — Commercial: $243.10
  • Humana — Commercial: $200.20
  • MCM Maxcare — Commercial: $228.80
  • Mega Life — Commercial: $228.80
  • Multiplan — PHCS: $243.10
  • Novanet — Commercial: $42.90
  • TRPN — Commercial: $257.40
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY FAMILY THERAPY $286 $157.30 $42.90 – $257.40
Family psychotherapy, with the patient: 10 of 12 insurance plan rates
  • Aetna — Commercial: $171.60
  • BeechStreet — PHCS: $243.10
  • Coventry First Health — Commercial: $243.10
  • GEHA — Commercial: $243.10
  • Humana — Commercial: $200.20
  • MCM Maxcare — Commercial: $228.80
  • Mega Life — Commercial: $228.80
  • Multiplan — PHCS: $243.10
  • Novanet — Commercial: $42.90
  • TRPN — Commercial: $257.40
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY Family Therapy $295 $162.25 $44.25 – $265.50
Family psychotherapy, with the patient: 10 of 12 insurance plan rates
  • Aetna — Commercial: $177
  • BeechStreet — PHCS: $250.75
  • Coventry First Health — Commercial: $250.75
  • GEHA — Commercial: $250.75
  • Humana — Commercial: $206.50
  • MCM Maxcare — Commercial: $236
  • Mega Life — Commercial: $236
  • Multiplan — PHCS: $250.75
  • Novanet — Commercial: $44.25
  • TRPN — Commercial: $265.50
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY LTA ADOLESCENT GROUP THERAPY $365 $200.75 $54.75 – $328.50
Group psychotherapy: 10 of 12 insurance plan rates
  • Aetna — Commercial: $219
  • BeechStreet — PHCS: $310.25
  • Coventry First Health — Commercial: $310.25
  • GEHA — Commercial: $310.25
  • Humana — Commercial: $255.50
  • MCM Maxcare — Commercial: $292
  • Mega Life — Commercial: $292
  • Multiplan — PHCS: $310.25
  • Novanet — Commercial: $54.75
  • TRPN — Commercial: $328.50
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY GROUP THERAPY $365 $200.75 $54.75 – $328.50
Group psychotherapy: 10 of 12 insurance plan rates
  • Aetna — Commercial: $219
  • BeechStreet — PHCS: $310.25
  • Coventry First Health — Commercial: $310.25
  • GEHA — Commercial: $310.25
  • Humana — Commercial: $255.50
  • MCM Maxcare — Commercial: $292
  • Mega Life — Commercial: $292
  • Multiplan — PHCS: $310.25
  • Novanet — Commercial: $54.75
  • TRPN — Commercial: $328.50
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSY Group Therapy $376 $206.80 $56.40 – $338.40
Group psychotherapy: 10 of 12 insurance plan rates
  • Aetna — Commercial: $225.60
  • BeechStreet — PHCS: $319.60
  • Coventry First Health — Commercial: $319.60
  • GEHA — Commercial: $319.60
  • Humana — Commercial: $263.20
  • MCM Maxcare — Commercial: $300.80
  • Mega Life — Commercial: $300.80
  • Multiplan — PHCS: $319.60
  • Novanet — Commercial: $56.40
  • TRPN — Commercial: $338.40

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 19120 EXCISIONAL BX $6,802 $3,741.10 $1,020.30 – $6,121.80
Removal of breast growth (open surgery): 10 of 12 insurance plan rates
  • Aetna — Commercial: $4,081.20
  • BeechStreet — PHCS: $5,781.70
  • Coventry First Health — Commercial: $5,781.70
  • GEHA — Commercial: $5,781.70
  • Humana — Commercial: $4,761.40
  • MCM Maxcare — Commercial: $5,441.60
  • Mega Life — Commercial: $5,441.60
  • Multiplan — PHCS: $5,781.70
  • Novanet — Commercial: $1,020.30
  • TRPN — Commercial: $6,121.80
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 19120 EXCISIONAL BX $6,802 $3,741.10 $1,020.30 – $6,802
Removal of breast growth (open surgery): rates for 8 insurance plans
  • Aetna — Commercial: $6,802
  • Alabama Crime Victims — Commercial: $3,401
  • Coventry First Health — Commercial: $5,781.70
  • GEHA — Commercial: $5,781.70
  • MCM Maxcare — Commercial: $5,441.60
  • Mega Life — Commercial: $5,441.60
  • Novanet — Commercial: $1,020.30
  • TRPN — Commercial: $6,121.80
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion Not listed in the file Not listed in the file $1,890.64 – $8,622.98
Removal of breast growth (open surgery): rates for 10 insurance plans
  • Aetna — Commercial: $7,253.14
  • Blue Cross — Commercial: $1,890.64
  • Blue Cross — Medicare Advantage: $3,470.40
  • Blue Cross Lanier — Commercial: $1,890.64
  • Cigna — Commercial: $6,828.11
  • Humana — Commercial: $6,757.04
  • Humana — Medicare Advantage: $3,470.40
  • Simpra — Medicare Advantage: $3,470.40
  • Viva — Commercial: $8,622.98
  • Viva — Medicare Advantage: $3,470.40
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 27130 Arthroplas/acetab/prox fem replac $23,652 $13,008.60 $3,547.80 – $21,286.80
Total hip replacement: 10 of 12 insurance plan rates
  • Aetna — Commercial: $14,191.20
  • BeechStreet — PHCS: $20,104.20
  • Coventry First Health — Commercial: $20,104.20
  • GEHA — Commercial: $20,104.20
  • Humana — Commercial: $16,556.40
  • MCM Maxcare — Commercial: $18,921.60
  • Mega Life — Commercial: $18,921.60
  • Multiplan — PHCS: $20,104.20
  • Novanet — Commercial: $3,547.80
  • TRPN — Commercial: $21,286.80
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 27130 Arthroplas/acetab/prox fem replac $23,652 $13,008.60 $3,547.80 – $23,652
Total hip replacement: rates for 8 insurance plans
  • Aetna — Commercial: $23,652
  • Alabama Crime Victims — Commercial: $11,826
  • Coventry First Health — Commercial: $20,104.20
  • GEHA — Commercial: $20,104.20
  • MCM Maxcare — Commercial: $18,921.60
  • Mega Life — Commercial: $18,921.60
  • Novanet — Commercial: $3,547.80
  • TRPN — Commercial: $21,286.80
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty Not listed in the file Not listed in the file $11,660.94 – $28,974.17
Total hip replacement: rates for 10 insurance plans
  • Aetna — Commercial: $24,371.37
  • Blue Cross — Commercial: $14,335.96
  • Blue Cross — Medicare Advantage: $11,660.94
  • Blue Cross Lanier — Commercial: $14,335.96
  • Cigna — Commercial: $22,943.22
  • Humana — Commercial: $23,330.68
  • Humana — Medicare Advantage: $11,660.94
  • Simpra — Medicare Advantage: $11,660.94
  • Viva — Commercial: $28,974.17
  • Viva — Medicare Advantage: $11,660.94
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 27447 Arthroplasty/knee/med & lat comp $23,652 $13,008.60 $3,547.80 – $21,286.80
Total knee replacement: 10 of 12 insurance plan rates
  • Aetna — Commercial: $14,191.20
  • BeechStreet — PHCS: $20,104.20
  • Coventry First Health — Commercial: $20,104.20
  • GEHA — Commercial: $20,104.20
  • Humana — Commercial: $16,556.40
  • MCM Maxcare — Commercial: $18,921.60
  • Mega Life — Commercial: $18,921.60
  • Multiplan — PHCS: $20,104.20
  • Novanet — Commercial: $3,547.80
  • TRPN — Commercial: $21,286.80
Total knee replacement CPT 27447 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 27447 Arthroplasty/knee/med & lat comp $23,652 $13,008.60 $3,547.80 – $23,652
Total knee replacement: rates for 8 insurance plans
  • Aetna — Commercial: $23,652
  • Alabama Crime Victims — Commercial: $11,826
  • Coventry First Health — Commercial: $20,104.20
  • GEHA — Commercial: $20,104.20
  • MCM Maxcare — Commercial: $18,921.60
  • Mega Life — Commercial: $18,921.60
  • Novanet — Commercial: $3,547.80
  • TRPN — Commercial: $21,286.80
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty Not listed in the file Not listed in the file $11,660.94 – $28,974.17
Total knee replacement: rates for 10 insurance plans
  • Aetna — Commercial: $24,371.37
  • Blue Cross — Commercial: $14,335.96
  • Blue Cross — Medicare Advantage: $11,660.94
  • Blue Cross Lanier — Commercial: $14,335.96
  • Cigna — Commercial: $22,943.22
  • Humana — Commercial: $23,330.68
  • Humana — Medicare Advantage: $11,660.94
  • Simpra — Medicare Advantage: $11,660.94
  • Viva — Commercial: $28,974.17
  • Viva — Medicare Advantage: $11,660.94
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 29826 Arthroscop/shoulder/decomp/subacro $4,314 $2,372.70 $647.10 – $3,882.60
Shoulder arthroscopy: shaving of shoulder bone: 10 of 12 insurance plan rates
  • Aetna — Commercial: $2,588.40
  • BeechStreet — PHCS: $3,666.90
  • Coventry First Health — Commercial: $3,666.90
  • GEHA — Commercial: $3,666.90
  • Humana — Commercial: $3,019.80
  • MCM Maxcare — Commercial: $3,451.20
  • Mega Life — Commercial: $3,451.20
  • Multiplan — PHCS: $3,666.90
  • Novanet — Commercial: $647.10
  • TRPN — Commercial: $3,882.60
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 29826 Arthroscop/shoulder/decomp/subacro $4,314 $2,372.70 $647.10 – $4,314
Shoulder arthroscopy: shaving of shoulder bone: rates for 8 insurance plans
  • Aetna — Commercial: $4,314
  • Alabama Crime Victims — Commercial: $2,157
  • Coventry First Health — Commercial: $3,666.90
  • GEHA — Commercial: $3,666.90
  • MCM Maxcare — Commercial: $3,451.20
  • Mega Life — Commercial: $3,451.20
  • Novanet — Commercial: $647.10
  • TRPN — Commercial: $3,882.60
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $3,375.97
Shoulder arthroscopy: shaving of shoulder bone: rates for 2 insurance plans
  • Blue Cross — Commercial: $3,375.97
  • Blue Cross Lanier — Commercial: $3,375.97
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 29881 Arthroscopy/knee/menisc/med or lat $5,764 $3,170.20 $864.60 – $5,187.60
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 12 insurance plan rates
  • Aetna — Commercial: $3,458.40
  • BeechStreet — PHCS: $4,899.40
  • Coventry First Health — Commercial: $4,899.40
  • GEHA — Commercial: $4,899.40
  • Humana — Commercial: $4,034.80
  • MCM Maxcare — Commercial: $4,611.20
  • Mega Life — Commercial: $4,611.20
  • Multiplan — PHCS: $4,899.40
  • Novanet — Commercial: $864.60
  • TRPN — Commercial: $5,187.60
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 29881 Arthroscopy/knee/menisc/med or lat $5,764 $3,170.20 $864.60 – $5,764
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 8 insurance plans
  • Aetna — Commercial: $5,764
  • Alabama Crime Victims — Commercial: $2,882
  • Coventry First Health — Commercial: $4,899.40
  • GEHA — Commercial: $4,899.40
  • MCM Maxcare — Commercial: $4,611.20
  • Mega Life — Commercial: $4,611.20
  • Novanet — Commercial: $864.60
  • TRPN — Commercial: $5,187.60
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery Not listed in the file Not listed in the file $2,940.53 – $7,306.38
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 10 insurance plans
  • Aetna — Commercial: $6,145.70
  • Blue Cross — Commercial: $3,375.97
  • Blue Cross — Medicare Advantage: $2,940.53
  • Blue Cross Lanier — Commercial: $3,375.97
  • Cigna — Commercial: $5,785.56
  • Humana — Commercial: $5,737.93
  • Humana — Medicare Advantage: $2,940.53
  • Simpra — Medicare Advantage: $2,940.53
  • Viva — Commercial: $7,306.38
  • Viva — Medicare Advantage: $2,940.53
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $2,951.18 – $13,321.19
Removal of tonsils and adenoids (under age 12): rates for 10 insurance plans
  • Aetna — Commercial: $11,205
  • Blue Cross — Commercial: $2,951.18
  • Blue Cross — Medicare Advantage: $5,361.24
  • Blue Cross Lanier — Commercial: $2,951.18
  • Cigna — Commercial: $10,548.39
  • Humana — Commercial: $10,381.20
  • Humana — Medicare Advantage: $5,361.24
  • Simpra — Medicare Advantage: $5,361.24
  • Viva — Commercial: $13,321.19
  • Viva — Medicare Advantage: $5,361.24
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $2,951.18 – $4,916.50
Removal of tonsils and adenoids (under age 12): rates for 3 insurance plans
  • BeechStreet — PHCS: $4,916.50
  • Blue Cross Lanier — Commercial: $2,951.18
  • Humana — Commercial: $4,916.50
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $212.20
Removal of tonsils and adenoids (under age 12): rates for 7 insurance plans
  • Aetna — Commercial: $212.20
  • Blue Cross — Medicare Advantage: $212.20
  • Cigna — Commercial: $212.20
  • Humana — Medicare Advantage: $212.20
  • Simpra — Medicare Advantage: $212.20
  • Viva — Commercial: $212.20
  • Viva — Medicare Advantage: $212.20
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $1,901 $1,045.55 $285.15 – $1,710.90
Upper GI endoscopy (diagnostic): 10 of 12 insurance plan rates
  • Aetna — Commercial: $1,140.60
  • BeechStreet — PHCS: $1,615.85
  • Coventry First Health — Commercial: $1,615.85
  • GEHA — Commercial: $1,615.85
  • Humana — Commercial: $1,330.70
  • MCM Maxcare — Commercial: $1,520.80
  • Mega Life — Commercial: $1,520.80
  • Multiplan — PHCS: $1,615.85
  • Novanet — Commercial: $285.15
  • TRPN — Commercial: $1,710.90
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $1,901 $1,045.55 $285.15 – $1,901
Upper GI endoscopy (diagnostic): rates for 8 insurance plans
  • Aetna — Commercial: $1,901
  • Alabama Crime Victims — Commercial: $950.50
  • Coventry First Health — Commercial: $1,615.85
  • GEHA — Commercial: $1,615.85
  • MCM Maxcare — Commercial: $1,520.80
  • Mega Life — Commercial: $1,520.80
  • Novanet — Commercial: $285.15
  • TRPN — Commercial: $1,710.90
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash Not listed in the file Not listed in the file $849.69 – $2,111.24
Upper GI endoscopy (diagnostic): rates for 10 insurance plans
  • Aetna — Commercial: $1,775.85
  • Blue Cross — Commercial: $1,376.94
  • Blue Cross — Medicare Advantage: $849.69
  • Blue Cross Lanier — Commercial: $1,376.94
  • Cigna — Commercial: $1,671.79
  • Humana — Commercial: $1,606.92
  • Humana — Medicare Advantage: $849.69
  • Simpra — Medicare Advantage: $849.69
  • Viva — Commercial: $2,111.24
  • Viva — Medicare Advantage: $849.69
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $1,901 $1,045.55 $285.15 – $1,710.90
Upper GI endoscopy with biopsy: 10 of 12 insurance plan rates
  • Aetna — Commercial: $1,140.60
  • BeechStreet — PHCS: $1,615.85
  • Coventry First Health — Commercial: $1,615.85
  • GEHA — Commercial: $1,615.85
  • Humana — Commercial: $1,330.70
  • MCM Maxcare — Commercial: $1,520.80
  • Mega Life — Commercial: $1,520.80
  • Multiplan — PHCS: $1,615.85
  • Novanet — Commercial: $285.15
  • TRPN — Commercial: $1,710.90
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $1,901 $1,045.55 $285.15 – $1,901
Upper GI endoscopy with biopsy: rates for 8 insurance plans
  • Aetna — Commercial: $1,901
  • Alabama Crime Victims — Commercial: $950.50
  • Coventry First Health — Commercial: $1,615.85
  • GEHA — Commercial: $1,615.85
  • MCM Maxcare — Commercial: $1,520.80
  • Mega Life — Commercial: $1,520.80
  • Novanet — Commercial: $285.15
  • TRPN — Commercial: $1,710.90
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple Not listed in the file Not listed in the file $849.69 – $2,111.24
Upper GI endoscopy with biopsy: rates for 10 insurance plans
  • Aetna — Commercial: $1,775.85
  • Blue Cross — Commercial: $1,376.94
  • Blue Cross — Medicare Advantage: $849.69
  • Blue Cross Lanier — Commercial: $1,376.94
  • Cigna — Commercial: $1,671.79
  • Humana — Commercial: $1,606.92
  • Humana — Medicare Advantage: $849.69
  • Simpra — Medicare Advantage: $849.69
  • Viva — Commercial: $2,111.24
  • Viva — Medicare Advantage: $849.69
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $1,930 $1,061.50 $289.50 – $1,737
Colonoscopy (diagnostic): 10 of 12 insurance plan rates
  • Aetna — Commercial: $1,158
  • BeechStreet — PHCS: $1,640.50
  • Coventry First Health — Commercial: $1,640.50
  • GEHA — Commercial: $1,640.50
  • Humana — Commercial: $1,351
  • MCM Maxcare — Commercial: $1,544
  • Mega Life — Commercial: $1,544
  • Multiplan — PHCS: $1,640.50
  • Novanet — Commercial: $289.50
  • TRPN — Commercial: $1,737
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $1,930 $1,061.50 $289.50 – $1,930
Colonoscopy (diagnostic): rates for 8 insurance plans
  • Aetna — Commercial: $1,930
  • Alabama Crime Victims — Commercial: $965
  • Coventry First Health — Commercial: $1,640.50
  • GEHA — Commercial: $1,640.50
  • MCM Maxcare — Commercial: $1,544
  • Mega Life — Commercial: $1,544
  • Novanet — Commercial: $289.50
  • TRPN — Commercial: $1,737
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy Not listed in the file Not listed in the file $826.26 – $2,053.03
Colonoscopy (diagnostic): rates for 10 insurance plans
  • Aetna — Commercial: $1,726.89
  • Blue Cross — Commercial: $1,150.26
  • Blue Cross — Medicare Advantage: $826.26
  • Blue Cross Lanier — Commercial: $1,150.26
  • Cigna — Commercial: $1,625.70
  • Humana — Commercial: $1,620.17
  • Humana — Medicare Advantage: $826.26
  • Simpra — Medicare Advantage: $826.26
  • Viva — Commercial: $2,053.03
  • Viva — Medicare Advantage: $826.26
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 45380 Colonoscopy w/ Biopsy Single/Multiple $2,158 $1,186.90 $323.70 – $1,942.20
Colonoscopy with biopsy: 10 of 12 insurance plan rates
  • Aetna — Commercial: $1,294.80
  • BeechStreet — PHCS: $1,834.30
  • Coventry First Health — Commercial: $1,834.30
  • GEHA — Commercial: $1,834.30
  • Humana — Commercial: $1,510.60
  • MCM Maxcare — Commercial: $1,726.40
  • Mega Life — Commercial: $1,726.40
  • Multiplan — PHCS: $1,834.30
  • Novanet — Commercial: $323.70
  • TRPN — Commercial: $1,942.20
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 45380 Colonoscopy w/ Biopsy Single/Multiple $2,158 $1,186.90 $323.70 – $2,158
Colonoscopy with biopsy: rates for 8 insurance plans
  • Aetna — Commercial: $2,158
  • Alabama Crime Victims — Commercial: $1,079
  • Coventry First Health — Commercial: $1,834.30
  • GEHA — Commercial: $1,834.30
  • MCM Maxcare — Commercial: $1,726.40
  • Mega Life — Commercial: $1,726.40
  • Novanet — Commercial: $323.70
  • TRPN — Commercial: $1,942.20
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy Not listed in the file Not listed in the file $1,068.58 – $2,655.12
Colonoscopy with biopsy: rates for 10 insurance plans
  • Aetna — Commercial: $2,233.33
  • Blue Cross — Commercial: $1,150.26
  • Blue Cross — Medicare Advantage: $1,068.58
  • Blue Cross Lanier — Commercial: $1,150.26
  • Cigna — Commercial: $2,102.46
  • Humana — Commercial: $2,091.91
  • Humana — Medicare Advantage: $1,068.58
  • Simpra — Medicare Advantage: $1,068.58
  • Viva — Commercial: $2,655.12
  • Viva — Medicare Advantage: $1,068.58
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $2,158 $1,186.90 $323.70 – $1,942.20
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates
  • Aetna — Commercial: $1,294.80
  • BeechStreet — PHCS: $1,834.30
  • Coventry First Health — Commercial: $1,834.30
  • GEHA — Commercial: $1,834.30
  • Humana — Commercial: $1,510.60
  • MCM Maxcare — Commercial: $1,726.40
  • Mega Life — Commercial: $1,726.40
  • Multiplan — PHCS: $1,834.30
  • Novanet — Commercial: $323.70
  • TRPN — Commercial: $1,942.20
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $2,158 $1,186.90 $323.70 – $2,158
Colonoscopy with removal of polyps (snare): rates for 8 insurance plans
  • Aetna — Commercial: $2,158
  • Alabama Crime Victims — Commercial: $1,079
  • Coventry First Health — Commercial: $1,834.30
  • GEHA — Commercial: $1,834.30
  • MCM Maxcare — Commercial: $1,726.40
  • Mega Life — Commercial: $1,726.40
  • Novanet — Commercial: $323.70
  • TRPN — Commercial: $1,942.20
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal Not listed in the file Not listed in the file $1,068.58 – $2,655.12
Colonoscopy with removal of polyps (snare): rates for 10 insurance plans
  • Aetna — Commercial: $2,233.33
  • Blue Cross — Commercial: $1,416.81
  • Blue Cross — Medicare Advantage: $1,068.58
  • Blue Cross Lanier — Commercial: $1,416.81
  • Cigna — Commercial: $2,102.46
  • Humana — Commercial: $2,091.91
  • Humana — Medicare Advantage: $1,068.58
  • Simpra — Medicare Advantage: $1,068.58
  • Viva — Commercial: $2,655.12
  • Viva — Medicare Advantage: $1,068.58
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $1,068.58 – $2,655.12
Ultrasound of the lower bowel by endoscope: rates for 10 insurance plans
  • Aetna — Commercial: $2,233.33
  • Blue Cross — Commercial: $1,426.78
  • Blue Cross — Medicare Advantage: $1,068.58
  • Blue Cross Lanier — Commercial: $1,426.78
  • Cigna — Commercial: $2,102.46
  • Humana — Commercial: $2,091.91
  • Humana — Medicare Advantage: $1,068.58
  • Simpra — Medicare Advantage: $1,068.58
  • Viva — Commercial: $2,655.12
  • Viva — Medicare Advantage: $1,068.58
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $228.44 – $1,426.78
Ultrasound of the lower bowel by endoscope: rates for 10 insurance plans
  • Aetna — Commercial: $228.44
  • BeechStreet — PHCS: $990.72
  • Blue Cross — Medicare Advantage: $228.44
  • Blue Cross Lanier — Commercial: $1,426.78
  • Cigna — Commercial: $228.44
  • Humana — Commercial: $990.72
  • Humana — Medicare Advantage: $228.44
  • Simpra — Medicare Advantage: $228.44
  • Viva — Commercial: $228.44
  • Viva — Medicare Advantage: $228.44
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $826.26 – $2,053.03
Screening colonoscopy (not high risk): rates for 10 insurance plans
  • Aetna — Commercial: $1,726.89
  • Blue Cross — Commercial: $1,150.26
  • Blue Cross — Medicare Advantage: $826.26
  • Blue Cross Lanier — Commercial: $1,150.26
  • Cigna — Commercial: $1,625.70
  • Humana — Commercial: $1,620.17
  • Humana — Medicare Advantage: $826.26
  • Simpra — Medicare Advantage: $826.26
  • Viva — Commercial: $2,053.03
  • Viva — Medicare Advantage: $826.26
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $767.31 – $1,150.26
Screening colonoscopy (not high risk): rates for 3 insurance plans
  • BeechStreet — PHCS: $767.31
  • Blue Cross Lanier — Commercial: $1,150.26
  • Humana — Commercial: $767.31
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $147.33
Screening colonoscopy (not high risk): rates for 7 insurance plans
  • Aetna — Commercial: $147.33
  • Blue Cross — Medicare Advantage: $147.33
  • Cigna — Commercial: $147.33
  • Humana — Medicare Advantage: $147.33
  • Simpra — Medicare Advantage: $147.33
  • Viva — Commercial: $147.33
  • Viva — Medicare Advantage: $147.33
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $5,287.57 – $13,138.12
Gallbladder removal by laparoscope: rates for 10 insurance plans
  • Aetna — Commercial: $11,051.01
  • Blue Cross — Commercial: $6,190.47
  • Blue Cross — Medicare Advantage: $5,287.57
  • Blue Cross Lanier — Commercial: $6,190.47
  • Cigna — Commercial: $10,403.43
  • Humana — Commercial: $10,228.41
  • Humana — Medicare Advantage: $5,287.57
  • Simpra — Medicare Advantage: $5,287.57
  • Viva — Commercial: $13,138.12
  • Viva — Medicare Advantage: $5,287.57
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $4,844.14 – $6,190.47
Gallbladder removal by laparoscope: rates for 3 insurance plans
  • BeechStreet — PHCS: $4,844.14
  • Blue Cross Lanier — Commercial: $6,190.47
  • Humana — Commercial: $4,844.14
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $472.49
Gallbladder removal by laparoscope: rates for 7 insurance plans
  • Aetna — Commercial: $472.49
  • Blue Cross — Medicare Advantage: $472.49
  • Cigna — Commercial: $472.49
  • Humana — Medicare Advantage: $472.49
  • Simpra — Medicare Advantage: $472.49
  • Viva — Commercial: $472.49
  • Viva — Medicare Advantage: $472.49
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 49505 RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $6,759 $3,717.45 $1,013.85 – $6,083.10
Groin (inguinal) hernia repair, age 5 or older: 10 of 12 insurance plan rates
  • Aetna — Commercial: $4,055.40
  • BeechStreet — PHCS: $5,745.15
  • Coventry First Health — Commercial: $5,745.15
  • GEHA — Commercial: $5,745.15
  • Humana — Commercial: $4,731.30
  • MCM Maxcare — Commercial: $5,407.20
  • Mega Life — Commercial: $5,407.20
  • Multiplan — PHCS: $5,745.15
  • Novanet — Commercial: $1,013.85
  • TRPN — Commercial: $6,083.10
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 49505 RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $6,759 $3,717.45 $1,013.85 – $6,759
Groin (inguinal) hernia repair, age 5 or older: rates for 8 insurance plans
  • Aetna — Commercial: $6,759
  • Alabama Crime Victims — Commercial: $3,379.50
  • Coventry First Health — Commercial: $5,745.15
  • GEHA — Commercial: $5,745.15
  • MCM Maxcare — Commercial: $5,407.20
  • Mega Life — Commercial: $5,407.20
  • Novanet — Commercial: $1,013.85
  • TRPN — Commercial: $6,083.10
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $3,198.32 – $7,946.92
Groin (inguinal) hernia repair, age 5 or older: rates for 10 insurance plans
  • Aetna — Commercial: $6,684.48
  • Blue Cross — Commercial: $3,903.86
  • Blue Cross — Medicare Advantage: $3,198.32
  • Blue Cross Lanier — Commercial: $3,903.86
  • Cigna — Commercial: $6,292.77
  • Humana — Commercial: $6,132.93
  • Humana — Medicare Advantage: $3,198.32
  • Simpra — Medicare Advantage: $3,198.32
  • Viva — Commercial: $7,946.92
  • Viva — Medicare Advantage: $3,198.32
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RAD CT PROSTATE NEEDLE BIOPSY ANY APPROACH $3,862 $2,124.10 $579.30 – $3,475.80
Prostate biopsy: 10 of 12 insurance plan rates
  • Aetna — Commercial: $2,317.20
  • BeechStreet — PHCS: $3,282.70
  • Coventry First Health — Commercial: $3,282.70
  • GEHA — Commercial: $3,282.70
  • Humana — Commercial: $2,703.40
  • MCM Maxcare — Commercial: $3,089.60
  • Mega Life — Commercial: $3,089.60
  • Multiplan — PHCS: $3,282.70
  • Novanet — Commercial: $579.30
  • TRPN — Commercial: $3,475.80
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 55700 Prostate biopsy $3,978 $2,187.90 $596.70 – $3,580.20
Prostate biopsy: 10 of 12 insurance plan rates
  • Aetna — Commercial: $2,386.80
  • BeechStreet — PHCS: $3,381.30
  • Coventry First Health — Commercial: $3,381.30
  • GEHA — Commercial: $3,381.30
  • Humana — Commercial: $2,784.60
  • MCM Maxcare — Commercial: $3,182.40
  • Mega Life — Commercial: $3,182.40
  • Multiplan — PHCS: $3,381.30
  • Novanet — Commercial: $596.70
  • TRPN — Commercial: $3,580.20
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RAD CT PROSTATE NEEDLE BIOPSY ANY APPROACH $3,862 $2,124.10 $579.30 – $3,862
Prostate biopsy: rates for 8 insurance plans
  • Aetna — Commercial: $3,862
  • Alabama Crime Victims — Commercial: $1,931
  • Coventry First Health — Commercial: $3,282.70
  • GEHA — Commercial: $3,282.70
  • MCM Maxcare — Commercial: $3,089.60
  • Mega Life — Commercial: $3,089.60
  • Novanet — Commercial: $579.30
  • TRPN — Commercial: $3,475.80
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 55866 LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT $19,049 $10,476.95 $2,857.35 – $17,144.10
Prostate removal by laparoscope (radical prostatectomy): 10 of 12 insurance plan rates
  • Aetna — Commercial: $11,429.40
  • BeechStreet — PHCS: $16,191.65
  • Coventry First Health — Commercial: $16,191.65
  • GEHA — Commercial: $16,191.65
  • Humana — Commercial: $13,334.30
  • MCM Maxcare — Commercial: $15,239.20
  • Mega Life — Commercial: $15,239.20
  • Multiplan — PHCS: $16,191.65
  • Novanet — Commercial: $2,857.35
  • TRPN — Commercial: $17,144.10
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 55866 LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT $19,049 $10,476.95 $2,857.35 – $19,049
Prostate removal by laparoscope (radical prostatectomy): rates for 8 insurance plans
  • Aetna — Commercial: $19,049
  • Alabama Crime Victims — Commercial: $9,524.50
  • Coventry First Health — Commercial: $16,191.65
  • GEHA — Commercial: $16,191.65
  • MCM Maxcare — Commercial: $15,239.20
  • Mega Life — Commercial: $15,239.20
  • Novanet — Commercial: $2,857.35
  • TRPN — Commercial: $17,144.10
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $9,435.48 – $23,444.53
Prostate removal by laparoscope (radical prostatectomy): rates for 10 insurance plans
  • Aetna — Commercial: $19,720.16
  • Blue Cross — Commercial: $11,036.68
  • Blue Cross — Medicare Advantage: $9,435.48
  • Blue Cross Lanier — Commercial: $11,036.68
  • Cigna — Commercial: $18,564.57
  • Humana — Commercial: $18,247.61
  • Humana — Medicare Advantage: $9,435.48
  • Simpra — Medicare Advantage: $9,435.48
  • Viva — Commercial: $23,444.53
  • Viva — Medicare Advantage: $9,435.48
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 58558 HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C $5,817 $3,199.35 $872.55 – $5,235.30
Hysteroscopy with biopsy of the uterus lining: 10 of 12 insurance plan rates
  • Aetna — Commercial: $3,490.20
  • BeechStreet — PHCS: $4,944.45
  • Coventry First Health — Commercial: $4,944.45
  • GEHA — Commercial: $4,944.45
  • Humana — Commercial: $4,071.90
  • MCM Maxcare — Commercial: $4,653.60
  • Mega Life — Commercial: $4,653.60
  • Multiplan — PHCS: $4,944.45
  • Novanet — Commercial: $872.55
  • TRPN — Commercial: $5,235.30
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 58558 HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C $5,817 $3,199.35 $872.55 – $5,817
Hysteroscopy with biopsy of the uterus lining: rates for 8 insurance plans
  • Aetna — Commercial: $5,817
  • Alabama Crime Victims — Commercial: $2,908.50
  • Coventry First Health — Commercial: $4,944.45
  • GEHA — Commercial: $4,944.45
  • MCM Maxcare — Commercial: $4,653.60
  • Mega Life — Commercial: $4,653.60
  • Novanet — Commercial: $872.55
  • TRPN — Commercial: $5,235.30
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy Not listed in the file Not listed in the file $2,881.54 – $7,159.82
Hysteroscopy with biopsy of the uterus lining: rates for 10 insurance plans
  • Aetna — Commercial: $6,022.42
  • Blue Cross — Commercial: $3,457.34
  • Blue Cross — Medicare Advantage: $2,881.54
  • Blue Cross Lanier — Commercial: $3,457.34
  • Cigna — Commercial: $5,669.51
  • Humana — Commercial: $5,542.09
  • Humana — Medicare Advantage: $2,881.54
  • Simpra — Medicare Advantage: $2,881.54
  • Viva — Commercial: $7,159.82
  • Viva — Medicare Advantage: $2,881.54
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac Not listed in the file Not listed in the file $627.62 – $1,559.46
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans
  • Aetna — Commercial: $1,311.72
  • Blue Cross — Commercial: $1,320.45
  • Blue Cross — Medicare Advantage: $627.62
  • Blue Cross Lanier — Commercial: $1,320.45
  • Cigna — Commercial: $1,234.86
  • Humana — Commercial: $1,225.89
  • Humana — Medicare Advantage: $627.62
  • Simpra — Medicare Advantage: $627.62
  • Viva — Commercial: $1,559.46
  • Viva — Medicare Advantage: $627.62
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Njx interlaminar lmbr/sac Not listed in the file Not listed in the file $89.49 – $1,320.45
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans
  • Aetna — Commercial: $89.49
  • BeechStreet — PHCS: $580.58
  • Blue Cross — Medicare Advantage: $89.49
  • Blue Cross Lanier — Commercial: $1,320.45
  • Cigna — Commercial: $89.49
  • Humana — Commercial: $580.58
  • Humana — Medicare Advantage: $89.49
  • Simpra — Medicare Advantage: $89.49
  • Viva — Commercial: $89.49
  • Viva — Medicare Advantage: $89.49
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx aa&/strd tfrm epi l/s 1 Not listed in the file Not listed in the file $806.85 – $2,004.80
Nerve root injection, lower back, with imaging guidance: rates for 10 insurance plans
  • Aetna — Commercial: $1,686.32
  • Blue Cross — Commercial: $1,320.45
  • Blue Cross — Medicare Advantage: $806.85
  • Blue Cross Lanier — Commercial: $1,320.45
  • Cigna — Commercial: $1,587.50
  • Humana — Commercial: $1,615.77
  • Humana — Medicare Advantage: $806.85
  • Simpra — Medicare Advantage: $806.85
  • Viva — Commercial: $2,004.80
  • Viva — Medicare Advantage: $806.85
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Njx aa&/strd tfrm epi l/s 1 Not listed in the file Not listed in the file $765.22 – $1,320.45
Nerve root injection, lower back, with imaging guidance: rates for 3 insurance plans
  • BeechStreet — PHCS: $765.22
  • Blue Cross Lanier — Commercial: $1,320.45
  • Humana — Commercial: $765.22
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Njx aa&/strd tfrm epi l/s 1 Not listed in the file Not listed in the file $150.20
Nerve root injection, lower back, with imaging guidance: rates for 7 insurance plans
  • Aetna — Commercial: $150.20
  • Blue Cross — Medicare Advantage: $150.20
  • Cigna — Commercial: $150.20
  • Humana — Medicare Advantage: $150.20
  • Simpra — Medicare Advantage: $150.20
  • Viva — Commercial: $150.20
  • Viva — Medicare Advantage: $150.20
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 64721 Carpal tunnel surgery $3,469 $1,907.95 $520.35 – $3,122.10
Carpal tunnel release: 10 of 12 insurance plan rates
  • Aetna — Commercial: $2,081.40
  • BeechStreet — PHCS: $2,948.65
  • Coventry First Health — Commercial: $2,948.65
  • GEHA — Commercial: $2,948.65
  • Humana — Commercial: $2,428.30
  • MCM Maxcare — Commercial: $2,775.20
  • Mega Life — Commercial: $2,775.20
  • Multiplan — PHCS: $2,948.65
  • Novanet — Commercial: $520.35
  • TRPN — Commercial: $3,122.10
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 64721 Carpal tunnel surgery $3,469 $1,907.95 $520.35 – $3,469
Carpal tunnel release: rates for 8 insurance plans
  • Aetna — Commercial: $3,469
  • Alabama Crime Victims — Commercial: $1,734.50
  • Coventry First Health — Commercial: $2,948.65
  • GEHA — Commercial: $2,948.65
  • MCM Maxcare — Commercial: $2,775.20
  • Mega Life — Commercial: $2,775.20
  • Novanet — Commercial: $520.35
  • TRPN — Commercial: $3,122.10
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $1,769.76 – $4,397.36
Carpal tunnel release: rates for 10 insurance plans
  • Aetna — Commercial: $3,698.80
  • Blue Cross — Commercial: $2,179.01
  • Blue Cross — Medicare Advantage: $1,769.76
  • Blue Cross Lanier — Commercial: $2,179.01
  • Cigna — Commercial: $3,482.05
  • Humana — Commercial: $3,422.68
  • Humana — Medicare Advantage: $1,769.76
  • Simpra — Medicare Advantage: $1,769.76
  • Viva — Commercial: $4,397.36
  • Viva — Medicare Advantage: $1,769.76
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery Not listed in the file Not listed in the file $497.19 – $1,235.37
Laser treatment of clouding after cataract surgery: rates for 10 insurance plans
  • Aetna — Commercial: $1,039.12
  • Blue Cross — Commercial: $886.14
  • Blue Cross — Medicare Advantage: $497.19
  • Blue Cross Lanier — Commercial: $886.14
  • Cigna — Commercial: $978.23
  • Humana — Commercial: $1,030.41
  • Humana — Medicare Advantage: $497.19
  • Simpra — Medicare Advantage: $497.19
  • Viva — Commercial: $1,235.37
  • Viva — Medicare Advantage: $497.19
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: After cataract laser surgery Not listed in the file Not listed in the file $488 – $886.14
Laser treatment of clouding after cataract surgery: rates for 3 insurance plans
  • BeechStreet — PHCS: $488
  • Blue Cross Lanier — Commercial: $886.14
  • Humana — Commercial: $488
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: After cataract laser surgery Not listed in the file Not listed in the file $407.76
Laser treatment of clouding after cataract surgery: rates for 7 insurance plans
  • Aetna — Commercial: $407.76
  • Blue Cross — Medicare Advantage: $407.76
  • Cigna — Commercial: $407.76
  • Humana — Medicare Advantage: $407.76
  • Simpra — Medicare Advantage: $407.76
  • Viva — Commercial: $407.76
  • Viva — Medicare Advantage: $407.76
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $2,066.98 – $5,135.86
Cataract removal with lens implant: rates for 10 insurance plans
  • Aetna — Commercial: $4,319.99
  • Blue Cross — Commercial: $2,618.08
  • Blue Cross — Medicare Advantage: $2,066.98
  • Blue Cross Lanier — Commercial: $2,618.08
  • Cigna — Commercial: $4,066.84
  • Humana — Commercial: $4,131.02
  • Humana — Medicare Advantage: $2,066.98
  • Simpra — Medicare Advantage: $2,066.98
  • Viva — Commercial: $5,135.86
  • Viva — Medicare Advantage: $2,066.98
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $1,956.44 – $2,618.08
Cataract removal with lens implant: rates for 3 insurance plans
  • BeechStreet — PHCS: $1,956.44
  • Blue Cross Lanier — Commercial: $2,618.08
  • Humana — Commercial: $1,956.44
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $718.97
Cataract removal with lens implant: rates for 7 insurance plans
  • Aetna — Commercial: $718.97
  • Blue Cross — Medicare Advantage: $718.97
  • Cigna — Commercial: $718.97
  • Humana — Medicare Advantage: $718.97
  • Simpra — Medicare Advantage: $718.97
  • Viva — Commercial: $718.97
  • Viva — Medicare Advantage: $718.97

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Obstetrical care Not listed in the file Not listed in the file $2,108.02 – $3,061.82
Vaginal delivery, with care before and after: rates for 8 insurance plans
  • Aetna — Commercial: $2,108.02
  • Blue Cross — Medicare Advantage: $2,108.02
  • Blue Cross Lanier — Commercial: $3,061.82
  • Cigna — Commercial: $2,108.02
  • Humana — Medicare Advantage: $2,108.02
  • Simpra — Medicare Advantage: $2,108.02
  • Viva — Commercial: $2,108.02
  • Viva — Medicare Advantage: $2,108.02
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care Not listed in the file Not listed in the file $3,061.82
Vaginal delivery, with care before and after: rates for 2 insurance plans
  • Blue Cross — Commercial: $3,061.82
  • Blue Cross Lanier — Commercial: $3,061.82
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $2,330.72 – $3,918.32
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans
  • Aetna — Commercial: $2,330.72
  • Blue Cross — Medicare Advantage: $2,330.72
  • Blue Cross Lanier — Commercial: $3,918.32
  • Cigna — Commercial: $2,330.72
  • Humana — Medicare Advantage: $2,330.72
  • Simpra — Medicare Advantage: $2,330.72
  • Viva — Commercial: $2,330.72
  • Viva — Medicare Advantage: $2,330.72
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $3,918.32
Cesarean delivery (C-section), with care before and after: rates for 2 insurance plans
  • Blue Cross — Commercial: $3,918.32
  • Blue Cross Lanier — Commercial: $3,918.32
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Vbac delivery Not listed in the file Not listed in the file $2,196.55
Vaginal delivery after a previous C-section, with care before and after: rates for 7 insurance plans
  • Aetna — Commercial: $2,196.55
  • Blue Cross — Medicare Advantage: $2,196.55
  • Cigna — Commercial: $2,196.55
  • Humana — Medicare Advantage: $2,196.55
  • Simpra — Medicare Advantage: $2,196.55
  • Viva — Commercial: $2,196.55
  • Viva — Medicare Advantage: $2,196.55

Source: The East Alabama Healthcare Authority’s standard charges file (eastalabamahealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address2000 Pepperell Parkway, Opelika, AL 36801
CountyLee County
StateAlabama
Phone(334) 528‑1300
Emergency servicesYes
OwnershipGovernment - Hospital District or Authority
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number010029
Name in Medicare recordsTHE EAST ALABAMA HEALTHCARE AUTHORITY
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(334) 749‑3411[4]
Name on the hospital’s websiteEast Alabama Medical Center
Official websiteeastalabamahealth.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. East Alabama Medical Center | East Alabama Health — eastalabamahealth.org
  2. Visiting Hours and Policies — eastalabamahealth.org
  3. East Alabama Medical Center | East Alabama Health — eastalabamahealth.org
  4. Awards | East Alabama Health — eastalabamahealth.org
  5. Find Us | East Alabama Health — eastalabamahealth.org
  6. Neurology Care | East Alabama Health — eastalabamahealth.org
  7. Surgery | East Alabama Health — eastalabamahealth.org
  8. Women's Health | East Alabama Health — eastalabamahealth.org