Does The Outer Banks Hospital, Inc have an emergency room?

Yes. Medicare (CMS) data lists emergency services at The Outer Banks Hospital, Inc. In a medical emergency, call 911.

Where is The Outer Banks Hospital, Inc?

4800 South Croatan Highway, Nags Head, NC 27959, in Dare County, North Carolina.

What is the phone number of The Outer Banks Hospital, Inc?

(252) 449-4500, as listed by Medicare (CMS).

What is the Medicare star rating of The Outer Banks Hospital, Inc?

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

The Outer Banks Hospital, Inc — Nags Head, NC

Quick answers

Does The Outer Banks Hospital, Inc have an emergency room?: Yes. Medicare (CMS) data lists emergency services at The Outer Banks Hospital, Inc. In a medical emergency, call 911.
Where is The Outer Banks Hospital, Inc?: 4800 South Croatan Highway, Nags Head, NC 27959, in Dare County, North Carolina.
What is the phone number of The Outer Banks Hospital, Inc?: (252) 449-4500, as listed by Medicare (CMS).
What is the Medicare star rating of The Outer Banks Hospital, Inc?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[5][6][12][13]}

Emergency services
Cancer care
Women's care
Orthopedics and sports medicine
Cardiology
Ear, nose and throat
Family medicine and primary care
Laboratory
Rehabilitation therapy
Pulmonary and respiratory care
Radiology and imaging
Stroke care
Surgical services
Urology
Oncology
Gynecology
Obstetrics
Pediatrics

Conditions treated^[4][6][13]

Cancer
Endometriosis
Uterine fibroids
Incontinence
Heavy bleeding
Enlarged prostate

Treatments^[4][17][18]

Chemotherapy
Radiation therapy
3-D conformal radiation
Scalp cooling
Aquablation therapy

Procedures^{[9][10][13][14][15][16]}

Lymph node resection
Breast surgery and reconstruction
Gastrointestinal and colon cancer surgery
Head and neck cancer surgery
Colonoscopy
3-D digital mammography
Stereotactic breast biopsy
Bone density testing
Low-dose CT lung cancer screening
Genetic screening
Skin cancer screening
Hysteroscopy
Laparoscopy
Tubal ligation
Dilation and curettage (D&C)
Vaginal and vulvar surgery
Hysterectomy
Ovarian cystectomy

Programs and centers^{[5][7][8][9][12][14][16][17]}

The Center for Healthy Living
Nurse Navigator Program
Breast Health Program
Symptom Management Clinic
Palliative care
Free screening mammograms
Free lung cancer screening
Free skin cancer screening
Tobacco cessation program
Labor and delivery
Prenatal classes
Prenatal yoga

Emergency care (hospital website)^[5]

Emergency room	Yes

Visiting and practical information

Visiting	Visitor guidelines and overnight visitation are described on the Visitor Information page^[11]
Parking	Parking information is listed on the Patients & Visitors page^[11]

Recognition^[6][8]

Commission on Cancer accreditation (American College of Surgeons)
National Accreditation Program for Breast Centers (NAPBC) accredited breast program

Doctors and clinicians (372)

372 doctors and other clinicians list The Outer Banks Hospital, Inc as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 348 more: the button below opens the full list.

Other emergency rooms nearby

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

Sentara Albemarle Medical Center44 mi · Elizabeth City, NC · Acute Care Hospital
Vidant Chowan Hospital56 mi · Edenton, NC · Critical Access Hospital
Sentara Princess Anne Hospital60 mi · Virginia Beach, VA · Acute Care Hospital
Washington County Hosp Inc62 mi · Plymouth, NC · Critical Access Hospital
Chesapeake General Hospital66 mi · Chesapeake, VA · Acute Care Hospital

Other hospitals nearby

Sentara Virginia Beach General Hospital68 mi · Virginia Beach, VA · Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Peak Resources-Outer Banks3.0 mi · Nags Head, NC · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Adoration Home Health and Hospice3.5 mi · Nags Head, NC

All hospice providers in the state →

Home health agencies

Adoration Home Health and Hospice3.5 mi · Nags Head, NC

All home health agencies in the state →

Dialysis facilities

FMC Dare County Dialysis4.3 mi · Manteo, NC · 3 of 5 stars

All dialysis facilities in the state →

Community care nearby

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

Community health centers

Manteo Community Health Center3.9 mi · Manteo, NC · Community health center

Clinics and urgent care

Outer Banks Professional Services, LLC3.5 mi · Nags Head, NC · Urgent care center

Pharmacies

Community Care Clinic of Dare3.5 mi · Nags Head, NC · Clinic pharmacy
Island Pharmacy Inc4.3 mi · Manteo, NC · Clinic pharmacy
North Carolina CVS Pharmacy LLC4.3 mi · Manteo, NC · Pharmacy

Assisted living nearby

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

Spring Arbor of the Outer Banks6.8 mi · Kill Devil Hills, NC

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	5 of 5 stars
Doctors communicated well	4 of 5 stars
Staff explained medicines	4 of 5 stars
Information about recovery at home	5 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	78%National average: 72%
Would definitely recommend the hospital	80%National average: 71%
Nurses “always” communicated well	87%National average: 80%
Doctors “always” communicated well	85%National average: 80%
Staff “always” explained medicines before giving them	70%National average: 62%
Were given information about recovery at home	93%National average: 86%
Room and bathroom “always” clean	76%National average: 74%
Area around the room “always” quiet at night	61%National average: 60%
Completed surveys	289Response rate: 26%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0.55No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	9.5%
Deaths within 30 days: pneumonia patients	13.6%
Deaths within 30 days: COPD patients	9%
Deaths within 30 days: stroke patients	10.8%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	22.5%
Readmitted within 30 days: pneumonia	18.5%
Readmitted within 30 days: COPD	19.8%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	208 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

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 North Carolina Best hospitals in North Carolina

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as The Outer Banks Hospital, Inc 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 →

$ 7 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,NEW,LOW/30 MIN REQ	$224	$145.60	$55.33 – $217.28
New patient office visit (about 30–44 minutes): 10 of 16 insurance plan rates AETNA — ALL PRODUCTS: $172.48 AETNA — Medicare Advantage: $55.33 BCBS — ALL PRODUCTS: $201.60 BCBS — EMPLOYEE PLAN: $134.40 CENPATICO — Managed Medicaid: $56.04 CIGNA — ALL PRODUCTS: $217.28 HUMANA — ALL PRODUCTS: $212.80 MERCY CARE — COMPLETE CARE: $61.49 MERCY CARE — COMPLETE CARE PEDS: $61.49 NAPHCARE — Managed Medicaid: $56.04
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,NEW,LOW/30 MIN REQ	$224	$145.60	$55.33 – $217.28
New patient office visit (about 30–44 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $208.32
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUPATIENT,TECH,NEW,LOW/30 MIN REQ,MOD 25	$224	$145.60	$55.33 – $217.28
New patient office visit (about 30–44 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $208.32
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,NEW,MOD/45 MIN REQ	$224	$145.60	$55.33 – $217.28
New patient office visit (about 45–59 minutes): 10 of 16 insurance plan rates AETNA — ALL PRODUCTS: $172.48 AETNA — Medicare Advantage: $55.33 BCBS — ALL PRODUCTS: $201.60 BCBS — EMPLOYEE PLAN: $134.40 CENPATICO — Managed Medicaid: $56.04 CIGNA — ALL PRODUCTS: $217.28 HUMANA — ALL PRODUCTS: $212.80 MERCY CARE — COMPLETE CARE: $61.49 MERCY CARE — COMPLETE CARE PEDS: $61.49 NAPHCARE — Managed Medicaid: $56.04
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,NEW,MOD/45 MIN REQ	$224	$145.60	$55.33 – $217.28
New patient office visit (about 45–59 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $208.32
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,NEW,MOD/45 MIN REQ,MOD25	$224	$145.60	$55.33 – $217.28
New patient office visit (about 45–59 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $208.32
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,NEW,HIGH/60 MIN REQ	$224	$145.60	$55.33 – $217.28
New patient office visit (about 60–74 minutes): 10 of 16 insurance plan rates AETNA — ALL PRODUCTS: $172.48 AETNA — Medicare Advantage: $55.33 BCBS — ALL PRODUCTS: $201.60 BCBS — EMPLOYEE PLAN: $134.40 CENPATICO — Managed Medicaid: $56.04 CIGNA — ALL PRODUCTS: $217.28 HUMANA — ALL PRODUCTS: $212.80 MERCY CARE — COMPLETE CARE: $61.49 MERCY CARE — COMPLETE CARE PEDS: $61.49 NAPHCARE — Managed Medicaid: $56.04
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,NEW,HIGH/60 MIN REQ	$224	$145.60	$55.33 – $217.28
New patient office visit (about 60–74 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $208.32
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,NEW,HIGH/60 MIN REQ,MOD25	$224	$145.60	$55.33 – $217.28
New patient office visit (about 60–74 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $208.32
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,ESTAB,LOW/20 MIN REQ	$224	$145.60	$55.33 – $217.28
Established patient office visit (about 20–29 minutes): 10 of 16 insurance plan rates AETNA — ALL PRODUCTS: $172.48 AETNA — Medicare Advantage: $55.33 BCBS — ALL PRODUCTS: $201.60 BCBS — EMPLOYEE PLAN: $134.40 CENPATICO — Managed Medicaid: $56.04 CIGNA — ALL PRODUCTS: $217.28 HUMANA — ALL PRODUCTS: $212.80 MERCY CARE — COMPLETE CARE: $61.49 MERCY CARE — COMPLETE CARE PEDS: $61.49 NAPHCARE — Managed Medicaid: $56.04
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,ESTAB,LOW/20 MIN REQ	$224	$145.60	$55.33 – $217.28
Established patient office visit (about 20–29 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $208.32
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,ESTAB,LOW/20 MIN REQ,MOD 25	$224	$145.60	$55.33 – $217.28
Established patient office visit (about 20–29 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $208.32
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,ESTAB,MOD/30 MIN REQ	$224	$145.60	$55.33 – $217.28
Established patient office visit (about 30–39 minutes): 10 of 16 insurance plan rates AETNA — ALL PRODUCTS: $172.48 AETNA — Medicare Advantage: $55.33 BCBS — ALL PRODUCTS: $201.60 BCBS — EMPLOYEE PLAN: $134.40 CENPATICO — Managed Medicaid: $56.04 CIGNA — ALL PRODUCTS: $217.28 HUMANA — ALL PRODUCTS: $212.80 MERCY CARE — COMPLETE CARE: $61.49 MERCY CARE — COMPLETE CARE PEDS: $61.49 NAPHCARE — Managed Medicaid: $56.04
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,ESTAB,MOD/30 MIN REQ	$224	$145.60	$55.33 – $217.28
Established patient office visit (about 30–39 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $208.32
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPATIENT,TECH,ESTAB,MOD/30 MIN REQ,MOD 25	$224	$145.60	$55.33 – $217.28
Established patient office visit (about 30–39 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $208.32
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$205	$133.25	$26.96 – $198.85
Office consultation with a specialist (moderate): 10 of 16 insurance plan rates AETNA — ALL PRODUCTS: $157.85 AETNA — Medicare Advantage: $50.64 BCBS — ALL PRODUCTS: $184.50 BCBS — EMPLOYEE PLAN: $123 CENPATICO — Managed Medicaid: $33.05 CIGNA — ALL PRODUCTS: $198.85 HUMANA — ALL PRODUCTS: $194.75 MERCY CARE — COMPLETE CARE: $26.96 MERCY CARE — COMPLETE CARE PEDS: $26.96 NAPHCARE — Managed Medicaid: $33.05
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$205	$133.25	$26.96 – $198.85
Office consultation with a specialist (moderate): rates for 1 insurance plan UHC — ALL PRODUCTS: $190.65
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$205	$133.25	$26.96 – $198.85
Office consultation with a specialist (moderate to high): 10 of 16 insurance plan rates AETNA — ALL PRODUCTS: $157.85 AETNA — Medicare Advantage: $50.64 BCBS — ALL PRODUCTS: $184.50 BCBS — EMPLOYEE PLAN: $123 CENPATICO — Managed Medicaid: $33.05 CIGNA — ALL PRODUCTS: $198.85 HUMANA — ALL PRODUCTS: $194.75 MERCY CARE — COMPLETE CARE: $26.96 MERCY CARE — COMPLETE CARE PEDS: $26.96 NAPHCARE — Managed Medicaid: $33.05
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$205	$133.25	$26.96 – $198.85
Office consultation with a specialist (moderate to high): rates for 1 insurance plan UHC — ALL PRODUCTS: $190.65
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$205	$133.25	$78.10 – $153.30
Preventive checkup, new patient, age 18–39: 10 of 42 insurance plan rates AETNA — AETNA-MLPF: $86.69 AETNA — AETNA-MLPFN: $120.34 AETNA — AETNA-PF: $96.32 AETNA — AETNA-PN: $133.71 CENPATICO — Facility All Other: $80.17 CENPATICO — Managed Medicaid-MLPF: $80.17 CENPATICO — Managed Medicaid-MLPFN: $111.47 CENPATICO — Managed Medicaid-PF: $80.17 CENPATICO — Managed Medicaid-PN: $111.47 CENPATICO — Non-Facility All Other: $111.47
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$32.16 – $35.29
Preventive checkup, new patient, age 18–39: rates for 9 insurance plans CENPATICO — Managed Medicaid: $32.16 MERCY CARE — COMPLETE CARE: $35.29 MERCY CARE — COMPLETE CARE PEDS: $35.29 NAPHCARE — Managed Medicaid: $32.16 NAPHCARE — Managed Medicaid Peds: $32.16 UAHP — FAMILY CARE: $32.16 UAHP — FAMILY CARE PEDS: $32.16 UHC — COMMUNITY CARE: $32.16 UHC — COMMUNITY CARE PEDS: $32.16
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$236	$153.40	$95.98 – $179.35
Preventive checkup, new patient, age 40–64: 10 of 42 insurance plan rates AETNA — AETNA-MLPF: $104.98 AETNA — AETNA-MLPFN: $138.64 AETNA — AETNA-PF: $116.65 AETNA — AETNA-PN: $154.04 CENPATICO — Facility All Other: $97.43 CENPATICO — Managed Medicaid-MLPF: $97.43 CENPATICO — Managed Medicaid-MLPFN: $128.44 CENPATICO — Managed Medicaid-PF: $97.43 CENPATICO — Managed Medicaid-PN: $128.44 CENPATICO — Non-Facility All Other: $128.44
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$31.86 – $34.96
Preventive checkup, new patient, age 40–64: rates for 9 insurance plans CENPATICO — Managed Medicaid: $31.86 MERCY CARE — COMPLETE CARE: $34.96 MERCY CARE — COMPLETE CARE PEDS: $34.96 NAPHCARE — Managed Medicaid: $31.86 NAPHCARE — Managed Medicaid Peds: $31.86 UAHP — FAMILY CARE: $31.86 UAHP — FAMILY CARE PEDS: $31.86 UHC — COMMUNITY CARE: $31.86 UHC — COMMUNITY CARE PEDS: $31.86
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER SERVICE LEVEL 3	$2,382	$1,548.30	$1,429.20 – $2,310.54
Emergency room visit (moderate): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $1,834.14 AETNA — Medicare Advantage: $291.29 BCBS — ALL PRODUCTS: $2,143.80 BCBS — EMPLOYEE PLAN: $1,429.20 CENPATICO — Managed Medicaid: $257.09 CIGNA — ALL PRODUCTS: $2,310.54 HUMANA — ALL PRODUCTS: $2,262.90 HUMANA — Medicare Advantage: $295.11 MERCY CARE — COMPLETE CARE: $282.11 MERCY CARE — COMPLETE CARE PEDS: $282.11
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OB TRIAGE SERVICE LEVEL 3	$2,382	$1,548.30	$1,429.20 – $2,310.54
Emergency room visit (moderate): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $1,834.14 AETNA — Medicare Advantage: $291.29 BCBS — ALL PRODUCTS: $2,143.80 BCBS — EMPLOYEE PLAN: $1,429.20 CENPATICO — Managed Medicaid: $257.09 CIGNA — ALL PRODUCTS: $2,310.54 HUMANA — ALL PRODUCTS: $2,262.90 HUMANA — Medicare Advantage: $295.11 MERCY CARE — COMPLETE CARE: $282.11 MERCY CARE — COMPLETE CARE PEDS: $282.11
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ER SERVICE LEVEL 3	$2,382	$1,548.30	$1,429.20 – $2,310.54
Emergency room visit (moderate): rates for 1 insurance plan UHC — ALL PRODUCTS: $2,215.26
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER SERVICE LEVEL 4	$4,401	$2,860.65	$2,640.60 – $4,268.97
Emergency room visit (moderately high): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $3,388.77 AETNA — Medicare Advantage: $445.25 BCBS — ALL PRODUCTS: $3,960.90 BCBS — EMPLOYEE PLAN: $2,640.60 CENPATICO — Managed Medicaid: $411.35 CIGNA — ALL PRODUCTS: $4,268.97 HUMANA — ALL PRODUCTS: $4,180.95 HUMANA — Medicare Advantage: $453.85 MERCY CARE — COMPLETE CARE: $451.38 MERCY CARE — COMPLETE CARE PEDS: $451.38
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OB TRIAGE SERVICE LEVEL 4	$4,401	$2,860.65	$2,640.60 – $4,268.97
Emergency room visit (moderately high): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $3,388.77 AETNA — Medicare Advantage: $445.25 BCBS — ALL PRODUCTS: $3,960.90 BCBS — EMPLOYEE PLAN: $2,640.60 CENPATICO — Managed Medicaid: $411.35 CIGNA — ALL PRODUCTS: $4,268.97 HUMANA — ALL PRODUCTS: $4,180.95 HUMANA — Medicare Advantage: $453.85 MERCY CARE — COMPLETE CARE: $451.38 MERCY CARE — COMPLETE CARE PEDS: $451.38
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ER SERVICE LEVEL 4	$4,401	$2,860.65	$2,640.60 – $4,268.97
Emergency room visit (moderately high): rates for 1 insurance plan UHC — ALL PRODUCTS: $4,092.93
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ER SERVICE LEVEL 5	$7,334	$4,767.10	$4,400.40 – $7,113.98
Emergency room visit (high): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $5,647.18 AETNA — Medicare Advantage: $635.48 BCBS — ALL PRODUCTS: $6,600.60 BCBS — EMPLOYEE PLAN: $4,400.40 CENPATICO — Managed Medicaid: $618.19 CIGNA — ALL PRODUCTS: $7,113.98 HUMANA — ALL PRODUCTS: $6,967.30 HUMANA — Medicare Advantage: $653.45 MERCY CARE — COMPLETE CARE: $678.35 MERCY CARE — COMPLETE CARE PEDS: $678.35
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OB TRIAGE SERVICE LEVEL 5	$7,334	$4,767.10	$4,400.40 – $7,113.98
Emergency room visit (high): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $5,647.18 AETNA — Medicare Advantage: $635.48 BCBS — ALL PRODUCTS: $6,600.60 BCBS — EMPLOYEE PLAN: $4,400.40 CENPATICO — Managed Medicaid: $618.19 CIGNA — ALL PRODUCTS: $7,113.98 HUMANA — ALL PRODUCTS: $6,967.30 HUMANA — Medicare Advantage: $653.45 MERCY CARE — COMPLETE CARE: $678.35 MERCY CARE — COMPLETE CARE PEDS: $678.35
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ER SERVICE LEVEL 5	$7,334	$4,767.10	$4,400.40 – $7,113.98
Emergency room visit (high): rates for 1 insurance plan UHC — ALL PRODUCTS: $6,820.62

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL (CALCIUM,TOTAL)	$457	$297.05	$274.20 – $443.29
Basic metabolic panel (blood test): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $351.89 AETNA — Medicare Advantage: $8.46 BCBS — ALL PRODUCTS: $411.30 BCBS — EMPLOYEE PLAN: $274.20 CENPATICO — Managed Medicaid: $8.69 CIGNA — ALL PRODUCTS: $443.29 HUMANA — ALL PRODUCTS: $434.15 HUMANA — Medicare Advantage: $8.46 MERCY CARE — COMPLETE CARE: $9.54 MERCY CARE — COMPLETE CARE PEDS: $9.54
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL (CALCIUM,TOTAL)	$457	$297.05	$274.20 – $443.29
Basic metabolic panel (blood test): rates for 1 insurance plan UHC — ALL PRODUCTS: $425.01
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPREHENSIVE METABOLIC PANEL	$794	$516.10	$10.56
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $611.38 AETNA — Medicare Advantage: $10.56 BCBS — ALL PRODUCTS: $714.60 BCBS — EMPLOYEE PLAN: $476.40 CENPATICO — Managed Medicaid: $10.85 CIGNA — ALL PRODUCTS: $770.18 HUMANA — ALL PRODUCTS: $754.30 HUMANA — Medicare Advantage: $10.56 MERCY CARE — COMPLETE CARE: $11.91 MERCY CARE — COMPLETE CARE PEDS: $11.91
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPREHENSIVE METABOLIC PANEL	$794	$516.10	$476.40 – $770.18
Comprehensive metabolic panel (blood test): rates for 1 insurance plan UHC — ALL PRODUCTS: $738.42
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$47.81
Obstetric blood test panel: 10 of 12 insurance plan rates AETNA — Medicare Advantage: $47.81 CENPATICO — Managed Medicaid: $49.12 HUMANA — Medicare Advantage: $47.81 MERCY CARE — COMPLETE CARE: $53.91 MERCY CARE — COMPLETE CARE PEDS: $53.91 NAPHCARE — Managed Medicaid: $49.12 NAPHCARE — Managed Medicaid Peds: $49.12 UAHP — FAMILY CARE: $49.12 UAHP — FAMILY CARE PEDS: $49.12 UAHP — UNIVERSITY CARE: $47.81
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL	$630	$409.50	$13.39
Cholesterol panel (lipid panel): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $485.10 AETNA — Medicare Advantage: $13.39 BCBS — ALL PRODUCTS: $567 BCBS — EMPLOYEE PLAN: $378 CENPATICO — Managed Medicaid: $13.76 CIGNA — ALL PRODUCTS: $611.10 HUMANA — ALL PRODUCTS: $598.50 HUMANA — Medicare Advantage: $13.39 MERCY CARE — COMPLETE CARE: $15.10 MERCY CARE — COMPLETE CARE PEDS: $15.10
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL S/O	$68	$44.20	$40.80 – $65.96
Cholesterol panel (lipid panel): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $52.36 AETNA — Medicare Advantage: $13.39 BCBS — ALL PRODUCTS: $61.20 BCBS — EMPLOYEE PLAN: $40.80 CENPATICO — Managed Medicaid: $13.76 CIGNA — ALL PRODUCTS: $65.96 HUMANA — ALL PRODUCTS: $64.60 HUMANA — Medicare Advantage: $13.39 MERCY CARE — COMPLETE CARE: $15.10 MERCY CARE — COMPLETE CARE PEDS: $15.10
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LIPID PANEL	$630	$409.50	$378 – $611.10
Cholesterol panel (lipid panel): rates for 1 insurance plan UHC — ALL PRODUCTS: $585.90
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL	$565	$367.25	$8.68
Kidney function panel: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $435.05 AETNA — Medicare Advantage: $8.68 BCBS — ALL PRODUCTS: $508.50 BCBS — EMPLOYEE PLAN: $339 CENPATICO — Managed Medicaid: $8.92 CIGNA — ALL PRODUCTS: $548.05 HUMANA — ALL PRODUCTS: $536.75 HUMANA — Medicare Advantage: $8.68 MERCY CARE — COMPLETE CARE: $9.79 MERCY CARE — COMPLETE CARE PEDS: $9.79
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL	$565	$367.25	$339 – $548.05
Kidney function panel: rates for 1 insurance plan UHC — ALL PRODUCTS: $525.45
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION	$496	$322.40	$8.17
Liver function panel: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $381.92 AETNA — Medicare Advantage: $8.17 BCBS — ALL PRODUCTS: $446.40 BCBS — EMPLOYEE PLAN: $297.60 CENPATICO — Managed Medicaid: $8.39 CIGNA — ALL PRODUCTS: $481.12 HUMANA — ALL PRODUCTS: $471.20 HUMANA — Medicare Advantage: $8.17 MERCY CARE — COMPLETE CARE: $9.21 MERCY CARE — COMPLETE CARE PEDS: $9.21
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION	$496	$322.40	$297.60 – $481.12
Liver function panel: rates for 1 insurance plan UHC — ALL PRODUCTS: $461.28
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTOMATED W MICROSCOPY	$158	$102.70	$94.80 – $153.26
Urine test (automated, with microscope): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $121.66 AETNA — Medicare Advantage: $3.17 BCBS — ALL PRODUCTS: $142.20 BCBS — EMPLOYEE PLAN: $94.80 CENPATICO — Managed Medicaid: $3.26 CIGNA — ALL PRODUCTS: $153.26 HUMANA — ALL PRODUCTS: $150.10 HUMANA — Medicare Advantage: $3.17 MERCY CARE — COMPLETE CARE: $3.57 MERCY CARE — COMPLETE CARE PEDS: $3.57
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTOMATED W MICROSCOPY	$158	$102.70	$94.80 – $153.26
Urine test (automated, with microscope): rates for 1 insurance plan UHC — ALL PRODUCTS: $146.94
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS NON-AUTOMATED, W/O MICROSCOPY	$67	$43.55	$40.20 – $64.99
Urine test (manual, without microscope): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $51.59 AETNA — Medicare Advantage: $3.48 BCBS — ALL PRODUCTS: $60.30 BCBS — EMPLOYEE PLAN: $40.20 CENPATICO — Managed Medicaid: $3.58 CIGNA — ALL PRODUCTS: $64.99 HUMANA — ALL PRODUCTS: $63.65 HUMANA — Medicare Advantage: $3.48 MERCY CARE — COMPLETE CARE: $3.92 MERCY CARE — COMPLETE CARE PEDS: $3.92
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BILIRUBIN, RANDOM, U,NON-AUTO,W/O MICROSCOPY S/O	$62	$40.30	$3.48
Urine test (manual, without microscope): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $47.74 AETNA — Medicare Advantage: $3.48 BCBS — ALL PRODUCTS: $55.80 BCBS — EMPLOYEE PLAN: $37.20 CENPATICO — Managed Medicaid: $3.58 CIGNA — ALL PRODUCTS: $60.14 HUMANA — ALL PRODUCTS: $58.90 HUMANA — Medicare Advantage: $3.48 MERCY CARE — COMPLETE CARE: $3.92 MERCY CARE — COMPLETE CARE PEDS: $3.92
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS NON-AUTOMATED, W/O MICROSCOPY	$67	$43.55	$40.20 – $64.99
Urine test (manual, without microscope): rates for 1 insurance plan UHC — ALL PRODUCTS: $62.31
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$59	$38.35	$1.35 – $2.25
Urine test (automated, without microscope): 10 of 41 insurance plan rates AETNA — AETNA-MLPF: $1.56 AETNA — AETNA-MLPFN: $1.56 AETNA — AETNA-PF: $1.74 AETNA — AETNA-PN: $1.74 CENPATICO — Facility All Other: $2.25 CENPATICO — Managed Medicaid-MLPF: $2.25 CENPATICO — Managed Medicaid-MLPFN: $2.25 CENPATICO — Managed Medicaid-PF: $2.25 CENPATICO — Managed Medicaid-PN: $2.25 CENPATICO — Non-Facility All Other: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTOMATED WO MICROSCOPY	$139	$90.35	$83.40 – $134.83
Urine test (automated, without microscope): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $107.03 AETNA — Medicare Advantage: $2.25 BCBS — ALL PRODUCTS: $125.10 BCBS — EMPLOYEE PLAN: $83.40 CENPATICO — Managed Medicaid: $2.31 CIGNA — ALL PRODUCTS: $134.83 HUMANA — ALL PRODUCTS: $132.05 HUMANA — Medicare Advantage: $2.25 MERCY CARE — COMPLETE CARE: $2.54 MERCY CARE — COMPLETE CARE PEDS: $2.54
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/O MICRO	$129	$83.85	$2.25
Urine test (automated, without microscope): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $99.33 AETNA — Medicare Advantage: $2.25 BCBS — ALL PRODUCTS: $116.10 BCBS — EMPLOYEE PLAN: $77.40 CENPATICO — Managed Medicaid: $2.31 CIGNA — ALL PRODUCTS: $125.13 HUMANA — ALL PRODUCTS: $122.55 HUMANA — Medicare Advantage: $2.25 MERCY CARE — COMPLETE CARE: $2.54 MERCY CARE — COMPLETE CARE PEDS: $2.54
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSA(PROSTATE SPECIFIC ANTIGEN),TOTAL	$279	$181.35	$167.40 – $270.63
PSA (prostate specific antigen) blood test: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $214.83 AETNA — Medicare Advantage: $18.39 BCBS — ALL PRODUCTS: $251.10 BCBS — EMPLOYEE PLAN: $167.40 CENPATICO — Managed Medicaid: $18.90 CIGNA — ALL PRODUCTS: $270.63 HUMANA — ALL PRODUCTS: $265.05 HUMANA — Medicare Advantage: $18.39 MERCY CARE — COMPLETE CARE: $20.73 MERCY CARE — COMPLETE CARE PEDS: $20.73
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSA(PROSTATE SPEC ANTIGEN),TOTAL S/O	$31	$20.15	$18.39
PSA (prostate specific antigen) blood test: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $23.87 AETNA — Medicare Advantage: $18.39 BCBS — ALL PRODUCTS: $27.90 BCBS — EMPLOYEE PLAN: $18.60 CENPATICO — Managed Medicaid: $18.90 CIGNA — ALL PRODUCTS: $30.07 HUMANA — ALL PRODUCTS: $29.45 HUMANA — Medicare Advantage: $18.39 MERCY CARE — COMPLETE CARE: $20.73 MERCY CARE — COMPLETE CARE PEDS: $20.73
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSA(PROSTATE SPECIFIC ANTIGEN),TOTAL	$279	$181.35	$167.40 – $270.63
PSA (prostate specific antigen) blood test: rates for 1 insurance plan UHC — ALL PRODUCTS: $259.47
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC TSH (THYROID STIMULATING HORMONE)	$515	$334.75	$16.80
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $396.55 AETNA — Medicare Advantage: $16.80 BCBS — ALL PRODUCTS: $463.50 BCBS — EMPLOYEE PLAN: $309 CENPATICO — Managed Medicaid: $17.26 CIGNA — ALL PRODUCTS: $499.55 HUMANA — ALL PRODUCTS: $489.25 HUMANA — Medicare Advantage: $16.80 MERCY CARE — COMPLETE CARE: $18.94 MERCY CARE — COMPLETE CARE PEDS: $18.94
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THYROID FUNCT CASCADE, S S/O	$57	$37.05	$16.80
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $43.89 AETNA — Medicare Advantage: $16.80 BCBS — ALL PRODUCTS: $51.30 BCBS — EMPLOYEE PLAN: $34.20 CENPATICO — Managed Medicaid: $17.26 CIGNA — ALL PRODUCTS: $55.29 HUMANA — ALL PRODUCTS: $54.15 HUMANA — Medicare Advantage: $16.80 MERCY CARE — COMPLETE CARE: $18.94 MERCY CARE — COMPLETE CARE PEDS: $18.94
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE (TSH) S/O	$129	$83.85	$77.40 – $125.13
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $99.33 AETNA — Medicare Advantage: $16.80 BCBS — ALL PRODUCTS: $116.10 BCBS — EMPLOYEE PLAN: $77.40 CENPATICO — Managed Medicaid: $17.26 CIGNA — ALL PRODUCTS: $125.13 HUMANA — ALL PRODUCTS: $122.55 HUMANA — Medicare Advantage: $16.80 MERCY CARE — COMPLETE CARE: $18.94 MERCY CARE — COMPLETE CARE PEDS: $18.94
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BLOOD COUNT,CBC W DIFF WBC AND PLATELET	$307	$199.55	$7.77
Complete blood count (CBC) with differential: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $236.39 AETNA — Medicare Advantage: $7.77 BCBS — ALL PRODUCTS: $276.30 BCBS — EMPLOYEE PLAN: $184.20 CENPATICO — Managed Medicaid: $7.98 CIGNA — ALL PRODUCTS: $297.79 HUMANA — ALL PRODUCTS: $291.65 HUMANA — Medicare Advantage: $7.77 MERCY CARE — COMPLETE CARE: $8.76 MERCY CARE — COMPLETE CARE PEDS: $8.76
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BLOOD COUNT,CBC W DIFF WBC AND PLATELET	$307	$199.55	$184.20 – $297.79
Complete blood count (CBC) with differential: rates for 1 insurance plan UHC — ALL PRODUCTS: $285.51
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BLOOD COUNT,CBC(HEMOGRAM,NO DIFF)	$245	$159.25	$147 – $237.65
Complete blood count (CBC), automated: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $188.65 AETNA — Medicare Advantage: $6.47 BCBS — ALL PRODUCTS: $220.50 BCBS — EMPLOYEE PLAN: $147 CENPATICO — Managed Medicaid: $6.65 CIGNA — ALL PRODUCTS: $237.65 HUMANA — ALL PRODUCTS: $232.75 HUMANA — Medicare Advantage: $6.47 MERCY CARE — COMPLETE CARE: $7.29 MERCY CARE — COMPLETE CARE PEDS: $7.29
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BLOOD COUNT,CBC(HEMOGRAM,NO DIFF)	$245	$159.25	$147 – $237.65
Complete blood count (CBC), automated: rates for 1 insurance plan UHC — ALL PRODUCTS: $227.85
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG PROTHROMBIN TIME	$29	$18.85	$2.40 – $4.29
Blood clotting time test (prothrombin time, PT): 10 of 41 insurance plan rates AETNA — AETNA-MLPF: $2.97 AETNA — AETNA-MLPFN: $2.97 AETNA — AETNA-PF: $3.30 AETNA — AETNA-PN: $3.30 CENPATICO — Facility All Other: $4.29 CENPATICO — Managed Medicaid-MLPF: $4.29 CENPATICO — Managed Medicaid-MLPFN: $4.29 CENPATICO — Managed Medicaid-PF: $4.29 CENPATICO — Managed Medicaid-PN: $4.29 CENPATICO — Non-Facility All Other: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTIME	$156	$101.40	$4.29
Blood clotting time test (prothrombin time, PT): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $120.12 AETNA — Medicare Advantage: $4.29 BCBS — ALL PRODUCTS: $140.40 BCBS — EMPLOYEE PLAN: $93.60 CENPATICO — Managed Medicaid: $4.41 CIGNA — ALL PRODUCTS: $151.32 HUMANA — ALL PRODUCTS: $148.20 HUMANA — Medicare Advantage: $4.29 MERCY CARE — COMPLETE CARE: $4.84 MERCY CARE — COMPLETE CARE PEDS: $4.84
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTIME S/O	$58	$37.70	$4.29
Blood clotting time test (prothrombin time, PT): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $44.66 AETNA — Medicare Advantage: $4.29 BCBS — ALL PRODUCTS: $52.20 BCBS — EMPLOYEE PLAN: $34.80 CENPATICO — Managed Medicaid: $4.41 CIGNA — ALL PRODUCTS: $56.26 HUMANA — ALL PRODUCTS: $55.10 HUMANA — Medicare Advantage: $4.29 MERCY CARE — COMPLETE CARE: $4.84 MERCY CARE — COMPLETE CARE PEDS: $4.84
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PTT	$198	$128.70	$118.80 – $192.06
Blood clotting test (partial thromboplastin time, PTT): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $152.46 AETNA — Medicare Advantage: $6.01 BCBS — ALL PRODUCTS: $178.20 BCBS — EMPLOYEE PLAN: $118.80 CENPATICO — Managed Medicaid: $6.18 CIGNA — ALL PRODUCTS: $192.06 HUMANA — ALL PRODUCTS: $188.10 HUMANA — Medicare Advantage: $6.01 MERCY CARE — COMPLETE CARE: $6.78 MERCY CARE — COMPLETE CARE PEDS: $6.78
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PTT, BLOOD S/O	$80	$52	$6.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $61.60 AETNA — Medicare Advantage: $6.01 BCBS — ALL PRODUCTS: $72 BCBS — EMPLOYEE PLAN: $48 CENPATICO — Managed Medicaid: $6.18 CIGNA — ALL PRODUCTS: $77.60 HUMANA — ALL PRODUCTS: $76 HUMANA — Medicare Advantage: $6.01 MERCY CARE — COMPLETE CARE: $6.78 MERCY CARE — COMPLETE CARE PEDS: $6.78
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PTT	$198	$128.70	$118.80 – $192.06
Blood clotting test (partial thromboplastin time, PTT): rates for 1 insurance plan UHC — ALL PRODUCTS: $184.14

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT HEAD/BRAIN WO	$3,048	$1,981.20	$1,828.80 – $2,956.56
CT scan of the head or brain, without contrast: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $2,346.96 AETNA — Medicare Advantage: $111.56 BCBS — ALL PRODUCTS: $2,743.20 BCBS — EMPLOYEE PLAN: $1,828.80 CENPATICO — Managed Medicaid: $81.17 CIGNA — ALL PRODUCTS: $2,956.56 HUMANA — ALL PRODUCTS: $2,895.60 HUMANA — Medicare Advantage: $113.34 MERCY CARE — COMPLETE CARE: $89.07 MERCY CARE — COMPLETE CARE PEDS: $89.07
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT HEAD/BRAIN WO	$3,048	$1,981.20	$1,828.80 – $2,956.56
CT scan of the head or brain, without contrast: rates for 1 insurance plan UHC — ALL PRODUCTS: $2,834.64
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL	$65	$42.25	$33.03 – $110.88
CT scan of the head or brain, without contrast: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $50.45 AETNA — AETNA-MLPFN: $50.45 AETNA — AETNA-PF: $56.05 AETNA — AETNA-PN: $56.05 AETNA — Medicare Advantage-MLPF: $33.03 AETNA — Medicare Advantage-MLPFN: $33.03 AETNA — Medicare Advantage-PF: $38.86 AETNA — Medicare Advantage-PN: $38.86 CENPATICO — Facility All Other: $110.88 CENPATICO — Managed Medicaid-MLPF: $65
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN W & W/O (IAC, PITUITARY)	$5,477	$3,560.05	$3,286.20 – $5,312.69
MRI of the brain, before and after contrast: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $4,217.29 AETNA — Medicare Advantage: $372.28 BCBS — ALL PRODUCTS: $4,929.30 BCBS — EMPLOYEE PLAN: $3,286.20 CENPATICO — Managed Medicaid: $274.23 CIGNA — ALL PRODUCTS: $5,312.69 HUMANA — ALL PRODUCTS: $5,203.15 HUMANA — Medicare Advantage: $380.64 MERCY CARE — COMPLETE CARE: $300.92 MERCY CARE — COMPLETE CARE PEDS: $300.92
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI BRAIN W & W/O (IAC, PITUITARY)	$5,477	$3,560.05	$3,286.20 – $5,312.69
MRI of the brain, before and after contrast: rates for 1 insurance plan UHC — ALL PRODUCTS: $5,093.61
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$174	$113.10	$88.20 – $331.59
MRI of the brain, before and after contrast: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $141.43 AETNA — AETNA-MLPFN: $141.43 AETNA — AETNA-PF: $157.15 AETNA — AETNA-PN: $157.15 AETNA — Medicare Advantage-MLPF: $88.20 AETNA — Medicare Advantage-MLPFN: $88.20 AETNA — Medicare Advantage-PF: $103.77 AETNA — Medicare Advantage-PN: $103.77 CENPATICO — Facility All Other: $331.59 CENPATICO — Managed Medicaid-MLPF: $174
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC XR CHEST EXAM; 2 VIEWS	$614	$399.10	$368.40 – $595.58
Chest X-ray, 2 views: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $472.78 AETNA — Medicare Advantage: $92.86 BCBS — ALL PRODUCTS: $552.60 BCBS — EMPLOYEE PLAN: $368.40 CENPATICO — Managed Medicaid: $60.26 CIGNA — ALL PRODUCTS: $595.58 HUMANA — ALL PRODUCTS: $583.30 HUMANA — Medicare Advantage: $93.85 MERCY CARE — COMPLETE CARE: $66.13 MERCY CARE — COMPLETE CARE PEDS: $66.13
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC XR CHEST EXAM; 2 VIEWS	$614	$399.10	$368.40 – $595.58
Chest X-ray, 2 views: rates for 1 insurance plan UHC — ALL PRODUCTS: $571.02
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG RADIOLOGIC EXAM CHEST 2 VIEWS	$17	$11.05	$8.41 – $36.85
Chest X-ray, 2 views: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $11.19 AETNA — AETNA-MLPFN: $11.19 AETNA — AETNA-PF: $12.43 AETNA — AETNA-PN: $12.43 AETNA — Medicare Advantage-MLPF: $8.41 AETNA — Medicare Advantage-MLPFN: $8.41 AETNA — Medicare Advantage-PF: $9.89 AETNA — Medicare Advantage-PN: $9.89 CENPATICO — Facility All Other: $36.85 CENPATICO — Managed Medicaid-MLPF: $17
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC XR LUMBOSACRAL SPINE 4 VIEWS MINIMUM	$1,178	$765.70	$706.80 – $1,142.66
X-ray of the lower spine, at least 4 views: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $907.06 AETNA — Medicare Advantage: $111.56 BCBS — ALL PRODUCTS: $1,060.20 BCBS — EMPLOYEE PLAN: $706.80 CENPATICO — Managed Medicaid: $81.17 CIGNA — ALL PRODUCTS: $1,142.66 HUMANA — ALL PRODUCTS: $1,119.10 HUMANA — Medicare Advantage: $113.34 MERCY CARE — COMPLETE CARE: $89.07 MERCY CARE — COMPLETE CARE PEDS: $89.07
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC XR LUMBOSACRAL SPINE 4 VIEWS MINIMUM	$1,178	$765.70	$706.80 – $1,142.66
X-ray of the lower spine, at least 4 views: rates for 1 insurance plan UHC — ALL PRODUCTS: $1,095.54
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LUMBAR SPINE WO	$4,255	$2,765.75	$2,553 – $4,127.35
MRI of the lower back (lumbar spine), without contrast: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $3,276.35 AETNA — Medicare Advantage: $254.61 BCBS — ALL PRODUCTS: $3,829.50 BCBS — EMPLOYEE PLAN: $2,553 CENPATICO — Managed Medicaid: $171.43 CIGNA — ALL PRODUCTS: $4,127.35 HUMANA — ALL PRODUCTS: $4,042.25 HUMANA — Medicare Advantage: $257.63 MERCY CARE — COMPLETE CARE: $188.11 MERCY CARE — COMPLETE CARE PEDS: $188.11
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI LUMBAR SPINE WO	$4,255	$2,765.75	$2,553 – $4,127.35
MRI of the lower back (lumbar spine), without contrast: rates for 1 insurance plan UHC — ALL PRODUCTS: $3,957.15
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$113	$73.45	$57.41 – $198.74
MRI of the lower back (lumbar spine), without contrast: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $130.41 AETNA — AETNA-MLPFN: $130.41 AETNA — AETNA-PF: $144.90 AETNA — AETNA-PN: $144.90 AETNA — Medicare Advantage-MLPF: $57.41 AETNA — Medicare Advantage-MLPFN: $57.41 AETNA — Medicare Advantage-PF: $67.54 AETNA — Medicare Advantage-PN: $67.54 CENPATICO — Facility All Other: $198.74 CENPATICO — Managed Medicaid-MLPF: $113
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT PELVIS W	$4,325	$2,811.25	$187.17 – $189.74
CT scan of the pelvis, with contrast: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $3,330.25 AETNA — Medicare Advantage: $187.17 BCBS — ALL PRODUCTS: $3,892.50 BCBS — EMPLOYEE PLAN: $2,595 CENPATICO — Managed Medicaid: $133.01 CIGNA — ALL PRODUCTS: $4,195.25 HUMANA — ALL PRODUCTS: $4,108.75 HUMANA — Medicare Advantage: $189.74 MERCY CARE — COMPLETE CARE: $145.95 MERCY CARE — COMPLETE CARE PEDS: $145.95
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT PELVIS W	$4,325	$2,811.25	$2,595 – $4,195.25
CT scan of the pelvis, with contrast: rates for 1 insurance plan UHC — ALL PRODUCTS: $4,022.25
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG CT PELVIS W/CONTRAST MATERIAL	$89	$57.85	$44.79 – $235.35
CT scan of the pelvis, with contrast: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $68.55 AETNA — AETNA-MLPFN: $68.55 AETNA — AETNA-PF: $76.16 AETNA — AETNA-PN: $76.16 AETNA — Medicare Advantage-MLPF: $44.79 AETNA — Medicare Advantage-MLPFN: $44.79 AETNA — Medicare Advantage-PF: $52.69 AETNA — Medicare Advantage-PN: $52.69 CENPATICO — Facility All Other: $235.35 CENPATICO — Managed Medicaid-MLPF: $89
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LOWER EXTREMITY JOINT WO	$4,220	$2,743	$2,532 – $4,093.40
MRI of a leg joint (such as the knee), without contrast: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $3,249.40 AETNA — Medicare Advantage: $254.61 BCBS — ALL PRODUCTS: $3,798 BCBS — EMPLOYEE PLAN: $2,532 CENPATICO — Managed Medicaid: $171.43 CIGNA — ALL PRODUCTS: $4,093.40 HUMANA — ALL PRODUCTS: $4,009 HUMANA — Medicare Advantage: $257.63 MERCY CARE — COMPLETE CARE: $188.11 MERCY CARE — COMPLETE CARE PEDS: $188.11
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI LOWER EXTREMITY JOINT WO	$4,220	$2,743	$2,532 – $4,093.40
MRI of a leg joint (such as the knee), without contrast: rates for 1 insurance plan UHC — ALL PRODUCTS: $3,924.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$104	$67.60	$52.66 – $211.29
MRI of a leg joint (such as the knee), without contrast: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $130.41 AETNA — AETNA-MLPFN: $130.41 AETNA — AETNA-PF: $144.90 AETNA — AETNA-PN: $144.90 AETNA — Medicare Advantage-MLPF: $52.66 AETNA — Medicare Advantage-MLPFN: $52.66 AETNA — Medicare Advantage-PF: $61.95 AETNA — Medicare Advantage-PN: $61.95 CENPATICO — Facility All Other: $211.29 CENPATICO — Managed Medicaid-MLPF: $104
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT ABDOMEN W & PELVIS W	$6,640	$4,316	$372.28 – $380.64
CT scan of the abdomen and pelvis, with contrast: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $5,112.80 AETNA — Medicare Advantage: $372.28 BCBS — ALL PRODUCTS: $5,976 BCBS — EMPLOYEE PLAN: $3,984 CENPATICO — Managed Medicaid: $248.47 CIGNA — ALL PRODUCTS: $6,440.80 HUMANA — ALL PRODUCTS: $6,308 HUMANA — Medicare Advantage: $380.64 MERCY CARE — COMPLETE CARE: $272.65 MERCY CARE — COMPLETE CARE PEDS: $272.65
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT ABDOMEN W & PELVIS W	$6,640	$4,316	$3,984 – $6,440.80
CT scan of the abdomen and pelvis, with contrast: rates for 1 insurance plan UHC — ALL PRODUCTS: $6,175.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$139	$90.35	$70.25 – $313.45
CT scan of the abdomen and pelvis, with contrast: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $108.37 AETNA — AETNA-MLPFN: $108.37 AETNA — AETNA-PF: $120.42 AETNA — AETNA-PN: $120.42 AETNA — Medicare Advantage-MLPF: $70.25 AETNA — Medicare Advantage-MLPFN: $70.25 AETNA — Medicare Advantage-PF: $82.65 AETNA — Medicare Advantage-PN: $82.65 CENPATICO — Facility All Other: $313.45 CENPATICO — Managed Medicaid-MLPF: $139
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US ABDOMINAL COMPLETE	$2,063	$1,340.95	$111.56 – $113.34
Ultrasound of the abdomen, complete: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $1,588.51 AETNA — Medicare Advantage: $111.56 BCBS — ALL PRODUCTS: $1,856.70 BCBS — EMPLOYEE PLAN: $1,237.80 CENPATICO — Managed Medicaid: $81.17 CIGNA — ALL PRODUCTS: $2,001.11 HUMANA — ALL PRODUCTS: $1,959.85 HUMANA — Medicare Advantage: $113.34 MERCY CARE — COMPLETE CARE: $89.07 MERCY CARE — COMPLETE CARE PEDS: $89.07
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US ABDOMINAL COMPLETE	$2,063	$1,340.95	$1,237.80 – $2,001.11
Ultrasound of the abdomen, complete: rates for 1 insurance plan UHC — ALL PRODUCTS: $1,918.59
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$62	$40.30	$31.38 – $118.20
Ultrasound of the abdomen, complete: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $41.12 AETNA — AETNA-MLPFN: $41.12 AETNA — AETNA-PF: $45.69 AETNA — AETNA-PN: $45.69 AETNA — Medicare Advantage-MLPF: $31.38 AETNA — Medicare Advantage-MLPFN: $31.38 AETNA — Medicare Advantage-PF: $36.92 AETNA — Medicare Advantage-PN: $36.92 CENPATICO — Facility All Other: $118.20 CENPATICO — Managed Medicaid-MLPF: $62
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US PREG SNGL/FIRST GESTATION =>14 WKS	$1,383	$898.95	$829.80 – $1,341.51
Pregnancy ultrasound (after the first trimester): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $1,064.91 AETNA — Medicare Advantage: $111.56 BCBS — ALL PRODUCTS: $1,244.70 BCBS — EMPLOYEE PLAN: $829.80 CENPATICO — Managed Medicaid: $81.17 CIGNA — ALL PRODUCTS: $1,341.51 HUMANA — ALL PRODUCTS: $1,313.85 HUMANA — Medicare Advantage: $113.34 MERCY CARE — COMPLETE CARE: $89.07 MERCY CARE — COMPLETE CARE PEDS: $89.07
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US PREG SNGL/FIRST GESTATION =>14 WKS	$1,383	$898.95	$829.80 – $1,341.51
Pregnancy ultrasound (after the first trimester): rates for 1 insurance plan UHC — ALL PRODUCTS: $1,286.19
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$77	$50.05	$39.21 – $137.38
Pregnancy ultrasound (after the first trimester): 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $50.89 AETNA — AETNA-MLPFN: $50.89 AETNA — AETNA-PF: $56.55 AETNA — AETNA-PN: $56.55 AETNA — Medicare Advantage-MLPF: $39.21 AETNA — Medicare Advantage-MLPFN: $39.21 AETNA — Medicare Advantage-PF: $46.13 AETNA — Medicare Advantage-PN: $46.13 CENPATICO — Facility All Other: $137.38 CENPATICO — Managed Medicaid-MLPF: $77
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US TRANSVAGINAL NON-OB	$1,296	$842.40	$81.17 – $113.34
Transvaginal ultrasound: 10 of 17 insurance plan rates AETNA — Medicare Advantage: $111.56 BCBS — ALL PRODUCTS: $1,166.40 BCBS — EMPLOYEE PLAN: $777.60 CENPATICO — Managed Medicaid: $81.17 CIGNA — ALL PRODUCTS: $1,257.12 HUMANA — ALL PRODUCTS: $1,231.20 HUMANA — Medicare Advantage: $113.34 MERCY CARE — COMPLETE CARE: $89.07 MERCY CARE — COMPLETE CARE PEDS: $89.07 NAPHCARE — Managed Medicaid: $81.17
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US TRANSVAGINAL NON-OB	$1,296	$842.40	$777.60 – $1,257.12
Transvaginal ultrasound: rates for 1 insurance plan UHC — ALL PRODUCTS: $1,205.28
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG US TRANSVAGINAL	$53	$34.45	$27.15 – $120.29
Transvaginal ultrasound: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $35.37 AETNA — AETNA-MLPFN: $35.37 AETNA — AETNA-PF: $39.30 AETNA — AETNA-PN: $39.30 AETNA — Medicare Advantage-MLPF: $27.15 AETNA — Medicare Advantage-MLPFN: $27.15 AETNA — Medicare Advantage-PF: $31.94 AETNA — Medicare Advantage-PN: $31.94 CENPATICO — Facility All Other: $120.29 CENPATICO — Managed Medicaid-MLPF: $53
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMMO DIAGNOSTIC, INCL CAD; UNILATERAL	$714	$464.10	$118.82 – $120.67
Diagnostic mammogram, one breast: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $549.78 AETNA — Medicare Advantage: $120.67 BCBS — ALL PRODUCTS: $642.60 BCBS — EMPLOYEE PLAN: $428.40 CENPATICO — Managed Medicaid: $115.10 CIGNA — ALL PRODUCTS: $692.58 HUMANA — ALL PRODUCTS: $678.30 HUMANA — Medicare Advantage: $118.82 MERCY CARE — COMPLETE CARE: $93.89 MERCY CARE — COMPLETE CARE PEDS: $93.89
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAMMO DIAGNOSTIC, INCL CAD; UNILATERAL	$714	$464.10	$93.89 – $692.58
Diagnostic mammogram, one breast: rates for 1 insurance plan UHC — ALL PRODUCTS: $664.02
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$62	$40.30	$31.62 – $128.66
Diagnostic mammogram, one breast: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $41.12 AETNA — AETNA-MLPFN: $41.12 AETNA — AETNA-PF: $45.69 AETNA — AETNA-PN: $45.69 AETNA — Medicare Advantage-MLPF: $31.62 AETNA — Medicare Advantage-MLPFN: $31.62 AETNA — Medicare Advantage-PF: $37.20 AETNA — Medicare Advantage-PN: $37.20 CENPATICO — Facility All Other: $128.66 CENPATICO — Managed Medicaid-MLPF: $62
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMMO DIAGNOSTIC, INCL CAD; BILATERAL	$854	$555.10	$149.76 – $152.83
Diagnostic mammogram, both breasts: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $657.58 AETNA — Medicare Advantage: $152.83 BCBS — ALL PRODUCTS: $768.60 BCBS — EMPLOYEE PLAN: $512.40 CENPATICO — Managed Medicaid: $137.66 CIGNA — ALL PRODUCTS: $828.38 HUMANA — ALL PRODUCTS: $811.30 HUMANA — Medicare Advantage: $149.76 MERCY CARE — COMPLETE CARE: $112.30 MERCY CARE — COMPLETE CARE PEDS: $112.30
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAMMO DIAGNOSTIC, INCL CAD; BILATERAL	$854	$555.10	$112.30 – $828.38
Diagnostic mammogram, both breasts: rates for 1 insurance plan UHC — ALL PRODUCTS: $794.22
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$76	$49.40	$38.91 – $162.13
Diagnostic mammogram, both breasts: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $50.55 AETNA — AETNA-MLPFN: $50.55 AETNA — AETNA-PF: $56.17 AETNA — AETNA-PN: $56.17 AETNA — Medicare Advantage-MLPF: $38.91 AETNA — Medicare Advantage-MLPFN: $38.91 AETNA — Medicare Advantage-PF: $45.78 AETNA — Medicare Advantage-PN: $45.78 CENPATICO — Facility All Other: $162.13 CENPATICO — Managed Medicaid-MLPF: $76
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMMO SCREENING, BILAT, INCL CAD	$703	$456.95	$92.44 – $681.91
Screening mammogram, both breasts: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $541.31 AETNA — Medicare Advantage: $122.92 BCBS — ALL PRODUCTS: $632.70 BCBS — EMPLOYEE PLAN: $421.80 CENPATICO — Managed Medicaid: $113.32 CIGNA — ALL PRODUCTS: $681.91 HUMANA — ALL PRODUCTS: $667.85 HUMANA — Medicare Advantage: $121.37 MERCY CARE — COMPLETE CARE: $92.44 MERCY CARE — COMPLETE CARE PEDS: $92.44
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAMMO SCREENING, BILAT, INCL CAD	$703	$456.95	$92.44 – $681.91
Screening mammogram, both breasts: rates for 1 insurance plan UHC — ALL PRODUCTS: $653.79
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$58	$37.70	$29.41 – $131.45
Screening mammogram, both breasts: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $38.95 AETNA — AETNA-MLPFN: $38.95 AETNA — AETNA-PF: $43.27 AETNA — AETNA-PN: $43.27 AETNA — Medicare Advantage-MLPF: $29.41 AETNA — Medicare Advantage-MLPFN: $29.41 AETNA — Medicare Advantage-PF: $34.60 AETNA — Medicare Advantage-PN: $34.60 CENPATICO — Facility All Other: $131.45 CENPATICO — Managed Medicaid-MLPF: $58

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$627	$407.55	$12.74 – $33.57
Electrocardiogram (ECG/EKG) with reading: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $13.82 AETNA — AETNA-MLPFN: $13.82 AETNA — AETNA-PF: $15.35 AETNA — AETNA-PN: $15.35 AETNA — Medicare Advantage-MLPF: $12.74 AETNA — Medicare Advantage-MLPFN: $12.74 AETNA — Medicare Advantage-PF: $14.99 AETNA — Medicare Advantage-PN: $14.99 CENPATICO — Facility All Other: $15.02 CENPATICO — Managed Medicaid-MLPF: $15.02
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LEFT HEART CATH W/ANGIOGRAPHY,WHEN DONE,NO CORONARIES	$13,186	$8,570.90	$2,159.59 – $3,459.41
Left heart catheterization (diagnostic): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $10,153.22 AETNA — Medicare Advantage: $3,459.41 BCBS — ALL PRODUCTS: $11,867.40 BCBS — EMPLOYEE PLAN: $7,911.60 CENPATICO — Managed Medicaid: $2,159.59 CIGNA — ALL PRODUCTS: $12,790.42 HUMANA — ALL PRODUCTS: $12,526.70 HUMANA — Medicare Advantage: $3,428.11 MERCY CARE — COMPLETE CARE: $2,369.77 MERCY CARE — COMPLETE CARE PEDS: $2,369.77
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LEFT HEART CATH W/ANGIOGRAPHY,WHEN DONE,NO CORONARIES	$13,186	$8,570.90	$7,911.60 – $12,790.42
Left heart catheterization (diagnostic): rates for 1 insurance plan UHC — ALL PRODUCTS: $12,262.98
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$386	$250.90	$191.51 – $872.72
Left heart catheterization (diagnostic): 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $220.80 AETNA — AETNA-MLPFN: $220.80 AETNA — AETNA-PF: $245.33 AETNA — AETNA-PN: $245.33 AETNA — Medicare Advantage-MLPF: $191.51 AETNA — Medicare Advantage-MLPFN: $191.51 AETNA — Medicare Advantage-PF: $225.31 AETNA — Medicare Advantage-PN: $225.31 CENPATICO — Facility All Other: $872.72 CENPATICO — Managed Medicaid-MLPF: $386
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EPS COMPREHENSIVE WO INDUCTION OF ARRHYTHMIA	$9,683	$6,293.95	$5,809.80 – $9,392.51
Heart rhythm study (electrophysiology evaluation): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $7,455.91 AETNA — Medicare Advantage: $8,322.88 BCBS — ALL PRODUCTS: $8,714.70 BCBS — EMPLOYEE PLAN: $5,809.80 CENPATICO — Managed Medicaid: $4,528.09 CIGNA — ALL PRODUCTS: $9,392.51 HUMANA — ALL PRODUCTS: $9,198.85 HUMANA — Medicare Advantage: $8,087.55 MERCY CARE — COMPLETE CARE: $4,968.78 MERCY CARE — COMPLETE CARE PEDS: $4,968.78
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC EPS COMPREHENSIVE WO INDUCTION OF ARRHYTHMIA	$9,683	$6,293.95	$5,809.80 – $9,392.51
Heart rhythm study (electrophysiology evaluation): rates for 1 insurance plan UHC — ALL PRODUCTS: $9,005.19
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$599	$389.35	$311.29 – $591.82
Heart rhythm study (electrophysiology evaluation): 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $358.31 AETNA — AETNA-MLPFN: $358.31 AETNA — AETNA-PF: $398.12 AETNA — AETNA-PN: $398.12 AETNA — Medicare Advantage-MLPF: $311.29 AETNA — Medicare Advantage-MLPFN: $311.29 AETNA — Medicare Advantage-PF: $366.22 AETNA — Medicare Advantage-PN: $366.22 CENPATICO — Facility All Other: $434.54 CENPATICO — Managed Medicaid-MLPF: $434.54
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$1,720	$1,118	$666.43 – $1,816.95
Heart rhythm study with ablation for atrial fibrillation: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $885.55 AETNA — AETNA-MLPFN: $885.55 AETNA — AETNA-PF: $983.94 AETNA — AETNA-PN: $983.94 AETNA — Medicare Advantage-MLPF: $666.43 AETNA — Medicare Advantage-MLPFN: $666.43 AETNA — Medicare Advantage-PF: $784.04 AETNA — Medicare Advantage-PN: $784.04 CENPATICO — Facility All Other: $941.06 CENPATICO — Managed Medicaid-MLPF: $941.06
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ABLATION,PULM VEIN AF W COMP EPS,W TRANSEP,3D MAP & ICE	$68,718	$44,666.70	$41,230.80 – $66,656.46
Heart rhythm study with ablation for atrial fibrillation: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $52,912.86 AETNA — Medicare Advantage: $27,891.25 BCBS — ALL PRODUCTS: $61,846.20 BCBS — EMPLOYEE PLAN: $41,230.80 CENPATICO — Managed Medicaid: $15,989.65 CIGNA — ALL PRODUCTS: $66,656.46 HUMANA — ALL PRODUCTS: $65,282.10 HUMANA — Medicare Advantage: $26,147.02 MERCY CARE — COMPLETE CARE: $17,545.82 MERCY CARE — COMPLETE CARE PEDS: $17,545.82
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ABLATION,PULM VEIN AF W COMP EPS,W TRANSEP,3D MAP & ICE	$68,718	$44,666.70	$41,230.80 – $66,656.46
Heart rhythm study with ablation for atrial fibrillation: rates for 1 insurance plan UHC — ALL PRODUCTS: $63,907.74
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	$685.21 – $1,084.35
Sleep study (overnight, in a sleep lab): 10 of 12 insurance plan rates AETNA — Medicare Advantage: $916.35 CENPATICO — Managed Medicaid: $685.21 HUMANA — Medicare Advantage: $1,084.35 MERCY CARE — COMPLETE CARE: $751.90 MERCY CARE — COMPLETE CARE PEDS: $751.90 NAPHCARE — Managed Medicaid: $685.21 NAPHCARE — Managed Medicaid Peds: $685.21 UAHP — FAMILY CARE: $685.21 UAHP — FAMILY CARE PEDS: $685.21 UAHP — UNIVERSITY CARE: $1,084.35

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THERAPEUTIC EXERC 1+AREAS EA 15MIN	$190	$123.50	$24.99 – $184.30
Physical therapy: therapeutic exercise (each 15 minutes): rates for 1 insurance plan UHC — ALL PRODUCTS: $176.70
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES	Not listed in the file	Not listed in the file	$28.12 – $28.59
Physical therapy: therapeutic exercise (each 15 minutes): rates for 3 insurance plans AETNA — Medicare Advantage: $28.59 HUMANA — Medicare Advantage: $28.12 UAHP — UNIVERSITY CARE: $28.12
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: HC THERAPEUTIC EXERC 1+AREAS EA 15MIN	$190	$123.50	$24.99 – $184.30
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 16 insurance plan rates AETNA — ALL PRODUCTS: $146.30 AETNA — Medicare Advantage: $46.93 BCBS — ALL PRODUCTS: $171 BCBS — EMPLOYEE PLAN: $114 CENPATICO — Managed Medicaid: $30.63 CIGNA — ALL PRODUCTS: $184.30 HUMANA — ALL PRODUCTS: $180.50 MERCY CARE — COMPLETE CARE: $24.99 MERCY CARE — COMPLETE CARE PEDS: $24.99 NAPHCARE — Managed Medicaid: $30.63
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$403	$261.95	$82.20 – $128.49
Physical therapy evaluation (low complexity): 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $84.02 AETNA — AETNA-MLPFN: $84.02 AETNA — AETNA-PF: $93.36 AETNA — AETNA-PN: $93.36 AETNA — Medicare Advantage-MLPF: $82.20 AETNA — Medicare Advantage-MLPFN: $82.20 AETNA — Medicare Advantage-PF: $96.71 AETNA — Medicare Advantage-PN: $96.71 CENPATICO — Facility All Other: $104.25 CENPATICO — Managed Medicaid-MLPF: $104.25
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PHYSICAL THERAPY; LOW COMPLEXITY, 20 MIN	$403	$261.95	$52.99 – $390.91
Physical therapy evaluation (low complexity): rates for 1 insurance plan UHC — ALL PRODUCTS: $374.79
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	$95.70 – $96.39
Physical therapy evaluation (low complexity): rates for 3 insurance plans AETNA — Medicare Advantage: $96.39 HUMANA — Medicare Advantage: $95.70 UAHP — UNIVERSITY CARE: $95.70
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PHYSICAL THERAPY; MODERATE COMPLEXITY, 30 MIN	$513	$333.45	$67.46 – $497.61
Physical therapy evaluation (moderate complexity): rates for 1 insurance plan UHC — ALL PRODUCTS: $477.09
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	$95.70 – $96.39
Physical therapy evaluation (moderate complexity): rates for 3 insurance plans AETNA — Medicare Advantage: $96.39 HUMANA — Medicare Advantage: $95.70 UAHP — UNIVERSITY CARE: $95.70
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: HC PHYSICAL THERAPY; MODERATE COMPLEXITY, 30 MIN	$513	$333.45	$67.46 – $497.61
Physical therapy evaluation (moderate complexity): 10 of 16 insurance plan rates AETNA — ALL PRODUCTS: $395.01 AETNA — Medicare Advantage: $126.71 BCBS — ALL PRODUCTS: $461.70 BCBS — EMPLOYEE PLAN: $307.80 CENPATICO — Managed Medicaid: $82.70 CIGNA — ALL PRODUCTS: $497.61 HUMANA — ALL PRODUCTS: $487.35 MERCY CARE — COMPLETE CARE: $67.46 MERCY CARE — COMPLETE CARE PEDS: $67.46 NAPHCARE — Managed Medicaid: $82.70
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PHYSICAL THERAPY; HIGH COMPLEXITY, 45 MIN	$569	$369.85	$74.82 – $551.93
Physical therapy evaluation (high complexity): rates for 1 insurance plan UHC — ALL PRODUCTS: $529.17
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	$95.70 – $96.39
Physical therapy evaluation (high complexity): rates for 3 insurance plans AETNA — Medicare Advantage: $96.39 HUMANA — Medicare Advantage: $95.70 UAHP — UNIVERSITY CARE: $95.70
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: HC PHYSICAL THERAPY; HIGH COMPLEXITY, 45 MIN	$569	$369.85	$74.82 – $551.93
Physical therapy evaluation (high complexity): 10 of 16 insurance plan rates AETNA — ALL PRODUCTS: $438.13 AETNA — Medicare Advantage: $140.54 BCBS — ALL PRODUCTS: $512.10 BCBS — EMPLOYEE PLAN: $341.40 CENPATICO — Managed Medicaid: $91.72 CIGNA — ALL PRODUCTS: $551.93 HUMANA — ALL PRODUCTS: $540.55 MERCY CARE — COMPLETE CARE: $74.82 MERCY CARE — COMPLETE CARE PEDS: $74.82 NAPHCARE — Managed Medicaid: $91.72
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$302	$196.30	$58.90 – $104.17
Psychotherapy, 30 minutes: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $63.83 AETNA — AETNA-MLPFN: $72.94 AETNA — AETNA-PF: $70.92 AETNA — AETNA-PN: $81.04 AETNA — Medicare Advantage-MLPF: $58.90 AETNA — Medicare Advantage-MLPFN: $72.38 AETNA — Medicare Advantage-PF: $69.29 AETNA — Medicare Advantage-PN: $85.15 CENPATICO — Facility All Other: $75.26 CENPATICO — Managed Medicaid-MLPF: $75.26
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY, W/PATIENT 30 MIN	$194	$126.10	$116.40 – $188.18
Psychotherapy, 30 minutes: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $149.38 AETNA — Medicare Advantage: $189.40 BCBS — ALL PRODUCTS: $174.60 BCBS — EMPLOYEE PLAN: $116.40 CENPATICO — Managed Medicaid: $99.54 CIGNA — ALL PRODUCTS: $188.18 HUMANA — ALL PRODUCTS: $184.30 HUMANA — Medicare Advantage: $171.25 MERCY CARE — COMPLETE CARE: $109.23 MERCY CARE — COMPLETE CARE PEDS: $109.23
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY, W/PATIENT 30 MIN	$194	$126.10	$116.40 – $188.18
Psychotherapy, 30 minutes: rates for 1 insurance plan UHC — ALL PRODUCTS: $180.42
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$374	$243.10	$77.84 – $134.56
Psychotherapy, 45 minutes: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $84.22 AETNA — AETNA-MLPFN: $96.26 AETNA — AETNA-PF: $93.58 AETNA — AETNA-PN: $106.95 AETNA — Medicare Advantage-MLPF: $77.84 AETNA — Medicare Advantage-MLPFN: $96 AETNA — Medicare Advantage-PF: $91.58 AETNA — Medicare Advantage-PN: $112.94 CENPATICO — Facility All Other: $99.05 CENPATICO — Managed Medicaid-MLPF: $99.05
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY, W/PATIENT 45 MIN	$232	$150.80	$139.20 – $225.04
Psychotherapy, 45 minutes: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $178.64 AETNA — Medicare Advantage: $189.40 BCBS — ALL PRODUCTS: $208.80 BCBS — EMPLOYEE PLAN: $139.20 CENPATICO — Managed Medicaid: $99.54 CIGNA — ALL PRODUCTS: $225.04 HUMANA — ALL PRODUCTS: $220.40 HUMANA — Medicare Advantage: $171.25 MERCY CARE — COMPLETE CARE: $109.23 MERCY CARE — COMPLETE CARE PEDS: $109.23
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY, W/PATIENT 45 MIN	$232	$150.80	$139.20 – $225.04
Psychotherapy, 45 minutes: rates for 1 insurance plan UHC — ALL PRODUCTS: $215.76
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$479	$311.35	$114.68 – $197.08
Psychotherapy, 60 minutes: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $124.66 AETNA — AETNA-MLPFN: $142.57 AETNA — AETNA-PF: $138.51 AETNA — AETNA-PN: $158.41 AETNA — Medicare Advantage-MLPF: $114.68 AETNA — Medicare Advantage-MLPFN: $140.82 AETNA — Medicare Advantage-PF: $134.92 AETNA — Medicare Advantage-PN: $165.67 CENPATICO — Facility All Other: $146.97 CENPATICO — Managed Medicaid-MLPF: $146.97
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY, W/PATIENT 60 MIN	$271	$176.15	$171.25 – $189.40
Psychotherapy, 60 minutes: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $208.67 AETNA — Medicare Advantage: $189.40 BCBS — ALL PRODUCTS: $243.90 BCBS — EMPLOYEE PLAN: $162.60 CENPATICO — Managed Medicaid: $99.54 CIGNA — ALL PRODUCTS: $262.87 HUMANA — ALL PRODUCTS: $257.45 HUMANA — Medicare Advantage: $171.25 MERCY CARE — COMPLETE CARE: $109.23 MERCY CARE — COMPLETE CARE PEDS: $109.23
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY, W/PATIENT 60 MIN	$271	$176.15	$162.60 – $262.87
Psychotherapy, 60 minutes: rates for 1 insurance plan UHC — ALL PRODUCTS: $252.03
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN	$212	$137.80	$127.20 – $205.64
Family psychotherapy, without the patient: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $163.24 AETNA — Medicare Advantage: $189.40 BCBS — ALL PRODUCTS: $190.80 BCBS — EMPLOYEE PLAN: $127.20 CENPATICO — Managed Medicaid: $99.54 CIGNA — ALL PRODUCTS: $205.64 HUMANA — ALL PRODUCTS: $201.40 HUMANA — Medicare Advantage: $171.25 MERCY CARE — COMPLETE CARE: $109.23 MERCY CARE — COMPLETE CARE PEDS: $109.23
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN	$212	$137.80	$127.20 – $205.64
Family psychotherapy, without the patient: rates for 1 insurance plan UHC — ALL PRODUCTS: $197.16
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$424	$275.60	$87.18 – $157.53
Family psychotherapy, with the patient: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $94.97 AETNA — AETNA-MLPFN: $95.26 AETNA — AETNA-PF: $105.52 AETNA — AETNA-PN: $105.85 AETNA — Medicare Advantage-MLPF: $87.18 AETNA — Medicare Advantage-MLPFN: $92.68 AETNA — Medicare Advantage-PF: $102.57 AETNA — Medicare Advantage-PN: $109.04 CENPATICO — Facility All Other: $111.83 CENPATICO — Managed Medicaid-MLPF: $111.83
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY W/PATIENT, 50 MIN	$266	$172.90	$159.60 – $258.02
Family psychotherapy, with the patient: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $204.82 AETNA — Medicare Advantage: $189.40 BCBS — ALL PRODUCTS: $239.40 BCBS — EMPLOYEE PLAN: $159.60 CENPATICO — Managed Medicaid: $99.54 CIGNA — ALL PRODUCTS: $258.02 HUMANA — ALL PRODUCTS: $252.70 HUMANA — Medicare Advantage: $171.25 MERCY CARE — COMPLETE CARE: $109.23 MERCY CARE — COMPLETE CARE PEDS: $109.23
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY W/PATIENT, 50 MIN	$266	$172.90	$159.60 – $258.02
Family psychotherapy, with the patient: rates for 1 insurance plan UHC — ALL PRODUCTS: $247.38
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC GROUP PSYCHOTHERAPY,NOT MULT-FAM GROUP	$318	$206.70	$98.59 – $108.40
Group psychotherapy: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $244.86 AETNA — Medicare Advantage: $108.40 BCBS — ALL PRODUCTS: $286.20 BCBS — EMPLOYEE PLAN: $190.80 CENPATICO — Managed Medicaid: $55.77 CIGNA — ALL PRODUCTS: $308.46 HUMANA — ALL PRODUCTS: $302.10 HUMANA — Medicare Advantage: $98.59 MERCY CARE — COMPLETE CARE: $61.20 MERCY CARE — COMPLETE CARE PEDS: $61.20
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC GROUP PSYCHOTHERAPY,NOT MULT-FAM GROUP	$318	$206.70	$190.80 – $308.46
Group psychotherapy: rates for 1 insurance plan UHC — ALL PRODUCTS: $295.74

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$623	$404.95	$336.33 – $668.20
Removal of breast growth (open surgery): 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $460.35 AETNA — AETNA-MLPFN: $569.56 AETNA — AETNA-PF: $511.50 AETNA — AETNA-PN: $632.84 AETNA — Medicare Advantage-MLPF: $336.33 AETNA — Medicare Advantage-MLPFN: $472.51 AETNA — Medicare Advantage-PF: $395.68 AETNA — Medicare Advantage-PN: $555.89 CENPATICO — Facility All Other: $432.70 CENPATICO — Managed Medicaid-MLPF: $432.70
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	$4,081.32 – $4,178.09
Removal of breast growth (open surgery): 10 of 12 insurance plan rates AETNA — Medicare Advantage: $4,178.09 CENPATICO — Managed Medicaid: $110.23 HUMANA — Medicare Advantage: $4,081.32 MERCY CARE — COMPLETE CARE: $120.96 MERCY CARE — COMPLETE CARE PEDS: $120.96 NAPHCARE — Managed Medicaid: $110.23 NAPHCARE — Managed Medicaid Peds: $110.23 UAHP — FAMILY CARE: $110.23 UAHP — FAMILY CARE PEDS: $110.23 UAHP — UNIVERSITY CARE: $4,081.32
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	$13,699.93 – $13,713.71
Total hip replacement: 10 of 12 insurance plan rates AETNA — Medicare Advantage: $13,699.93 CENPATICO — Managed Medicaid: $9,173.73 HUMANA — Medicare Advantage: $13,713.71 MERCY CARE — COMPLETE CARE: $10,066.55 MERCY CARE — COMPLETE CARE PEDS: $10,066.55 NAPHCARE — Managed Medicaid: $9,173.73 NAPHCARE — Managed Medicaid Peds: $9,173.73 UAHP — FAMILY CARE: $9,173.73 UAHP — FAMILY CARE PEDS: $9,173.73 UAHP — UNIVERSITY CARE: $13,713.71
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	$13,699.93 – $13,713.71
Total knee replacement: 10 of 12 insurance plan rates AETNA — Medicare Advantage: $13,699.93 CENPATICO — Managed Medicaid: $9,173.73 HUMANA — Medicare Advantage: $13,713.71 MERCY CARE — COMPLETE CARE: $10,066.55 MERCY CARE — COMPLETE CARE PEDS: $10,066.55 NAPHCARE — Managed Medicaid: $9,173.73 NAPHCARE — Managed Medicaid Peds: $9,173.73 UAHP — FAMILY CARE: $9,173.73 UAHP — FAMILY CARE PEDS: $9,173.73 UAHP — UNIVERSITY CARE: $13,713.71
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	$2,092.24 – $2,295.86
Shoulder arthroscopy: shaving of shoulder bone: rates for 9 insurance plans CENPATICO — Managed Medicaid: $2,092.24 MERCY CARE — COMPLETE CARE: $2,295.86 MERCY CARE — COMPLETE CARE PEDS: $2,295.86 NAPHCARE — Managed Medicaid: $2,092.24 NAPHCARE — Managed Medicaid Peds: $2,092.24 UAHP — FAMILY CARE: $2,092.24 UAHP — FAMILY CARE PEDS: $2,092.24 UHC — COMMUNITY CARE: $2,092.24 UHC — COMMUNITY CARE PEDS: $2,092.24
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$2,108.47 – $3,491.49
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 12 insurance plan rates AETNA — Medicare Advantage: $3,491.49 CENPATICO — Managed Medicaid: $2,108.47 HUMANA — Medicare Advantage: $3,458.17 MERCY CARE — COMPLETE CARE: $2,313.68 MERCY CARE — COMPLETE CARE PEDS: $2,313.68 NAPHCARE — Managed Medicaid: $2,108.47 NAPHCARE — Managed Medicaid Peds: $2,108.47 UAHP — FAMILY CARE: $2,108.47 UAHP — FAMILY CARE PEDS: $2,108.47 UAHP — UNIVERSITY CARE: $3,458.17
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$435	$282.75	$216.58 – $397.25
Removal of tonsils and adenoids (under age 12): 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $343.92 AETNA — AETNA-MLPFN: $343.92 AETNA — AETNA-PF: $382.13 AETNA — AETNA-PN: $382.13 AETNA — Medicare Advantage-MLPF: $216.58 AETNA — Medicare Advantage-MLPFN: $216.58 AETNA — Medicare Advantage-PF: $254.80 AETNA — Medicare Advantage-PN: $254.80 CENPATICO — Facility All Other: $303.34 CENPATICO — Managed Medicaid-MLPF: $303.34
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: T&A YOUNGER THAN AGE 12	Not listed in the file	Not listed in the file	$3,788.79 – $6,316.95
Removal of tonsils and adenoids (under age 12): 10 of 12 insurance plan rates AETNA — Medicare Advantage: $6,316.95 CENPATICO — Managed Medicaid: $3,788.79 HUMANA — Medicare Advantage: $6,305.03 MERCY CARE — COMPLETE CARE: $4,157.53 MERCY CARE — COMPLETE CARE PEDS: $4,157.53 NAPHCARE — Managed Medicaid: $3,788.79 NAPHCARE — Managed Medicaid Peds: $3,788.79 UAHP — FAMILY CARE: $3,788.79 UAHP — FAMILY CARE PEDS: $3,788.79 UAHP — UNIVERSITY CARE: $6,305.03
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$194	$126.10	$92.09 – $421.46
Upper GI endoscopy (diagnostic): 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $141.46 AETNA — AETNA-MLPFN: $329.96 AETNA — AETNA-PF: $157.18 AETNA — AETNA-PN: $366.62 AETNA — Medicare Advantage-MLPF: $92.09 AETNA — Medicare Advantage-MLPFN: $267.05 AETNA — Medicare Advantage-PF: $108.34 AETNA — Medicare Advantage-PN: $314.18 CENPATICO — Facility All Other: $124.82 CENPATICO — Managed Medicaid-MLPF: $124.82
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC UPPER GI ENDO,DIAGNOSTIC	$4,312	$2,802.80	$2,587.20 – $4,182.64
Upper GI endoscopy (diagnostic): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $3,320.24 AETNA — Medicare Advantage: $967.83 BCBS — ALL PRODUCTS: $3,880.80 BCBS — EMPLOYEE PLAN: $2,587.20 CENPATICO — Managed Medicaid: $603.10 CIGNA — ALL PRODUCTS: $4,182.64 HUMANA — ALL PRODUCTS: $4,096.40 HUMANA — Medicare Advantage: $999.27 MERCY CARE — COMPLETE CARE: $661.80 MERCY CARE — COMPLETE CARE PEDS: $661.80
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC UPPER GI ENDO,DIAGNOSTIC	$4,312	$2,802.80	$2,587.20 – $4,182.64
Upper GI endoscopy (diagnostic): rates for 1 insurance plan UHC — ALL PRODUCTS: $4,010.16
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$220	$143	$102.98 – $501.15
Upper GI endoscopy with biopsy: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $159.01 AETNA — AETNA-MLPFN: $426.52 AETNA — AETNA-PF: $176.68 AETNA — AETNA-PN: $473.91 AETNA — Medicare Advantage-MLPF: $102.98 AETNA — Medicare Advantage-MLPFN: $346.17 AETNA — Medicare Advantage-PF: $121.15 AETNA — Medicare Advantage-PN: $407.26 CENPATICO — Facility All Other: $140.17 CENPATICO — Managed Medicaid-MLPF: $140.17
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC UPPER GI ENDO W/BIOPSY	$3,171	$2,061.15	$1,902.60 – $3,075.87
Upper GI endoscopy with biopsy: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $2,441.67 AETNA — Medicare Advantage: $967.83 BCBS — ALL PRODUCTS: $2,853.90 BCBS — EMPLOYEE PLAN: $1,902.60 CENPATICO — Managed Medicaid: $603.10 CIGNA — ALL PRODUCTS: $3,075.87 HUMANA — ALL PRODUCTS: $3,012.45 HUMANA — Medicare Advantage: $999.27 MERCY CARE — COMPLETE CARE: $661.80 MERCY CARE — COMPLETE CARE PEDS: $661.80
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC UPPER GI ENDO W/BIOPSY	$3,171	$2,061.15	$1,902.60 – $3,075.87
Upper GI endoscopy with biopsy: rates for 1 insurance plan UHC — ALL PRODUCTS: $2,949.03
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$294	$191.10	$137.11 – $550.97
Colonoscopy (diagnostic): 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $212.40 AETNA — AETNA-MLPFN: $391.63 AETNA — AETNA-PF: $236 AETNA — AETNA-PN: $435.15 AETNA — Medicare Advantage-MLPF: $137.11 AETNA — Medicare Advantage-MLPFN: $312.90 AETNA — Medicare Advantage-PF: $161.31 AETNA — Medicare Advantage-PN: $368.12 CENPATICO — Facility All Other: $187.24 CENPATICO — Managed Medicaid-MLPF: $187.24
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY,FLEX;DIAG,INC COLLECT SPEC	$3,871	$2,516.15	$2,322.60 – $3,754.87
Colonoscopy (diagnostic): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $2,980.67 AETNA — Medicare Advantage: $992.34 BCBS — ALL PRODUCTS: $3,483.90 BCBS — EMPLOYEE PLAN: $2,322.60 CENPATICO — Managed Medicaid: $591.22 CIGNA — ALL PRODUCTS: $3,754.87 HUMANA — ALL PRODUCTS: $3,677.45 HUMANA — Medicare Advantage: $971.72 MERCY CARE — COMPLETE CARE: $648.76 MERCY CARE — COMPLETE CARE PEDS: $648.76
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLONOSCOPY,FLEX;DIAG,INC COLLECT SPEC	$3,871	$2,516.15	$2,322.60 – $3,754.87
Colonoscopy (diagnostic): rates for 1 insurance plan UHC — ALL PRODUCTS: $3,600.03
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$319	$207.35	$148.06 – $658.18
Colonoscopy with biopsy: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $231 AETNA — AETNA-MLPFN: $495.42 AETNA — AETNA-PF: $256.66 AETNA — AETNA-PN: $550.47 AETNA — Medicare Advantage-MLPF: $148.06 AETNA — Medicare Advantage-MLPFN: $397.31 AETNA — Medicare Advantage-PF: $174.19 AETNA — Medicare Advantage-PN: $467.42 CENPATICO — Facility All Other: $203.62 CENPATICO — Managed Medicaid-MLPF: $203.62
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY,FLEX,W/BIOPSY	$4,042	$2,627.30	$772.47 – $1,276.92
Colonoscopy with biopsy: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $3,112.34 AETNA — Medicare Advantage: $1,276.92 BCBS — ALL PRODUCTS: $3,637.80 BCBS — EMPLOYEE PLAN: $2,425.20 CENPATICO — Managed Medicaid: $772.47 CIGNA — ALL PRODUCTS: $3,920.74 HUMANA — ALL PRODUCTS: $3,839.90 HUMANA — Medicare Advantage: $1,256.69 MERCY CARE — COMPLETE CARE: $847.65 MERCY CARE — COMPLETE CARE PEDS: $847.65
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLONOSCOPY,FLEX,W/BIOPSY	$4,042	$2,627.30	$2,425.20 – $3,920.74
Colonoscopy with biopsy: rates for 1 insurance plan UHC — ALL PRODUCTS: $3,759.06
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$405	$263.25	$186.34 – $739.89
Colonoscopy with removal of polyps (snare): 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $291.31 AETNA — AETNA-MLPFN: $520.66 AETNA — AETNA-PF: $323.68 AETNA — AETNA-PN: $578.51 AETNA — Medicare Advantage-MLPF: $186.34 AETNA — Medicare Advantage-MLPFN: $414.40 AETNA — Medicare Advantage-PF: $219.22 AETNA — Medicare Advantage-PN: $487.53 CENPATICO — Facility All Other: $256.97 CENPATICO — Managed Medicaid-MLPF: $256.97
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY,FLEX,W/RMVE TUMOR,SNARE	$4,202	$2,731.30	$772.47 – $1,276.92
Colonoscopy with removal of polyps (snare): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $3,235.54 AETNA — Medicare Advantage: $1,276.92 BCBS — ALL PRODUCTS: $3,781.80 BCBS — EMPLOYEE PLAN: $2,521.20 CENPATICO — Managed Medicaid: $772.47 CIGNA — ALL PRODUCTS: $4,075.94 HUMANA — ALL PRODUCTS: $3,991.90 HUMANA — Medicare Advantage: $1,256.69 MERCY CARE — COMPLETE CARE: $847.65 MERCY CARE — COMPLETE CARE PEDS: $847.65
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLONOSCOPY,FLEX,W/RMVE TUMOR,SNARE	$4,202	$2,731.30	$2,521.20 – $4,075.94
Colonoscopy with removal of polyps (snare): rates for 1 insurance plan UHC — ALL PRODUCTS: $3,907.86
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$409	$265.85	$188.38 – $405.96
Ultrasound of the lower bowel by endoscope: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $295.33 AETNA — AETNA-MLPFN: $295.33 AETNA — AETNA-PF: $328.15 AETNA — AETNA-PN: $328.15 AETNA — Medicare Advantage-MLPF: $188.38 AETNA — Medicare Advantage-MLPFN: $188.38 AETNA — Medicare Advantage-PF: $221.62 AETNA — Medicare Advantage-PN: $221.62 CENPATICO — Facility All Other: $260.46 CENPATICO — Managed Medicaid-MLPF: $260.46
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY FLEX W/ENDO US EXAM	$3,408	$2,215.20	$2,044.80 – $3,305.76
Ultrasound of the lower bowel by endoscope: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $2,624.16 AETNA — Medicare Advantage: $1,276.92 BCBS — ALL PRODUCTS: $3,067.20 BCBS — EMPLOYEE PLAN: $2,044.80 CENPATICO — Managed Medicaid: $772.47 CIGNA — ALL PRODUCTS: $3,305.76 HUMANA — ALL PRODUCTS: $3,237.60 HUMANA — Medicare Advantage: $1,256.69 MERCY CARE — COMPLETE CARE: $847.65 MERCY CARE — COMPLETE CARE PEDS: $847.65
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLONOSCOPY FLEX W/ENDO US EXAM	$3,408	$2,215.20	$2,044.80 – $3,305.76
Ultrasound of the lower bowel by endoscope: rates for 1 insurance plan UHC — ALL PRODUCTS: $3,169.44
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLON CA SCRN NOT HI RSK IND	$276	$179.40	$137.35 – $446.64
Screening colonoscopy (not high risk): 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $154.93 AETNA — AETNA-MLPFN: $285.46 AETNA — AETNA-PF: $172.14 AETNA — AETNA-PN: $317.18 AETNA — Medicare Advantage-MLPF: $137.35 AETNA — Medicare Advantage-MLPFN: $313.15 AETNA — Medicare Advantage-PF: $161.59 AETNA — Medicare Advantage-PN: $368.41 CENPATICO — Facility All Other: $187.58 CENPATICO — Managed Medicaid-MLPF: $187.58
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLORECTAL CANCER SCREENING; COLONOSCOPY INDV NOT MEETING CRI	$3,690	$2,398.50	$591.22 – $992.34
Screening colonoscopy (not high risk): 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $2,841.30 AETNA — Medicare Advantage: $992.34 BCBS — ALL PRODUCTS: $3,321 BCBS — EMPLOYEE PLAN: $2,214 CENPATICO — Managed Medicaid: $591.22 CIGNA — ALL PRODUCTS: $3,579.30 HUMANA — ALL PRODUCTS: $3,505.50 HUMANA — Medicare Advantage: $971.72 MERCY CARE — COMPLETE CARE: $648.76 MERCY CARE — COMPLETE CARE PEDS: $648.76
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLORECTAL CANCER SCREENING; COLONOSCOPY INDV NOT MEETING CRI	$3,690	$2,398.50	$2,214 – $3,579.30
Screening colonoscopy (not high risk): rates for 1 insurance plan UHC — ALL PRODUCTS: $3,431.70
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR LAPAROSCOPY SURG CHOLECYSTECTOMY	$1,000	$650	$520.68 – $948.84
Gallbladder removal by laparoscope: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $771.04 AETNA — AETNA-MLPFN: $771.04 AETNA — AETNA-PF: $856.72 AETNA — AETNA-PN: $856.72 AETNA — Medicare Advantage-MLPF: $520.68 AETNA — Medicare Advantage-MLPFN: $520.68 AETNA — Medicare Advantage-PF: $612.56 AETNA — Medicare Advantage-PN: $612.56 CENPATICO — Facility All Other: $679.91 CENPATICO — Managed Medicaid-MLPF: $679.91
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	$3,769.71 – $6,451.08
Gallbladder removal by laparoscope: 10 of 12 insurance plan rates AETNA — Medicare Advantage: $6,451.08 CENPATICO — Managed Medicaid: $3,769.71 HUMANA — Medicare Advantage: $6,218.38 MERCY CARE — COMPLETE CARE: $4,136.59 MERCY CARE — COMPLETE CARE PEDS: $4,136.59 NAPHCARE — Managed Medicaid: $3,769.71 NAPHCARE — Managed Medicaid Peds: $3,769.71 UAHP — FAMILY CARE: $3,769.71 UAHP — FAMILY CARE PEDS: $3,769.71 UAHP — UNIVERSITY CARE: $6,218.38
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$790	$513.50	$418.45 – $680.85
Groin (inguinal) hernia repair, age 5 or older: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $612.76 AETNA — AETNA-MLPFN: $612.76 AETNA — AETNA-PF: $680.85 AETNA — AETNA-PN: $680.85 AETNA — Medicare Advantage-MLPF: $418.45 AETNA — Medicare Advantage-MLPFN: $418.45 AETNA — Medicare Advantage-PF: $492.29 AETNA — Medicare Advantage-PN: $492.29 CENPATICO — Facility All Other: $540.44 CENPATICO — Managed Medicaid-MLPF: $540.44
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	$2,371.44 – $3,820.58
Groin (inguinal) hernia repair, age 5 or older: 10 of 12 insurance plan rates AETNA — Medicare Advantage: $3,820.58 CENPATICO — Managed Medicaid: $2,371.44 HUMANA — Medicare Advantage: $3,761.34 MERCY CARE — COMPLETE CARE: $2,602.24 MERCY CARE — COMPLETE CARE PEDS: $2,602.24 NAPHCARE — Managed Medicaid: $2,371.44 NAPHCARE — Managed Medicaid Peds: $2,371.44 UAHP — FAMILY CARE: $2,371.44 UAHP — FAMILY CARE PEDS: $2,371.44 UAHP — UNIVERSITY CARE: $3,761.34
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PROSTATE NEEDLE BIOPSY ANY APPROACH	$5,847	$3,800.55	$132.15 – $355.59
Prostate biopsy: 10 of 42 insurance plan rates AETNA — AETNA-MLPF: $165.32 AETNA — AETNA-MLPFN: $307.76 AETNA — AETNA-PF: $183.69 AETNA — AETNA-PN: $341.95 CENPATICO — Facility All Other: $132.15 CENPATICO — Managed Medicaid-MLPF: $132.15 CENPATICO — Managed Medicaid-MLPFN: $246.16 CENPATICO — Managed Medicaid-PF: $132.15 CENPATICO — Managed Medicaid-PN: $246.16 CENPATICO — Non-Facility All Other: $246.16
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BX PROSTATE NDLE/PUNCH SING/MULT ANY APPROACH	$5,639	$3,665.35	$1,392.83 – $5,469.83
Prostate biopsy: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $4,342.03 AETNA — Medicare Advantage: $1,392.83 BCBS — ALL PRODUCTS: $5,075.10 BCBS — EMPLOYEE PLAN: $3,383.40 CENPATICO — Managed Medicaid: $1,335.67 CIGNA — ALL PRODUCTS: $5,469.83 HUMANA — ALL PRODUCTS: $5,357.05 HUMANA — Medicare Advantage: $2,183.34 MERCY CARE — COMPLETE CARE: $1,465.66 MERCY CARE — COMPLETE CARE PEDS: $1,465.66
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BX PROSTATE NDLE/PUNCH SING/MULT ANY APPROACH	$5,639	$3,665.35	$1,392.83 – $5,469.83
Prostate biopsy: rates for 1 insurance plan UHC — ALL PRODUCTS: $5,244.27
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	$11,096.49 – $11,342.91
Prostate removal by laparoscope (radical prostatectomy): 10 of 12 insurance plan rates AETNA — Medicare Advantage: $11,342.91 CENPATICO — Managed Medicaid: $6,635.65 HUMANA — Medicare Advantage: $11,096.49 MERCY CARE — COMPLETE CARE: $7,281.45 MERCY CARE — COMPLETE CARE PEDS: $7,281.45 NAPHCARE — Managed Medicaid: $6,635.65 NAPHCARE — Managed Medicaid Peds: $6,635.65 UAHP — FAMILY CARE: $6,635.65 UAHP — FAMILY CARE PEDS: $6,635.65 UAHP — UNIVERSITY CARE: $11,096.49
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$351	$228.15	$169.63 – $1,869.84
Hysteroscopy with biopsy of the uterus lining: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $254.41 AETNA — AETNA-MLPFN: $1,365.06 AETNA — AETNA-PF: $282.67 AETNA — AETNA-PN: $1,516.73 AETNA — Medicare Advantage-MLPF: $169.63 AETNA — Medicare Advantage-MLPFN: $1,048.05 AETNA — Medicare Advantage-PF: $199.57 AETNA — Medicare Advantage-PN: $1,233 CENPATICO — Facility All Other: $236.40 CENPATICO — Managed Medicaid-MLPF: $236.40
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HYSTEROSCOPY,SURGICAL;W BX OF ENDOMETRIUM,W WO D&C	$3,877	$2,520.05	$2,326.20 – $3,760.69
Hysteroscopy with biopsy of the uterus lining: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $2,985.29 AETNA — Medicare Advantage: $3,454.28 BCBS — ALL PRODUCTS: $3,489.30 BCBS — EMPLOYEE PLAN: $2,326.20 CENPATICO — Managed Medicaid: $1,954.13 CIGNA — ALL PRODUCTS: $3,760.69 HUMANA — ALL PRODUCTS: $3,683.15 HUMANA — Medicare Advantage: $3,388.81 MERCY CARE — COMPLETE CARE: $2,144.31 MERCY CARE — COMPLETE CARE PEDS: $2,144.31
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HYSTEROSCOPY,SURGICAL;W BX OF ENDOMETRIUM,W WO D&C	$3,877	$2,520.05	$2,326.20 – $3,760.69
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan UHC — ALL PRODUCTS: $3,605.61
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$151	$98.15	$74.46 – $388.14
Spinal injection, lower back (epidural), with imaging guidance: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $109.49 AETNA — AETNA-MLPFN: $279.86 AETNA — AETNA-PF: $121.66 AETNA — AETNA-PN: $310.95 AETNA — Medicare Advantage-MLPF: $74.46 AETNA — Medicare Advantage-MLPFN: $226.04 AETNA — Medicare Advantage-PF: $87.60 AETNA — Medicare Advantage-PN: $265.93 CENPATICO — Facility All Other: $101.81 CENPATICO — Managed Medicaid-MLPF: $101.81
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJECT, EPIDURAL/SUBARACHNOID, INCL NEEDLE/CATH PLMT, LUMBAR/	$3,399	$2,209.35	$738.10 – $753.23
Spinal injection, lower back (epidural), with imaging guidance: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $2,617.23 AETNA — Medicare Advantage: $753.23 BCBS — ALL PRODUCTS: $3,059.10 BCBS — EMPLOYEE PLAN: $2,039.40 CENPATICO — Managed Medicaid: $472.73 CIGNA — ALL PRODUCTS: $3,297.03 HUMANA — ALL PRODUCTS: $3,229.05 HUMANA — Medicare Advantage: $738.10 MERCY CARE — COMPLETE CARE: $518.74 MERCY CARE — COMPLETE CARE PEDS: $518.74
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC INJECT, EPIDURAL/SUBARACHNOID, INCL NEEDLE/CATH PLMT, LUMBAR/	$3,399	$2,209.35	$2,039.40 – $3,297.03
Spinal injection, lower back (epidural), with imaging guidance: rates for 1 insurance plan UHC — ALL PRODUCTS: $3,161.07
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJECTION TRANSFORAM EPIDURAL W GUIDE,LUMBAR/SACRAL, SNGLE LE	$3,250	$2,112.50	$1,950 – $3,152.50
Nerve root injection, lower back, with imaging guidance: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $2,502.50 AETNA — Medicare Advantage: $943.81 BCBS — ALL PRODUCTS: $2,925 BCBS — EMPLOYEE PLAN: $1,950 CENPATICO — Managed Medicaid: $612.68 CIGNA — ALL PRODUCTS: $3,152.50 HUMANA — ALL PRODUCTS: $3,087.50 HUMANA — Medicare Advantage: $948.89 MERCY CARE — COMPLETE CARE: $672.31 MERCY CARE — COMPLETE CARE PEDS: $672.31
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC INJECTION TRANSFORAM EPIDURAL W GUIDE,LUMBAR/SACRAL, SNGLE LE	$3,250	$2,112.50	$1,950 – $3,152.50
Nerve root injection, lower back, with imaging guidance: rates for 1 insurance plan UHC — ALL PRODUCTS: $3,022.50
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	$2,081.30 – $2,083.72
Carpal tunnel release: 10 of 12 insurance plan rates AETNA — Medicare Advantage: $2,083.72 CENPATICO — Managed Medicaid: $8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) HUMANA — Medicare Advantage: $2,081.30 MERCY CARE — COMPLETE CARE: $8.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) MERCY CARE — COMPLETE CARE PEDS: $8.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) NAPHCARE — Managed Medicaid: $8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) NAPHCARE — Managed Medicaid Peds: $8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) UAHP — FAMILY CARE: $8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) UAHP — FAMILY CARE PEDS: $8.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) UAHP — UNIVERSITY CARE: $2,081.30
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR POST-CATARACT LASER SURGERY	$1,663	$1,080.95	$228.82 – $483.10
Laser treatment of clouding after cataract surgery: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $406.38 AETNA — AETNA-MLPFN: $434.79 AETNA — AETNA-PF: $451.53 AETNA — AETNA-PN: $483.10 AETNA — Medicare Advantage-MLPF: $228.82 AETNA — Medicare Advantage-MLPFN: $278.33 AETNA — Medicare Advantage-PF: $269.20 AETNA — Medicare Advantage-PN: $327.45 CENPATICO — Facility All Other: $315.90 CENPATICO — Managed Medicaid-MLPF: $315.90
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DISCISSION SECONDARY MEMBRANOUS CATARACT; LASER SGY,=>1 STAGE	$1,193	$775.45	$375.35 – $586.89
Laser treatment of clouding after cataract surgery: 10 of 18 insurance plan rates AETNA — ALL PRODUCTS: $918.61 AETNA — Medicare Advantage: $586.89 BCBS — ALL PRODUCTS: $1,073.70 BCBS — EMPLOYEE PLAN: $715.80 CENPATICO — Managed Medicaid: $375.35 CIGNA — ALL PRODUCTS: $1,157.21 HUMANA — ALL PRODUCTS: $1,133.35 HUMANA — Medicare Advantage: $584.71 MERCY CARE — COMPLETE CARE: $411.88 MERCY CARE — COMPLETE CARE PEDS: $411.88
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DISCISSION SECONDARY MEMBRANOUS CATARACT; LASER SGY,=>1 STAGE	$1,193	$775.45	$715.80 – $1,157.21
Laser treatment of clouding after cataract surgery: rates for 1 insurance plan UHC — ALL PRODUCTS: $1,109.49
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$967	$628.55	$385.87 – $927.90
Cataract removal with lens implant: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $710.33 AETNA — AETNA-MLPFN: $710.33 AETNA — AETNA-PF: $789.25 AETNA — AETNA-PN: $789.25 AETNA — Medicare Advantage-MLPF: $385.87 AETNA — Medicare Advantage-MLPFN: $385.87 AETNA — Medicare Advantage-PF: $453.97 AETNA — Medicare Advantage-PN: $453.97 CENPATICO — Facility All Other: $552.29 CENPATICO — Managed Medicaid-MLPF: $552.29
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	$1,548.84 – $2,462.64
Cataract removal with lens implant: 10 of 12 insurance plan rates AETNA — Medicare Advantage: $2,462.64 CENPATICO — Managed Medicaid: $1,548.84 HUMANA — Medicare Advantage: $2,430.85 MERCY CARE — COMPLETE CARE: $1,699.58 MERCY CARE — COMPLETE CARE PEDS: $1,699.58 NAPHCARE — Managed Medicaid: $1,548.84 NAPHCARE — Managed Medicaid Peds: $1,548.84 UAHP — FAMILY CARE: $1,548.84 UAHP — FAMILY CARE PEDS: $1,548.84 UAHP — UNIVERSITY CARE: $2,430.85

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$5,718	$3,716.70	$1,805.22 – $3,811.89
Vaginal delivery, with care before and after: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $2,457 AETNA — AETNA-MLPFN: $2,457 AETNA — AETNA-PF: $2,730 AETNA — AETNA-PN: $2,730 AETNA — Medicare Advantage-MLPF: $1,822.46 AETNA — Medicare Advantage-MLPFN: $1,822.46 AETNA — Medicare Advantage-PF: $2,144.07 AETNA — Medicare Advantage-PN: $2,144.07 CENPATICO — Facility All Other: $3,805.74 CENPATICO — Managed Medicaid-MLPF: $3,805.74
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$6,307	$4,099.55	$2,031.87 – $4,220.17
Cesarean delivery (C-section), with care before and after: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $2,457 AETNA — AETNA-MLPFN: $2,457 AETNA — AETNA-PF: $2,730 AETNA — AETNA-PN: $2,730 AETNA — Medicare Advantage-MLPF: $2,031.87 AETNA — Medicare Advantage-MLPFN: $2,031.87 AETNA — Medicare Advantage-PF: $2,390.43 AETNA — Medicare Advantage-PN: $2,390.43 CENPATICO — Facility All Other: $4,220.17 CENPATICO — Managed Medicaid-MLPF: $4,220.17
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$5,972	$3,881.80	$1,900.27 – $3,981.05
Vaginal delivery after a previous C-section, with care before and after: 10 of 52 insurance plan rates AETNA — AETNA-MLPF: $2,457 AETNA — AETNA-MLPFN: $2,457 AETNA — AETNA-PF: $2,730 AETNA — AETNA-PN: $2,730 AETNA — Medicare Advantage-MLPF: $1,913.85 AETNA — Medicare Advantage-MLPFN: $1,913.85 AETNA — Medicare Advantage-PF: $2,251.59 AETNA — Medicare Advantage-PN: $2,251.59 CENPATICO — Facility All Other: $3,978.51 CENPATICO — Managed Medicaid-MLPF: $3,978.51

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$88,645.37 – $140,166.47
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 6 insurance plans AETNA — Medicare Advantage: $88,645.37 BCBS — ALL PRODUCTS: $140,166.47 BCBS — EMPLOYEE PLAN: $140,166.47 HUMANA — Medicare Advantage: $88,645.37 UAHP — UNIVERSITY CARE: $88,645.37 UHC — ALL PRODUCTS: 93% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$17,549.15 – $36,233.98
Hip or knee replacement (major joint of the leg), without major complications: rates for 5 insurance plans AETNA — Medicare Advantage: $17,549.15 BCBS — ALL PRODUCTS: $36,233.98 BCBS — EMPLOYEE PLAN: $36,233.98 HUMANA — Medicare Advantage: $17,549.15 UAHP — UNIVERSITY CARE: $17,549.15
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major joint replacement or reattachment of lower extremity w/o MCC	Not listed in the file	Not listed in the file	Not listed in the file
Hip or knee replacement (major joint of the leg), without major complications: rates for 1 insurance plan UHC — ALL PRODUCTS: 93% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$22,187.57 – $29,738.98
Neck (cervical) spinal fusion, without complications: rates for 6 insurance plans AETNA — Medicare Advantage: $22,187.57 BCBS — ALL PRODUCTS: $29,738.98 BCBS — EMPLOYEE PLAN: $29,738.98 HUMANA — Medicare Advantage: $22,187.57 UAHP — UNIVERSITY CARE: $22,187.57 UHC — ALL PRODUCTS: 93% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$11,319.32 – $14,931.56
Uterus and ovary surgery (not for cancer), without complications: rates for 6 insurance plans AETNA — Medicare Advantage: $11,319.32 BCBS — ALL PRODUCTS: $14,931.56 BCBS — EMPLOYEE PLAN: $14,931.56 HUMANA — Medicare Advantage: $11,319.32 UAHP — UNIVERSITY CARE: $11,319.32 UHC — ALL PRODUCTS: 93% (a percentage in the contract, not a dollar amount)

Source: The Outer Banks Hospital, Inc’s standard charges file (yumaregional.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 30, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	4800 South Croatan Highway, Nags Head, NC 27959
County	Dare County
State	North Carolina
Phone	(252) 449‑4500
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	341324
Name in Medicare records	THE OUTER BANKS HOSPITAL, INC
Profile level	Medicare data + hospital website
Name on the hospital’s website	Outer Banks Health
Official website	outerbankshealth.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Outer Banks Health — outerbankshealth.org
Our Health Services - Outer Banks Health — outerbankshealth.org
Cancer Care Services - Outer Banks Health — outerbankshealth.org
Nurse Navigator Program - Outer Banks Health — outerbankshealth.org
Breast Cancer Health Program - Outer Banks Health — outerbankshealth.org
Lung CT Screening Services - Outer Banks Health — outerbankshealth.org
Cancer Symptom Management Clinic - Outer Banks Health — outerbankshealth.org
Patient and Visitor Information - Outer Banks Health — outerbankshealth.org
Maternity Services - Outer Banks Health — outerbankshealth.org
Gynecologic Surgery - Outer Banks Health — outerbankshealth.org
Breast Cancer Screenings - Outer Banks Health — outerbankshealth.org
Colon Cancer Screenings - Outer Banks Health — outerbankshealth.org
Free Cancer Screenings - Outer Banks Health — outerbankshealth.org
Chemotherapy Treatment - Outer Banks Health — outerbankshealth.org
Radiation Therapy Treatment - Outer Banks Health — outerbankshealth.org

The Outer Banks Hospital, Inc

Summary

Profile from official sources

At a glance