Does Tristar Northcrest Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Tristar Northcrest Medical Center. In a medical emergency, call 911.

Where is Tristar Northcrest Medical Center?

100 Northcrest Drive, Springfield, TN 37172, in Robertson County, Tennessee.

What is the phone number of Tristar Northcrest Medical Center?

(615) 384-2411, as listed by Medicare (CMS).

What is the Medicare star rating of Tristar Northcrest Medical Center?

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

Tristar Northcrest Medical Center

Quick answers

Does Tristar Northcrest Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Tristar Northcrest Medical Center. In a medical emergency, call 911.
Where is Tristar Northcrest Medical Center?: 100 Northcrest Drive, Springfield, TN 37172, in Robertson County, Tennessee.
What is the phone number of Tristar Northcrest Medical Center?: (615) 384-2411, as listed by Medicare (CMS).
What is the Medicare star rating of Tristar Northcrest Medical Center?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[4][5][6][8][13][15][16][17][18][19]}

Conditions treated^{[6][7][8][10][11][13][14][15][18][19]}

Chest pain
Heart attack
Heart failure
Angina
Stroke
Anemia
Dehydration
Multiple sclerosis
Crohn's disease
Rheumatoid arthritis
Osteoporosis
Guillain-Barré syndrome
Hemophilia
Kawasaki syndrome
Scleroderma
Dermatomyositis
Bullous pemphigoid
Immune deficiencies
Bone fractures
Traumatic fractures
Joint pain
Strains and sprains
Rib and pelvic bone injuries
Work-related injuries
Lymphedema
Cognitive impairments
Language impairments
Speech impairments
Swallowing impairments
Voice impairments
Urinary incontinence
Pelvic prolapse
Breast cancer
Lung cancer

Treatments^{[4][7][10][12][13][15][19]}

Infusion therapy
Hyperbaric oxygen therapy
Pulmonary rehabilitation
Speech therapy
Complete decongestive therapy
Manual lymphatic drainage
Compression garment recommendation
Cardiac rehabilitation
Anesthesia blocks
Biopsies

Procedures^{[5][6][10][11][12][14][15]}

Cardiac catheterization
Angioplasty
Stents
Angiography
Cardiac stress test
Nuclear stress test
Echocardiogram
Transesophageal echocardiography
Holter monitoring
Electrocardiogram
Ambulatory cardiac monitoring
Cardiac calcium scoring
Computed tomography (CT)
Magnetic resonance imaging (MRI)
Mammography
DEXA scan
PET scan
Nuclear medicine
Ultrasound
Digital stereotactic breast biopsy
Total joint replacement
Joint arthroscopy
Hand surgery
Sports medicine
Trauma-related fracture care
Cardiovascular surgery
Ear, nose and throat (ENT) surgery
Eye surgery
Gastrointestinal surgery
General surgery
Gynecologic surgery
Neurological surgery
Obstetric surgery
Orthopedic surgery
Plastic surgery
Podiatry surgery
Transplant surgery
Trauma surgery
Urologic surgery
Weight loss surgery
Robotic and laparoscopic surgery
Clinical chemistry lab testing
Hematology lab testing
Microbiology lab testing
Urinalysis

Programs and centers^{[4][5][7][16]}

Cardiac catheterization lab
Lung Cancer Screening Program
Sleep Diagnostic Center
Cardiac rehabilitation program
Pulmonary rehabilitation
Couplet Care

Emergency care (hospital website)^[4][5][8]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Visiting	Recommended visiting hours 6:00am-8:30pm daily; quiet time 2:00-4:00pm^[9]
Parking	Visitor parking in front of the hospital, behind The Birth Center and beside the emergency room entrance^[9]

Recognition^{[4][5][6][14][16]}

Certified Chest Pain Center
Certified imaging laboratory accredited by the College of American Pathologists (CAP) and CLIA
National Safe Sleep Hospital Certification

Doctors and clinicians (225)

225 doctors and other clinicians list Tristar Northcrest Medical Center 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 201 more: the button below opens the full list.

Other emergency rooms nearby

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

Tristar Hendersonville Medical Center20 mi · Hendersonville, TN · Acute Care Hospital
The Medical Center at Russellville22 mi · Russellville, KY · Acute Care Hospital
Tristar Skyline Medical Center22 mi · Nashville, TN · Acute Care Hospital
Tristar Ashland City Medical Center22 mi · Ashland City, TN · Rural Emergency Hospital
Vanderbilt Clarksville Hospital23 mi · Clarksville, TN · Acute Care Hospital

Other hospitals nearby

Unity Psychiatric Care-Clarksville24 mi · Clarksville, TN · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

The Waters of Springfield LLC3.1 mi · Springfield, TN · 1 of 5 stars
NHC Healthcare, Springfield3.3 mi · Springfield, TN · 3 of 5 stars
White House Health Care Inc10 mi · White House, TN · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Aveanna Hospice0.0 mi · Springfield, TN
Caris Healthcare0.0 mi · Springfield, TN · 3 of 5 stars
Gentiva II0.0 mi · Springfield, TN

All hospice providers in the state →

Home health agencies

Lifeline Home Health Care0.0 mi · Springfield, TN
NHC Homecare Springfield0.0 mi · Springfield, TN · 4 of 5 stars
Beacon Home Health15 mi · Goodlettsville, TN · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

RCG Springfield0.0 mi · Springfield, TN · 3 of 5 stars
FKC Goodlettsville15 mi · Goodlettsville, TN · 1 of 5 stars
FMC Hendersonville20 mi · Hendersonville, TN · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

LVC Outpatient Surgery Center15 mi · Goodlettsville, TN
Music City Surgery Center, LLC15 mi · Goodlettsville, TN
Indian Lake Surgery Center20 mi · Hendersonville, TN

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Logan County Community Health Center19 mi · Russellville, KY · Community health center
CHCWK - Todd County Site20 mi · Guthrie, KY · Community health center
Madison Family Clinic22 mi · Madison, TN · Community health center

Clinics and urgent care

Ascension Saint Thomas Urgent Care0.0 mi · Springfield, TN · Rural health clinic
Fast Pace Health0.0 mi · Springfield, TN · Rural health clinic
Fast Pace Medical Clinic PLLC0.0 mi · Springfield, TN · Urgent care center

Pharmacies

Tennessee CVS Pharmacy, L.L.C.0.0 mi · Springfield, TN · Pharmacy
Wal-Mart Stores East LP0.0 mi · Springfield, TN · Community/retail pharmacy
Walgreen Co0.0 mi · Springfield, TN · Pharmacy

Assisted living nearby

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

Morningside of Springfield0.0 mi · Springfield, TN
Springfield Heights Assisted Living0.0 mi · Springfield, TN
Springfield Heights Memory Care0.0 mi · Springfield, TN
Charter Senior Living of White House10 mi · White House, TN

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 Tristar Northcrest Medical Center 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	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	4 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	71%National average: 72%
Would definitely recommend the hospital	69%National average: 71%
Nurses “always” communicated well	80%National average: 80%
Doctors “always” communicated well	80%National average: 80%
Staff “always” explained medicines before giving them	62%National average: 62%
Were given information about recovery at home	85%National average: 86%
Room and bathroom “always” clean	80%National average: 74%
Area around the room “always” quiet at night	60%National average: 60%
Completed surveys	595Response rate: 21%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	11.9%
Deaths within 30 days: heart failure patients	10.5%
Deaths within 30 days: pneumonia patients	11.2%
Deaths within 30 days: COPD patients	9.2%
Deaths within 30 days: stroke patients	16.1%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.95No different from the national rate
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	14%
Readmitted within 30 days: heart failure	22.4%
Readmitted within 30 days: pneumonia	17.1%
Readmitted within 30 days: COPD	18.5%
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)	142 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	74%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Tennessee Best hospitals in Tennessee

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 77 common services exactly as Tristar Northcrest Medical Center 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 →

$ 3 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) In the file: OP VISIT LEVEL 3 NP	$742.21	$742.21	$51.95 – $608.61
New patient office visit (about 30–44 minutes): 10 of 14 insurance plan rates Aetna — COMM: $207.82 Aetna — MGMCRHMO: $111.33 Aetna — MGMCRPPO: $111.33 Aetna — MGMCRSNP: $111.33 Aetna — NAP: $371.11 Aetna — NewBusiness: $178.13 City of Springfield — COMM: $482.44 Molina — MCD: $51.95 Multiplan — ComplementaryNetwork: $578.92 Multiplan — PrimaryNetwork: $608.61
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e	$742.21	$742.21	Not listed in the file
New patient office visit (about 30–44 minutes): rates for 1 insurance plan BCBS — NetworkP: 23% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 NP	$931.61	$931.61	$65.21 – $763.92
New patient office visit (about 45–59 minutes): 10 of 14 insurance plan rates Aetna — COMM: $260.85 Aetna — MGMCRHMO: $139.74 Aetna — MGMCRPPO: $139.74 Aetna — MGMCRSNP: $139.74 Aetna — NAP: $465.81 Aetna — NewBusiness: $223.59 City of Springfield — COMM: $605.55 Molina — MCD: $65.21 Multiplan — ComplementaryNetwork: $726.66 Multiplan — PrimaryNetwork: $763.92
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e	$931.61	$931.61	Not listed in the file
New patient office visit (about 45–59 minutes): rates for 1 insurance plan BCBS — NetworkP: 23% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e	Not listed in the file	Not listed in the file	Not listed in the file
New patient office visit (about 60–74 minutes): rates for 1 insurance plan BCBS — NetworkP: 23% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 EST	$571.29	$571.29	$39.99 – $468.46
Established patient office visit (about 20–29 minutes): 10 of 14 insurance plan rates Aetna — COMM: $159.96 Aetna — MGMCRHMO: $85.69 Aetna — MGMCRPPO: $85.69 Aetna — MGMCRSNP: $85.69 Aetna — NAP: $285.64 Aetna — NewBusiness: $137.11 City of Springfield — COMM: $371.34 Molina — MCD: $39.99 Multiplan — ComplementaryNetwork: $445.61 Multiplan — PrimaryNetwork: $468.46
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history	$571.29	$571.29	Not listed in the file
Established patient office visit (about 20–29 minutes): rates for 1 insurance plan BCBS — NetworkP: 23% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 EST	$742.21	$742.21	$51.95 – $608.61
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates Aetna — COMM: $207.82 Aetna — MGMCRHMO: $111.33 Aetna — MGMCRPPO: $111.33 Aetna — MGMCRSNP: $111.33 Aetna — NAP: $371.11 Aetna — NewBusiness: $178.13 City of Springfield — COMM: $482.44 Molina — MCD: $51.95 Multiplan — ComplementaryNetwork: $578.92 Multiplan — PrimaryNetwork: $608.61
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history	$742.21	$742.21	Not listed in the file
Established patient office visit (about 30–39 minutes): rates for 1 insurance plan BCBS — NetworkP: 23% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	$2,072.92	$2,072.92	$225 – $3,212
Emergency room visit (moderate): 10 of 15 insurance plan rates Aetna — COMM: $2,655 Aetna — NewBusiness: $2,302 Ambetter — CORE: $805 BCBS — NetworkP: $1,059 Bright Health — HIX: $1,146 Bright Health — SmallGroup: $1,562 Cigna — NewBusiness: $2,430 Cigna — OAP: $2,735 Evergreen HMO — MCR: $775 Oscar — HIX: $1,937
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LVL 3 EMER DEPT	$2,072.92	$2,072.92	$145.10 – $1,699.79
Emergency room visit (moderate): rates for 8 insurance plans Aetna — NAP: $1,036.46 Cigna — PPO: $607.37 City of Springfield — COMM: $1,347.40 Molina — MCD: $145.10 Multiplan — ComplementaryNetwork: $1,616.88 Multiplan — PrimaryNetwork: $1,699.79 United — GlobalBenefitPlan: $932.81 United — OptionsPPO: $445.68
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	$3,170.23	$3,170.23	$401 – $3,212
Emergency room visit (moderately high): 10 of 15 insurance plan rates Aetna — COMM: $3,350 Aetna — NewBusiness: $2,736 Ambetter — CORE: $1,035 BCBS — NetworkP: $2,100 Bright Health — HIX: $1,189 Bright Health — SmallGroup: $1,621 Cigna — NewBusiness: $2,641 Cigna — OAP: $2,972 Evergreen HMO — MCR: $775 Oscar — HIX: $1,963
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: LVL 4 EMER DEPT	$3,170.23	$3,170.23	$221.92 – $2,599.59
Emergency room visit (moderately high): rates for 8 insurance plans Aetna — NAP: $1,585.12 Cigna — PPO: $928.88 City of Springfield — COMM: $2,060.65 Molina — MCD: $221.92 Multiplan — ComplementaryNetwork: $2,472.78 Multiplan — PrimaryNetwork: $2,599.59 United — GlobalBenefitPlan: $1,426.60 United — OptionsPPO: $681.60
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	$5,070.25	$5,070.25	$715 – $5,749
Emergency room visit (high): 10 of 15 insurance plan rates Aetna — COMM: $3,350 Aetna — NewBusiness: $2,736 Ambetter — CORE: $1,800 BCBS — NetworkP: $2,100 Bright Health — HIX: $1,698 Bright Health — SmallGroup: $2,315 Cigna — NewBusiness: $3,946 Cigna — OAP: $4,440 Evergreen HMO — MCR: $950 Oscar — HIX: $2,769
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: LVL 5 EMER DEPT	$5,070.25	$5,070.25	$354.92 – $4,157.60
Emergency room visit (high): rates for 8 insurance plans Aetna — NAP: $2,535.13 Cigna — PPO: $1,485.58 City of Springfield — COMM: $3,295.66 Molina — MCD: $354.92 Multiplan — ComplementaryNetwork: $3,954.80 Multiplan — PrimaryNetwork: $4,157.60 United — GlobalBenefitPlan: $2,281.61 United — OptionsPPO: $1,090.10

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch	$150.71	$150.71	$8.46
Basic metabolic panel (blood test): 10 of 43 insurance plan rates Aetna — COMM: $6.73 Aetna — MGMCRHMO: $8.54 Aetna — MGMCRPPO: $8.54 Aetna — MGMCRSNP: $8.54 Aetna — NewBusiness: $6.73 Alive Hospice — MCR: $8.46 Ambetter — CORE: $9.47 Ambetter — Select: $8.80 American Health Advantage — MCRHMO: $8.88 American Health Advantage — MCRPFFS: $8.88
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP TOTAL CALCIUM	$150.71	$150.71	$28.63 – $123.58
Basic metabolic panel (blood test): rates for 8 insurance plans Aetna — NAP: $75.36 Cigna — PPO: $44.16 City of Springfield — COMM: $97.96 Multiplan — ComplementaryNetwork: $117.55 Multiplan — PrimaryNetwork: $123.58 NHC Advantage, Inc. — MCRHMO: $28.63 United — GlobalBenefitPlan: $67.82 United — OptionsPPO: $32.40
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · modifier QW In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch	$150.71	$150.71	$8.80 – $9.47
Basic metabolic panel (blood test): rates for 2 insurance plans Ambetter — CORE: $9.47 Ambetter — Select: $8.80
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon	$187	$187	$10.56
Comprehensive metabolic panel (blood test): 10 of 43 insurance plan rates Aetna — COMM: $8.40 Aetna — MGMCRHMO: $10.67 Aetna — MGMCRPPO: $10.67 Aetna — MGMCRSNP: $10.67 Aetna — NewBusiness: $8.40 Alive Hospice — MCR: $10.56 Ambetter — CORE: $11.83 Ambetter — Select: $10.99 American Health Advantage — MCRHMO: $11.09 American Health Advantage — MCRPFFS: $11.09
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL	$187	$187	$35.53 – $153.34
Comprehensive metabolic panel (blood test): rates for 8 insurance plans Aetna — NAP: $93.50 Cigna — PPO: $54.79 City of Springfield — COMM: $121.55 Multiplan — ComplementaryNetwork: $145.86 Multiplan — PrimaryNetwork: $153.34 NHC Advantage, Inc. — MCRHMO: $35.53 United — GlobalBenefitPlan: $84.15 United — OptionsPPO: $40.20
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · modifier QW In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon	$187	$187	$10.99 – $11.83
Comprehensive metabolic panel (blood test): rates for 2 insurance plans Ambetter — CORE: $11.83 Ambetter — Select: $10.99
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or	Not listed in the file	Not listed in the file	$21.51 – $143.43
Obstetric blood test panel: 10 of 43 insurance plan rates Aetna — COMM: $38.01 Aetna — MGMCRHMO: $48.29 Aetna — MGMCRPPO: $48.29 Aetna — MGMCRSNP: $48.29 Aetna — NewBusiness: $38.01 Alive Hospice — MCR: $47.81 Ambetter — CORE: $53.55 Ambetter — Select: $49.73 American Health Advantage — MCRHMO: $50.20 American Health Advantage — MCRPFFS: $50.20
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester	$317.29	$317.29	$13.39
Cholesterol panel (lipid panel): 10 of 43 insurance plan rates Aetna — COMM: $10.64 Aetna — MGMCRHMO: $13.52 Aetna — MGMCRPPO: $13.52 Aetna — MGMCRSNP: $13.52 Aetna — NewBusiness: $10.64 Alive Hospice — MCR: $13.39 Ambetter — CORE: $15 Ambetter — Select: $13.93 American Health Advantage — MCRHMO: $14.06 American Health Advantage — MCRPFFS: $14.06
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL	$317.29	$317.29	$60.29 – $260.18
Cholesterol panel (lipid panel): rates for 8 insurance plans Aetna — NAP: $158.65 Cigna — PPO: $92.97 City of Springfield — COMM: $206.24 Multiplan — ComplementaryNetwork: $247.49 Multiplan — PrimaryNetwork: $260.18 NHC Advantage, Inc. — MCRHMO: $60.29 United — GlobalBenefitPlan: $142.78 United — OptionsPPO: $68.22
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · modifier QW In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester	$317.29	$317.29	$13.93 – $15
Cholesterol panel (lipid panel): rates for 2 insurance plans Ambetter — CORE: $15 Ambetter — Select: $13.93
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo	$154.68	$154.68	$8.68
Kidney function panel: 10 of 43 insurance plan rates Aetna — COMM: $6.90 Aetna — MGMCRHMO: $8.77 Aetna — MGMCRPPO: $8.77 Aetna — MGMCRSNP: $8.77 Aetna — NewBusiness: $6.90 Alive Hospice — MCR: $8.68 Ambetter — CORE: $9.72 Ambetter — Select: $9.03 American Health Advantage — MCRHMO: $9.11 American Health Advantage — MCRPFFS: $9.11
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$154.68	$154.68	$29.39 – $126.84
Kidney function panel: rates for 8 insurance plans Aetna — NAP: $77.34 Cigna — PPO: $45.32 City of Springfield — COMM: $100.54 Multiplan — ComplementaryNetwork: $120.65 Multiplan — PrimaryNetwork: $126.84 NHC Advantage, Inc. — MCRHMO: $29.39 United — GlobalBenefitPlan: $69.61 United — OptionsPPO: $33.26
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · modifier QW In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo	$154.68	$154.68	$9.03 – $9.72
Kidney function panel: rates for 2 insurance plans Ambetter — CORE: $9.72 Ambetter — Select: $9.03
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase	$146.74	$146.74	$8.17
Liver function panel: 10 of 43 insurance plan rates Aetna — COMM: $6.50 Aetna — MGMCRHMO: $8.25 Aetna — MGMCRPPO: $8.25 Aetna — MGMCRSNP: $8.25 Aetna — NewBusiness: $6.50 Alive Hospice — MCR: $8.17 Ambetter — CORE: $9.15 Ambetter — Select: $8.50 American Health Advantage — MCRHMO: $8.58 American Health Advantage — MCRPFFS: $8.58
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL	$146.74	$146.74	$27.88 – $120.33
Liver function panel: rates for 8 insurance plans Aetna — NAP: $73.37 Cigna — PPO: $42.99 City of Springfield — COMM: $95.38 Multiplan — ComplementaryNetwork: $114.46 Multiplan — PrimaryNetwork: $120.33 NHC Advantage, Inc. — MCRHMO: $27.88 United — GlobalBenefitPlan: $66.03 United — OptionsPPO: $31.55
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$132.87	$132.87	$3.17
Urine test (automated, with microscope): 10 of 43 insurance plan rates Aetna — COMM: $2.52 Aetna — MGMCRHMO: $3.20 Aetna — MGMCRPPO: $3.20 Aetna — MGMCRSNP: $3.20 Aetna — NewBusiness: $2.52 Alive Hospice — MCR: $3.17 Ambetter — CORE: $3.55 Ambetter — Select: $3.30 American Health Advantage — MCRHMO: $3.33 American Health Advantage — MCRPFFS: $3.33
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO	$132.87	$132.87	$25.25 – $108.95
Urine test (automated, with microscope): rates for 8 insurance plans Aetna — NAP: $66.44 Cigna — PPO: $38.93 City of Springfield — COMM: $86.37 Multiplan — ComplementaryNetwork: $103.64 Multiplan — PrimaryNetwork: $108.95 NHC Advantage, Inc. — MCRHMO: $25.25 United — GlobalBenefitPlan: $59.79 United — OptionsPPO: $28.57
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	Not listed in the file	Not listed in the file	$3.48
Urine test (manual, without microscope): 10 of 43 insurance plan rates Aetna — COMM: $2.77 Aetna — MGMCRHMO: $3.51 Aetna — MGMCRPPO: $3.51 Aetna — MGMCRSNP: $3.51 Aetna — NewBusiness: $2.77 Alive Hospice — MCR: $3.48 Ambetter — CORE: $3.90 Ambetter — Select: $3.62 American Health Advantage — MCRHMO: $3.65 American Health Advantage — MCRPFFS: $3.65
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$113.03	$113.03	$2.25
Urine test (automated, without microscope): 10 of 43 insurance plan rates Aetna — COMM: $1.79 Aetna — MGMCRHMO: $2.27 Aetna — MGMCRPPO: $2.27 Aetna — MGMCRSNP: $2.27 Aetna — NewBusiness: $1.79 Alive Hospice — MCR: $2.25 Ambetter — CORE: $2.52 Ambetter — Select: $2.34 American Health Advantage — MCRHMO: $2.36 American Health Advantage — MCRPFFS: $2.36
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W O MICRO AUTO	$113.03	$113.03	$21.48 – $92.68
Urine test (automated, without microscope): rates for 8 insurance plans Aetna — NAP: $56.52 Cigna — PPO: $33.12 City of Springfield — COMM: $73.47 Multiplan — ComplementaryNetwork: $88.16 Multiplan — PrimaryNetwork: $92.68 NHC Advantage, Inc. — MCRHMO: $21.48 United — GlobalBenefitPlan: $50.86 United — OptionsPPO: $24.30
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · modifier QW In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$113.03	$113.03	$2.34 – $2.52
Urine test (automated, without microscope): rates for 2 insurance plans Ambetter — CORE: $2.52 Ambetter — Select: $2.34
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total	$390	$390	$18.39
PSA (prostate specific antigen) blood test: 10 of 43 insurance plan rates Aetna — COMM: $14.62 Aetna — MGMCRHMO: $18.57 Aetna — MGMCRPPO: $18.57 Aetna — MGMCRSNP: $18.57 Aetna — NewBusiness: $14.62 Alive Hospice — MCR: $18.39 Ambetter — CORE: $20.60 Ambetter — Select: $19.13 American Health Advantage — MCRHMO: $19.31 American Health Advantage — MCRPFFS: $19.31
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROS SPEC AG (PSA) TOTAL	$390	$390	$74.10 – $319.80
PSA (prostate specific antigen) blood test: rates for 8 insurance plans Aetna — NAP: $195 Cigna — PPO: $114.27 City of Springfield — COMM: $253.50 Multiplan — ComplementaryNetwork: $304.20 Multiplan — PrimaryNetwork: $319.80 NHC Advantage, Inc. — MCRHMO: $74.10 United — GlobalBenefitPlan: $175.50 United — OptionsPPO: $83.85
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH)	$349	$349	$16.80
Thyroid stimulating hormone (TSH) test: 10 of 43 insurance plan rates Aetna — COMM: $13.36 Aetna — MGMCRHMO: $16.97 Aetna — MGMCRPPO: $16.97 Aetna — MGMCRSNP: $16.97 Aetna — NewBusiness: $13.36 Alive Hospice — MCR: $16.80 Ambetter — CORE: $18.82 Ambetter — Select: $17.47 American Health Advantage — MCRHMO: $17.64 American Health Advantage — MCRPFFS: $17.64
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH	$349	$349	$66.31 – $286.18
Thyroid stimulating hormone (TSH) test: rates for 8 insurance plans Aetna — NAP: $174.50 Cigna — PPO: $102.26 City of Springfield — COMM: $226.85 Multiplan — ComplementaryNetwork: $272.22 Multiplan — PrimaryNetwork: $286.18 NHC Advantage, Inc. — MCRHMO: $66.31 United — GlobalBenefitPlan: $157.05 United — OptionsPPO: $75.03
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · modifier QW In the file: Thyroid stimulating hormone (TSH)	$349	$349	$17.47 – $18.82
Thyroid stimulating hormone (TSH) test: rates for 2 insurance plans Ambetter — CORE: $18.82 Ambetter — Select: $17.47
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count	Not listed in the file	Not listed in the file	$7.77
Complete blood count (CBC) with differential: 10 of 43 insurance plan rates Aetna — COMM: $6.18 Aetna — MGMCRHMO: $7.85 Aetna — MGMCRPPO: $7.85 Aetna — MGMCRSNP: $7.85 Aetna — NewBusiness: $6.18 Alive Hospice — MCR: $7.77 Ambetter — CORE: $8.70 Ambetter — Select: $8.08 American Health Advantage — MCRHMO: $8.16 American Health Advantage — MCRPFFS: $8.16
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · modifier QW In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count	Not listed in the file	Not listed in the file	$8.08 – $8.70
Complete blood count (CBC) with differential: rates for 2 insurance plans Ambetter — CORE: $8.70 Ambetter — Select: $8.08
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)	$122.96	$122.96	$6.47
Complete blood count (CBC), automated: 10 of 43 insurance plan rates Aetna — COMM: $5.14 Aetna — MGMCRHMO: $6.53 Aetna — MGMCRPPO: $6.53 Aetna — MGMCRSNP: $6.53 Aetna — NewBusiness: $5.14 Alive Hospice — MCR: $6.47 Ambetter — CORE: $7.25 Ambetter — Select: $6.73 American Health Advantage — MCRHMO: $6.79 American Health Advantage — MCRPFFS: $6.79
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC AUTOMATED	$122.96	$122.96	$23.36 – $100.83
Complete blood count (CBC), automated: rates for 8 insurance plans Aetna — NAP: $61.48 Cigna — PPO: $36.03 City of Springfield — COMM: $79.92 Multiplan — ComplementaryNetwork: $95.91 Multiplan — PrimaryNetwork: $100.83 NHC Advantage, Inc. — MCRHMO: $23.36 United — GlobalBenefitPlan: $55.33 United — OptionsPPO: $26.44
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time;	$130.89	$130.89	$4.29
Blood clotting time test (prothrombin time, PT): 10 of 43 insurance plan rates Aetna — COMM: $3.41 Aetna — MGMCRHMO: $4.33 Aetna — MGMCRPPO: $4.33 Aetna — MGMCRSNP: $4.33 Aetna — NewBusiness: $3.41 Alive Hospice — MCR: $4.29 Ambetter — CORE: $4.81 Ambetter — Select: $4.46 American Health Advantage — MCRHMO: $4.50 American Health Advantage — MCRPFFS: $4.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME	$130.89	$130.89	$24.87 – $107.33
Blood clotting time test (prothrombin time, PT): rates for 8 insurance plans Aetna — NAP: $65.44 Cigna — PPO: $38.35 City of Springfield — COMM: $85.08 Multiplan — ComplementaryNetwork: $102.09 Multiplan — PrimaryNetwork: $107.33 NHC Advantage, Inc. — MCRHMO: $24.87 United — GlobalBenefitPlan: $58.90 United — OptionsPPO: $28.14
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · modifier QW In the file: Prothrombin time;	$130.89	$130.89	$4.46 – $4.81
Blood clotting time test (prothrombin time, PT): rates for 2 insurance plans Ambetter — CORE: $4.81 Ambetter — Select: $4.46
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood	$150.71	$150.71	$6.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 43 insurance plan rates Aetna — COMM: $4.78 Aetna — MGMCRHMO: $6.07 Aetna — MGMCRPPO: $6.07 Aetna — MGMCRSNP: $6.07 Aetna — NewBusiness: $4.78 Alive Hospice — MCR: $6.01 Ambetter — CORE: $6.73 Ambetter — Select: $6.25 American Health Advantage — MCRHMO: $6.31 American Health Advantage — MCRPFFS: $6.31
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT	$150.71	$150.71	$28.63 – $123.58
Blood clotting test (partial thromboplastin time, PTT): rates for 8 insurance plans Aetna — NAP: $75.36 Cigna — PPO: $44.16 City of Springfield — COMM: $97.96 Multiplan — ComplementaryNetwork: $117.55 Multiplan — PrimaryNetwork: $123.58 NHC Advantage, Inc. — MCRHMO: $28.63 United — GlobalBenefitPlan: $67.82 United — OptionsPPO: $32.40

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) In the file: CT HEAD/BRAIN W/O CONT	$3,901.37	$3,901.37	$273.10 – $3,199.12
CT scan of the head or brain, without contrast: rates for 9 insurance plans Aetna — NAP: $1,950.68 Cigna — PPO: $1,143.10 City of Springfield — COMM: $2,535.89 Molina — MCD: $273.10 Multiplan — ComplementaryNetwork: $3,043.07 Multiplan — PrimaryNetwork: $3,199.12 NHC Advantage, Inc. — MCRHMO: $741.26 United — GlobalBenefitPlan: $1,755.62 United — OptionsPPO: $838.79
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: Computed tomography, head or brain; without contrast material	$3,901.37	$3,901.37	$154.52
CT scan of the head or brain, without contrast: rates for 5 insurance plans Aetna — COMM: $459.25 Aetna — NewBusiness: $459.25 United — AllPayerAppendix: $154.52 United — Core: $154.52 United — HeritageSelect: $154.52
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · modifier TC In the file: Computed tomography, head or brain; without contrast material	$3,901.37	$3,901.37	$459.25
CT scan of the head or brain, without contrast: rates for 2 insurance plans Aetna — COMM: $459.25 Aetna — NewBusiness: $459.25
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W&WO CONT	$6,273.48	$6,273.48	$439.14 – $5,144.25
MRI of the brain, before and after contrast: rates for 9 insurance plans Aetna — NAP: $3,136.74 Cigna — PPO: $1,838.13 City of Springfield — COMM: $4,077.76 Molina — MCD: $439.14 Multiplan — ComplementaryNetwork: $4,893.31 Multiplan — PrimaryNetwork: $5,144.25 NHC Advantage, Inc. — MCRHMO: $1,191.96 United — GlobalBenefitPlan: $2,823.07 United — OptionsPPO: $1,348.80
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth	$6,273.48	$6,273.48	$616.10
MRI of the brain, before and after contrast: rates for 5 insurance plans Aetna — COMM: $887.81 Aetna — NewBusiness: $887.81 United — AllPayerAppendix: $616.10 United — Core: $616.10 United — HeritageSelect: $616.10
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · modifier 26 In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth	$6,273.48	$6,273.48	$887.81
MRI of the brain, before and after contrast: rates for 2 insurance plans Aetna — COMM: $887.81 Aetna — NewBusiness: $887.81
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST XRAY 2 V	$588.36	$588.36	$41.19 – $482.46
Chest X-ray, 2 views: rates for 9 insurance plans Aetna — NAP: $294.18 Cigna — PPO: $172.39 City of Springfield — COMM: $382.43 Molina — MCD: $41.19 Multiplan — ComplementaryNetwork: $458.92 Multiplan — PrimaryNetwork: $482.46 NHC Advantage, Inc. — MCRHMO: $111.79 United — GlobalBenefitPlan: $264.76 United — OptionsPPO: $126.50
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiologic examination, chest; 2 views	$588.36	$588.36	$83.86
Chest X-ray, 2 views: rates for 8 insurance plans Aetna — COMM: $45.12 Aetna — NewBusiness: $45.12 BCBS — NetworkP: $17.35 Cigna — NewBusiness: $76.44 Cigna — OAP: $85.92 United — AllPayerAppendix: $83.86 United — Core: $83.86 United — HeritageSelect: $83.86
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination, chest; 2 views	$588.36	$588.36	$45.12
Chest X-ray, 2 views: rates for 2 insurance plans Aetna — COMM: $45.12 Aetna — NewBusiness: $45.12
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR L-SPINE 4 + VIEWS	$1,200.21	$1,200.21	$84.01 – $984.17
X-ray of the lower spine, at least 4 views: rates for 9 insurance plans Aetna — NAP: $600.11 Cigna — PPO: $351.66 City of Springfield — COMM: $780.14 Molina — MCD: $84.01 Multiplan — ComplementaryNetwork: $936.16 Multiplan — PrimaryNetwork: $984.17 NHC Advantage, Inc. — MCRHMO: $228.04 United — GlobalBenefitPlan: $540.09 United — OptionsPPO: $258.05
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views	$1,200.21	$1,200.21	$154.52
X-ray of the lower spine, at least 4 views: rates for 8 insurance plans Aetna — COMM: $67.95 Aetna — NewBusiness: $67.95 BCBS — NetworkP: $29.82 Cigna — NewBusiness: $129.20 Cigna — OAP: $145.22 United — AllPayerAppendix: $154.52 United — Core: $154.52 United — HeritageSelect: $154.52
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views	$1,200.21	$1,200.21	$67.95
X-ray of the lower spine, at least 4 views: rates for 2 insurance plans Aetna — COMM: $67.95 Aetna — NewBusiness: $67.95
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI L-SPINE W/O CONT	$4,317.01	$4,317.01	$302.19 – $3,539.95
MRI of the lower back (lumbar spine), without contrast: rates for 9 insurance plans Aetna — NAP: $2,158.51 Cigna — PPO: $1,264.88 City of Springfield — COMM: $2,806.06 Molina — MCD: $302.19 Multiplan — ComplementaryNetwork: $3,367.27 Multiplan — PrimaryNetwork: $3,539.95 NHC Advantage, Inc. — MCRHMO: $820.23 United — GlobalBenefitPlan: $1,942.65 United — OptionsPPO: $928.16
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	$4,317.01	$4,317.01	$530.38
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans Aetna — COMM: $530.38 Aetna — NewBusiness: $530.38 United — AllPayerAppendix: $313.62 United — Core: $313.62 United — HeritageSelect: $313.62
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · modifier TC In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	$4,317.01	$4,317.01	$530.38
MRI of the lower back (lumbar spine), without contrast: rates for 2 insurance plans Aetna — COMM: $530.38 Aetna — NewBusiness: $530.38
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST	$5,594	$5,594	$391.58 – $4,587.08
CT scan of the pelvis, with contrast: rates for 9 insurance plans Aetna — NAP: $2,797 Cigna — PPO: $1,639.04 City of Springfield — COMM: $3,636.10 Molina — MCD: $391.58 Multiplan — ComplementaryNetwork: $4,363.32 Multiplan — PrimaryNetwork: $4,587.08 NHC Advantage, Inc. — MCRHMO: $1,062.86 United — GlobalBenefitPlan: $2,517.30 United — OptionsPPO: $1,202.71
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Computed tomography, pelvis; with contrast material(s)	$5,594	$5,594	$459.25
CT scan of the pelvis, with contrast: rates for 5 insurance plans Aetna — COMM: $459.25 Aetna — NewBusiness: $459.25 United — AllPayerAppendix: $341.20 United — Core: $341.20 United — HeritageSelect: $341.20
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · modifier 26 In the file: Computed tomography, pelvis; with contrast material(s)	$5,594	$5,594	$459.25
CT scan of the pelvis, with contrast: rates for 2 insurance plans Aetna — COMM: $459.25 Aetna — NewBusiness: $459.25
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material	Not listed in the file	Not listed in the file	$313.62
MRI of a leg joint (such as the knee), without contrast: rates for 5 insurance plans Aetna — COMM: $557.98 Aetna — NewBusiness: $557.98 United — AllPayerAppendix: $313.62 United — Core: $313.62 United — HeritageSelect: $313.62
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier RT In the file: MRI LW JNT W/O CONT RT	$4,317.01	$4,317.01	$302.19 – $3,539.95
MRI of a leg joint (such as the knee), without contrast: rates for 9 insurance plans Aetna — NAP: $2,158.51 Cigna — PPO: $1,264.88 City of Springfield — COMM: $2,806.06 Molina — MCD: $302.19 Multiplan — ComplementaryNetwork: $3,367.27 Multiplan — PrimaryNetwork: $3,539.95 NHC Advantage, Inc. — MCRHMO: $820.23 United — GlobalBenefitPlan: $1,942.65 United — OptionsPPO: $928.16
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier LT In the file: MRI LW JNT W/O CONT LT	$4,317.01	$4,317.01	$302.19 – $3,539.95
MRI of a leg joint (such as the knee), without contrast: rates for 9 insurance plans Aetna — NAP: $2,158.51 Cigna — PPO: $1,264.88 City of Springfield — COMM: $2,806.06 Molina — MCD: $302.19 Multiplan — ComplementaryNetwork: $3,367.27 Multiplan — PrimaryNetwork: $3,539.95 NHC Advantage, Inc. — MCRHMO: $820.23 United — GlobalBenefitPlan: $1,942.65 United — OptionsPPO: $928.16
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD&PELVIS W/CONT	$11,194.96	$11,194.96	$783.65 – $9,179.87
CT scan of the abdomen and pelvis, with contrast: rates for 9 insurance plans Aetna — NAP: $5,597.48 Cigna — PPO: $3,280.12 City of Springfield — COMM: $7,276.72 Molina — MCD: $783.65 Multiplan — ComplementaryNetwork: $8,732.07 Multiplan — PrimaryNetwork: $9,179.87 NHC Advantage, Inc. — MCRHMO: $2,127.04 United — GlobalBenefitPlan: $5,037.73 United — OptionsPPO: $2,406.92
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: Computed tomography, abdomen and pelvis; with contrast material(s)	$11,194.96	$11,194.96	$341.20
CT scan of the abdomen and pelvis, with contrast: rates for 5 insurance plans Aetna — COMM: $459.25 Aetna — NewBusiness: $459.25 United — AllPayerAppendix: $341.20 United — Core: $341.20 United — HeritageSelect: $341.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · modifier 26 In the file: Computed tomography, abdomen and pelvis; with contrast material(s)	$11,194.96	$11,194.96	$459.25
CT scan of the abdomen and pelvis, with contrast: rates for 2 insurance plans Aetna — COMM: $459.25 Aetna — NewBusiness: $459.25
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE	$2,307.86	$2,307.86	$161.55 – $1,892.45
Ultrasound of the abdomen, complete: rates for 9 insurance plans Aetna — NAP: $1,153.93 Cigna — PPO: $676.20 City of Springfield — COMM: $1,500.11 Molina — MCD: $161.55 Multiplan — ComplementaryNetwork: $1,800.13 Multiplan — PrimaryNetwork: $1,892.45 NHC Advantage, Inc. — MCRHMO: $438.49 United — GlobalBenefitPlan: $1,038.54 United — OptionsPPO: $496.19
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Ultrasound, abdominal, real time with image documentation; complete	$2,307.86	$2,307.86	$154.52
Ultrasound of the abdomen, complete: rates for 8 insurance plans Aetna — COMM: $164.86 Aetna — NewBusiness: $164.86 BCBS — NetworkP: $89.41 Cigna — NewBusiness: $253.97 Cigna — OAP: $285.46 United — AllPayerAppendix: $154.52 United — Core: $154.52 United — HeritageSelect: $154.52
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, abdominal, real time with image documentation; complete	$2,307.86	$2,307.86	$164.86
Ultrasound of the abdomen, complete: rates for 2 insurance plans Aetna — COMM: $164.86 Aetna — NewBusiness: $164.86
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREG AFTER 1ST TRI	$1,284.44	$1,284.44	$89.91 – $1,053.24
Pregnancy ultrasound (after the first trimester): rates for 9 insurance plans Aetna — NAP: $642.22 Cigna — PPO: $376.34 City of Springfield — COMM: $834.89 Molina — MCD: $89.91 Multiplan — ComplementaryNetwork: $1,001.86 Multiplan — PrimaryNetwork: $1,053.24 NHC Advantage, Inc. — MCRHMO: $244.04 United — GlobalBenefitPlan: $578 United — OptionsPPO: $276.15
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day	$1,284.44	$1,284.44	$154.52
Pregnancy ultrasound (after the first trimester): rates for 8 insurance plans Aetna — COMM: $189.81 Aetna — NewBusiness: $189.81 BCBS — NetworkP: $85.94 Cigna — NewBusiness: $285.84 Cigna — OAP: $321.29 United — AllPayerAppendix: $154.52 United — Core: $154.52 United — HeritageSelect: $154.52
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier 26 In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day	$1,284.44	$1,284.44	$189.81
Pregnancy ultrasound (after the first trimester): rates for 2 insurance plans Aetna — COMM: $189.81 Aetna — NewBusiness: $189.81
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANSVAGINAL	$2,155.94	$2,155.94	$150.92 – $1,767.87
Transvaginal ultrasound: rates for 9 insurance plans Aetna — NAP: $1,077.97 Cigna — PPO: $631.69 City of Springfield — COMM: $1,401.36 Molina — MCD: $150.92 Multiplan — ComplementaryNetwork: $1,681.63 Multiplan — PrimaryNetwork: $1,767.87 NHC Advantage, Inc. — MCRHMO: $409.63 United — GlobalBenefitPlan: $970.17 United — OptionsPPO: $463.53
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound, transvaginal	$2,155.94	$2,155.94	$81.52 – $313.88
Transvaginal ultrasound: rates for 8 insurance plans Aetna — COMM: $167.37 Aetna — NewBusiness: $167.37 BCBS — NetworkP: $81.52 Cigna — NewBusiness: $279.25 Cigna — OAP: $313.88 United — AllPayerAppendix: $154.52 United — Core: $154.52 United — HeritageSelect: $154.52
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier 26 In the file: Ultrasound, transvaginal	$2,155.94	$2,155.94	$167.37
Transvaginal ultrasound: rates for 2 insurance plans Aetna — COMM: $167.37 Aetna — NewBusiness: $167.37
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral	Not listed in the file	Not listed in the file	$129.76
Diagnostic mammogram, one breast: 10 of 37 insurance plan rates Aetna — COMM: $173.45 Aetna — MGMCRHMO: $78.99 Aetna — MGMCRPPO: $78.99 Aetna — MGMCRSNP: $78.99 Aetna — NewBusiness: $173.45 Alive Hospice — MCR: $78.21 American Health Advantage — MCRHMO: $82.12 American Health Advantage — MCRPFFS: $82.12 American Health Advantage — MCRPOS: $82.12 American Health Advantage — MCRPPO: $82.12
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier LT In the file: MAMMO DIAG CAD UNI LT	$694.71	$694.71	$48.63 – $569.66
Diagnostic mammogram, one breast: rates for 9 insurance plans Aetna — NAP: $347.36 Cigna — PPO: $203.55 City of Springfield — COMM: $451.56 Molina — MCD: $48.63 Multiplan — ComplementaryNetwork: $541.87 Multiplan — PrimaryNetwork: $569.66 NHC Advantage, Inc. — MCRHMO: $131.99 United — GlobalBenefitPlan: $312.62 United — OptionsPPO: $149.36
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier RT In the file: MAMMO DIAG CAD UNI RT	$694.71	$694.71	$48.63 – $569.66
Diagnostic mammogram, one breast: rates for 9 insurance plans Aetna — NAP: $347.36 Cigna — PPO: $203.55 City of Springfield — COMM: $451.56 Molina — MCD: $48.63 Multiplan — ComplementaryNetwork: $541.87 Multiplan — PrimaryNetwork: $569.66 NHC Advantage, Inc. — MCRHMO: $131.99 United — GlobalBenefitPlan: $312.62 United — OptionsPPO: $149.36
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	$843.88	$843.88	$165.73
Diagnostic mammogram, both breasts: 10 of 37 insurance plan rates Aetna — COMM: $219.50 Aetna — MGMCRHMO: $101.25 Aetna — MGMCRPPO: $101.25 Aetna — MGMCRSNP: $101.25 Aetna — NewBusiness: $219.50 Alive Hospice — MCR: $100.25 American Health Advantage — MCRHMO: $105.26 American Health Advantage — MCRPFFS: $105.26 American Health Advantage — MCRPOS: $105.26 American Health Advantage — MCRPPO: $105.26
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMMO DIAG CAD BI	$843.88	$843.88	$59.07 – $691.98
Diagnostic mammogram, both breasts: rates for 9 insurance plans Aetna — NAP: $421.94 Cigna — PPO: $247.26 City of Springfield — COMM: $548.52 Molina — MCD: $59.07 Multiplan — ComplementaryNetwork: $658.23 Multiplan — PrimaryNetwork: $691.98 NHC Advantage, Inc. — MCRHMO: $160.34 United — GlobalBenefitPlan: $379.75 United — OptionsPPO: $181.43
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier TC In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	$843.88	$843.88	$219.50
Diagnostic mammogram, both breasts: rates for 2 insurance plans Aetna — COMM: $219.50 Aetna — NewBusiness: $219.50
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCR CAD BI	$765.14	$765.14	$53.56 – $627.41
Screening mammogram, both breasts: rates for 9 insurance plans Aetna — NAP: $382.57 Cigna — PPO: $224.19 City of Springfield — COMM: $497.34 Molina — MCD: $53.56 Multiplan — ComplementaryNetwork: $596.81 Multiplan — PrimaryNetwork: $627.41 NHC Advantage, Inc. — MCRHMO: $145.38 United — GlobalBenefitPlan: $344.31 United — OptionsPPO: $164.51
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed	Not listed in the file	Not listed in the file	$82.76 – $341.52
Screening mammogram, both breasts: 10 of 37 insurance plan rates Aetna — COMM: $177.25 Aetna — MGMCRHMO: $83.59 Aetna — MGMCRPPO: $83.59 Aetna — MGMCRSNP: $83.59 Aetna — NewBusiness: $177.25 Alive Hospice — MCR: $82.76 American Health Advantage — MCRHMO: $86.90 American Health Advantage — MCRPFFS: $86.90 American Health Advantage — MCRPOS: $86.90 American Health Advantage — MCRPPO: $86.90
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier 52 In the file: MAMMO SCR CAD 1BRST	$765	$765	$53.55 – $627.30
Screening mammogram, both breasts: rates for 9 insurance plans Aetna — NAP: $382.50 Cigna — PPO: $224.15 City of Springfield — COMM: $497.25 Molina — MCD: $53.55 Multiplan — ComplementaryNetwork: $596.70 Multiplan — PrimaryNetwork: $627.30 NHC Advantage, Inc. — MCRHMO: $145.35 United — GlobalBenefitPlan: $344.25 United — OptionsPPO: $164.47

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	Not listed in the file	Not listed in the file	$3,807 – $4,700
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans Aetna — COMM: $4,700 Aetna — NewBusiness: $3,807
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe	Not listed in the file	Not listed in the file	$1,886 – $9,813
Left heart catheterization (diagnostic): 10 of 16 insurance plan rates Aetna — COMM: $16,577 Aetna — NewBusiness: $14,137 Ambetter — CORE: $8,436 Ambetter — Select: $7,800 BCBS — NetworkP: $8,657 Bright Health — HIX: $5,140 Bright Health — SmallGroup: $7,009 Cigna — NewBusiness: $16,049 Cigna — OAP: $18,061 NHC Advantage, Inc. — MCRHMO: $3,850
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recor	Not listed in the file	Not listed in the file	$2,418 – $21,155
Heart rhythm study (electrophysiology evaluation): 10 of 13 insurance plan rates Aetna — COMM: $30,393 Aetna — NewBusiness: $25,919 Ambetter — CORE: $16,873 Ambetter — Select: $15,600 Bright Health — HIX: $5,094 Bright Health — SmallGroup: $6,946 Cigna — NewBusiness: $11,132 Cigna — OAP: $12,528 Oscar — HIX: $8,071 United — AllPayerAppendix: $21,155
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters,	Not listed in the file	Not listed in the file	$3,723 – $36,635
Heart rhythm study with ablation for atrial fibrillation: 10 of 12 insurance plan rates Aetna — COMM: $30,393 Aetna — NewBusiness: $25,919 BCBS — NetworkP: $34,632 Bright Health — HIX: $3,723 Bright Health — SmallGroup: $5,078 Cigna — NewBusiness: $11,132 Cigna — OAP: $12,528 Oscar — HIX: $5,077 United — AllPayerAppendix: $36,635 United — Core: $27,476
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAPHY >4 PAR	$6,777	$6,777	$474.39 – $5,557.14
Sleep study (overnight, in a sleep lab): 10 of 17 insurance plan rates Aetna — NAP: $3,388.50 Ambetter — CORE: $1,307.96 Ambetter — Select: $1,355.40 BCBS — NetworkP: $1,694.25 Bright Health — HIX: $1,016.55 Bright Health — SmallGroup: $1,423.17 Cigna — NewBusiness: $1,707.80 Cigna — OAP: $1,938.22 Cigna — PPO: $1,985.66 City of Springfield — COMM: $4,405.05
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist	$6,777	$6,777	$1,343 – $1,790
Sleep study (overnight, in a sleep lab): rates for 5 insurance plans Aetna — COMM: $2,710 Aetna — NewBusiness: $2,311 United — AllPayerAppendix: $1,790 United — Core: $1,343 United — HeritageSelect: $1,432

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib	Not listed in the file	Not listed in the file	$59.27
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 32 insurance plan rates Aetna — COMM: $326 Aetna — MGMCRHMO: $27.94 Aetna — MGMCRPPO: $27.94 Aetna — MGMCRSNP: $27.94 Aetna — NewBusiness: $274 Alive Hospice — MCR: $27.66 American Health Advantage — MCRHMO: $29.04 American Health Advantage — MCRPFFS: $29.04 American Health Advantage — MCRPOS: $29.04 American Health Advantage — MCRPPO: $29.04
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO In the file: THER EXERCISES 15 MIN OT	$341.13	$341.13	$23.88 – $279.73
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 16 insurance plan rates Aetna — NAP: $170.56 Ambetter — CORE: $65.84 Ambetter — Select: $68.23 Bright Health — HIX: $51.17 Bright Health — SmallGroup: $71.64 Cigna — NewBusiness: $85.96 Cigna — OAP: $97.56 Cigna — PPO: $99.95 City of Springfield — COMM: $221.73 Molina — MCD: $23.88
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: THER EXERCISES 15 MIN PT	$341.13	$341.13	$23.88 – $279.73
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 16 insurance plan rates Aetna — NAP: $170.56 Ambetter — CORE: $65.84 Ambetter — Select: $68.23 Bright Health — HIX: $51.17 Bright Health — SmallGroup: $71.64 Cigna — NewBusiness: $85.96 Cigna — OAP: $97.56 Cigna — PPO: $99.95 City of Springfield — COMM: $221.73 Molina — MCD: $23.88
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact	$857.92	$857.92	$201.74
Physical therapy evaluation (low complexity): 10 of 32 insurance plan rates Aetna — COMM: $326 Aetna — MGMCRHMO: $94.46 Aetna — MGMCRPPO: $94.46 Aetna — MGMCRSNP: $94.46 Aetna — NewBusiness: $274 Alive Hospice — MCR: $93.52 American Health Advantage — MCRHMO: $98.20 American Health Advantage — MCRPFFS: $98.20 American Health Advantage — MCRPOS: $98.20 American Health Advantage — MCRPPO: $98.20
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact	$857.92	$857.92	$82.30
Physical therapy evaluation (low complexity): 10 of 29 insurance plan rates Aetna — MGMCRHMO: $83.12 Aetna — MGMCRPPO: $83.12 Aetna — MGMCRSNP: $83.12 Alive Hospice — MCR: $82.30 American Health Advantage — MCRHMO: $86.41 American Health Advantage — MCRPFFS: $86.41 American Health Advantage — MCRPOS: $86.41 American Health Advantage — MCRPPO: $86.41 American Health Advantage — MCRSNP: $86.41 Amerigroup — MGMCR: $82.30
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT LOW COMPLEX	$857.92	$857.92	$60.05 – $703.49
Physical therapy evaluation (low complexity): 10 of 16 insurance plan rates Aetna — NAP: $428.96 Ambetter — CORE: $165.58 Ambetter — Select: $171.58 Bright Health — HIX: $128.69 Bright Health — SmallGroup: $180.16 Cigna — NewBusiness: $216.20 Cigna — OAP: $245.37 Cigna — PPO: $251.37 City of Springfield — COMM: $557.65 Molina — MCD: $60.05
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or	$1,183.70	$1,183.70	$201.74
Physical therapy evaluation (moderate complexity): 10 of 32 insurance plan rates Aetna — COMM: $326 Aetna — MGMCRHMO: $94.46 Aetna — MGMCRPPO: $94.46 Aetna — MGMCRSNP: $94.46 Aetna — NewBusiness: $274 Alive Hospice — MCR: $93.52 American Health Advantage — MCRHMO: $98.20 American Health Advantage — MCRPFFS: $98.20 American Health Advantage — MCRPOS: $98.20 American Health Advantage — MCRPPO: $98.20
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or	$1,183.70	$1,183.70	$82.30 – $120.98
Physical therapy evaluation (moderate complexity): 10 of 29 insurance plan rates Aetna — MGMCRHMO: $83.12 Aetna — MGMCRPPO: $83.12 Aetna — MGMCRSNP: $83.12 Alive Hospice — MCR: $82.30 American Health Advantage — MCRHMO: $86.41 American Health Advantage — MCRPFFS: $86.41 American Health Advantage — MCRPOS: $86.41 American Health Advantage — MCRPPO: $86.41 American Health Advantage — MCRSNP: $86.41 Amerigroup — MGMCR: $82.30
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT MOD COMPLEX	$1,183.70	$1,183.70	$82.86 – $970.63
Physical therapy evaluation (moderate complexity): 10 of 16 insurance plan rates Aetna — NAP: $591.85 Ambetter — CORE: $228.45 Ambetter — Select: $236.74 Bright Health — HIX: $177.56 Bright Health — SmallGroup: $248.58 Cigna — NewBusiness: $298.29 Cigna — OAP: $338.54 Cigna — PPO: $346.82 City of Springfield — COMM: $769.40 Molina — MCD: $82.86
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o	$1,567.46	$1,567.46	$201.74
Physical therapy evaluation (high complexity): 10 of 32 insurance plan rates Aetna — COMM: $326 Aetna — MGMCRHMO: $94.46 Aetna — MGMCRPPO: $94.46 Aetna — MGMCRSNP: $94.46 Aetna — NewBusiness: $274 Alive Hospice — MCR: $93.52 American Health Advantage — MCRHMO: $98.20 American Health Advantage — MCRPFFS: $98.20 American Health Advantage — MCRPOS: $98.20 American Health Advantage — MCRPPO: $98.20
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o	$1,567.46	$1,567.46	$82.30 – $120.98
Physical therapy evaluation (high complexity): 10 of 29 insurance plan rates Aetna — MGMCRHMO: $83.12 Aetna — MGMCRPPO: $83.12 Aetna — MGMCRSNP: $83.12 Alive Hospice — MCR: $82.30 American Health Advantage — MCRHMO: $86.41 American Health Advantage — MCRPFFS: $86.41 American Health Advantage — MCRPOS: $86.41 American Health Advantage — MCRPPO: $86.41 American Health Advantage — MCRSNP: $86.41 Amerigroup — MGMCR: $82.30
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT HIGH COMPLEX	$1,567.46	$1,567.46	$109.72 – $1,285.32
Physical therapy evaluation (high complexity): 10 of 16 insurance plan rates Aetna — NAP: $783.73 Ambetter — CORE: $302.52 Ambetter — Select: $313.49 Bright Health — HIX: $235.12 Bright Health — SmallGroup: $329.17 Cigna — NewBusiness: $395 Cigna — OAP: $448.29 Cigna — PPO: $459.27 City of Springfield — COMM: $1,018.85 Molina — MCD: $109.72

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19	Not listed in the file	Not listed in the file	$1,208 – $6,446
Removal of breast growth (open surgery): 10 of 15 insurance plan rates Aetna — COMM: $6,446 Aetna — NewBusiness: $5,050 Ambetter — CORE: $2,490 Ambetter — Select: $2,302 BCBS — NetworkP: $3,043 Bright Health — HIX: $1,257 Bright Health — SmallGroup: $1,714 Cigna — NewBusiness: $8,960 Cigna — OAP: $10,083 NHC Advantage, Inc. — MCRHMO: $4,950
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft	Not listed in the file	Not listed in the file	$2,550 – $34,140
Total hip replacement: 10 of 21 insurance plan rates Aetna — COMM: $26,035 Aetna — NewBusiness: $20,979 Ambetter — CORE: $20,500 Ambetter — Select: $18,954 ATRIO Golden Times — MCR: $16,012.31 BCBS — NetworkP: $32,971 Bright Health — HIX: $19,564 Bright Health — MCRNarrow: $12,950 Bright Health — SmallGroup: $26,677 Cigna — NewBusiness: $30,338
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)	Not listed in the file	Not listed in the file	$4,851 – $32,971
Total knee replacement: 10 of 21 insurance plan rates Aetna — COMM: $26,035 Aetna — NewBusiness: $20,979 Ambetter — CORE: $20,500 Ambetter — Select: $18,954 ATRIO Golden Times — MCR: $16,012.31 BCBS — NetworkP: $32,971 Bright Health — HIX: $19,564 Bright Health — MCRNarrow: $12,950 Bright Health — SmallGroup: $26,677 Cigna — NewBusiness: $30,338
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) rele	Not listed in the file	Not listed in the file	$226 – $2,900
Shoulder arthroscopy: shaving of shoulder bone: 10 of 15 insurance plan rates Aetna — COMM: $7,182 Aetna — NewBusiness: $7,566 Ambetter — CORE: $2,490 Ambetter — Select: $2,302 BCBS — NetworkP: $3,043 Bright Health — HIX: $1,257 Bright Health — SmallGroup: $1,714 Cigna — NewBusiness: $8,960 Cigna — OAP: $10,083 NHC Advantage, Inc. — MCRHMO: $4,950
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articula	Not listed in the file	Not listed in the file	$1,471 – $2,760
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 15 insurance plan rates Aetna — COMM: $7,182 Aetna — NewBusiness: $7,566 Ambetter — CORE: $2,760 Ambetter — Select: $2,552 BCBS — NetworkP: $3,433 Bright Health — HIX: $1,471 Bright Health — SmallGroup: $2,007 Cigna — NewBusiness: $8,960 Cigna — OAP: $10,083 NHC Advantage, Inc. — MCRHMO: $4,950
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Tonsillectomy and adenoidectomy; younger than age 12	Not listed in the file	Not listed in the file	$5,050 – $6,446
Removal of tonsils and adenoids (under age 12): 10 of 15 insurance plan rates Aetna — COMM: $6,446 Aetna — NewBusiness: $5,050 Ambetter — CORE: $2,490 Ambetter — Select: $2,302 BCBS — NetworkP: $3,911 Bright Health — HIX: $1,257 Bright Health — SmallGroup: $1,714 Cigna — NewBusiness: $3,536 Cigna — OAP: $3,979 NHC Advantage, Inc. — MCRHMO: $2,550
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (sep	Not listed in the file	Not listed in the file	$607 – $4,100
Upper GI endoscopy (diagnostic): 10 of 15 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 Ambetter — CORE: $1,069 Ambetter — Select: $988 BCBS — NetworkP: $2,003 Bright Health — HIX: $607 Bright Health — SmallGroup: $827 Cigna — NewBusiness: $3,131 Cigna — OAP: $3,523 NHC Advantage, Inc. — MCRHMO: $2,550
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	Not listed in the file	Not listed in the file	$1,804 – $2,303
Upper GI endoscopy with biopsy: 10 of 15 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 Ambetter — CORE: $1,687 Ambetter — Select: $1,560 BCBS — NetworkP: $2,435 Bright Health — HIX: $870 Bright Health — SmallGroup: $1,187 Cigna — NewBusiness: $3,536 Cigna — OAP: $3,979 NHC Advantage, Inc. — MCRHMO: $2,550
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)	Not listed in the file	Not listed in the file	$3,536 – $3,979
Colonoscopy (diagnostic): 10 of 15 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 Ambetter — CORE: $1,687 Ambetter — Select: $1,560 BCBS — NetworkP: $2,435 Bright Health — HIX: $870 Bright Health — SmallGroup: $1,187 Cigna — NewBusiness: $3,536 Cigna — OAP: $3,979 NHC Advantage, Inc. — MCRHMO: $2,550
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with biopsy, single or multiple	Not listed in the file	Not listed in the file	$825 – $4,100
Colonoscopy with biopsy: 10 of 15 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 Ambetter — CORE: $1,687 Ambetter — Select: $1,560 BCBS — NetworkP: $2,435 Bright Health — HIX: $870 Bright Health — SmallGroup: $1,187 Cigna — NewBusiness: $3,536 Cigna — OAP: $3,979 NHC Advantage, Inc. — MCRHMO: $2,550
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	Not listed in the file	Not listed in the file	$825 – $4,100
Colonoscopy with removal of polyps (snare): 10 of 15 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 Ambetter — CORE: $1,687 Ambetter — Select: $1,560 BCBS — NetworkP: $2,435 Bright Health — HIX: $870 Bright Health — SmallGroup: $1,187 Cigna — NewBusiness: $3,536 Cigna — OAP: $3,979 NHC Advantage, Inc. — MCRHMO: $2,550
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and	Not listed in the file	Not listed in the file	$825 – $4,100
Ultrasound of the lower bowel by endoscope: 10 of 15 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 Ambetter — CORE: $1,687 Ambetter — Select: $1,560 BCBS — NetworkP: $2,435 Bright Health — HIX: $870 Bright Health — SmallGroup: $1,187 Cigna — NewBusiness: $3,536 Cigna — OAP: $3,979 NHC Advantage, Inc. — MCRHMO: $2,550
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	Not listed in the file	Not listed in the file	$870 – $2,303
Screening colonoscopy (not high risk): 10 of 14 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 Ambetter — CORE: $1,687 Ambetter — Select: $1,560 BCBS — NetworkP: $2,003 Bright Health — HIX: $870 Bright Health — SmallGroup: $1,187 Cigna — NewBusiness: $3,536 Cigna — OAP: $3,979 Oscar — HIX: $1,418
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical; cholecystectomy	Not listed in the file	Not listed in the file	$1,876 – $9,431
Gallbladder removal by laparoscope: 10 of 13 insurance plan rates Aetna — COMM: $6,227 Aetna — NewBusiness: $5,310 BCBS — NetworkP: $5,550 Bright Health — HIX: $1,876 Bright Health — SmallGroup: $2,559 Cigna — NewBusiness: $12,999 Cigna — OAP: $14,628 NHC Advantage, Inc. — MCRHMO: $4,950 Oscar — HIX: $3,542 United — AllPayerAppendix: $9,431
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair initial inguinal hernia, age 5 years or older; reducible	Not listed in the file	Not listed in the file	$3,839 – $4,320
Groin (inguinal) hernia repair, age 5 or older: 10 of 15 insurance plan rates Aetna — COMM: $6,446 Aetna — NewBusiness: $5,050 Ambetter — CORE: $2,760 Ambetter — Select: $2,552 BCBS — NetworkP: $3,433 Bright Health — HIX: $1,471 Bright Health — SmallGroup: $2,007 Cigna — NewBusiness: $3,839 Cigna — OAP: $4,320 NHC Advantage, Inc. — MCRHMO: $4,950
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy, prostate; needle or punch, single or multiple, any approach	Not listed in the file	Not listed in the file	$825 – $3,979
Prostate biopsy: rates for 9 insurance plans Ambetter — CORE: $1,687 Ambetter — Select: $1,560 BCBS — NetworkP: $2,435 Bright Health — HIX: $870 Bright Health — SmallGroup: $1,187 Cigna — NewBusiness: $3,536 Cigna — OAP: $3,979 Oscar — HIX: $2,048 United — MCD: $825
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;	Not listed in the file	Not listed in the file	$4,851 – $13,472
Prostate removal by laparoscope (radical prostatectomy): 10 of 15 insurance plan rates Aetna — COMM: $20,647 Aetna — NewBusiness: $17,607 Ambetter — CORE: $6,468 Ambetter — Select: $5,980 BCBS — NetworkP: $5,550 Bright Health — HIX: $2,662 Bright Health — SmallGroup: $3,629 Cigna — NewBusiness: $8,353 Cigna — OAP: $9,400 NHC Advantage, Inc. — MCRHMO: $2,550
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C	Not listed in the file	Not listed in the file	$1,208 – $6,446
Hysteroscopy with biopsy of the uterus lining: 10 of 15 insurance plan rates Aetna — COMM: $6,446 Aetna — NewBusiness: $5,050 Ambetter — CORE: $2,490 Ambetter — Select: $2,302 BCBS — NetworkP: $3,043 Bright Health — HIX: $1,257 Bright Health — SmallGroup: $1,714 Cigna — NewBusiness: $8,960 Cigna — OAP: $10,083 NHC Advantage, Inc. — MCRHMO: $4,950
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neur	Not listed in the file	Not listed in the file	$403 – $3,523
Spinal injection, lower back (epidural), with imaging guidance: 10 of 13 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 BCBS — NetworkP: $2,435 Bright Health — HIX: $607 Bright Health — SmallGroup: $827 Cigna — NewBusiness: $3,131 Cigna — OAP: $3,523 NHC Advantage, Inc. — MCRHMO: $2,550 Oscar — HIX: $1,418 United — AllPayerAppendix: $3,250
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing	Not listed in the file	Not listed in the file	$403 – $3,523
Nerve root injection, lower back, with imaging guidance: 10 of 15 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 Ambetter — CORE: $1,069 Ambetter — Select: $988 BCBS — NetworkP: $2,003 Bright Health — HIX: $607 Bright Health — SmallGroup: $827 Cigna — NewBusiness: $3,131 Cigna — OAP: $3,523 NHC Advantage, Inc. — MCRHMO: $2,550
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel	Not listed in the file	Not listed in the file	$1,804 – $2,303
Carpal tunnel release: 10 of 15 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 Ambetter — CORE: $1,687 Ambetter — Select: $1,560 BCBS — NetworkP: $2,435 Bright Health — HIX: $870 Bright Health — SmallGroup: $1,187 Cigna — NewBusiness: $3,536 Cigna — OAP: $3,979 NHC Advantage, Inc. — MCRHMO: $4,950
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or	Not listed in the file	Not listed in the file	$1,418 – $2,550
Laser treatment of clouding after cataract surgery: 10 of 15 insurance plan rates Aetna — COMM: $2,303 Aetna — NewBusiness: $1,804 Ambetter — CORE: $1,687 Ambetter — Select: $1,560 BCBS — NetworkP: $2,435 Bright Health — HIX: $870 Bright Health — SmallGroup: $1,187 Cigna — NewBusiness: $3,536 Cigna — OAP: $3,979 NHC Advantage, Inc. — MCRHMO: $2,550
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irriga	Not listed in the file	Not listed in the file	$1,208 – $8,069
Cataract removal with lens implant: 10 of 15 insurance plan rates Aetna — COMM: $6,446 Aetna — NewBusiness: $5,050 Ambetter — CORE: $4,652 Ambetter — Select: $4,301 BCBS — NetworkP: $5,353 Bright Health — HIX: $3,114 Bright Health — SmallGroup: $4,247 Cigna — NewBusiness: $7,171 Cigna — OAP: $8,069 NHC Advantage, Inc. — MCRHMO: $2,550

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) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care	Not listed in the file	Not listed in the file	$825 – $3,435
Vaginal delivery, with care before and after: rates for 4 insurance plans BCBS — NetworkP: $3,433 NHC Advantage, Inc. — MCRHMO: $2,550 Oscar — HIX: $3,435 United — MCD: $825
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, cesarean delivery, and postpartum care	Not listed in the file	Not listed in the file	$825 – $3,435
Cesarean delivery (C-section), with care before and after: rates for 4 insurance plans BCBS — NetworkP: $3,911 NHC Advantage, Inc. — MCRHMO: $2,550 Oscar — HIX: $3,435 United — MCD: $825
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after p	Not listed in the file	Not listed in the file	$825 – $3,435
Vaginal delivery after a previous C-section, with care before and after: rates for 4 insurance plans BCBS — NetworkP: $3,433 NHC Advantage, Inc. — MCRHMO: $2,550 Oscar — HIX: $3,435 United — MCD: $825

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) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA	Not listed in the file	Not listed in the file	$450 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,225
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 51 insurance plan rates Aetna — COMM: $242,867.79 Aetna — MGMCRHMO: $69,379.26 Aetna — MGMCRPPO: $69,379.26 Aetna — MGMCRSNP: $69,379.26 Aetna — NewBusiness: $195,704.91 Alive Hospice — MCR: $61,823.11 Ambetter — CORE: $83,633.16 Ambetter — Select: $77,323.25 American Health Advantage — MCRHMO: $450 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) American Health Advantage — MCRPFFS: $450 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$31,801.78 – $38,111.66
Spinal fusion (not neck), without major complications: rates for 4 insurance plans Bright Health — HIX: $31,801.78 Bright Health — SmallGroup: $38,111.66 NovaNET — WORKERSCOMP: $2,300.06 Prime Health — WORKERSCOMP: $2,253.12
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT	Not listed in the file	Not listed in the file	$16,359.50 – $19,605.43
Hip or knee replacement (major joint of the leg), without major complications: 10 of 51 insurance plan rates Aetna — COMM: $47,886.87 Aetna — MGMCRHMO: $14,817.56 Aetna — MGMCRPPO: $14,817.56 Aetna — MGMCRSNP: $14,817.56 Aetna — NewBusiness: $38,587.64 Alive Hospice — MCR: $13,203.77 Ambetter — CORE: $16,490.17 Ambetter — Select: $15,246.03 American Health Advantage — MCRHMO: $15,404.39 American Health Advantage — MCRPFFS: $15,404.39
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$21,392.46 – $25,636.99
Neck (cervical) spinal fusion, without complications: 10 of 51 insurance plan rates Aetna — COMM: $39,464 Aetna — MGMCRHMO: $18,377.24 Aetna — MGMCRPPO: $18,377.24 Aetna — MGMCRSNP: $18,377.24 Aetna — NewBusiness: $32,566 Alive Hospice — MCR: $16,375.76 Ambetter — CORE: $20,870.67 Ambetter — Select: $19,296.04 American Health Advantage — MCRHMO: $450 American Health Advantage — MCRPFFS: $450
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$10,102.43 – $12,106.88
Uterus and ovary surgery (not for cancer), without complications: 10 of 51 insurance plan rates Aetna — COMM: $22,928 Aetna — MGMCRHMO: $10,036.58 Aetna — MGMCRPPO: $10,036.58 Aetna — MGMCRSNP: $10,036.58 Aetna — NewBusiness: $19,553 Alive Hospice — MCR: $8,943.49 Ambetter — CORE: $10,606.74 Ambetter — Select: $9,806.49 American Health Advantage — MCRHMO: $10,434.07 American Health Advantage — MCRPFFS: $10,434.07

Source: Tristar Northcrest Medical Center’s standard charges file (stctrprodsnsvc00455826e6.blob.core.windows.net, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	100 Northcrest Drive, Springfield, TN 37172
County	Robertson County
State	Tennessee
Phone	(615) 384‑2411
Emergency services	Yes
Ownership	Voluntary non-profit - Other
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	440065
Name in Medicare records	TRISTAR NORTHCREST MEDICAL CENTER
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(615) 698‑3000^[4]
Official website	tristarhealth.com
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

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

TriStar NorthCrest Medical Center — tristarhealth.com
Hospital in Springfield, TN — tristarhealth.com
Imaging Center in Springfield | TriStar NorthCrest Medical Center — tristarhealth.com
Cardiac Rehabilitation | TriStar NorthCrest Medical Center — tristarhealth.com
Emergency Care | TriStar NorthCrest Medical Center — tristarhealth.com
For Visitors | TriStar NorthCrest Medical Center — tristarhealth.com
Heart Care in Springfield, TN | TriStar NorthCrest Medical Center — tristarhealth.com
Orthopedics in Springfield, TN | TriStar NorthCrest Medical Center — tristarhealth.com
Surgical Care in Springfield | TriStar NorthCrest Medical Center — tristarhealth.com
Speech Therapy | TriStar NorthCrest Medical Center — tristarhealth.com
Women's Care in Springfield | TriStar NorthCrest Medical Center — tristarhealth.com
Breast health | TriStar NorthCrest Medical Center — tristarhealth.com
Labor and delivery | TriStar NorthCrest Medical Center — tristarhealth.com
Specialties | TriStar NorthCrest Medical Center — tristarhealth.com
Infusion Therapy | TriStar NorthCrest Medical Center — tristarhealth.com
Lymphedema Therapy | TriStar NorthCrest Medical Center — tristarhealth.com