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Acute Care Hospital

Tristar Southern Hills Medical Center

Nashville, Tennessee · Davidson County · Emergency services listed

Summary

Tristar Southern Hills Medical Center is an acute care hospital in Nashville, Tennessee. Medicare data lists emergency services. CMS overall star rating: 4 of 5 stars. Its official website lists 73 services, specialties and programs. Medicare lists 200 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

Call(615) 781‑4000 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
4 of 5 stars4 of 5 stars · Medicare rating
136Beds (hospital website)
200Doctors and clinicians
73Services listed

Quick answers

Does Tristar Southern Hills Medical Center have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Tristar Southern Hills Medical Center. In a medical emergency, call 911.
Where is Tristar Southern Hills Medical Center?
391 Wallace Rd, Nashville, TN 37211, in Davidson County, Tennessee.
What is the phone number of Tristar Southern Hills Medical Center?
(615) 781-4000, as listed by Medicare (CMS).
What is the Medicare star rating of Tristar Southern Hills Medical Center?
4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][5][7][8][13][15][17][18]

Conditions treated[6][10][12][13][14][16]

Treatments[7][10][12][13][14][15][16][17]

  • Coronary stenting
  • Coronary balloon angioplasty (PTCA)
  • Cardiac catheterization (angiogram)
  • Pacemaker and defibrillator implantation
  • Thrombectomy
  • Echocardiogram
  • Stress testing
  • Cardiac rehabilitation
  • Laparoscopic sleeve gastrectomy
  • Laparoscopic Roux-en-Y gastric bypass
  • Joint replacement (knee, hip, shoulder)
  • Arthroscopy
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT)
  • Mammography
  • Bone density testing (DEXA)
  • Ultrasound
  • Biopsy

Procedures[8][14][15][16]

  • Laparoscopic gastric bypass
  • Minimally invasive surgery
  • Physical therapy
  • Occupational therapy
  • Speech therapy

Programs and centers[4][5][6][8][10][11][12][13][14][16]

  • Hospitalist care
  • Chest Pain Center (accredited)
  • Stroke care program (primary stroke center)
  • Joint and Spine Center
  • Inpatient rehabilitation unit
  • Sleep disorders clinic
  • Breast Imaging Center of Excellence
  • Oncology program
  • Weight loss surgery seminars
  • Outpatient rehabilitation

Emergency care (hospital website)[4][5][6][11]

Emergency roomYes
Open 24/7Yes
Stroke designationPrimary Stroke Center

Visiting and practical information

ParkingFree valet parking Mon-Fri 7:30am-4:30pm; enter from Wallace Road and follow signs to the main entrance[15]

Recognition[4][5][11]

  • Accredited Chest Pain Center with PCI
  • Primary Stroke Center
  • Certified in joint replacement of the hip (The Joint Commission)
  • Certified in chest pain (The Joint Commission)
  • Accredited for Acute Coronary Syndrome (The Joint Commission)
  • ACR accreditation: MRI, mammography, CT, nuclear medicine, ultrasound
  • Accreditation with Commendation (Commission on Cancer, American College of Surgeons)
  • Accredited Bariatric Surgery Center (American College of Surgeons)
  • Top performer in quality measures (The Joint Commission)

Doctors and clinicians (200)

200 doctors and other clinicians list Tristar Southern Hills 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

Doctors with a page on this site (200)

And 176 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

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 Southern Hills 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) 3 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean4 of 5 stars
Quiet at night4 of 5 stars
Rated the hospital 9 or 10 out of 1072%National average: 72%
Would definitely recommend the hospital64%National average: 71%
Nurses “always” communicated well77%National average: 80%
Doctors “always” communicated well77%National average: 80%
Staff “always” explained medicines before giving them58%National average: 62%
Were given information about recovery at home82%National average: 86%
Room and bathroom “always” clean74%National average: 74%
Area around the room “always” quiet at night62%National average: 60%
Completed surveys519Response rate: 17%

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)0No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.351No different from the national benchmark
Surgical site infections after colon surgery1.783No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0.724No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.21Better 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 patients11.2%
Deaths within 30 days: heart failure patients14.7%
Deaths within 30 days: pneumonia patients15.5%
Deaths within 30 days: COPD patients8.3%
Deaths within 30 days: stroke patients10.5%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)0.93No different from the national rate
Complications after hip or knee replacementToo 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 attack14.1%
Readmitted within 30 days: heart failure22.3%
Readmitted within 30 days: pneumonia17.4%
Readmitted within 30 days: COPD19.2%
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacementToo 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)High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)119 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 NashvilleBest hospitals in Nashville

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 84 common services exactly as Tristar Southern Hills 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 →

$ 2 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

ServiceHospital chargeCash priceInsurance 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 $817.32 $817.32 $122.60 – $719.24
New patient office visit (about 30–44 minutes): 10 of 23 insurance plan rates
  • Aetna — COMM: $269.72
  • Aetna — MGMCRHMO: $122.60
  • Aetna — MGMCRPPO: $122.60
  • Aetna — MGMCRSNP: $122.60
  • Aetna — NAP: $408.66
  • Aetna — NewBusiness: $228.85
  • Apex Health — MCR: $155.29
  • Beech Street — COMM: $719.24
  • BGFH SingleSource — DIRECTNETWORK: $408.66
  • BGFH SingleSource — LEASEDNETWORK: $694.72
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 $817.32 $817.32 $96.99 – $162.97
New patient office visit (about 30–44 minutes): rates for 4 insurance plans
  • BCBS — BlueCare: $162.97
  • BCBS — COVERKIDS: $104.89
  • BCBS — TENNCARE: $96.99
  • 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 $1,114.54 $1,114.54 $167.18 – $980.80
New patient office visit (about 45–59 minutes): 10 of 23 insurance plan rates
  • Aetna — COMM: $367.80
  • Aetna — MGMCRHMO: $167.18
  • Aetna — MGMCRPPO: $167.18
  • Aetna — MGMCRSNP: $167.18
  • Aetna — NAP: $557.27
  • Aetna — NewBusiness: $312.07
  • Apex Health — MCR: $211.76
  • Beech Street — COMM: $980.80
  • BGFH SingleSource — DIRECTNETWORK: $557.27
  • BGFH SingleSource — LEASEDNETWORK: $947.36
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 $1,114.54 $1,114.54 $143.62 – $241.31
New patient office visit (about 45–59 minutes): rates for 4 insurance plans
  • BCBS — BlueCare: $241.31
  • BCBS — COVERKIDS: $155.31
  • BCBS — TENNCARE: $143.62
  • 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: OP VISIT LEVEL 5 NP $1,114.54 $1,114.54 $167.18 – $980.80
New patient office visit (about 60–74 minutes): 10 of 23 insurance plan rates
  • Aetna — COMM: $367.80
  • Aetna — MGMCRHMO: $167.18
  • Aetna — MGMCRPPO: $167.18
  • Aetna — MGMCRSNP: $167.18
  • Aetna — NAP: $557.27
  • Aetna — NewBusiness: $312.07
  • Apex Health — MCR: $211.76
  • Beech Street — COMM: $980.80
  • BGFH SingleSource — DIRECTNETWORK: $557.27
  • BGFH SingleSource — LEASEDNETWORK: $947.36
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 $1,114.54 $1,114.54 $180.67 – $303.57
New patient office visit (about 60–74 minutes): rates for 4 insurance plans
  • BCBS — BlueCare: $303.57
  • BCBS — COVERKIDS: $195.37
  • BCBS — TENNCARE: $180.67
  • 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 $817.32 $817.32 $122.60 – $719.24
Established patient office visit (about 20–29 minutes): 10 of 23 insurance plan rates
  • Aetna — COMM: $269.72
  • Aetna — MGMCRHMO: $122.60
  • Aetna — MGMCRPPO: $122.60
  • Aetna — MGMCRSNP: $122.60
  • Aetna — NAP: $408.66
  • Aetna — NewBusiness: $228.85
  • Apex Health — MCR: $155.29
  • Beech Street — COMM: $719.24
  • BGFH SingleSource — DIRECTNETWORK: $408.66
  • BGFH SingleSource — LEASEDNETWORK: $694.72
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 $817.32 $817.32 $65.15 – $109.47
Established patient office visit (about 20–29 minutes): rates for 4 insurance plans
  • BCBS — BlueCare: $109.47
  • BCBS — COVERKIDS: $70.46
  • BCBS — TENNCARE: $65.15
  • 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 $1,114.54 $1,114.54 $167.18 – $980.80
Established patient office visit (about 30–39 minutes): 10 of 23 insurance plan rates
  • Aetna — COMM: $367.80
  • Aetna — MGMCRHMO: $167.18
  • Aetna — MGMCRPPO: $167.18
  • Aetna — MGMCRSNP: $167.18
  • Aetna — NAP: $557.27
  • Aetna — NewBusiness: $312.07
  • Apex Health — MCR: $211.76
  • Beech Street — COMM: $980.80
  • BGFH SingleSource — DIRECTNETWORK: $557.27
  • BGFH SingleSource — LEASEDNETWORK: $947.36
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 $1,114.54 $1,114.54 $83.64 – $140.54
Established patient office visit (about 30–39 minutes): rates for 4 insurance plans
  • BCBS — BlueCare: $140.54
  • BCBS — COVERKIDS: $90.45
  • BCBS — TENNCARE: $83.64
  • BCBS — NetworkP: 23% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $136.59 – $229.49
Office consultation with a specialist (moderate): rates for 3 insurance plans
  • BCBS — BlueCare: $229.49
  • BCBS — COVERKIDS: $147.70
  • BCBS — TENNCARE: $136.59
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $195.46 – $328.42
Office consultation with a specialist (moderate to high): rates for 3 insurance plans
  • BCBS — BlueCare: $328.42
  • BCBS — COVERKIDS: $211.37
  • BCBS — TENNCARE: $195.46
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin Not listed in the file Not listed in the file $78.81 – $132.42
Preventive checkup, new patient, age 18–39: rates for 3 insurance plans
  • BCBS — BlueCare: $132.42
  • BCBS — COVERKIDS: $85.23
  • BCBS — TENNCARE: $78.81
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin Not listed in the file Not listed in the file $96.18 – $161.61
Preventive checkup, new patient, age 40–64: rates for 3 insurance plans
  • BCBS — BlueCare: $161.61
  • BCBS — COVERKIDS: $104.01
  • BCBS — TENNCARE: $96.18
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LVL 3 EMER DEPT $2,162.32 $2,162.32 $398.08 – $1,902.84
Emergency room visit (moderate): 10 of 12 insurance plan rates
  • Aetna — NAP: $1,081.16
  • Beech Street — COMM: $1,902.84
  • BGFH SingleSource — DIRECTNETWORK: $1,081.16
  • BGFH SingleSource — LEASEDNETWORK: $1,837.97
  • Cigna — PPO: $704.92
  • Employers Health Network — COMM: $1,513.62
  • Humana — TRICARE: $540.58
  • Kentucky Labor Cabinet — WORKERSCOMP: $398.08
  • Multiplan — COMM: $1,254.15
  • Prime Health — COMMPPO: $1,902.84
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 Not listed in the file Not listed in the file $775 – $2,735
Emergency room visit (moderate): 10 of 18 insurance plan rates
  • Aetna — COMM: $2,655
  • Aetna — NewBusiness: $2,302
  • Ambetter — CORE: $805
  • BCBS — BlueCare: $440
  • BCBS — COVERKIDS: $138.45
  • BCBS — NetworkP: $1,196
  • BCBS — TENNCARE: $127.77
  • Bright Health — HIX: $1,146
  • Bright Health — SmallGroup: $1,562
  • Cigna — NewBusiness: $2,430
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · modifier ER In the file: LVL 3 FREE STD EMER DEPT $2,162.32 $2,162.32 $398.08 – $1,902.84
Emergency room visit (moderate): 10 of 12 insurance plan rates
  • Aetna — NAP: $1,081.16
  • Beech Street — COMM: $1,902.84
  • BGFH SingleSource — DIRECTNETWORK: $1,081.16
  • BGFH SingleSource — LEASEDNETWORK: $1,837.97
  • Cigna — PPO: $704.92
  • Employers Health Network — COMM: $1,513.62
  • Humana — TRICARE: $540.58
  • Kentucky Labor Cabinet — WORKERSCOMP: $398.08
  • Multiplan — COMM: $1,254.15
  • Prime Health — COMMPPO: $1,902.84
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: LVL 4 EMER DEPT $3,703.29 $3,703.29 $681.78 – $3,258.90
Emergency room visit (moderately high): 10 of 12 insurance plan rates
  • Aetna — NAP: $1,851.64
  • Beech Street — COMM: $3,258.90
  • BGFH SingleSource — DIRECTNETWORK: $1,851.64
  • BGFH SingleSource — LEASEDNETWORK: $3,147.80
  • Cigna — PPO: $1,207.27
  • Employers Health Network — COMM: $2,592.30
  • Humana — TRICARE: $925.82
  • Kentucky Labor Cabinet — WORKERSCOMP: $681.78
  • Multiplan — COMM: $2,147.91
  • Prime Health — COMMPPO: $3,258.90
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 Not listed in the file Not listed in the file $127.77 – $3,212
Emergency room visit (moderately high): 10 of 18 insurance plan rates
  • Aetna — COMM: $3,350
  • Aetna — NewBusiness: $2,736
  • Ambetter — CORE: $1,035
  • BCBS — BlueCare: $440
  • BCBS — COVERKIDS: $138.45
  • BCBS — NetworkP: $2,374
  • BCBS — TENNCARE: $127.77
  • Bright Health — HIX: $1,189
  • Bright Health — SmallGroup: $1,621
  • Cigna — NewBusiness: $2,641
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · modifier ER In the file: LVL 4 FREE STD EMER DEPT $3,703.29 $3,703.29 $681.78 – $3,258.90
Emergency room visit (moderately high): 10 of 12 insurance plan rates
  • Aetna — NAP: $1,851.64
  • Beech Street — COMM: $3,258.90
  • BGFH SingleSource — DIRECTNETWORK: $1,851.64
  • BGFH SingleSource — LEASEDNETWORK: $3,147.80
  • Cigna — PPO: $1,207.27
  • Employers Health Network — COMM: $2,592.30
  • Humana — TRICARE: $925.82
  • Kentucky Labor Cabinet — WORKERSCOMP: $681.78
  • Multiplan — COMM: $2,147.91
  • Prime Health — COMMPPO: $3,258.90
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: LVL 5 EMER DEPT $4,813.26 $4,813.26 $886.12 – $4,235.67
Emergency room visit (high): 10 of 12 insurance plan rates
  • Aetna — NAP: $2,406.63
  • Beech Street — COMM: $4,235.67
  • BGFH SingleSource — DIRECTNETWORK: $2,406.63
  • BGFH SingleSource — LEASEDNETWORK: $4,091.27
  • Cigna — PPO: $1,569.12
  • Employers Health Network — COMM: $3,369.28
  • Humana — TRICARE: $1,203.32
  • Kentucky Labor Cabinet — WORKERSCOMP: $886.12
  • Multiplan — COMM: $2,791.69
  • Prime Health — COMMPPO: $4,235.67
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 Not listed in the file Not listed in the file $371.67 – $5,749
Emergency room visit (high): 10 of 18 insurance plan rates
  • Aetna — COMM: $3,350
  • Aetna — NewBusiness: $2,736
  • Ambetter — CORE: $1,800
  • BCBS — BlueCare: $784
  • BCBS — COVERKIDS: $402.74
  • BCBS — NetworkP: $2,374
  • BCBS — TENNCARE: $371.67
  • Bright Health — HIX: $1,698
  • Bright Health — SmallGroup: $2,315
  • Cigna — NewBusiness: $3,946
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · modifier ER In the file: LVL 5 FREE STD EMER DEPT $4,813.26 $4,813.26 $886.12 – $4,235.67
Emergency room visit (high): 10 of 12 insurance plan rates
  • Aetna — NAP: $2,406.63
  • Beech Street — COMM: $4,235.67
  • BGFH SingleSource — DIRECTNETWORK: $2,406.63
  • BGFH SingleSource — LEASEDNETWORK: $4,091.27
  • Cigna — PPO: $1,569.12
  • Employers Health Network — COMM: $3,369.28
  • Humana — TRICARE: $1,203.32
  • Kentucky Labor Cabinet — WORKERSCOMP: $886.12
  • Multiplan — COMM: $2,791.69
  • Prime Health — COMMPPO: $4,235.67

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP TOTAL CALCIUM $1,007 $1,007 $185.39 – $886.16
Basic metabolic panel (blood test): 10 of 17 insurance plan rates
  • Aetna — NAP: $503.50
  • Apex Health — MCR: $191.33
  • Beech Street — COMM: $886.16
  • BGFH SingleSource — DIRECTNETWORK: $503.50
  • BGFH SingleSource — LEASEDNETWORK: $855.95
  • Centurion — PRISON: $414.88
  • Cigna — PPO: $328.28
  • Employers Health Network — COMM: $704.90
  • Humana — TRICARE: $251.75
  • Kentucky Labor Cabinet — WORKERSCOMP: $185.39
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 Not listed in the file Not listed in the file $8.46
Basic metabolic panel (blood test): 10 of 46 insurance plan rates
  • Aetna — COMM: $6.73
  • Aetna — MGMCRHMO: $8.54
  • Aetna — MGMCRPPO: $8.54
  • Aetna — MGMCRSNP: $8.54
  • Aetna — NewBusiness: $6.73
  • Ambetter — CORE: $9.47
  • Ambetter — Select: $8.80
  • American Health Advantage — MCRHMO: $8.88
  • American Health Advantage — MCRPFFS: $8.88
  • American Health Advantage — MCRPOS: $8.88
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 Not listed in the file Not listed in the file $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: COMP METABOLIC PANEL $1,450 $1,450 $266.94 – $1,276
Comprehensive metabolic panel (blood test): 10 of 17 insurance plan rates
  • Aetna — NAP: $725
  • Apex Health — MCR: $275.50
  • Beech Street — COMM: $1,276
  • BGFH SingleSource — DIRECTNETWORK: $725
  • BGFH SingleSource — LEASEDNETWORK: $1,232.50
  • Centurion — PRISON: $597.40
  • Cigna — PPO: $472.70
  • Employers Health Network — COMM: $1,015
  • Humana — TRICARE: $362.50
  • Kentucky Labor Cabinet — WORKERSCOMP: $266.94
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 Not listed in the file Not listed in the file $10.56
Comprehensive metabolic panel (blood test): 10 of 46 insurance plan rates
  • Aetna — COMM: $8.40
  • Aetna — MGMCRHMO: $10.67
  • Aetna — MGMCRPPO: $10.67
  • Aetna — MGMCRSNP: $10.67
  • Aetna — NewBusiness: $8.40
  • Ambetter — CORE: $11.83
  • Ambetter — Select: $10.99
  • American Health Advantage — MCRHMO: $11.09
  • American Health Advantage — MCRPFFS: $11.09
  • American Health Advantage — MCRPOS: $11.09
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 Not listed in the file Not listed in the file $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 $47.81
Obstetric blood test panel: 10 of 46 insurance plan rates
  • Aetna — COMM: $38.01
  • Aetna — MGMCRHMO: $48.29
  • Aetna — MGMCRPPO: $48.29
  • Aetna — MGMCRSNP: $48.29
  • Aetna — NewBusiness: $38.01
  • Ambetter — CORE: $53.55
  • Ambetter — Select: $49.73
  • American Health Advantage — MCRHMO: $50.20
  • American Health Advantage — MCRPFFS: $50.20
  • American Health Advantage — MCRPOS: $50.20
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL $1,143 $1,143 $210.43 – $1,005.84
Cholesterol panel (lipid panel): 10 of 17 insurance plan rates
  • Aetna — NAP: $571.50
  • Apex Health — MCR: $217.17
  • Beech Street — COMM: $1,005.84
  • BGFH SingleSource — DIRECTNETWORK: $571.50
  • BGFH SingleSource — LEASEDNETWORK: $971.55
  • Centurion — PRISON: $470.92
  • Cigna — PPO: $372.62
  • Employers Health Network — COMM: $800.10
  • Humana — TRICARE: $285.75
  • Kentucky Labor Cabinet — WORKERSCOMP: $210.43
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 Not listed in the file Not listed in the file $13.39
Cholesterol panel (lipid panel): 10 of 46 insurance plan rates
  • Aetna — COMM: $10.64
  • Aetna — MGMCRHMO: $13.52
  • Aetna — MGMCRPPO: $13.52
  • Aetna — MGMCRSNP: $13.52
  • Aetna — NewBusiness: $10.64
  • Ambetter — CORE: $15
  • Ambetter — Select: $13.93
  • American Health Advantage — MCRHMO: $14.06
  • American Health Advantage — MCRPFFS: $14.06
  • American Health Advantage — MCRPOS: $14.06
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 Not listed in the file Not listed in the file $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 $914 $914 $168.27 – $804.32
Kidney function panel: 10 of 17 insurance plan rates
  • Aetna — NAP: $457
  • Apex Health — MCR: $173.66
  • Beech Street — COMM: $804.32
  • BGFH SingleSource — DIRECTNETWORK: $457
  • BGFH SingleSource — LEASEDNETWORK: $776.90
  • Centurion — PRISON: $376.57
  • Cigna — PPO: $297.96
  • Employers Health Network — COMM: $639.80
  • Humana — TRICARE: $228.50
  • Kentucky Labor Cabinet — WORKERSCOMP: $168.27
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 Not listed in the file Not listed in the file $8.68
Kidney function panel: 10 of 46 insurance plan rates
  • Aetna — COMM: $6.90
  • Aetna — MGMCRHMO: $8.77
  • Aetna — MGMCRPPO: $8.77
  • Aetna — MGMCRSNP: $8.77
  • Aetna — NewBusiness: $6.90
  • Ambetter — CORE: $9.72
  • Ambetter — Select: $9.03
  • American Health Advantage — MCRHMO: $9.11
  • American Health Advantage — MCRPFFS: $9.11
  • American Health Advantage — MCRPOS: $9.11
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 Not listed in the file Not listed in the file $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 $1,722.75 $1,722.75 $317.16 – $1,516.02
Liver function panel: 10 of 17 insurance plan rates
  • Aetna — NAP: $861.38
  • Apex Health — MCR: $327.32
  • Beech Street — COMM: $1,516.02
  • BGFH SingleSource — DIRECTNETWORK: $861.38
  • BGFH SingleSource — LEASEDNETWORK: $1,464.34
  • Centurion — PRISON: $709.77
  • Cigna — PPO: $561.62
  • Employers Health Network — COMM: $1,205.92
  • Humana — TRICARE: $430.69
  • Kentucky Labor Cabinet — WORKERSCOMP: $317.16
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 Not listed in the file Not listed in the file $8.17
Liver function panel: 10 of 46 insurance plan rates
  • Aetna — COMM: $6.50
  • Aetna — MGMCRHMO: $8.25
  • Aetna — MGMCRPPO: $8.25
  • Aetna — MGMCRSNP: $8.25
  • Aetna — NewBusiness: $6.50
  • Ambetter — CORE: $9.15
  • Ambetter — Select: $8.50
  • American Health Advantage — MCRHMO: $8.58
  • American Health Advantage — MCRPFFS: $8.58
  • American Health Advantage — MCRPOS: $8.58
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO $341 $341 $62.78 – $300.08
Urine test (automated, with microscope): 10 of 17 insurance plan rates
  • Aetna — NAP: $170.50
  • Apex Health — MCR: $64.79
  • Beech Street — COMM: $300.08
  • BGFH SingleSource — DIRECTNETWORK: $170.50
  • BGFH SingleSource — LEASEDNETWORK: $289.85
  • Centurion — PRISON: $140.49
  • Cigna — PPO: $111.17
  • Employers Health Network — COMM: $238.70
  • Humana — TRICARE: $85.25
  • Kentucky Labor Cabinet — WORKERSCOMP: $62.78
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, Not listed in the file Not listed in the file $3.17
Urine test (automated, with microscope): 10 of 46 insurance plan rates
  • Aetna — COMM: $2.52
  • Aetna — MGMCRHMO: $3.20
  • Aetna — MGMCRPPO: $3.20
  • Aetna — MGMCRSNP: $3.20
  • Aetna — NewBusiness: $2.52
  • Ambetter — CORE: $3.55
  • Ambetter — Select: $3.30
  • American Health Advantage — MCRHMO: $3.33
  • American Health Advantage — MCRPFFS: $3.33
  • American Health Advantage — MCRPOS: $3.33
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 46 insurance plan rates
  • Aetna — COMM: $2.77
  • Aetna — MGMCRHMO: $3.51
  • Aetna — MGMCRPPO: $3.51
  • Aetna — MGMCRSNP: $3.51
  • Aetna — NewBusiness: $2.77
  • Ambetter — CORE: $3.90
  • Ambetter — Select: $3.62
  • American Health Advantage — MCRHMO: $3.65
  • American Health Advantage — MCRPFFS: $3.65
  • American Health Advantage — MCRPOS: $3.65
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W O MICRO AUTO $365 $365 $67.20 – $321.20
Urine test (automated, without microscope): 10 of 17 insurance plan rates
  • Aetna — NAP: $182.50
  • Apex Health — MCR: $69.35
  • Beech Street — COMM: $321.20
  • BGFH SingleSource — DIRECTNETWORK: $182.50
  • BGFH SingleSource — LEASEDNETWORK: $310.25
  • Centurion — PRISON: $150.38
  • Cigna — PPO: $118.99
  • Employers Health Network — COMM: $255.50
  • Humana — TRICARE: $91.25
  • Kentucky Labor Cabinet — WORKERSCOMP: $67.20
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, Not listed in the file Not listed in the file $2.25
Urine test (automated, without microscope): 10 of 46 insurance plan rates
  • Aetna — COMM: $1.79
  • Aetna — MGMCRHMO: $2.27
  • Aetna — MGMCRPPO: $2.27
  • Aetna — MGMCRSNP: $2.27
  • Aetna — NewBusiness: $1.79
  • Ambetter — CORE: $2.52
  • Ambetter — Select: $2.34
  • American Health Advantage — MCRHMO: $2.36
  • American Health Advantage — MCRPFFS: $2.36
  • American Health Advantage — MCRPOS: $2.36
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, Not listed in the file Not listed in the file $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 $595 $595 $18.39
PSA (prostate specific antigen) blood test: 10 of 46 insurance plan rates
  • Aetna — COMM: $14.62
  • Aetna — MGMCRHMO: $18.57
  • Aetna — MGMCRPPO: $18.57
  • Aetna — MGMCRSNP: $18.57
  • Aetna — NewBusiness: $14.62
  • Ambetter — CORE: $20.60
  • Ambetter — Select: $19.13
  • American Health Advantage — MCRHMO: $19.31
  • American Health Advantage — MCRPFFS: $19.31
  • American Health Advantage — MCRPOS: $19.31
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROS SPEC AG (PSA) TOTAL $595 $595 $109.54 – $523.60
PSA (prostate specific antigen) blood test: 10 of 17 insurance plan rates
  • Aetna — NAP: $297.50
  • Apex Health — MCR: $113.05
  • Beech Street — COMM: $523.60
  • BGFH SingleSource — DIRECTNETWORK: $297.50
  • BGFH SingleSource — LEASEDNETWORK: $505.75
  • Centurion — PRISON: $245.14
  • Cigna — PPO: $193.97
  • Employers Health Network — COMM: $416.50
  • Humana — TRICARE: $148.75
  • Kentucky Labor Cabinet — WORKERSCOMP: $109.54
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH) $559 $559 $16.80
Thyroid stimulating hormone (TSH) test: 10 of 46 insurance plan rates
  • Aetna — COMM: $13.36
  • Aetna — MGMCRHMO: $16.97
  • Aetna — MGMCRPPO: $16.97
  • Aetna — MGMCRSNP: $16.97
  • Aetna — NewBusiness: $13.36
  • Ambetter — CORE: $18.82
  • Ambetter — Select: $17.47
  • American Health Advantage — MCRHMO: $17.64
  • American Health Advantage — MCRPFFS: $17.64
  • American Health Advantage — MCRPOS: $17.64
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH $559 $559 $102.91 – $491.92
Thyroid stimulating hormone (TSH) test: 10 of 17 insurance plan rates
  • Aetna — NAP: $279.50
  • Apex Health — MCR: $106.21
  • Beech Street — COMM: $491.92
  • BGFH SingleSource — DIRECTNETWORK: $279.50
  • BGFH SingleSource — LEASEDNETWORK: $475.15
  • Centurion — PRISON: $230.31
  • Cigna — PPO: $182.23
  • Employers Health Network — COMM: $391.30
  • Humana — TRICARE: $139.75
  • Kentucky Labor Cabinet — WORKERSCOMP: $102.91
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · modifier QW In the file: Thyroid stimulating hormone (TSH) $559 $559 $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 $3.50 – $43.75
Complete blood count (CBC) with differential: 10 of 46 insurance plan rates
  • Aetna — COMM: $6.18
  • Aetna — MGMCRHMO: $7.85
  • Aetna — MGMCRPPO: $7.85
  • Aetna — MGMCRSNP: $7.85
  • Aetna — NewBusiness: $6.18
  • Ambetter — CORE: $8.70
  • Ambetter — Select: $8.08
  • American Health Advantage — MCRHMO: $8.16
  • American Health Advantage — MCRPFFS: $8.16
  • American Health Advantage — MCRPOS: $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: CBC AUTOMATED $642 $642 $118.19 – $564.96
Complete blood count (CBC), automated: 10 of 17 insurance plan rates
  • Aetna — NAP: $321
  • Apex Health — MCR: $121.98
  • Beech Street — COMM: $564.96
  • BGFH SingleSource — DIRECTNETWORK: $321
  • BGFH SingleSource — LEASEDNETWORK: $545.70
  • Centurion — PRISON: $264.50
  • Cigna — PPO: $209.29
  • Employers Health Network — COMM: $449.40
  • Humana — TRICARE: $160.50
  • Kentucky Labor Cabinet — WORKERSCOMP: $118.19
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) Not listed in the file Not listed in the file $6.47
Complete blood count (CBC), automated: 10 of 46 insurance plan rates
  • Aetna — COMM: $5.14
  • Aetna — MGMCRHMO: $6.53
  • Aetna — MGMCRPPO: $6.53
  • Aetna — MGMCRSNP: $6.53
  • Aetna — NewBusiness: $5.14
  • Ambetter — CORE: $7.25
  • Ambetter — Select: $6.73
  • American Health Advantage — MCRHMO: $6.79
  • American Health Advantage — MCRPFFS: $6.79
  • American Health Advantage — MCRPOS: $6.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME $595 $595 $109.54 – $523.60
Blood clotting time test (prothrombin time, PT): 10 of 17 insurance plan rates
  • Aetna — NAP: $297.50
  • Apex Health — MCR: $113.05
  • Beech Street — COMM: $523.60
  • BGFH SingleSource — DIRECTNETWORK: $297.50
  • BGFH SingleSource — LEASEDNETWORK: $505.75
  • Centurion — PRISON: $245.14
  • Cigna — PPO: $193.97
  • Employers Health Network — COMM: $416.50
  • Humana — TRICARE: $148.75
  • Kentucky Labor Cabinet — WORKERSCOMP: $109.54
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time; Not listed in the file Not listed in the file $4.29
Blood clotting time test (prothrombin time, PT): 10 of 46 insurance plan rates
  • Aetna — COMM: $3.41
  • Aetna — MGMCRHMO: $4.33
  • Aetna — MGMCRPPO: $4.33
  • Aetna — MGMCRSNP: $4.33
  • Aetna — NewBusiness: $3.41
  • Ambetter — CORE: $4.81
  • Ambetter — Select: $4.46
  • American Health Advantage — MCRHMO: $4.50
  • American Health Advantage — MCRPFFS: $4.50
  • American Health Advantage — MCRPOS: $4.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · modifier QW In the file: Prothrombin time; Not listed in the file Not listed in the file $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: PTT $615 $615 $113.22 – $541.20
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates
  • Aetna — NAP: $307.50
  • Apex Health — MCR: $116.85
  • Beech Street — COMM: $541.20
  • BGFH SingleSource — DIRECTNETWORK: $307.50
  • BGFH SingleSource — LEASEDNETWORK: $522.75
  • Centurion — PRISON: $253.38
  • Cigna — PPO: $200.49
  • Employers Health Network — COMM: $430.50
  • Humana — TRICARE: $153.75
  • Kentucky Labor Cabinet — WORKERSCOMP: $113.22
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood Not listed in the file Not listed in the file $6.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 46 insurance plan rates
  • Aetna — COMM: $4.78
  • Aetna — MGMCRHMO: $6.07
  • Aetna — MGMCRPPO: $6.07
  • Aetna — MGMCRSNP: $6.07
  • Aetna — NewBusiness: $4.78
  • Ambetter — CORE: $6.73
  • Ambetter — Select: $6.25
  • American Health Advantage — MCRHMO: $6.31
  • American Health Advantage — MCRPFFS: $6.31
  • American Health Advantage — MCRPOS: $6.31

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD/BRAIN W/O CONT $6,535.95 $6,535.95 $1,203.27 – $5,751.64
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates
  • Aetna — NAP: $3,267.97
  • Apex Health — MCR: $1,241.83
  • Beech Street — COMM: $5,751.64
  • BGFH SingleSource — DIRECTNETWORK: $3,267.97
  • BGFH SingleSource — LEASEDNETWORK: $5,555.56
  • Cigna — PPO: $2,130.72
  • Employers Health Network — COMM: $4,575.16
  • Humana — TRICARE: $1,633.99
  • Kentucky Labor Cabinet — WORKERSCOMP: $1,203.27
  • Multiplan — COMM: $3,790.85
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 Not listed in the file Not listed in the file $154.52
CT scan of the head or brain, without contrast: rates for 8 insurance plans
  • Aetna — COMM: $459.25
  • Aetna — NewBusiness: $459.25
  • BCBS — BlueCare: $355.72
  • BCBS — COVERKIDS: $230.02
  • BCBS — TENNCARE: $212.63
  • 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 Not listed in the file Not listed in the file $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 $10,547.33 $10,547.33 $1,941.76 – $9,281.65
MRI of the brain, before and after contrast: 10 of 15 insurance plan rates
  • Aetna — NAP: $5,273.66
  • Apex Health — MCR: $2,003.99
  • Beech Street — COMM: $9,281.65
  • BGFH SingleSource — DIRECTNETWORK: $5,273.66
  • BGFH SingleSource — LEASEDNETWORK: $8,965.23
  • Cigna — PPO: $3,438.43
  • Employers Health Network — COMM: $7,383.13
  • Humana — TRICARE: $2,636.83
  • Kentucky Labor Cabinet — WORKERSCOMP: $1,941.76
  • Multiplan — COMM: $6,117.45
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 $10,547.33 $10,547.33 $616.10
MRI of the brain, before and after contrast: rates for 8 insurance plans
  • Aetna — COMM: $887.81
  • Aetna — NewBusiness: $887.81
  • BCBS — BlueCare: $1,875.09
  • BCBS — COVERKIDS: $1,212.46
  • BCBS — TENNCARE: $1,120.82
  • 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 TC In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth $10,547.33 $10,547.33 $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 $1,044.72 $1,044.72 $192.33 – $919.35
Chest X-ray, 2 views: 10 of 17 insurance plan rates
  • Aetna — NAP: $522.36
  • Apex Health — MCR: $198.50
  • Beech Street — COMM: $919.35
  • BGFH SingleSource — DIRECTNETWORK: $522.36
  • BGFH SingleSource — LEASEDNETWORK: $888.01
  • Centurion — PRISON: $430.42
  • Cigna — PPO: $340.58
  • Employers Health Network — COMM: $731.30
  • Humana — TRICARE: $261.18
  • Kentucky Labor Cabinet — WORKERSCOMP: $192.33
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiologic examination, chest; 2 views Not listed in the file Not listed in the file $83.86
Chest X-ray, 2 views: 10 of 11 insurance plan rates
  • Aetna — COMM: $45.12
  • Aetna — NewBusiness: $45.12
  • BCBS — BlueCare: $38.25
  • BCBS — COVERKIDS: $24.73
  • BCBS — NetworkP: $17.35
  • BCBS — TENNCARE: $22.86
  • Cigna — NewBusiness: $76.44
  • Cigna — OAP: $85.92
  • United — AllPayerAppendix: $83.86
  • United — Core: $83.86
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination, chest; 2 views Not listed in the file Not listed in the file $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 $1,499.11 $1,499.11 $275.99 – $1,319.22
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates
  • Aetna — NAP: $749.55
  • Apex Health — MCR: $284.83
  • Beech Street — COMM: $1,319.22
  • BGFH SingleSource — DIRECTNETWORK: $749.55
  • BGFH SingleSource — LEASEDNETWORK: $1,274.24
  • Centurion — PRISON: $617.63
  • Cigna — PPO: $488.71
  • Employers Health Network — COMM: $1,049.38
  • Humana — TRICARE: $374.78
  • Kentucky Labor Cabinet — WORKERSCOMP: $275.99
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 Not listed in the file Not listed in the file $154.52
X-ray of the lower spine, at least 4 views: 10 of 11 insurance plan rates
  • Aetna — COMM: $67.95
  • Aetna — NewBusiness: $67.95
  • BCBS — BlueCare: $68.81
  • BCBS — COVERKIDS: $44.50
  • BCBS — NetworkP: $29.82
  • BCBS — TENNCARE: $41.13
  • Cigna — NewBusiness: $129.20
  • Cigna — OAP: $145.22
  • United — AllPayerAppendix: $154.52
  • United — Core: $154.52
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier 26 In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views Not listed in the file Not listed in the file $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 $8,454.45 $8,454.45 $1,556.46 – $7,439.92
MRI of the lower back (lumbar spine), without contrast: 10 of 15 insurance plan rates
  • Aetna — NAP: $4,227.23
  • Apex Health — MCR: $1,606.35
  • Beech Street — COMM: $7,439.92
  • BGFH SingleSource — DIRECTNETWORK: $4,227.23
  • BGFH SingleSource — LEASEDNETWORK: $7,186.28
  • Cigna — PPO: $2,756.15
  • Employers Health Network — COMM: $5,918.11
  • Humana — TRICARE: $2,113.61
  • Kentucky Labor Cabinet — WORKERSCOMP: $1,556.46
  • Multiplan — COMM: $4,903.58
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 $8,454.45 $8,454.45 $313.62
MRI of the lower back (lumbar spine), without contrast: rates for 8 insurance plans
  • Aetna — COMM: $530.38
  • Aetna — NewBusiness: $530.38
  • BCBS — BlueCare: $937.38
  • BCBS — COVERKIDS: $606.13
  • BCBS — TENNCARE: $560.32
  • 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 26 In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material $8,454.45 $8,454.45 $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 $6,865.43 $6,865.43 $1,263.93 – $6,041.58
CT scan of the pelvis, with contrast: 10 of 15 insurance plan rates
  • Aetna — NAP: $3,432.72
  • Apex Health — MCR: $1,304.43
  • Beech Street — COMM: $6,041.58
  • BGFH SingleSource — DIRECTNETWORK: $3,432.72
  • BGFH SingleSource — LEASEDNETWORK: $5,835.62
  • Cigna — PPO: $2,238.13
  • Employers Health Network — COMM: $4,805.80
  • Humana — TRICARE: $1,716.36
  • Kentucky Labor Cabinet — WORKERSCOMP: $1,263.93
  • Multiplan — COMM: $3,981.95
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Computed tomography, pelvis; with contrast material(s) Not listed in the file Not listed in the file $341.20
CT scan of the pelvis, with contrast: rates for 8 insurance plans
  • Aetna — COMM: $459.25
  • Aetna — NewBusiness: $459.25
  • BCBS — BlueCare: $515.45
  • BCBS — COVERKIDS: $333.30
  • BCBS — TENNCARE: $308.11
  • 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 TC In the file: Computed tomography, pelvis; with contrast material(s) Not listed in the file Not listed in the file $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 $504.63 – $844.23
MRI of a leg joint (such as the knee), without contrast: rates for 8 insurance plans
  • Aetna — COMM: $557.98
  • Aetna — NewBusiness: $557.98
  • BCBS — BlueCare: $844.23
  • BCBS — COVERKIDS: $545.89
  • BCBS — TENNCARE: $504.63
  • 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 LT In the file: MRI LW JNT W/O CONT LT $8,254.19 $8,254.19 $1,519.60 – $7,263.69
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates
  • Aetna — NAP: $4,127.10
  • Apex Health — MCR: $1,568.30
  • Beech Street — COMM: $7,263.69
  • BGFH SingleSource — DIRECTNETWORK: $4,127.10
  • BGFH SingleSource — LEASEDNETWORK: $7,016.06
  • Cigna — PPO: $2,690.87
  • Employers Health Network — COMM: $5,777.93
  • Humana — TRICARE: $2,063.55
  • Kentucky Labor Cabinet — WORKERSCOMP: $1,519.60
  • Multiplan — COMM: $4,787.43
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 $8,254.19 $8,254.19 $1,519.60 – $7,263.69
MRI of a leg joint (such as the knee), without contrast: 10 of 15 insurance plan rates
  • Aetna — NAP: $4,127.10
  • Apex Health — MCR: $1,568.30
  • Beech Street — COMM: $7,263.69
  • BGFH SingleSource — DIRECTNETWORK: $4,127.10
  • BGFH SingleSource — LEASEDNETWORK: $7,016.06
  • Cigna — PPO: $2,690.87
  • Employers Health Network — COMM: $5,777.93
  • Humana — TRICARE: $2,063.55
  • Kentucky Labor Cabinet — WORKERSCOMP: $1,519.60
  • Multiplan — COMM: $4,787.43
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD&PELVIS W/CONT $13,984.87 $13,984.87 $2,574.61 – $12,306.69
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates
  • Aetna — NAP: $6,992.44
  • Apex Health — MCR: $2,657.13
  • Beech Street — COMM: $12,306.69
  • BGFH SingleSource — DIRECTNETWORK: $6,992.44
  • BGFH SingleSource — LEASEDNETWORK: $11,887.14
  • Cigna — PPO: $4,559.07
  • Employers Health Network — COMM: $9,789.41
  • Humana — TRICARE: $3,496.22
  • Kentucky Labor Cabinet — WORKERSCOMP: $2,574.61
  • Multiplan — COMM: $8,111.22
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) Not listed in the file Not listed in the file $341.20
CT scan of the abdomen and pelvis, with contrast: rates for 8 insurance plans
  • Aetna — COMM: $459.25
  • Aetna — NewBusiness: $459.25
  • BCBS — BlueCare: $513.19
  • BCBS — COVERKIDS: $331.84
  • BCBS — TENNCARE: $306.76
  • 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) Not listed in the file Not listed in the file $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 $2,690.52 $2,690.52 $495.32 – $2,367.66
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates
  • Aetna — NAP: $1,345.26
  • Apex Health — MCR: $511.20
  • Beech Street — COMM: $2,367.66
  • BGFH SingleSource — DIRECTNETWORK: $1,345.26
  • BGFH SingleSource — LEASEDNETWORK: $2,286.94
  • Centurion — PRISON: $1,108.49
  • Cigna — PPO: $877.11
  • Employers Health Network — COMM: $1,883.36
  • Humana — TRICARE: $672.63
  • Kentucky Labor Cabinet — WORKERSCOMP: $495.32
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Ultrasound, abdominal, real time with image documentation; complete Not listed in the file Not listed in the file $88.55 – $285.46
Ultrasound of the abdomen, complete: 10 of 11 insurance plan rates
  • Aetna — COMM: $164.86
  • Aetna — NewBusiness: $164.86
  • BCBS — BlueCare: $148.14
  • BCBS — COVERKIDS: $95.79
  • BCBS — NetworkP: $89.41
  • BCBS — TENNCARE: $88.55
  • Cigna — NewBusiness: $253.97
  • Cigna — OAP: $285.46
  • United — AllPayerAppendix: $154.52
  • United — Core: $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 Not listed in the file Not listed in the file $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 $2,280.64 $2,280.64 $419.87 – $2,006.96
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates
  • Aetna — NAP: $1,140.32
  • Apex Health — MCR: $433.32
  • Beech Street — COMM: $2,006.96
  • BGFH SingleSource — DIRECTNETWORK: $1,140.32
  • BGFH SingleSource — LEASEDNETWORK: $1,938.54
  • Centurion — PRISON: $939.62
  • Cigna — PPO: $743.49
  • Employers Health Network — COMM: $1,596.45
  • Humana — TRICARE: $570.16
  • Kentucky Labor Cabinet — WORKERSCOMP: $419.87
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 Not listed in the file Not listed in the file $154.52
Pregnancy ultrasound (after the first trimester): 10 of 11 insurance plan rates
  • Aetna — COMM: $189.81
  • Aetna — NewBusiness: $189.81
  • BCBS — BlueCare: $158.19
  • BCBS — COVERKIDS: $102.29
  • BCBS — NetworkP: $85.94
  • BCBS — TENNCARE: $94.56
  • Cigna — NewBusiness: $285.84
  • Cigna — OAP: $321.29
  • United — AllPayerAppendix: $154.52
  • United — Core: $154.52
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day Not listed in the file Not listed in the file $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 $2,369.10 $2,369.10 $436.15 – $2,084.81
Transvaginal ultrasound: 10 of 17 insurance plan rates
  • Aetna — NAP: $1,184.55
  • Apex Health — MCR: $450.13
  • Beech Street — COMM: $2,084.81
  • BGFH SingleSource — DIRECTNETWORK: $1,184.55
  • BGFH SingleSource — LEASEDNETWORK: $2,013.73
  • Centurion — PRISON: $976.07
  • Cigna — PPO: $772.33
  • Employers Health Network — COMM: $1,658.37
  • Humana — TRICARE: $592.27
  • Kentucky Labor Cabinet — WORKERSCOMP: $436.15
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound, transvaginal Not listed in the file Not listed in the file $154.52
Transvaginal ultrasound: 10 of 11 insurance plan rates
  • Aetna — COMM: $167.37
  • Aetna — NewBusiness: $167.37
  • BCBS — BlueCare: $115.18
  • BCBS — COVERKIDS: $74.48
  • BCBS — NetworkP: $81.52
  • BCBS — TENNCARE: $68.85
  • Cigna — NewBusiness: $279.25
  • Cigna — OAP: $313.88
  • United — AllPayerAppendix: $154.52
  • United — Core: $154.52
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, transvaginal Not listed in the file Not listed in the file $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 $56.31 – $323.76
Diagnostic mammogram, one breast: 10 of 41 insurance plan rates
  • Aetna — COMM: $173.45
  • Aetna — MGMCRHMO: $78.99
  • Aetna — MGMCRPPO: $78.99
  • Aetna — MGMCRSNP: $78.99
  • Aetna — NewBusiness: $173.45
  • American Health Advantage — MCRHMO: $82.12
  • American Health Advantage — MCRPFFS: $82.12
  • American Health Advantage — MCRPOS: $82.12
  • American Health Advantage — MCRPPO: $82.12
  • American Health Advantage — MCRSNP: $82.12
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier RT In the file: MAMMO DIAG CAD UNI RT $827.01 $827.01 $152.25 – $727.77
Diagnostic mammogram, one breast: 10 of 16 insurance plan rates
  • Aetna — NAP: $413.50
  • Apex Health — MCR: $157.13
  • Beech Street — COMM: $727.77
  • BGFH SingleSource — DIRECTNETWORK: $413.50
  • BGFH SingleSource — LEASEDNETWORK: $702.96
  • Cigna — PPO: $269.61
  • Employers Health Network — COMM: $578.91
  • Humana — TRICARE: $206.75
  • Kentucky Labor Cabinet — WORKERSCOMP: $152.25
  • Multiplan — COMM: $479.67
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier LT In the file: MAMMO DIAG CAD UNI LT $827.01 $827.01 $152.25 – $727.77
Diagnostic mammogram, one breast: 10 of 16 insurance plan rates
  • Aetna — NAP: $413.50
  • Apex Health — MCR: $157.13
  • Beech Street — COMM: $727.77
  • BGFH SingleSource — DIRECTNETWORK: $413.50
  • BGFH SingleSource — LEASEDNETWORK: $702.96
  • Cigna — PPO: $269.61
  • Employers Health Network — COMM: $578.91
  • Humana — TRICARE: $206.75
  • Kentucky Labor Cabinet — WORKERSCOMP: $152.25
  • Multiplan — COMM: $479.67
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral $982.30 $982.30 $165.73
Diagnostic mammogram, both breasts: 10 of 41 insurance plan rates
  • Aetna — COMM: $219.50
  • Aetna — MGMCRHMO: $101.25
  • Aetna — MGMCRPPO: $101.25
  • Aetna — MGMCRSNP: $101.25
  • Aetna — NewBusiness: $219.50
  • American Health Advantage — MCRHMO: $105.26
  • American Health Advantage — MCRPFFS: $105.26
  • American Health Advantage — MCRPOS: $105.26
  • American Health Advantage — MCRPPO: $105.26
  • American Health Advantage — MCRSNP: $105.26
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMMO DIAG CAD BI $982.30 $982.30 $180.84 – $864.42
Diagnostic mammogram, both breasts: 10 of 16 insurance plan rates
  • Aetna — NAP: $491.15
  • Apex Health — MCR: $186.64
  • Beech Street — COMM: $864.42
  • BGFH SingleSource — DIRECTNETWORK: $491.15
  • BGFH SingleSource — LEASEDNETWORK: $834.96
  • Cigna — PPO: $320.23
  • Employers Health Network — COMM: $687.61
  • Humana — TRICARE: $245.57
  • Kentucky Labor Cabinet — WORKERSCOMP: $180.84
  • Multiplan — COMM: $569.73
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 $982.30 $982.30 $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 $949.78 $949.78 $174.85 – $835.81
Screening mammogram, both breasts: 10 of 17 insurance plan rates
  • Aetna — NAP: $474.89
  • Apex Health — MCR: $180.46
  • Beech Street — COMM: $835.81
  • BGFH SingleSource — DIRECTNETWORK: $474.89
  • BGFH SingleSource — LEASEDNETWORK: $807.31
  • Centurion — PRISON: $391.31
  • Cigna — PPO: $309.63
  • Employers Health Network — COMM: $664.85
  • Humana — TRICARE: $237.44
  • Kentucky Labor Cabinet — WORKERSCOMP: $174.85
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 $137.05
Screening mammogram, both breasts: 10 of 41 insurance plan rates
  • Aetna — COMM: $177.25
  • Aetna — MGMCRHMO: $83.59
  • Aetna — MGMCRPPO: $83.59
  • Aetna — MGMCRSNP: $83.59
  • Aetna — NewBusiness: $177.25
  • American Health Advantage — MCRHMO: $86.90
  • American Health Advantage — MCRPFFS: $86.90
  • American Health Advantage — MCRPOS: $86.90
  • American Health Advantage — MCRPPO: $86.90
  • American Health Advantage — MCRSNP: $86.90
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier 52 In the file: MAMMO SCR CAD 1BRST $949.78 $949.78 $174.85 – $835.81
Screening mammogram, both breasts: 10 of 17 insurance plan rates
  • Aetna — NAP: $474.89
  • Apex Health — MCR: $180.46
  • Beech Street — COMM: $835.81
  • BGFH SingleSource — DIRECTNETWORK: $474.89
  • BGFH SingleSource — LEASEDNETWORK: $807.31
  • Centurion — PRISON: $391.31
  • Cigna — PPO: $309.63
  • Employers Health Network — COMM: $664.85
  • Humana — TRICARE: $237.44
  • Kentucky Labor Cabinet — WORKERSCOMP: $174.85

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance 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 $41.18 – $4,700
Electrocardiogram (ECG/EKG) with reading: rates for 5 insurance plans
  • Aetna — COMM: $4,700
  • Aetna — NewBusiness: $3,807
  • BCBS — BlueCare: $69.19
  • BCBS — COVERKIDS: $44.53
  • BCBS — TENNCARE: $41.18
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 $1,607.50 – $9,813
Left heart catheterization (diagnostic): 10 of 21 insurance plan rates
  • Aetna — COMM: $16,577
  • Aetna — NewBusiness: $14,137
  • Ambetter — CORE: $8,436
  • Ambetter — Select: $7,800
  • Apex Health — MCR: $3,850
  • BCBS — BlueCare: $1,815
  • BCBS — COVERKIDS: $1,741.89
  • BCBS — NetworkP: $9,786
  • BCBS — TENNCARE: $1,607.50
  • Bright Health — HIX: $5,140
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 $2,187 – $21,155
Heart rhythm study (electrophysiology evaluation): 10 of 17 insurance plan rates
  • Aetna — COMM: $30,393
  • Aetna — NewBusiness: $25,919
  • Ambetter — CORE: $16,873
  • Ambetter — Select: $15,600
  • Apex Health — MCR: $7,950
  • BCBS — BlueCare: $725.74
  • BCBS — COVERKIDS: $467.08
  • BCBS — TENNCARE: $431.93
  • Bright Health — HIX: $5,094
  • Bright Health — SmallGroup: $6,946
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 $2,706 – $36,635
Heart rhythm study with ablation for atrial fibrillation: 10 of 16 insurance plan rates
  • Aetna — COMM: $30,393
  • Aetna — NewBusiness: $25,919
  • Apex Health — MCR: $7,950
  • BCBS — BlueCare: $2,706
  • BCBS — COVERKIDS: $6,355.86
  • BCBS — NetworkP: $39,148
  • BCBS — TENNCARE: $5,865.50
  • Bright Health — HIX: $3,723
  • Bright Health — SmallGroup: $5,078
  • Cigna — NewBusiness: $11,132
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 Not listed in the file Not listed in the file $1,343 – $1,790
Sleep study (overnight, in a sleep lab): rates for 8 insurance plans
  • Aetna — COMM: $2,710
  • Aetna — NewBusiness: $2,311
  • BCBS — BlueCare: $452.14
  • BCBS — COVERKIDS: $291
  • BCBS — TENNCARE: $269.09
  • United — AllPayerAppendix: $1,790
  • United — Core: $1,343
  • United — HeritageSelect: $1,432

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance 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 $19.92 – $326
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 36 insurance plan rates
  • Aetna — COMM: $326
  • Aetna — MGMCRHMO: $27.94
  • Aetna — MGMCRPPO: $27.94
  • Aetna — MGMCRSNP: $27.94
  • Aetna — NewBusiness: $274
  • American Health Advantage — MCRHMO: $29.04
  • American Health Advantage — MCRPFFS: $29.04
  • American Health Advantage — MCRPOS: $29.04
  • American Health Advantage — MCRPPO: $29.04
  • American Health Advantage — MCRSNP: $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 $580.92 $580.92 $98.76 – $511.21
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates
  • Aetna — NAP: $290.46
  • Ambetter — CORE: $129.55
  • Ambetter — Select: $134.77
  • Apex Health — MCR: $110.37
  • Beech Street — COMM: $511.21
  • BGFH SingleSource — DIRECTNETWORK: $290.46
  • BGFH SingleSource — LEASEDNETWORK: $493.78
  • Bright Health — HIX: $98.76
  • Bright Health — SmallGroup: $139.42
  • Cigna — NewBusiness: $146.39
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO|CO In the file: THER EXERCIS 15 MIN OTCO $580.92 $580.92 $98.76 – $511.21
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates
  • Aetna — NAP: $290.46
  • Ambetter — CORE: $129.55
  • Ambetter — Select: $134.77
  • Apex Health — MCR: $110.37
  • Beech Street — COMM: $511.21
  • BGFH SingleSource — DIRECTNETWORK: $290.46
  • BGFH SingleSource — LEASEDNETWORK: $493.78
  • Bright Health — HIX: $98.76
  • Bright Health — SmallGroup: $139.42
  • Cigna — NewBusiness: $146.39
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 $717.62 $717.62 $201.74
Physical therapy evaluation (low complexity): 10 of 36 insurance plan rates
  • Aetna — COMM: $326
  • Aetna — MGMCRHMO: $94.46
  • Aetna — MGMCRPPO: $94.46
  • Aetna — MGMCRSNP: $94.46
  • Aetna — NewBusiness: $274
  • American Health Advantage — MCRHMO: $98.20
  • American Health Advantage — MCRPFFS: $98.20
  • American Health Advantage — MCRPOS: $98.20
  • American Health Advantage — MCRPPO: $98.20
  • American Health Advantage — MCRSNP: $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 $717.62 $717.62 $59.25 – $120.98
Physical therapy evaluation (low complexity): 10 of 30 insurance plan rates
  • Aetna — MGMCRHMO: $83.12
  • Aetna — MGMCRPPO: $83.12
  • Aetna — MGMCRSNP: $83.12
  • 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
  • ATRIO Golden Times — MCR: $90.53
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT LOW COMPLEX $717.62 $717.62 $122 – $631.51
Physical therapy evaluation (low complexity): 10 of 23 insurance plan rates
  • Aetna — NAP: $358.81
  • Ambetter — CORE: $160.03
  • Ambetter — Select: $166.49
  • Apex Health — MCR: $136.35
  • Beech Street — COMM: $631.51
  • BGFH SingleSource — DIRECTNETWORK: $358.81
  • BGFH SingleSource — LEASEDNETWORK: $609.98
  • Bright Health — HIX: $122
  • Bright Health — SmallGroup: $172.23
  • Cigna — NewBusiness: $180.84
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 $738.37 $738.37 $201.74
Physical therapy evaluation (moderate complexity): 10 of 36 insurance plan rates
  • Aetna — COMM: $326
  • Aetna — MGMCRHMO: $94.46
  • Aetna — MGMCRPPO: $94.46
  • Aetna — MGMCRSNP: $94.46
  • Aetna — NewBusiness: $274
  • American Health Advantage — MCRHMO: $98.20
  • American Health Advantage — MCRPFFS: $98.20
  • American Health Advantage — MCRPOS: $98.20
  • American Health Advantage — MCRPPO: $98.20
  • American Health Advantage — MCRSNP: $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 $738.37 $738.37 $59.25 – $120.98
Physical therapy evaluation (moderate complexity): 10 of 30 insurance plan rates
  • Aetna — MGMCRHMO: $83.12
  • Aetna — MGMCRPPO: $83.12
  • Aetna — MGMCRSNP: $83.12
  • 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
  • ATRIO Golden Times — MCR: $90.53
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT MOD COMPLEX $738.37 $738.37 $125.52 – $649.77
Physical therapy evaluation (moderate complexity): 10 of 23 insurance plan rates
  • Aetna — NAP: $369.19
  • Ambetter — CORE: $164.66
  • Ambetter — Select: $171.30
  • Apex Health — MCR: $140.29
  • Beech Street — COMM: $649.77
  • BGFH SingleSource — DIRECTNETWORK: $369.19
  • BGFH SingleSource — LEASEDNETWORK: $627.61
  • Bright Health — HIX: $125.52
  • Bright Health — SmallGroup: $177.21
  • Cigna — NewBusiness: $186.07
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 $759.72 $759.72 $201.74
Physical therapy evaluation (high complexity): 10 of 36 insurance plan rates
  • Aetna — COMM: $326
  • Aetna — MGMCRHMO: $94.46
  • Aetna — MGMCRPPO: $94.46
  • Aetna — MGMCRSNP: $94.46
  • Aetna — NewBusiness: $274
  • American Health Advantage — MCRHMO: $98.20
  • American Health Advantage — MCRPFFS: $98.20
  • American Health Advantage — MCRPOS: $98.20
  • American Health Advantage — MCRPPO: $98.20
  • American Health Advantage — MCRSNP: $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 $759.72 $759.72 $59.25 – $120.98
Physical therapy evaluation (high complexity): 10 of 30 insurance plan rates
  • Aetna — MGMCRHMO: $83.12
  • Aetna — MGMCRPPO: $83.12
  • Aetna — MGMCRSNP: $83.12
  • 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
  • ATRIO Golden Times — MCR: $90.53
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT HIGH COMPLEX $759.72 $759.72 $129.15 – $668.55
Physical therapy evaluation (high complexity): 10 of 23 insurance plan rates
  • Aetna — NAP: $379.86
  • Ambetter — CORE: $169.42
  • Ambetter — Select: $176.26
  • Apex Health — MCR: $144.35
  • Beech Street — COMM: $668.55
  • BGFH SingleSource — DIRECTNETWORK: $379.86
  • BGFH SingleSource — LEASEDNETWORK: $645.76
  • Bright Health — HIX: $129.15
  • Bright Health — SmallGroup: $182.33
  • Cigna — NewBusiness: $191.45
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psychotherapy (without the patient present), 50 minutes Not listed in the file Not listed in the file $139.82 – $234.93
Family psychotherapy, without the patient: rates for 3 insurance plans
  • BCBS — BlueCare: $234.93
  • BCBS — COVERKIDS: $151.20
  • BCBS — TENNCARE: $139.82
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes Not listed in the file Not listed in the file $159.13 – $267.38
Family psychotherapy, with the patient: rates for 3 insurance plans
  • BCBS — BlueCare: $267.38
  • BCBS — COVERKIDS: $172.09
  • BCBS — TENNCARE: $159.13
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Group psychotherapy (other than of a multiple-family group) Not listed in the file Not listed in the file $38.99 – $65.52
Group psychotherapy: rates for 3 insurance plans
  • BCBS — BlueCare: $65.52
  • BCBS — COVERKIDS: $42.17
  • BCBS — TENNCARE: $38.99

Procedures and surgery

ServiceHospital chargeCash priceInsurance 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 $1,257 – $6,446
Removal of breast growth (open surgery): 10 of 20 insurance plan rates
  • Aetna — COMM: $6,446
  • Aetna — NewBusiness: $5,050
  • Ambetter — CORE: $2,490
  • Ambetter — Select: $2,302
  • Apex Health — MCR: $4,950
  • BCBS — BlueCare: $1,815
  • BCBS — COVERKIDS: $1,741.89
  • BCBS — NetworkP: $3,441
  • BCBS — TENNCARE: $1,607.50
  • Bright Health — HIX: $1,257
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 28 insurance plan rates
  • Aetna — COMM: $26,035
  • Aetna — NewBusiness: $20,979
  • Ambetter — CORE: $20,500
  • Ambetter — Select: $18,954
  • Apex Health — MCR: $2,550
  • ATRIO Golden Times — MCR: $16,012.31
  • BCBS — BlueCare: $2,179
  • BCBS — COVERKIDS: $2,924.95
  • BCBS — NetworkP: $37,269
  • BCBS — TENNCARE: $2,699.29
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 $2,550 – $34,140
Total knee replacement: 10 of 28 insurance plan rates
  • Aetna — COMM: $26,035
  • Aetna — NewBusiness: $20,979
  • Ambetter — CORE: $20,500
  • Ambetter — Select: $18,954
  • Apex Health — MCR: $2,550
  • ATRIO Golden Times — MCR: $16,012.31
  • BCBS — BlueCare: $2,179
  • BCBS — COVERKIDS: $2,924.95
  • BCBS — NetworkP: $37,269
  • BCBS — TENNCARE: $2,699.29
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 $250 – $2,900
Shoulder arthroscopy: shaving of shoulder bone: 10 of 17 insurance plan rates
  • Aetna — COMM: $7,182
  • Aetna — NewBusiness: $7,566
  • Ambetter — CORE: $2,490
  • Ambetter — Select: $2,302
  • Apex Health — MCR: $4,950
  • BCBS — NetworkP: $3,441
  • Bright Health — HIX: $1,257
  • Bright Health — SmallGroup: $1,714
  • Cigna — NewBusiness: $8,960
  • Cigna — OAP: $10,083
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 $1,458 – $5,958
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates
  • Aetna — COMM: $7,182
  • Aetna — NewBusiness: $7,566
  • Ambetter — CORE: $2,760
  • Ambetter — Select: $2,552
  • Apex Health — MCR: $4,950
  • BCBS — BlueCare: $1,815
  • BCBS — COVERKIDS: $1,741.89
  • BCBS — NetworkP: $3,880
  • BCBS — TENNCARE: $1,607.50
  • Bright Health — HIX: $1,471
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 $1,257 – $6,446
Removal of tonsils and adenoids (under age 12): 10 of 20 insurance plan rates
  • Aetna — COMM: $6,446
  • Aetna — NewBusiness: $5,050
  • Ambetter — CORE: $2,490
  • Ambetter — Select: $2,302
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $1,753
  • BCBS — COVERKIDS: $2,522.21
  • BCBS — NetworkP: $4,421
  • BCBS — TENNCARE: $2,327.62
  • Bright Health — HIX: $1,257
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 20 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Ambetter — CORE: $1,069
  • Ambetter — Select: $988
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $990
  • BCBS — COVERKIDS: $921.29
  • BCBS — NetworkP: $2,264
  • BCBS — TENNCARE: $850.21
  • Bright Health — HIX: $607
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 $662 – $4,100
Upper GI endoscopy with biopsy: 10 of 20 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Ambetter — CORE: $1,687
  • Ambetter — Select: $1,560
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $990
  • BCBS — COVERKIDS: $921.29
  • BCBS — NetworkP: $2,753
  • BCBS — TENNCARE: $850.21
  • Bright Health — HIX: $870
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 $662 – $4,100
Colonoscopy (diagnostic): 10 of 20 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Ambetter — CORE: $1,687
  • Ambetter — Select: $1,560
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $990
  • BCBS — COVERKIDS: $921.29
  • BCBS — NetworkP: $2,753
  • BCBS — TENNCARE: $850.21
  • Bright Health — HIX: $870
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 $662 – $4,100
Colonoscopy with biopsy: 10 of 20 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Ambetter — CORE: $1,687
  • Ambetter — Select: $1,560
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $1,564
  • BCBS — COVERKIDS: $1,233.41
  • BCBS — NetworkP: $2,753
  • BCBS — TENNCARE: $1,138.25
  • Bright Health — HIX: $870
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 $662 – $4,100
Colonoscopy with removal of polyps (snare): 10 of 20 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Ambetter — CORE: $1,687
  • Ambetter — Select: $1,560
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $1,564
  • BCBS — COVERKIDS: $1,233.41
  • BCBS — NetworkP: $2,753
  • BCBS — TENNCARE: $1,138.25
  • Bright Health — HIX: $870
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 $662 – $4,100
Ultrasound of the lower bowel by endoscope: 10 of 20 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Ambetter — CORE: $1,687
  • Ambetter — Select: $1,560
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $1,564
  • BCBS — COVERKIDS: $1,233.41
  • BCBS — NetworkP: $2,753
  • BCBS — TENNCARE: $1,138.25
  • Bright Health — HIX: $870
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 17 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Ambetter — CORE: $1,687
  • Ambetter — Select: $1,560
  • BCBS — BlueCare: $990
  • BCBS — COVERKIDS: $921.29
  • BCBS — NetworkP: $2,264
  • BCBS — TENNCARE: $850.21
  • Bright Health — HIX: $870
  • Bright Health — SmallGroup: $1,187
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 $3,542 – $14,628
Gallbladder removal by laparoscope: 10 of 18 insurance plan rates
  • Aetna — COMM: $6,227
  • Aetna — NewBusiness: $5,310
  • Apex Health — MCR: $4,950
  • BCBS — BlueCare: $1,753
  • BCBS — COVERKIDS: $2,522.21
  • BCBS — NetworkP: $6,274
  • BCBS — TENNCARE: $2,327.62
  • Bright Health — HIX: $1,876
  • Bright Health — SmallGroup: $2,559
  • Cigna — NewBusiness: $12,999
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 $1,471 – $6,446
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates
  • Aetna — COMM: $6,446
  • Aetna — NewBusiness: $5,050
  • Ambetter — CORE: $2,760
  • Ambetter — Select: $2,552
  • Apex Health — MCR: $4,950
  • BCBS — BlueCare: $1,815
  • BCBS — COVERKIDS: $1,741.89
  • BCBS — NetworkP: $3,880
  • BCBS — TENNCARE: $1,607.50
  • Bright Health — HIX: $1,471
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 $3,536 – $3,979
Prostate biopsy: 10 of 12 insurance plan rates
  • Ambetter — CORE: $1,687
  • Ambetter — Select: $1,560
  • BCBS — BlueCare: $1,924
  • BCBS — COVERKIDS: $1,417.16
  • BCBS — NetworkP: $2,753
  • BCBS — TENNCARE: $1,307.83
  • Bright Health — HIX: $870
  • Bright Health — SmallGroup: $1,187
  • Cigna — NewBusiness: $3,536
  • Cigna — OAP: $3,979
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 $2,303 – $13,472
Prostate removal by laparoscope (radical prostatectomy): 10 of 20 insurance plan rates
  • Aetna — COMM: $20,647
  • Aetna — NewBusiness: $17,607
  • Ambetter — CORE: $6,468
  • Ambetter — Select: $5,980
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $2,303
  • BCBS — COVERKIDS: $2,758.81
  • BCBS — NetworkP: $6,274
  • BCBS — TENNCARE: $2,545.97
  • Bright Health — HIX: $2,662
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 $1,257 – $6,446
Hysteroscopy with biopsy of the uterus lining: 10 of 20 insurance plan rates
  • Aetna — COMM: $6,446
  • Aetna — NewBusiness: $5,050
  • Ambetter — CORE: $2,490
  • Ambetter — Select: $2,302
  • Apex Health — MCR: $4,950
  • BCBS — BlueCare: $1,815
  • BCBS — COVERKIDS: $1,741.89
  • BCBS — NetworkP: $3,441
  • BCBS — TENNCARE: $1,607.50
  • Bright Health — HIX: $1,257
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 $440 – $3,523
Spinal injection, lower back (epidural), with imaging guidance: 10 of 18 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $990
  • BCBS — COVERKIDS: $921.29
  • BCBS — NetworkP: $2,753
  • BCBS — TENNCARE: $850.21
  • Bright Health — HIX: $607
  • Bright Health — SmallGroup: $827
  • Cigna — NewBusiness: $3,131
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 $3,131 – $3,523
Nerve root injection, lower back, with imaging guidance: 10 of 20 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Ambetter — CORE: $1,069
  • Ambetter — Select: $988
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $990
  • BCBS — COVERKIDS: $921.29
  • BCBS — NetworkP: $2,264
  • BCBS — TENNCARE: $850.21
  • Bright Health — HIX: $607
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 $870 – $4,830
Carpal tunnel release: 10 of 20 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Ambetter — CORE: $1,687
  • Ambetter — Select: $1,560
  • Apex Health — MCR: $4,950
  • BCBS — BlueCare: $1,924
  • BCBS — COVERKIDS: $1,417.16
  • BCBS — NetworkP: $2,753
  • BCBS — TENNCARE: $1,307.83
  • Bright Health — HIX: $870
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 $3,536 – $3,979
Laser treatment of clouding after cataract surgery: 10 of 20 insurance plan rates
  • Aetna — COMM: $2,303
  • Aetna — NewBusiness: $1,804
  • Ambetter — CORE: $1,687
  • Ambetter — Select: $1,560
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $990
  • BCBS — COVERKIDS: $921.29
  • BCBS — NetworkP: $2,753
  • BCBS — TENNCARE: $850.21
  • Bright Health — HIX: $870
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 $1,307.83 – $6,446
Cataract removal with lens implant: 10 of 20 insurance plan rates
  • Aetna — COMM: $6,446
  • Aetna — NewBusiness: $5,050
  • Ambetter — CORE: $4,652
  • Ambetter — Select: $4,301
  • Apex Health — MCR: $2,550
  • BCBS — BlueCare: $1,924
  • BCBS — COVERKIDS: $1,417.16
  • BCBS — NetworkP: $6,051
  • BCBS — TENNCARE: $1,307.83
  • Bright Health — HIX: $3,114

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance 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 $3,435
Vaginal delivery, with care before and after: rates for 6 insurance plans
  • Apex Health — MCR: $2,550
  • BCBS — NetworkP: $3,880
  • NHC Advantage, Inc. — MCRHMO: $2,550
  • Oscar — HIX: $3,435
  • Pruitt Health (AllyAlign) — MCR: $2,550
  • United — TENNCARE: $1,405
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 $1,405 – $3,435
Cesarean delivery (C-section), with care before and after: rates for 6 insurance plans
  • Apex Health — MCR: $2,550
  • BCBS — NetworkP: $4,421
  • NHC Advantage, Inc. — MCRHMO: $2,550
  • Oscar — HIX: $3,435
  • Pruitt Health (AllyAlign) — MCR: $2,550
  • United — TENNCARE: $1,405
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 $1,405 – $3,435
Vaginal delivery after a previous C-section, with care before and after: rates for 6 insurance plans
  • Apex Health — MCR: $2,550
  • BCBS — NetworkP: $3,880
  • NHC Advantage, Inc. — MCRHMO: $2,550
  • Oscar — HIX: $3,435
  • Pruitt Health (AllyAlign) — MCR: $2,550
  • United — TENNCARE: $1,405

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance 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 $84,377.88 – $101,119.52
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 63 insurance plan rates
  • Aetna — COMM: $242,867.79
  • Aetna — MGMCRHMO: $78,931.37
  • Aetna — MGMCRPPO: $78,931.37
  • Aetna — MGMCRSNP: $78,931.37
  • Aetna — NewBusiness: $195,704.91
  • Alive Hospice, Inc. — COMM: $74,242.38
  • 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 $2,253.12 – $36,842.37
Spinal fusion (not neck), without major complications: rates for 5 insurance plans
  • Bright Health — HIX: $30,740.99
  • Bright Health — SmallGroup: $36,842.37
  • CorVel Corporation — WORKERSCOMP: $3,450.09
  • 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 $20,787.47
Hip or knee replacement (major joint of the leg), without major complications: 10 of 63 insurance plan rates
  • Aetna — COMM: $47,886.87
  • Aetna — MGMCRHMO: $19,086.68
  • Aetna — MGMCRPPO: $19,086.68
  • Aetna — MGMCRSNP: $19,086.68
  • Aetna — NewBusiness: $38,587.64
  • Alive Hospice, Inc. — COMM: $17,952.81
  • Ambetter — CORE: $16,490.17
  • Ambetter — Select: $15,246.03
  • American Health Advantage — MCRHMO: $19,842.59
  • American Health Advantage — MCRPFFS: $19,842.59
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 63 insurance plan rates
  • Aetna — COMM: $39,464
  • Aetna — MGMCRHMO: $22,991.03
  • Aetna — MGMCRPPO: $22,991.03
  • Aetna — MGMCRSNP: $22,991.03
  • Aetna — NewBusiness: $32,566
  • Alive Hospice, Inc. — COMM: $21,625.23
  • 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 63 insurance plan rates
  • Aetna — COMM: $22,928
  • Aetna — MGMCRHMO: $13,842.77
  • Aetna — MGMCRPPO: $13,842.77
  • Aetna — MGMCRSNP: $13,842.77
  • Aetna — NewBusiness: $19,553
  • Alive Hospice, Inc. — COMM: $13,020.42
  • Ambetter — CORE: $10,606.74
  • Ambetter — Select: $9,806.49
  • American Health Advantage — MCRHMO: $450
  • American Health Advantage — MCRPFFS: $450

Source: Tristar Southern Hills 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 typeAcute Care Hospital
Address391 Wallace Rd, Nashville, TN 37211
CountyDavidson County
StateTennessee
Phone(615) 781‑4000
Emergency servicesYes
OwnershipProprietary
Medicare overall rating4 of 5 stars
CMS Certification Number440197
Name in Medicare recordsTRISTAR SOUTHERN HILLS MEDICAL CENTER
Profile levelMedicare data + hospital website
Official websitetristarhealth.com
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. About Us - TriStar Southern Hills Medical Center — tristarhealth.com
  2. Hospital in South Nashville | TriStar Southern Hills Medical Center — tristarhealth.com
  3. 24/7 ER in South Nashville | TriStar Southern Hills Medical Center — tristarhealth.com
  4. Radiology in Nashville, TN | TriStar Southern Hills Medical Center — tristarhealth.com
  5. Physical Therapy | Tristar Southern Hills Medical Center | TriStar Southern Hills Medical Center — tristarhealth.com
  6. Stroke Care | TriStar Southern Hills Medical Center — tristarhealth.com
  7. Awards and Recognition | TriStar Southern Hills Medical Center — tristarhealth.com
  8. Heart Specialists | TriStar Southern Hills Medical Center — tristarhealth.com
  9. Neurology & Neurosurgery | TriStar Southern Hills Medical Center — tristarhealth.com
  10. Orthopedics in Nashville | TriStar Southern Hills Medical Center — tristarhealth.com
  11. Surgery in South Nashville | TriStar Southern Hills Medical Center — tristarhealth.com
  12. Bariatric Surgery | TriStar Southern Hills Medical Center — tristarhealth.com
  13. Breast Care | TriStar Southern Hills Medical Center — tristarhealth.com
  14. Women's Services | TriStar Southern Hills Medical Center — tristarhealth.com