Does University of Arkansas Medical Sciences have an emergency room?

Yes. Medicare (CMS) data lists emergency services at University of Arkansas Medical Sciences. In a medical emergency, call 911.

Where is University of Arkansas Medical Sciences?

4301 West Markham Street Mail Slot 612, Little Rock, AR 72205, in Pulaski County, Arkansas.

What is the phone number of University of Arkansas Medical Sciences?

(501) 686-5000, as listed by Medicare (CMS).

What is the Medicare star rating of University of Arkansas Medical Sciences?

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

University of Arkansas Medical Sciences

Quick answers

Does University of Arkansas Medical Sciences have an emergency room?: Yes. Medicare (CMS) data lists emergency services at University of Arkansas Medical Sciences. In a medical emergency, call 911.
Where is University of Arkansas Medical Sciences?: 4301 West Markham Street Mail Slot 612, Little Rock, AR 72205, in Pulaski County, Arkansas.
What is the phone number of University of Arkansas Medical Sciences?: (501) 686-5000, as listed by Medicare (CMS).
What is the Medicare star rating of University of Arkansas Medical Sciences?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Cardiothoracic surgery
Ear, nose and throat care
Neurology
Neurosurgery
Foot and ankle orthopaedics
Hand and upper extremity orthopaedics
Shoulder and elbow orthopaedics
Pregnancy and childbirth
Radiology
Rehabilitation and therapy services
Physical therapy
Trauma care
Stroke care

Conditions treated^[5]

High-risk pregnancy

Treatments^[4]

Breastfeeding and lactation support

Programs and centers^[4][5][6]

Stroke care
Neonatal Intensive Care Unit
Emergency Department

Emergency care (hospital website)^[4][6][7][8]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level I Adult
Stroke designation	Comprehensive Stroke Center (Joint Commission)

Recognition^[4][7][8]

Joint Commission certified Comprehensive Stroke Center
Comprehensive Stroke Center (The Joint Commission)

Doctors and clinicians (1,048)

1,048 doctors and other clinicians list University of Arkansas Medical Sciences 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 (1,048)

Aaron J. Wyble, MDPathology
Aaron M. Starks, CNACertified Registered Nurse Anesthetist (CRNA)
Aaron Wenger, MDInternal Medicine
Aarthi RaoInternal Medicine
Abdul-Nasser Adjei, MDCardiovascular Disease (Cardiology)
Abed N. Almashayekh, MDInternal Medicine
Abhilash Thatikala, MDNeurology
Abigail B. Richison, MDPsychiatry
Abigail E. NicholsCertified Nurse Midwife (CNM)
Adam M. Berry, DOInterventional Radiology
Adam R. Wolfe, MDRadiation Oncology
Adam S. Watkins, MDEmergency Medicine
Adam Sandlin, MDGynecological Oncology
Aditya V. Boddu, MDNeurology
Adriana P. Grigorian, MDOphthalmology
Adrianne F. Basa, MDNephrology
Ahmad M. Debian, MDFamily Practice
Ahmad R. Tarawneh, MDPulmonary Disease
Ahmed A. Sallam, MDOphthalmology
Ahmed F. Shakarchi, MDOphthalmology
Ahmed Y. Abuabdou, MDInternal Medicine
Ahmet M. AydinUrology
Akilah Jefferson, MDAllergy/Immunology
Akrm Abdalrahman, MDAnesthesiology

And 1,024 more: the button below opens the full list.

Other emergency rooms nearby

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

Arkansas State Hospital0.3 mi · Little Rock, AR · Psychiatric Hospital
VA Central Ar. Veterans Healthcare System LR0.5 mi · Little Rock, AR · Federal/VA Acute Care Hospital
Arkansas Children's Hospital1.7 mi · Little Rock, AR · Children's Hospital
Baptist Health Medical Center-Little Rock1.8 mi · Little Rock, AR · Acute Care Hospital
Chi-St Vincent Infirmary1.8 mi · Little Rock, AR · Acute Care Hospital

Other hospitals nearby

Baptist Health Extended Care Hospital-Lr Inc1.8 mi · Little Rock, AR · Long-Term Acute Care Hospital
Baptist Health Rehabilitation Institute1.8 mi · Little Rock, AR · Inpatient Rehabilitation Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

The Blossoms at Midtown Rehab & Nursing Center1.0 mi · Little Rock, AR · 1 of 5 stars
Briarwood Nursing and Rehabilitation Center, Inc1.5 mi · Little Rock, AR · 3 of 5 stars
The Green House Cottages of Poplar Grove2.4 mi · Little Rock, AR · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Gentiva1.8 mi · Little Rock, AR · 3 of 5 stars
Arkansas Hospice Inc5.4 mi · North Little Rock, AR · 4 of 5 stars
Hospice Home Care LLC5.5 mi · Little Rock, AR · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Commonspirit Health2.1 mi · Little Rock, AR
Care IV Home Health3.2 mi · Little Rock, AR
Basis Home Health LLC5.4 mi · North Little Rock, AR

All home health agencies in the state →

Dialysis facilities

DaVita Little Rock Midtown Dialysis1.8 mi · Little Rock, AR · 2 of 5 stars
Fmcna - Little Rock Dialysis1.8 mi · Little Rock, AR · 2 of 5 stars
DaVita Central Little Rock Dialysis3.2 mi · Little Rock, AR · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Aoc Surgery Center, Inc1.8 mi · Little Rock, AR
Arkansas Specialty Surgery Center1.8 mi · Little Rock, AR
CARTI Surgery Center1.8 mi · Little Rock, AR

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

ARcare - 1381.2 mi · Little Rock, AR · Community health center
Healthy Connections - Little Rock Midtown Ste 2001.4 mi · Little Rock, AR · Community health center
Little Rock CHC1.4 mi · Little Rock, AR · Community health center

Clinics and urgent care

Medexpress Urgent Care Arkansas, PA1.8 mi · Little Rock, AR · Urgent care center
Bright White LLC2.1 mi · Little Rock, AR · Urgent care center
THVC Services of AR PA2.2 mi · Little Rock, AR · Urgent care center

Pharmacies

Baptist Health1.8 mi · Little Rock, AR · Community/retail pharmacy
Central Arkansas Radiation Therapy Institute Inc1.8 mi · Little Rock, AR · Community/retail pharmacy
CHI St. Vincent Employee Pharmacy1.8 mi · Little Rock, AR · Community/retail pharmacy

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	71%National average: 72%
Would definitely recommend the hospital	76%National average: 71%
Nurses “always” communicated well	75%National average: 80%
Doctors “always” communicated well	78%National average: 80%
Staff “always” explained medicines before giving them	57%National average: 62%
Were given information about recovery at home	85%National average: 86%
Room and bathroom “always” clean	71%National average: 74%
Area around the room “always” quiet at night	57%National average: 60%
Completed surveys	1,489Response rate: 21%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	1.021No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.77No different from the national benchmark
Surgical site infections after colon surgery	0.855No different from the national benchmark
Surgical site infections after abdominal hysterectomy	0.45No different from the national benchmark
MRSA bloodstream infections	1.329No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.474Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	11.7%
Deaths within 30 days: heart failure patients	13.1%
Deaths within 30 days: pneumonia patients	12.6%
Deaths within 30 days: COPD patients	9.3%
Deaths within 30 days: stroke patients	13%
Deaths within 30 days: coronary bypass surgery (CABG)	Too few cases to report
Serious complications (patient safety indicator PSI-90)	0.94No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.1%
Readmitted within 30 days: heart failure	21.4%
Readmitted within 30 days: pneumonia	16.7%
Readmitted within 30 days: COPD	20.3%
Readmitted within 30 days: coronary bypass surgery	Too few cases to report
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	285 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	5%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	46%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 Little Rock Best hospitals in Little Rock

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 64 common services exactly as University of Arkansas Medical Sciences lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$410	$246	$247.56 – $972
Emergency room visit (moderate): 10 of 33 insurance plan rates Aetna — Medicare: $255.22 AmBetter — AmBetter: $375.17 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $262.88 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $262.72 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $262.88 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $301.42 Cigna — Cigna: $844 Cigna C — 16: $812 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $265.43 Devoted Health Plan — Devoted Health Plan: $267.98
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM	$447	$268.20	$247.56 – $972
Emergency room visit (moderate): 10 of 33 insurance plan rates Aetna — Medicare: $255.22 AmBetter — AmBetter: $375.17 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $262.88 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $262.72 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $262.88 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $301.42 Cigna — Cigna: $844 Cigna C — 16: $812 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $265.43 Devoted Health Plan — Devoted Health Plan: $267.98
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$410	$246	$247.56 – $972
Emergency room visit (moderate): 10 of 33 insurance plan rates Aetna — Medicare: $255.22 AmBetter — AmBetter: $375.17 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $262.88 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $262.88 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $301.42 Cigna — Cigna: $844 Cigna C — 16: $812 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $265.43 Devoted Health Plan — Devoted Health Plan: $267.98 Employers Health Network — Commercial: $484.92
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$735	$441	$319.98 – $1,218
Emergency room visit (moderately high): 10 of 33 insurance plan rates Aetna — Medicare: $390.13 AmBetter — AmBetter: $573.49 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $401.83 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $319.98 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $401.83 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $367.11 Cigna — Cigna: $844 Cigna C — 16: $812 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $405.74 Devoted Health Plan — Devoted Health Plan: $409.64
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM	$801	$480.60	$319.98 – $1,218
Emergency room visit (moderately high): 10 of 33 insurance plan rates Aetna — Medicare: $390.13 AmBetter — AmBetter: $573.49 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $401.83 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $319.98 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $401.83 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $367.11 Cigna — Cigna: $844 Cigna C — 16: $812 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $405.74 Devoted Health Plan — Devoted Health Plan: $409.64
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$735	$441	$367.11 – $1,218
Emergency room visit (moderately high): 10 of 33 insurance plan rates Aetna — Medicare: $390.13 AmBetter — AmBetter: $573.49 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $401.83 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $401.83 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $367.11 Cigna — Cigna: $844 Cigna C — 16: $812 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $405.74 Devoted Health Plan — Devoted Health Plan: $409.64 Employers Health Network — Commercial: $741.25
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM	$2,390	$1,434	$413.11 – $3,437
Emergency room visit (high): 10 of 33 insurance plan rates Aetna — Medicare: $556.81 AmBetter — AmBetter: $818.51 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $573.51 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $413.11 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $573.51 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $473.96 Cigna — Cigna: $3,437 Cigna C — 16: $3,306 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $579.08 Devoted Health Plan — Devoted Health Plan: $584.65
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$1,150	$690	$413.11 – $3,437
Emergency room visit (high): 10 of 33 insurance plan rates Aetna — Medicare: $556.81 AmBetter — AmBetter: $818.51 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $573.51 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $413.11 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $573.51 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $473.96 Cigna — Cigna: $3,437 Cigna C — 16: $3,306 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $579.08 Devoted Health Plan — Devoted Health Plan: $584.65
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$1,150	$690	$473.96 – $3,437
Emergency room visit (high): 10 of 33 insurance plan rates Aetna — Medicare: $556.81 AmBetter — AmBetter: $818.51 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $573.51 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $573.51 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $473.96 Cigna — Cigna: $3,437 Cigna C — 16: $3,306 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $579.08 Devoted Health Plan — Devoted Health Plan: $584.65 Employers Health Network — Commercial: $1,057.94

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: METABOLIC PANEL TOTAL CA	$107	$64.20	$8.21 – $887
Basic metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Medicare: $8.46 AmBetter — AmBetter: $12.44 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8.71 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $9.64 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8.71 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $9.64 Cigna — Cigna: $12.65 Cigna C — 16: $12.65 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $8.80 Devoted Health Plan — Devoted Health Plan: $8.88
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$212	$127.20	$8.21 – $887
Basic metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Medicare: $8.46 AmBetter — AmBetter: $12.44 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8.71 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $9.64 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8.71 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $9.64 Cigna — Cigna: $12.65 Cigna C — 16: $12.65 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $8.80 Devoted Health Plan — Devoted Health Plan: $8.88
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$98	$58.80	$8.21 – $887
Basic metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Medicare: $8.46 AmBetter — AmBetter: $12.44 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8.71 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8.71 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $8.80 Devoted Health Plan — Devoted Health Plan: $8.88 Employers Health Network — Commercial: $16.07 Essence Healthcare — Essence Healthcare: $8.80 Humana — ChoiceCare Medicare Advantage: $8.71 Northwest Health Plan — Northwest Health Plan: $14.34
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL	$231	$138.60	$10.24 – $887
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Medicare: $10.56 AmBetter — AmBetter: $15.52 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $10.88 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $12.04 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $10.88 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $12.04 Cigna — Cigna: $15.78 Cigna C — 16: $15.78 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $10.98 Devoted Health Plan — Devoted Health Plan: $11.09
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$338	$202.80	$10.24 – $887
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Medicare: $10.56 AmBetter — AmBetter: $15.52 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $10.88 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $12.04 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $10.88 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $12.04 Cigna — Cigna: $15.78 Cigna C — 16: $15.78 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $10.98 Devoted Health Plan — Devoted Health Plan: $11.09
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier Q1 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$224	$134.40	$10.24 – $887
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — Medicare: $10.56 AmBetter — AmBetter: $15.52 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $10.88 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $10.88 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $10.98 Devoted Health Plan — Devoted Health Plan: $11.09 Employers Health Network — Commercial: $20.06 Essence Healthcare — Essence Healthcare: $10.98 Humana — ChoiceCare Medicare Advantage: $10.88 Northwest Health Plan — Northwest Health Plan: $17.90
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$78	$46.80	$12.99 – $887
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates Aetna — Medicare: $13.39 AmBetter — AmBetter: $19.68 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $13.79 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $15.26 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $13.79 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $15.26 Cigna — Cigna: $20.01 Cigna C — 16: $20.01 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $13.93 Devoted Health Plan — Devoted Health Plan: $14.06
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$85	$51	$12.99 – $887
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates Aetna — Medicare: $13.39 AmBetter — AmBetter: $19.68 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $13.79 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $15.26 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $13.79 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $15.26 Cigna — Cigna: $20.01 Cigna C — 16: $20.01 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $13.93 Devoted Health Plan — Devoted Health Plan: $14.06
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier Q1 In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$85	$51	$12.99 – $887
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates Aetna — Medicare: $13.39 AmBetter — AmBetter: $19.68 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $13.79 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $13.79 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $13.93 Devoted Health Plan — Devoted Health Plan: $14.06 Employers Health Network — Commercial: $25.44 Essence Healthcare — Essence Healthcare: $13.93 Humana — ChoiceCare Medicare Advantage: $13.79 Northwest Health Plan — Northwest Health Plan: $22.70
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL	$132	$79.20	$8.42 – $887
Kidney function panel: 10 of 33 insurance plan rates Aetna — Medicare: $8.68 AmBetter — AmBetter: $12.76 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8.94 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $9.90 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8.94 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $9.90 Cigna — Cigna: $12.97 Cigna C — 16: $12.97 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $9.03 Devoted Health Plan — Devoted Health Plan: $9.11
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$128	$76.80	$8.42 – $887
Kidney function panel: 10 of 33 insurance plan rates Aetna — Medicare: $8.68 AmBetter — AmBetter: $12.76 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8.94 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $9.90 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8.94 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $9.90 Cigna — Cigna: $12.97 Cigna C — 16: $12.97 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $9.03 Devoted Health Plan — Devoted Health Plan: $9.11
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier Q1 In the file: KIDNEY FUNCTION BLOOD TEST PANEL	$132	$79.20	$8.42 – $887
Kidney function panel: 10 of 33 insurance plan rates Aetna — Medicare: $8.68 AmBetter — AmBetter: $12.76 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8.94 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8.94 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $9.03 Devoted Health Plan — Devoted Health Plan: $9.11 Employers Health Network — Commercial: $16.49 Essence Healthcare — Essence Healthcare: $9.03 Humana — ChoiceCare Medicare Advantage: $8.94 Northwest Health Plan — Northwest Health Plan: $14.71
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL	$105	$63	$7.92 – $887
Liver function panel: 10 of 33 insurance plan rates Aetna — Medicare: $8.17 AmBetter — AmBetter: $12.01 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8.42 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $9.31 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8.42 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $9.31 Cigna — Cigna: $12.21 Cigna C — 16: $12.21 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $8.50 Devoted Health Plan — Devoted Health Plan: $8.58
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$114	$68.40	$7.92 – $887
Liver function panel: 10 of 33 insurance plan rates Aetna — Medicare: $8.17 AmBetter — AmBetter: $12.01 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8.42 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $9.31 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8.42 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $9.31 Cigna — Cigna: $12.21 Cigna C — 16: $12.21 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $8.50 Devoted Health Plan — Devoted Health Plan: $8.58
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier Q1 In the file: LIVER FUNCTION BLOOD TEST PANEL	$114	$68.40	$7.92 – $887
Liver function panel: 10 of 33 insurance plan rates Aetna — Medicare: $8.17 AmBetter — AmBetter: $12.01 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8.42 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8.42 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $8.50 Devoted Health Plan — Devoted Health Plan: $8.58 Employers Health Network — Commercial: $15.52 Essence Healthcare — Essence Healthcare: $8.50 Humana — ChoiceCare Medicare Advantage: $8.42 Northwest Health Plan — Northwest Health Plan: $13.85
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE	$51	$30.60	$3.07 – $887
Urine test (automated, with microscope): 10 of 33 insurance plan rates Aetna — Medicare: $3.17 AmBetter — AmBetter: $4.66 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3.27 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3.61 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3.27 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3.61 Cigna — Cigna: $4.74 Cigna C — 16: $4.74 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3.30 Devoted Health Plan — Devoted Health Plan: $3.33
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$49	$29.40	$3.07 – $887
Urine test (automated, with microscope): 10 of 33 insurance plan rates Aetna — Medicare: $3.17 AmBetter — AmBetter: $4.66 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3.27 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3.61 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3.27 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3.61 Cigna — Cigna: $4.74 Cigna C — 16: $4.74 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3.30 Devoted Health Plan — Devoted Health Plan: $3.33
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ET In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$49	$29.40	$3.07 – $887
Urine test (automated, with microscope): 10 of 33 insurance plan rates Aetna — Medicare: $3.17 AmBetter — AmBetter: $4.66 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3.27 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3.27 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3.30 Devoted Health Plan — Devoted Health Plan: $3.33 Employers Health Network — Commercial: $6.02 Essence Healthcare — Essence Healthcare: $3.30 Humana — ChoiceCare Medicare Advantage: $3.27 Northwest Health Plan — Northwest Health Plan: $5.37
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	$33	$19.80	$3.38 – $887
Urine test (manual, without microscope): 10 of 33 insurance plan rates Aetna — Medicare: $3.48 AmBetter — AmBetter: $5.12 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3.58 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3.97 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3.58 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3.97 Cigna — Cigna: $5.20 Cigna C — 16: $5.20 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3.62 Devoted Health Plan — Devoted Health Plan: $3.65
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS; MANUAL TEST	$205	$123	$3.38 – $887
Urine test (manual, without microscope): 10 of 33 insurance plan rates Aetna — Medicare: $3.48 AmBetter — AmBetter: $5.12 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3.58 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3.97 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3.58 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3.97 Cigna — Cigna: $5.20 Cigna C — 16: $5.20 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3.62 Devoted Health Plan — Devoted Health Plan: $3.65
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: URINALYSIS; MANUAL TEST	$32	$19.20	$3.38 – $887
Urine test (manual, without microscope): 10 of 33 insurance plan rates Aetna — Medicare: $3.48 AmBetter — AmBetter: $5.12 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3.58 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3.58 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3.62 Devoted Health Plan — Devoted Health Plan: $3.65 Employers Health Network — Commercial: $6.61 Essence Healthcare — Essence Healthcare: $3.62 Humana — ChoiceCare Medicare Advantage: $3.58 Northwest Health Plan — Northwest Health Plan: $5.90
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST	$15	$9	$2.18 – $887
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna — Medicare: $2.25 AmBetter — AmBetter: $3.31 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $2.32 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $2.57 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $2.32 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $2.57 Cigna — Cigna: $3.36 Cigna C — 16: $3.36 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $2.34 Devoted Health Plan — Devoted Health Plan: $2.36
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE	$16	$9.60	$2.18 – $887
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna — Medicare: $2.25 AmBetter — AmBetter: $3.31 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $2.32 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $2.57 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $2.32 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $2.57 Cigna — Cigna: $3.36 Cigna C — 16: $3.36 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $2.34 Devoted Health Plan — Devoted Health Plan: $2.36
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: AUTOMATED URINALYSIS TEST	$15	$9	$2.18 – $887
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna — Medicare: $2.25 AmBetter — AmBetter: $3.31 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $2.32 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $2.32 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $2.34 Devoted Health Plan — Devoted Health Plan: $2.36 Employers Health Network — Commercial: $4.28 Essence Healthcare — Essence Healthcare: $2.34 Humana — ChoiceCare Medicare Advantage: $2.32 Northwest Health Plan — Northwest Health Plan: $3.81
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL	$133	$79.80	$17.84 – $887
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates Aetna — Medicare: $18.39 AmBetter — AmBetter: $27.03 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $18.94 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $20.96 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $18.94 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $20.96 Cigna — Cigna: $27.49 Cigna C — 16: $27.49 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $19.13 Devoted Health Plan — Devoted Health Plan: $19.31
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$129	$77.40	$17.84 – $887
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates Aetna — Medicare: $18.39 AmBetter — AmBetter: $27.03 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $18.94 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $20.96 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $18.94 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $20.96 Cigna — Cigna: $27.49 Cigna C — 16: $27.49 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $19.13 Devoted Health Plan — Devoted Health Plan: $19.31
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier Q1 In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$129	$77.40	$17.84 – $887
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates Aetna — Medicare: $18.39 AmBetter — AmBetter: $27.03 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $18.94 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $18.94 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $19.13 Devoted Health Plan — Devoted Health Plan: $19.31 Employers Health Network — Commercial: $34.94 Essence Healthcare — Essence Healthcare: $19.13 Humana — ChoiceCare Medicare Advantage: $18.94 Northwest Health Plan — Northwest Health Plan: $31.17
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE	$126.45	$75.87	$16.30 – $887
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates Aetna — Medicare: $16.80 AmBetter — AmBetter: $24.70 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $17.30 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $19.15 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $17.30 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $19.15 Cigna — Cigna: $25.12 Cigna C — 16: $25.12 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $17.47 Devoted Health Plan — Devoted Health Plan: $17.64
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$259	$155.40	$16.30 – $887
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates Aetna — Medicare: $16.80 AmBetter — AmBetter: $24.70 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $17.30 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $19.15 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $17.30 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $19.15 Cigna — Cigna: $25.12 Cigna C — 16: $25.12 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $17.47 Devoted Health Plan — Devoted Health Plan: $17.64
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$259	$155.40	$16.30 – $887
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates Aetna — Medicare: $16.80 AmBetter — AmBetter: $24.70 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $17.30 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $17.30 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $17.47 Devoted Health Plan — Devoted Health Plan: $17.64 Employers Health Network — Commercial: $31.92 Essence Healthcare — Essence Healthcare: $17.47 Humana — ChoiceCare Medicare Advantage: $17.30 Northwest Health Plan — Northwest Health Plan: $28.48
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC	$94	$56.40	$7.54 – $887
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates Aetna — Medicare: $7.77 AmBetter — AmBetter: $11.42 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $8.86 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $8.86 Cigna — Cigna: $11.62 Cigna C — 16: $11.62 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $8.08 Devoted Health Plan — Devoted Health Plan: $8.16
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$86	$51.60	$7.54 – $887
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates Aetna — Medicare: $7.77 AmBetter — AmBetter: $11.42 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $8.86 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $8.86 Cigna — Cigna: $11.62 Cigna C — 16: $11.62 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $8.08 Devoted Health Plan — Devoted Health Plan: $8.16
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$86	$51.60	$7.54 – $887
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates Aetna — Medicare: $7.77 AmBetter — AmBetter: $11.42 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $8 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $8 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $8.08 Devoted Health Plan — Devoted Health Plan: $8.16 Employers Health Network — Commercial: $14.76 Essence Healthcare — Essence Healthcare: $8.08 Humana — ChoiceCare Medicare Advantage: $8 Northwest Health Plan — Northwest Health Plan: $13.17
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$73	$43.80	$6.28 – $887
Complete blood count (CBC), automated: 10 of 33 insurance plan rates Aetna — Medicare: $6.47 AmBetter — AmBetter: $9.51 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $6.66 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $7.38 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $6.66 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $7.38 Cigna — Cigna: $9.68 Cigna C — 16: $9.68 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $6.73 Devoted Health Plan — Devoted Health Plan: $6.79
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED	$80	$48	$6.28 – $887
Complete blood count (CBC), automated: 10 of 33 insurance plan rates Aetna — Medicare: $6.47 AmBetter — AmBetter: $9.51 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $6.66 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $7.38 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $6.66 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $7.38 Cigna — Cigna: $9.68 Cigna C — 16: $9.68 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $6.73 Devoted Health Plan — Devoted Health Plan: $6.79
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ET In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$73	$43.80	$6.28 – $887
Complete blood count (CBC), automated: 10 of 33 insurance plan rates Aetna — Medicare: $6.47 AmBetter — AmBetter: $9.51 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $6.66 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $6.66 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $6.73 Devoted Health Plan — Devoted Health Plan: $6.79 Employers Health Network — Commercial: $12.29 Essence Healthcare — Essence Healthcare: $6.73 Humana — ChoiceCare Medicare Advantage: $6.66 Northwest Health Plan — Northwest Health Plan: $10.97
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME	$33	$19.80	$4.16 – $887
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates Aetna — Medicare: $4.29 AmBetter — AmBetter: $6.31 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $4.42 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $4.89 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $4.42 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $4.89 Cigna — Cigna: $6.42 Cigna C — 16: $6.42 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $4.46 Devoted Health Plan — Devoted Health Plan: $4.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$36	$21.60	$4.16 – $887
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates Aetna — Medicare: $4.29 AmBetter — AmBetter: $6.31 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $4.42 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $4.89 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $4.42 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $4.89 Cigna — Cigna: $6.42 Cigna C — 16: $6.42 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $4.46 Devoted Health Plan — Devoted Health Plan: $4.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; CLOTTING TIME	$33	$19.80	$4.16 – $887
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates Aetna — Medicare: $4.29 AmBetter — AmBetter: $6.31 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $4.42 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $4.42 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $4.46 Devoted Health Plan — Devoted Health Plan: $4.50 Employers Health Network — Commercial: $8.15 Essence Healthcare — Essence Healthcare: $4.46 Humana — ChoiceCare Medicare Advantage: $4.42 Northwest Health Plan — Northwest Health Plan: $7.27
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$64	$38.40	$5.83 – $887
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna — Medicare: $6.01 AmBetter — AmBetter: $8.83 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $6.19 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $6.85 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $6.19 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $6.85 Cigna — Cigna: $8.99 Cigna C — 16: $8.99 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $6.25 Devoted Health Plan — Devoted Health Plan: $6.31
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL	$70	$42	$5.83 – $887
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna — Medicare: $6.01 AmBetter — AmBetter: $8.83 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $6.19 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $6.85 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $6.19 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $6.85 Cigna — Cigna: $8.99 Cigna C — 16: $8.99 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $6.25 Devoted Health Plan — Devoted Health Plan: $6.31
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$64	$38.40	$5.83 – $887
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna — Medicare: $6.01 AmBetter — AmBetter: $8.83 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $6.19 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $6.19 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $6.25 Devoted Health Plan — Devoted Health Plan: $6.31 Employers Health Network — Commercial: $11.42 Essence Healthcare — Essence Healthcare: $6.25 Humana — ChoiceCare Medicare Advantage: $6.19 Northwest Health Plan — Northwest Health Plan: $10.19

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE	$993	$595.80	$94.82 – $887
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $168.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $168.93 Cigna — Cigna: $198.73 Cigna C — 16: $198.73 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$1,822	$1,093.20	$94.82 – $887
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $168.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $168.93 Cigna — Cigna: $198.73 Cigna C — 16: $198.73 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ET In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$911	$546.60	$94.82 – $887
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64 Employers Health Network — Commercial: $185.72 Essence Healthcare — Essence Healthcare: $101.66 Humana — ChoiceCare Medicare Advantage: $100.68 Northwest Health Plan — Northwest Health Plan: $165.69
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$2,534	$1,520.40	$316.39 – $887
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates Aetna — Medicare: $326.18 AmBetter — AmBetter: $479.48 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $335.97 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $575.55 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $335.97 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $575.55 Cigna — Cigna: $685.04 Cigna C — 16: $685.04 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $339.23 Devoted Health Plan — Devoted Health Plan: $342.49
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	$2,762	$1,657.20	$316.39 – $887
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates Aetna — Medicare: $326.18 AmBetter — AmBetter: $479.48 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $335.97 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $575.55 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $335.97 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $575.55 Cigna — Cigna: $685.04 Cigna C — 16: $685.04 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $339.23 Devoted Health Plan — Devoted Health Plan: $342.49
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier Q1 In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$2,534	$1,520.40	$316.39 – $887
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates Aetna — Medicare: $326.18 AmBetter — AmBetter: $479.48 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $335.97 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $335.97 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $339.23 Devoted Health Plan — Devoted Health Plan: $342.49 Employers Health Network — Commercial: $619.74 Essence Healthcare — Essence Healthcare: $339.23 Humana — ChoiceCare Medicare Advantage: $335.97 Northwest Health Plan — Northwest Health Plan: $552.88
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF CHEST; 2 VIEWS	$124	$74.40	$21.87 – $887
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna — Medicare: $81.37 AmBetter — AmBetter: $119.61 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $83.81 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $120.29 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $83.81 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $120.29 Cigna — Cigna: $124 Cigna C — 16: $124 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $84.62 Devoted Health Plan — Devoted Health Plan: $85.44
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS	$135	$81	$21.87 – $887
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna — Medicare: $81.37 AmBetter — AmBetter: $119.61 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $83.81 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $120.29 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $83.81 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $120.29 Cigna — Cigna: $135 Cigna C — 16: $135 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $84.62 Devoted Health Plan — Devoted Health Plan: $85.44
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: X-RAY OF CHEST; 2 VIEWS	$124	$74.40	$31.56 – $887
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna — Medicare: $32.54 AmBetter — AmBetter: $47.83 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $33.52 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $33.52 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $33.84 Devoted Health Plan — Devoted Health Plan: $34.17 Employers Health Network — Commercial: $61.83 Essence Healthcare — Essence Healthcare: $33.84 Humana — ChoiceCare Medicare Advantage: $33.52 Northwest Health Plan — Northwest Health Plan: $55.16
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$199	$119.40	$40 – $887
X-ray of the lower spine, at least 4 views: 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $168.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $168.93 Cigna — Cigna: $198.73 Cigna C — 16: $198.73 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	$217	$130.20	$40 – $887
X-ray of the lower spine, at least 4 views: 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $168.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $168.93 Cigna — Cigna: $198.73 Cigna C — 16: $198.73 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$199	$119.40	$37.93 – $887
X-ray of the lower spine, at least 4 views: 10 of 33 insurance plan rates Aetna — Medicare: $39.10 AmBetter — AmBetter: $57.48 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $40.27 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $40.27 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $40.66 Devoted Health Plan — Devoted Health Plan: $41.06 Employers Health Network — Commercial: $74.29 Essence Healthcare — Essence Healthcare: $40.66 Humana — ChoiceCare Medicare Advantage: $40.27 Northwest Health Plan — Northwest Health Plan: $66.27
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$970	$582	$216.40 – $887
MRI of the lower back (lumbar spine), without contrast: 10 of 33 insurance plan rates Aetna — Medicare: $223.09 AmBetter — AmBetter: $327.94 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $229.78 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $351.26 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $229.78 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $351.26 Cigna — Cigna: $434.20 Cigna C — 16: $434.20 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $232.01 Devoted Health Plan — Devoted Health Plan: $234.24
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	$1,057	$634.20	$216.40 – $887
MRI of the lower back (lumbar spine), without contrast: 10 of 33 insurance plan rates Aetna — Medicare: $223.09 AmBetter — AmBetter: $327.94 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $229.78 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $351.26 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $229.78 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $351.26 Cigna — Cigna: $434.20 Cigna C — 16: $434.20 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $232.01 Devoted Health Plan — Devoted Health Plan: $234.24
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$970	$582	$86.56 – $887
MRI of the lower back (lumbar spine), without contrast: 10 of 33 insurance plan rates Aetna — Medicare: $89.24 AmBetter — AmBetter: $131.18 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $91.92 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $91.92 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $92.81 Devoted Health Plan — Devoted Health Plan: $93.70 Employers Health Network — Commercial: $169.56 Essence Healthcare — Essence Healthcare: $92.81 Humana — ChoiceCare Medicare Advantage: $91.92 Northwest Health Plan — Northwest Health Plan: $151.26
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF PELVIS WITH CONTRAST	$1,190	$714	$159.07 – $887
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates Aetna — Medicare: $163.99 AmBetter — AmBetter: $241.07 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $168.91 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $274.66 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $168.91 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $274.66 Cigna — Cigna: $335.32 Cigna C — 16: $335.32 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $170.55 Devoted Health Plan — Devoted Health Plan: $172.19
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE	$1,297	$778.20	$159.07 – $887
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates Aetna — Medicare: $163.99 AmBetter — AmBetter: $241.07 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $168.91 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $274.66 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $168.91 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $274.66 Cigna — Cigna: $335.32 Cigna C — 16: $335.32 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $170.55 Devoted Health Plan — Devoted Health Plan: $172.19
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XE In the file: CT SCAN OF PELVIS WITH CONTRAST	$1,297	$778.20	$159.07 – $887
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates Aetna — Medicare: $163.99 AmBetter — AmBetter: $241.07 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $168.91 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $168.91 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $170.55 Devoted Health Plan — Devoted Health Plan: $172.19 Employers Health Network — Commercial: $311.58 Essence Healthcare — Essence Healthcare: $170.55 Humana — ChoiceCare Medicare Advantage: $168.91 Northwest Health Plan — Northwest Health Plan: $277.96
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	$1,082	$649.20	$216.40 – $887
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates Aetna — Medicare: $223.09 AmBetter — AmBetter: $327.94 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $229.78 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $351.26 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $229.78 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $351.26 Cigna — Cigna: $434.20 Cigna C — 16: $434.20 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $232.01 Devoted Health Plan — Devoted Health Plan: $234.24
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$966	$579.60	$216.40 – $887
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates Aetna — Medicare: $223.09 AmBetter — AmBetter: $327.94 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $229.78 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $229.78 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $232.01 Devoted Health Plan — Devoted Health Plan: $234.24 Employers Health Network — Commercial: $423.87 Essence Healthcare — Essence Healthcare: $232.01 Humana — ChoiceCare Medicare Advantage: $229.78 Northwest Health Plan — Northwest Health Plan: $378.14
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN_RT In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$966	$579.60	$86.56 – $887
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates Aetna — Medicare: $89.24 AmBetter — AmBetter: $131.18 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $91.92 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $91.92 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $92.81 Devoted Health Plan — Devoted Health Plan: $93.70 Employers Health Network — Commercial: $169.56 Essence Healthcare — Essence Healthcare: $92.81 Humana — ChoiceCare Medicare Advantage: $91.92 Northwest Health Plan — Northwest Health Plan: $151.26
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST	$1,996	$1,197.60	$206.27 – $887
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates Aetna — Medicare: $326.18 AmBetter — AmBetter: $479.48 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $335.97 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $575.55 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $335.97 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $575.55 Cigna — Cigna: $685.04 Cigna C — 16: $685.04 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $339.23 Devoted Health Plan — Devoted Health Plan: $342.49
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$1,838.20	$1,102.92	$206.27 – $887
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates Aetna — Medicare: $326.18 AmBetter — AmBetter: $479.48 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $335.97 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $575.55 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $335.97 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $575.55 Cigna — Cigna: $685.04 Cigna C — 16: $685.04 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $339.23 Devoted Health Plan — Devoted Health Plan: $342.49
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$1,831	$1,098.60	$126.57 – $887
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates Aetna — Medicare: $130.48 AmBetter — AmBetter: $191.81 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $134.39 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $134.39 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $135.70 Devoted Health Plan — Devoted Health Plan: $137 Employers Health Network — Commercial: $247.91 Essence Healthcare — Essence Healthcare: $135.70 Humana — ChoiceCare Medicare Advantage: $134.39 Northwest Health Plan — Northwest Health Plan: $221.16
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE	$473	$283.80	$56 – $887
Ultrasound of the abdomen, complete: 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $168.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $168.93 Cigna — Cigna: $198.73 Cigna C — 16: $198.73 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$434	$260.40	$56 – $887
Ultrasound of the abdomen, complete: 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $168.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $168.93 Cigna — Cigna: $198.73 Cigna C — 16: $198.73 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$434	$260.40	$37.93 – $887
Ultrasound of the abdomen, complete: 10 of 33 insurance plan rates Aetna — Medicare: $39.10 AmBetter — AmBetter: $57.48 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $40.27 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $40.27 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $40.66 Devoted Health Plan — Devoted Health Plan: $41.06 Employers Health Network — Commercial: $74.29 Essence Healthcare — Essence Healthcare: $40.66 Humana — ChoiceCare Medicare Advantage: $40.27 Northwest Health Plan — Northwest Health Plan: $66.27
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$245	$147	$56 – $887
Pregnancy ultrasound (after the first trimester): 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $168.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $168.93 Cigna — Cigna: $198.73 Cigna C — 16: $198.73 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >= 14 WKS SNGL FETUS	$267	$160.20	$56 – $887
Pregnancy ultrasound (after the first trimester): 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $168.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $168.93 Cigna — Cigna: $198.73 Cigna C — 16: $198.73 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$232	$139.20	$68 – $887
Transvaginal ultrasound: 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $168.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $168.93 Cigna — Cigna: $198.73 Cigna C — 16: $198.73 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL US NON-OB	$253	$151.80	$68 – $887
Transvaginal ultrasound: 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $168.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $168.93 Cigna — Cigna: $198.73 Cigna C — 16: $198.73 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XE In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$253	$151.80	$94.82 – $887
Transvaginal ultrasound: 10 of 33 insurance plan rates Aetna — Medicare: $97.75 AmBetter — AmBetter: $143.69 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $100.68 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $100.68 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $101.66 Devoted Health Plan — Devoted Health Plan: $102.64 Employers Health Network — Commercial: $185.72 Essence Healthcare — Essence Healthcare: $101.66 Humana — ChoiceCare Medicare Advantage: $100.68 Northwest Health Plan — Northwest Health Plan: $165.69
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI	$405	$243	$34.50 – $887
Diagnostic mammogram, one breast: 10 of 33 insurance plan rates Aetna — Medicare: $35.57 AmBetter — AmBetter: $52.29 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $36.64 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $137.72 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $36.64 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $137.72 Cigna — Cigna: $155 Cigna C — 16: $155 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $36.99 Devoted Health Plan — Devoted Health Plan: $37.35
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GG_LT In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$362	$217.20	$34.50 – $887
Diagnostic mammogram, one breast: 10 of 33 insurance plan rates Aetna — Medicare: $35.57 AmBetter — AmBetter: $52.29 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $36.64 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $36.64 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $36.99 Devoted Health Plan — Devoted Health Plan: $37.35 Employers Health Network — Commercial: $67.58 Essence Healthcare — Essence Healthcare: $36.99 Humana — ChoiceCare Medicare Advantage: $36.64 Northwest Health Plan — Northwest Health Plan: $60.29
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GG_LT_XE In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$362	$217.20	$34.50 – $887
Diagnostic mammogram, one breast: 10 of 33 insurance plan rates Aetna — Medicare: $35.57 AmBetter — AmBetter: $52.29 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $36.64 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $36.64 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $36.99 Devoted Health Plan — Devoted Health Plan: $37.35 Employers Health Network — Commercial: $67.58 Essence Healthcare — Essence Healthcare: $36.99 Humana — ChoiceCare Medicare Advantage: $36.64 Northwest Health Plan — Northwest Health Plan: $60.29
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$519	$311.40	$42.50 – $887
Diagnostic mammogram, both breasts: 10 of 33 insurance plan rates Aetna — Medicare: $43.81 AmBetter — AmBetter: $64.40 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $45.12 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $175.62 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $45.12 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $175.62 Cigna — Cigna: $197.67 Cigna C — 16: $197.67 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $45.56 Devoted Health Plan — Devoted Health Plan: $46
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI	$566	$339.60	$42.50 – $887
Diagnostic mammogram, both breasts: 10 of 33 insurance plan rates Aetna — Medicare: $43.81 AmBetter — AmBetter: $64.40 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $45.12 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $175.62 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $45.12 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $175.62 Cigna — Cigna: $197.67 Cigna C — 16: $197.67 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $45.56 Devoted Health Plan — Devoted Health Plan: $46
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GG In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$519	$311.40	$42.50 – $887
Diagnostic mammogram, both breasts: 10 of 33 insurance plan rates Aetna — Medicare: $43.81 AmBetter — AmBetter: $64.40 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $45.12 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $45.12 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $45.56 Devoted Health Plan — Devoted Health Plan: $46 Employers Health Network — Commercial: $83.24 Essence Healthcare — Essence Healthcare: $45.56 Humana — ChoiceCare Medicare Advantage: $45.12 Northwest Health Plan — Northwest Health Plan: $74.26
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD	$210	$126	$32.16 – $887
Screening mammogram, both breasts: 10 of 33 insurance plan rates Aetna — Medicare: $33.15 AmBetter — AmBetter: $48.73 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $34.14 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $145.62 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $34.14 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $145.62 Cigna — Cigna: $163.89 Cigna C — 16: $163.89 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $34.48 Devoted Health Plan — Devoted Health Plan: $34.81
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY	$193	$115.80	$32.16 – $887
Screening mammogram, both breasts: 10 of 33 insurance plan rates Aetna — Medicare: $33.15 AmBetter — AmBetter: $48.73 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $34.14 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $145.62 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $34.14 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $145.62 Cigna — Cigna: $163.89 Cigna C — 16: $163.89 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $34.48 Devoted Health Plan — Devoted Health Plan: $34.81
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: SCREENING MAMMOGRAPHY	$193	$115.80	$32.16 – $887
Screening mammogram, both breasts: 10 of 33 insurance plan rates Aetna — Medicare: $33.15 AmBetter — AmBetter: $48.73 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $34.14 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $34.14 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $34.48 Devoted Health Plan — Devoted Health Plan: $34.81 Employers Health Network — Commercial: $62.98 Essence Healthcare — Essence Healthcare: $34.48 Humana — ChoiceCare Medicare Advantage: $34.14 Northwest Health Plan — Northwest Health Plan: $56.19

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INSERTION OF TUBE IN LEFT HEART CHAMBERS FOR DIAGNOSIS WITH REVIEW BY RADIOLOGIST	$7,568	$4,540.80	$134.65 – $7,802
Left heart catheterization (diagnostic): 10 of 33 insurance plan rates Aetna — Medicare: $3,031.12 AmBetter — AmBetter: $4,455.75 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,122.05 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3,761.08 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,122.05 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3,761.08 Cigna — Cigna: $7,802 Cigna C — 16: $7,501 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,152.36 Devoted Health Plan — Devoted Health Plan: $3,182.68
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	$8,249	$4,949.40	$134.65 – $7,802
Left heart catheterization (diagnostic): 10 of 33 insurance plan rates Aetna — Medicare: $3,031.12 AmBetter — AmBetter: $4,455.75 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,122.05 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3,761.08 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,122.05 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3,761.08 Cigna — Cigna: $7,802 Cigna C — 16: $7,501 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,152.36 Devoted Health Plan — Devoted Health Plan: $3,182.68
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION	$10,226	$6,135.60	$383 – $13,855.73
Heart rhythm study (electrophysiology evaluation): 10 of 33 insurance plan rates Aetna — Medicare: $7,292.49 AmBetter — AmBetter: $10,719.96 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $7,511.26 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $8,559.30 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $7,511.26 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $8,559.30 Cigna — Cigna: $8,433.04 Cigna C — 16: $8,433.04 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $7,584.19 Devoted Health Plan — Devoted Health Plan: $7,657.11
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INSERTION OF CATHETERS FOR RECORDING AND PACING OF RIGHT HEART CHAMBERS RHYTHM	$9,382	$5,629.20	$383 – $13,855.73
Heart rhythm study (electrophysiology evaluation): 10 of 33 insurance plan rates Aetna — Medicare: $7,292.49 AmBetter — AmBetter: $10,719.96 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $7,511.26 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $8,559.30 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $7,511.26 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $8,559.30 Cigna — Cigna: $8,433.04 Cigna C — 16: $8,433.04 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $7,584.19 Devoted Health Plan — Devoted Health Plan: $7,657.11
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY CAUSING ATRIAL FIBRILLATION (UNCOORDINATED CONTRACTION	$32,776	$19,665.60	$530.95 – $46,432.68
Heart rhythm study with ablation for atrial fibrillation: 10 of 33 insurance plan rates Aetna — Medicare: $24,438.25 AmBetter — AmBetter: $35,924.23 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $25,171.40 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $29,851.56 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $25,171.40 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $29,851.56 Cigna — Cigna: $7,802 Cigna C — 16: $7,501 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $25,415.78 Devoted Health Plan — Devoted Health Plan: $25,660.16
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	$35,726	$21,435.60	$530.95 – $46,432.68
Heart rhythm study with ablation for atrial fibrillation: 10 of 33 insurance plan rates Aetna — Medicare: $24,438.25 AmBetter — AmBetter: $35,924.23 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $25,171.40 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $29,851.56 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $25,171.40 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $29,851.56 Cigna — Cigna: $7,802 Cigna C — 16: $7,501 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $25,415.78 Devoted Health Plan — Devoted Health Plan: $25,660.16
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY CAUSING ATRIAL FIBRILLATION (UNCOORDINATED CONTRACTION	$35,726	$21,435.60	$887 – $46,432.68
Heart rhythm study with ablation for atrial fibrillation: 10 of 33 insurance plan rates Aetna — Medicare: $24,438.25 AmBetter — AmBetter: $35,924.23 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $25,171.40 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $29,851.56 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $25,171.40 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $29,851.56 Cigna — Cigna: $7,802 Cigna C — 16: $7,501 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $25,415.78 Devoted Health Plan — Devoted Health Plan: $25,660.16

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES	$160	$96	$21.76 – $887
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates Aetna — Medicare: $26.97 AmBetter — AmBetter: $39.65 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $27.78 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $30.32 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $27.78 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $30.32 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $28.05 Devoted Health Plan — Devoted Health Plan: $28.32
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$441	$264.60	$21.76 – $887
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates Aetna — Medicare: $26.97 AmBetter — AmBetter: $39.65 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $27.78 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $30.32 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $27.78 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $30.32 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $28.05 Devoted Health Plan — Devoted Health Plan: $28.32
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier CQ_GP In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$147	$88.20	$26.16 – $887
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates Aetna — Medicare: $26.97 AmBetter — AmBetter: $39.65 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $27.78 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $27.78 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $28.05 Devoted Health Plan — Devoted Health Plan: $28.32 Employers Health Network — Commercial: $51.24 Essence Healthcare — Essence Healthcare: $28.05
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$436	$261.60	$88.46 – $887
Physical therapy evaluation (low complexity): 10 of 33 insurance plan rates Aetna — Medicare: $91.20 AmBetter — AmBetter: $134.06 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $93.94 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $103.29 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $93.94 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $103.29 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $94.85 Devoted Health Plan — Devoted Health Plan: $95.76
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_XP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$436	$261.60	$88.46 – $887
Physical therapy evaluation (low complexity): 10 of 33 insurance plan rates Aetna — Medicare: $91.20 AmBetter — AmBetter: $134.06 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $93.94 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $93.94 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $94.85 Devoted Health Plan — Devoted Health Plan: $95.76 Employers Health Network — Commercial: $173.28 Essence Healthcare — Essence Healthcare: $94.85
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_XU In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$436	$261.60	$88.46 – $887
Physical therapy evaluation (low complexity): 10 of 33 insurance plan rates Aetna — Medicare: $91.20 AmBetter — AmBetter: $134.06 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $93.94 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $93.94 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $94.85 Devoted Health Plan — Devoted Health Plan: $95.76 Employers Health Network — Commercial: $173.28 Essence Healthcare — Essence Healthcare: $94.85
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$525	$315	$88.46 – $887
Physical therapy evaluation (moderate complexity): 10 of 33 insurance plan rates Aetna — Medicare: $91.20 AmBetter — AmBetter: $134.06 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $93.94 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $103.29 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $93.94 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $103.29 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $94.85 Devoted Health Plan — Devoted Health Plan: $95.76
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_XP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$525	$315	$88.46 – $887
Physical therapy evaluation (moderate complexity): 10 of 33 insurance plan rates Aetna — Medicare: $91.20 AmBetter — AmBetter: $134.06 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $93.94 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $93.94 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $94.85 Devoted Health Plan — Devoted Health Plan: $95.76 Employers Health Network — Commercial: $173.28 Essence Healthcare — Essence Healthcare: $94.85
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_XU In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$525	$315	$88.46 – $887
Physical therapy evaluation (moderate complexity): 10 of 33 insurance plan rates Aetna — Medicare: $91.20 AmBetter — AmBetter: $134.06 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $93.94 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $93.94 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $94.85 Devoted Health Plan — Devoted Health Plan: $95.76 Employers Health Network — Commercial: $173.28 Essence Healthcare — Essence Healthcare: $94.85
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$624	$374.40	$88.46 – $887
Physical therapy evaluation (high complexity): 10 of 33 insurance plan rates Aetna — Medicare: $91.20 AmBetter — AmBetter: $134.06 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $93.94 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $103.29 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $93.94 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $103.29 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $94.85 Devoted Health Plan — Devoted Health Plan: $95.76
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$624	$374.40	$88.46 – $887
Physical therapy evaluation (high complexity): 10 of 33 insurance plan rates Aetna — Medicare: $91.20 AmBetter — AmBetter: $134.06 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $93.94 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $93.94 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $94.85 Devoted Health Plan — Devoted Health Plan: $95.76 Employers Health Network — Commercial: $173.28 Essence Healthcare — Essence Healthcare: $94.85
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_XP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$624	$374.40	$88.46 – $887
Physical therapy evaluation (high complexity): 10 of 33 insurance plan rates Aetna — Medicare: $91.20 AmBetter — AmBetter: $134.06 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $93.94 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $93.94 Cigna — Cigna: $165 Cigna C — 16: $157 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $94.85 Devoted Health Plan — Devoted Health Plan: $95.76 Employers Health Network — Commercial: $173.28 Essence Healthcare — Essence Healthcare: $94.85

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	$5,111	$3,066.60	$320 – $6,955.58
Removal of breast growth (open surgery): 10 of 33 insurance plan rates Aetna — Medicare: $3,660.83 AmBetter — AmBetter: $5,381.42 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,770.65 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $4,370.44 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,770.65 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $4,370.44 Cigna — Cigna: $2,001 Cigna C — 16: $1,674 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,807.26 Devoted Health Plan — Devoted Health Plan: $3,843.87
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$8,373.88	$5,024.33	$887 – $6,955.58
Removal of breast growth (open surgery): 10 of 33 insurance plan rates Aetna — Medicare: $3,660.83 AmBetter — AmBetter: $5,381.42 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,770.65 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $4,370.44 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,770.65 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $4,370.44 Cigna — Cigna: $2,001 Cigna C — 16: $1,674 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,807.26 Devoted Health Plan — Devoted Health Plan: $3,843.87
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$5,875	$3,525	$887 – $6,955.58
Removal of breast growth (open surgery): 10 of 33 insurance plan rates Aetna — Medicare: $3,660.83 AmBetter — AmBetter: $5,381.42 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,770.65 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $4,370.44 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,770.65 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $4,370.44 Cigna — Cigna: $2,001 Cigna C — 16: $1,674 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,807.26 Devoted Health Plan — Devoted Health Plan: $3,843.87
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$6,895	$4,137	$320 – $22,807.31
Total hip replacement: 10 of 33 insurance plan rates Aetna — Medicare: $12,003.85 AmBetter — AmBetter: $17,645.66 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $12,363.97 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $6,895 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $12,363.97 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $16,587.93 Cigna — Cigna: $2,759 Cigna C — 16: $2,306 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $12,484 Devoted Health Plan — Devoted Health Plan: $12,604.04
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$5,401.50	$3,240.90	$887 – $22,807.32
Total hip replacement: 10 of 33 insurance plan rates Aetna — Medicare: $12,003.85 AmBetter — AmBetter: $17,645.66 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $12,363.97 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $5,401.50 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $12,363.97 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $16,587.93 Cigna — Cigna: $2,759 Cigna C — 16: $2,306 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $12,484 Devoted Health Plan — Devoted Health Plan: $12,604.04
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_LT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$2,965	$1,779	$887 – $22,807.31
Total hip replacement: 10 of 33 insurance plan rates Aetna — Medicare: $12,003.85 AmBetter — AmBetter: $17,645.66 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $12,363.97 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $2,965 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $12,363.97 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $16,587.93 Cigna — Cigna: $2,759 Cigna C — 16: $2,306 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $12,484 Devoted Health Plan — Devoted Health Plan: $12,604.04
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$22,958.53	$13,775.12	$320 – $22,807.32
Total knee replacement: 10 of 33 insurance plan rates Aetna — Medicare: $12,003.85 AmBetter — AmBetter: $17,645.66 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $12,363.97 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $16,587.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $12,363.97 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $16,587.93 Cigna — Cigna: $2,759 Cigna C — 16: $2,306 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $12,484 Devoted Health Plan — Devoted Health Plan: $12,604.04
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 73 In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$2,965	$1,779	$887 – $16,587.93
Total knee replacement: 10 of 33 insurance plan rates Aetna — Medicare: $6,001.93 AmBetter — AmBetter: $8,822.84 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $6,181.99 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $16,587.93 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $6,181.99 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $16,587.93 Cigna — Cigna: $2,759 Cigna C — 16: $2,306 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $6,242.01 Devoted Health Plan — Devoted Health Plan: $6,302.03
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$5,259	$3,155.40	$887 – $22,807.32
Total knee replacement: 10 of 33 insurance plan rates Aetna — Medicare: $12,003.85 AmBetter — AmBetter: $17,645.66 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $12,363.97 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $5,259 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $12,363.97 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $16,587.93 Cigna — Cigna: $2,759 Cigna C — 16: $2,306 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $12,484 Devoted Health Plan — Devoted Health Plan: $12,604.04
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$3,245.50	$1,947.30	$129.93 – $2,001
Shoulder arthroscopy: shaving of shoulder bone: 10 of 30 insurance plan rates Aetna — Medicare: $133.95 AmBetter — AmBetter: $196.91 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $137.97 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $137.97 Cigna — Cigna: $2,001 Cigna C — 16: $1,674 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $139.31 Devoted Health Plan — Devoted Health Plan: $140.65 Employers Health Network — Commercial: $254.50 Essence Healthcare — Essence Healthcare: $139.31
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$1,175	$705	$129.93 – $2,001
Shoulder arthroscopy: shaving of shoulder bone: 10 of 30 insurance plan rates Aetna — Medicare: $133.95 AmBetter — AmBetter: $196.91 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $137.97 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $137.97 Cigna — Cigna: $2,001 Cigna C — 16: $1,674 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $139.31 Devoted Health Plan — Devoted Health Plan: $140.65 Employers Health Network — Commercial: $254.50 Essence Healthcare — Essence Healthcare: $139.31
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$3,620	$2,172	$297 – $5,812.56
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 33 insurance plan rates Aetna — Medicare: $3,059.24 AmBetter — AmBetter: $4,497.08 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,151.02 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3,620 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,151.02 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3,784.20 Cigna — Cigna: $2,470 Cigna C — 16: $2,066 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,181.61 Devoted Health Plan — Devoted Health Plan: $3,212.20
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$3,411	$2,046.60	$887 – $5,812.56
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 33 insurance plan rates Aetna — Medicare: $3,059.24 AmBetter — AmBetter: $4,497.08 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,151.02 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3,411 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,151.02 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3,784.20 Cigna — Cigna: $2,470 Cigna C — 16: $2,066 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,181.61 Devoted Health Plan — Devoted Health Plan: $3,212.20
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$3,411	$2,046.60	$887 – $5,812.56
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 33 insurance plan rates Aetna — Medicare: $3,059.24 AmBetter — AmBetter: $4,497.08 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,151.02 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3,411 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,151.02 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3,784.20 Cigna — Cigna: $2,470 Cigna C — 16: $2,066 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,181.61 Devoted Health Plan — Devoted Health Plan: $3,212.20
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,310	$1,386	$250 – $1,611.20
Upper GI endoscopy (diagnostic): 10 of 33 insurance plan rates Aetna — Medicare: $848 AmBetter — AmBetter: $1,246.56 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $873.44 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,049.48 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $873.44 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,049.48 Cigna — Cigna: $1,306 Cigna C — 16: $1,092 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $881.92 Devoted Health Plan — Devoted Health Plan: $890.40
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$531.75	$319.05	$822.56 – $1,611.20
Upper GI endoscopy (diagnostic): 10 of 33 insurance plan rates Aetna — Medicare: $848 AmBetter — AmBetter: $1,246.56 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $873.44 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,049.48 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $873.44 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,049.48 Cigna — Cigna: $1,306 Cigna C — 16: $1,092 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $881.92 Devoted Health Plan — Devoted Health Plan: $890.40
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,467	$880.20	$822.56 – $1,611.20
Upper GI endoscopy (diagnostic): 10 of 33 insurance plan rates Aetna — Medicare: $848 AmBetter — AmBetter: $1,246.56 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $873.44 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,049.48 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $873.44 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,049.48 Cigna — Cigna: $1,306 Cigna C — 16: $1,092 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $881.92 Devoted Health Plan — Devoted Health Plan: $890.40
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,622.75	$973.65	$297 – $1,751
Upper GI endoscopy with biopsy: 10 of 33 insurance plan rates Aetna — Medicare: $848 AmBetter — AmBetter: $1,246.56 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $873.44 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,049.48 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $873.44 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,049.48 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $881.92 Devoted Health Plan — Devoted Health Plan: $890.40
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 51 In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$777.50	$466.50	$822.56 – $1,751
Upper GI endoscopy with biopsy: 10 of 33 insurance plan rates Aetna — Medicare: $848 AmBetter — AmBetter: $1,246.56 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $873.44 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,049.48 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $873.44 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,049.48 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $881.92 Devoted Health Plan — Devoted Health Plan: $890.40
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 51_XU In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$777.50	$466.50	$822.56 – $1,751
Upper GI endoscopy with biopsy: 10 of 33 insurance plan rates Aetna — Medicare: $848 AmBetter — AmBetter: $1,246.56 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $873.44 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,049.48 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $873.44 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,049.48 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $881.92 Devoted Health Plan — Devoted Health Plan: $890.40
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$4,930	$2,958	$250 – $1,751
Colonoscopy (diagnostic): 10 of 33 insurance plan rates Aetna — Medicare: $869.49 AmBetter — AmBetter: $1,278.15 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $895.57 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,056.49 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $895.57 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,056.49 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $904.27 Devoted Health Plan — Devoted Health Plan: $912.96
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_PT In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,144.85	$1,286.91	$843.41 – $1,751
Colonoscopy (diagnostic): 10 of 33 insurance plan rates Aetna — Medicare: $869.49 AmBetter — AmBetter: $1,278.15 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $895.57 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,056.49 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $895.57 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,056.49 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $904.27 Devoted Health Plan — Devoted Health Plan: $912.96
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$777.50	$466.50	$843.41 – $1,751
Colonoscopy (diagnostic): 10 of 33 insurance plan rates Aetna — Medicare: $869.49 AmBetter — AmBetter: $1,278.15 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $895.57 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,056.49 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $895.57 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,056.49 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $904.27 Devoted Health Plan — Devoted Health Plan: $912.96
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$667	$400.20	$250 – $2,125.78
Colonoscopy with biopsy: 10 of 33 insurance plan rates Aetna — Medicare: $1,118.83 AmBetter — AmBetter: $1,644.68 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,152.39 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $667 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,152.39 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,376.69 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,163.58 Devoted Health Plan — Devoted Health Plan: $1,174.77
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,937.50	$1,762.50	$887 – $2,125.78
Colonoscopy with biopsy: 10 of 33 insurance plan rates Aetna — Medicare: $1,118.83 AmBetter — AmBetter: $1,644.68 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,152.39 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,376.69 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,152.39 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,376.69 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,163.58 Devoted Health Plan — Devoted Health Plan: $1,174.77
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_PT In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$920.50	$552.30	$887 – $2,125.78
Colonoscopy with biopsy: 10 of 33 insurance plan rates Aetna — Medicare: $1,118.83 AmBetter — AmBetter: $1,644.68 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,152.39 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,376.69 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,152.39 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,376.69 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,163.58 Devoted Health Plan — Devoted Health Plan: $1,174.77
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$2,465	$1,479	$250 – $2,125.78
Colonoscopy with removal of polyps (snare): 10 of 33 insurance plan rates Aetna — Medicare: $1,118.83 AmBetter — AmBetter: $1,644.68 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,152.39 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,376.69 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,152.39 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,376.69 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,163.58 Devoted Health Plan — Devoted Health Plan: $1,174.77
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_PT In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$2,259.92	$1,355.95	$887 – $2,125.78
Colonoscopy with removal of polyps (snare): 10 of 33 insurance plan rates Aetna — Medicare: $1,118.83 AmBetter — AmBetter: $1,644.68 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,152.39 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,376.69 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,152.39 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,376.69 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,163.58 Devoted Health Plan — Devoted Health Plan: $1,174.77
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$1,467	$880.20	$887 – $2,125.78
Colonoscopy with removal of polyps (snare): 10 of 33 insurance plan rates Aetna — Medicare: $1,118.83 AmBetter — AmBetter: $1,644.68 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,152.39 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,376.69 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,152.39 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,376.69 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,163.58 Devoted Health Plan — Devoted Health Plan: $1,174.77
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$777.50	$466.50	$297 – $2,125.78
Ultrasound of the lower bowel by endoscope: 10 of 33 insurance plan rates Aetna — Medicare: $1,118.83 AmBetter — AmBetter: $1,644.68 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,152.39 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $777.50 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,152.39 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,376.69 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,163.58 Devoted Health Plan — Devoted Health Plan: $1,174.77
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$1,467	$880.20	$843.41 – $1,751
Screening colonoscopy (not high risk): 10 of 33 insurance plan rates Aetna — Medicare: $869.49 AmBetter — AmBetter: $1,278.15 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $895.57 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,056.49 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $895.57 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,056.49 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $904.27 Devoted Health Plan — Devoted Health Plan: $912.96
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$2,268	$1,360.80	$843.41 – $1,751
Screening colonoscopy (not high risk): 10 of 33 insurance plan rates Aetna — Medicare: $869.49 AmBetter — AmBetter: $1,278.15 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $895.57 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,056.49 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $895.57 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,056.49 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $904.27 Devoted Health Plan — Devoted Health Plan: $912.96
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$920.50	$552.30	$843.41 – $1,751
Screening colonoscopy (not high risk): 10 of 33 insurance plan rates Aetna — Medicare: $869.49 AmBetter — AmBetter: $1,278.15 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $895.57 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,056.49 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $895.57 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,056.49 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $904.27 Devoted Health Plan — Devoted Health Plan: $912.96
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$15,714.64	$9,428.78	$363 – $10,739.60
Gallbladder removal by laparoscope: 10 of 33 insurance plan rates Aetna — Medicare: $5,652.42 AmBetter — AmBetter: $8,309.06 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $5,821.99 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $6,626.16 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $5,821.99 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $6,626.16 Cigna — Cigna: $6,631 Cigna C — 16: $6,375 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $5,878.52 Devoted Health Plan — Devoted Health Plan: $5,935.04
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_RT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$5,085	$3,051	$887 – $10,784.67
Groin (inguinal) hernia repair, age 5 or older: 10 of 33 insurance plan rates Aetna — Medicare: $5,676.14 AmBetter — AmBetter: $8,343.93 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $5,846.42 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $4,502.83 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $5,846.42 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $4,502.83 Cigna — Cigna: $2,470 Cigna C — 16: $2,066 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $5,903.19 Devoted Health Plan — Devoted Health Plan: $5,959.95
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$5,159	$3,095.40	$887 – $10,784.67
Groin (inguinal) hernia repair, age 5 or older: 10 of 33 insurance plan rates Aetna — Medicare: $5,676.14 AmBetter — AmBetter: $8,343.93 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $5,846.42 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $4,502.83 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $5,846.42 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $4,502.83 Cigna — Cigna: $2,470 Cigna C — 16: $2,066 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $5,903.19 Devoted Health Plan — Devoted Health Plan: $5,959.95
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$10,394.96	$6,236.98	$887 – $6,360.42
Groin (inguinal) hernia repair, age 5 or older: 10 of 33 insurance plan rates Aetna — Medicare: $3,347.59 AmBetter — AmBetter: $4,920.96 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,448.02 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $4,502.83 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,448.02 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $4,502.83 Cigna — Cigna: $2,470 Cigna C — 16: $2,066 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,481.49 Devoted Health Plan — Devoted Health Plan: $3,514.97
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE GLAND	$2,738	$1,642.80	$250 – $1,751
Prostate biopsy: rates for 10 insurance plans Cigna — Cigna: $1,751 Cigna C — 16: $1,464 United Healthcare — Commercial: $887 Aetna — Commercial: 65% (a percentage in the contract, not a dollar amount) First Health — First Health: 75% (a percentage in the contract, not a dollar amount) HealthSCOPE Benefits — HealthSCOPE Benefits: 70% (a percentage in the contract, not a dollar amount) Multiplan — Multiplan: 75% (a percentage in the contract, not a dollar amount) Municipal Health Benefit Fund — Municipal Health Benefit Fund: 55% (a percentage in the contract, not a dollar amount) PPOplus — Commercial: 70% (a percentage in the contract, not a dollar amount) St Bernard Hlthcr Assoc Reg Providers — Commercial: 70% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_PN In the file: BIOPSY OF PROSTATE GLAND	$3,760	$2,256	$887 – $1,751
Prostate biopsy: 10 of 13 insurance plan rates Cigna — Cigna: $1,751 Cigna C — 16: $1,464 United Healthcare — Commercial: $887 Aetna — Commercial: 65% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: 32% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: 49% (a percentage in the contract, not a dollar amount) First Health — First Health: 75% (a percentage in the contract, not a dollar amount) Health Advantage — Health Advantage: 49% (a percentage in the contract, not a dollar amount) HealthSCOPE Benefits — HealthSCOPE Benefits: 70% (a percentage in the contract, not a dollar amount) Multiplan — Multiplan: 75% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: BIOPSY OF PROSTATE GLAND	$2,207.50	$1,324.50	$887 – $1,751
Prostate biopsy: 10 of 13 insurance plan rates Cigna — Cigna: $1,751 Cigna C — 16: $1,464 United Healthcare — Commercial: $887 Aetna — Commercial: 65% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: 32% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: 49% (a percentage in the contract, not a dollar amount) First Health — First Health: 75% (a percentage in the contract, not a dollar amount) Health Advantage — Health Advantage: 49% (a percentage in the contract, not a dollar amount) HealthSCOPE Benefits — HealthSCOPE Benefits: 70% (a percentage in the contract, not a dollar amount) Multiplan — Multiplan: 75% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE	$21,022	$12,613.20	$363 – $18,883.40
Prostate removal by laparoscope (radical prostatectomy): 10 of 33 insurance plan rates Aetna — Medicare: $9,938.63 AmBetter — AmBetter: $14,609.79 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $10,236.79 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $11,552.61 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $10,236.79 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $11,552.61 Cigna — Cigna: $2,759 Cigna C — 16: $2,306 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $10,336.18 Devoted Health Plan — Devoted Health Plan: $10,435.56
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	$4,857	$2,914.20	$363 – $5,750.62
Hysteroscopy with biopsy of the uterus lining: 10 of 33 insurance plan rates Aetna — Medicare: $3,026.64 AmBetter — AmBetter: $4,449.16 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,117.44 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3,594.50 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,117.44 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3,594.50 Cigna — Cigna: $2,001 Cigna C — 16: $1,674 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,147.71 Devoted Health Plan — Devoted Health Plan: $3,177.97
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$4,774	$2,864.40	$363 – $5,750.62
Hysteroscopy with biopsy of the uterus lining: 10 of 33 insurance plan rates Aetna — Medicare: $3,026.64 AmBetter — AmBetter: $4,449.16 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,117.44 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3,594.50 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,117.44 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3,594.50 Cigna — Cigna: $2,001 Cigna C — 16: $1,674 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,147.71 Devoted Health Plan — Devoted Health Plan: $3,177.97
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$3,105	$1,863	$887 – $5,750.62
Hysteroscopy with biopsy of the uterus lining: 10 of 33 insurance plan rates Aetna — Medicare: $3,026.64 AmBetter — AmBetter: $4,449.16 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $3,117.44 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $3,594.50 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $3,117.44 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $3,594.50 Cigna — Cigna: $2,001 Cigna C — 16: $1,674 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $3,147.71 Devoted Health Plan — Devoted Health Plan: $3,177.97
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC	$1,325	$795	$250 – $1,306
Spinal injection, lower back (epidural), with imaging guidance: 10 of 33 insurance plan rates Aetna — Medicare: $659.98 AmBetter — AmBetter: $970.17 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $679.78 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $819.14 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $679.78 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $819.14 Cigna — Cigna: $1,306 Cigna C — 16: $1,092 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $686.38 Devoted Health Plan — Devoted Health Plan: $692.98
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$1,250	$750	$250 – $1,306
Spinal injection, lower back (epidural), with imaging guidance: 10 of 33 insurance plan rates Aetna — Medicare: $659.98 AmBetter — AmBetter: $970.17 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $679.78 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $819.14 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $679.78 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $819.14 Cigna — Cigna: $1,306 Cigna C — 16: $1,092 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $686.38 Devoted Health Plan — Devoted Health Plan: $692.98
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XS In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$1,250	$750	$640.18 – $1,306
Spinal injection, lower back (epidural), with imaging guidance: 10 of 33 insurance plan rates Aetna — Medicare: $659.98 AmBetter — AmBetter: $970.17 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $679.78 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $819.14 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $679.78 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $819.14 Cigna — Cigna: $1,306 Cigna C — 16: $1,092 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $686.38 Devoted Health Plan — Devoted Health Plan: $692.98
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	$1,331	$798.60	$250 – $1,571.22
Nerve root injection, lower back, with imaging guidance: 10 of 33 insurance plan rates Aetna — Medicare: $826.96 AmBetter — AmBetter: $1,215.63 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $851.77 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,083.36 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $851.77 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,083.36 Cigna — Cigna: $1,306 Cigna C — 16: $1,092 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $860.04 Devoted Health Plan — Devoted Health Plan: $868.31
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,256	$753.60	$250 – $1,571.22
Nerve root injection, lower back, with imaging guidance: 10 of 33 insurance plan rates Aetna — Medicare: $826.96 AmBetter — AmBetter: $1,215.63 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $851.77 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $1,083.36 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $851.77 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,083.36 Cigna — Cigna: $1,306 Cigna C — 16: $1,092 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $860.04 Devoted Health Plan — Devoted Health Plan: $868.31
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_RT In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$942	$565.20	$887 – $2,356.84
Nerve root injection, lower back, with imaging guidance: 10 of 33 insurance plan rates Aetna — Medicare: $1,240.44 AmBetter — AmBetter: $1,823.45 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,277.65 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $942 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,277.65 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $1,083.36 Cigna — Cigna: $1,306 Cigna C — 16: $1,092 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,290.06 Devoted Health Plan — Devoted Health Plan: $1,302.46
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$4,582	$2,749.20	$320 – $3,468.93
Carpal tunnel release: 10 of 33 insurance plan rates Aetna — Medicare: $1,825.75 AmBetter — AmBetter: $2,683.85 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,880.52 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $2,285.19 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,880.52 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $2,285.19 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,898.78 Devoted Health Plan — Devoted Health Plan: $1,917.04
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	$4,857	$2,914.20	$320 – $3,468.92
Carpal tunnel release: 10 of 33 insurance plan rates Aetna — Medicare: $1,825.75 AmBetter — AmBetter: $2,683.85 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,880.52 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $2,285.19 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,880.52 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $2,285.19 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,898.78 Devoted Health Plan — Devoted Health Plan: $1,917.04
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$4,582	$2,749.20	$887 – $3,468.93
Carpal tunnel release: 10 of 33 insurance plan rates Aetna — Medicare: $1,825.75 AmBetter — AmBetter: $2,683.85 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,880.52 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $2,285.19 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,880.52 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $2,285.19 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,898.78 Devoted Health Plan — Devoted Health Plan: $1,917.04
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	$1,325	$795	$250 – $1,751
Laser treatment of clouding after cataract surgery: 10 of 33 insurance plan rates Aetna — Medicare: $514.24 AmBetter — AmBetter: $755.93 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $529.67 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $674.76 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $529.67 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $674.76 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $534.81 Devoted Health Plan — Devoted Health Plan: $539.95
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER	$1,875	$1,125	$674.76 – $1,751
Laser treatment of clouding after cataract surgery: 10 of 33 insurance plan rates Aetna — Medicare: $771.35 AmBetter — AmBetter: $1,133.88 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $794.49 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $674.76 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $794.49 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $674.76 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $802.20 Devoted Health Plan — Devoted Health Plan: $809.92
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 79_LT In the file: REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER	$1,250	$750	$498.81 – $1,751
Laser treatment of clouding after cataract surgery: 10 of 33 insurance plan rates Aetna — Medicare: $514.24 AmBetter — AmBetter: $755.93 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $529.67 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $674.76 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $529.67 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $674.76 Cigna — Cigna: $1,751 Cigna C — 16: $1,464 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $534.81 Devoted Health Plan — Devoted Health Plan: $539.95
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 73_LT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,450	$1,470	$887 – $3,880
Cataract removal with lens implant: 10 of 33 insurance plan rates Aetna — Medicare: $1,078.88 AmBetter — AmBetter: $1,585.95 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $1,111.25 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $2,450 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $1,111.25 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $2,745.29 Cigna — Cigna: $3,880 Cigna C — 16: $3,243 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $1,122.04 Devoted Health Plan — Devoted Health Plan: $1,132.82
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_RT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$4,415	$2,649	$887 – $4,099.73
Cataract removal with lens implant: 10 of 33 insurance plan rates Aetna — Medicare: $2,157.75 AmBetter — AmBetter: $3,171.89 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $2,222.48 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $2,745.29 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $2,222.48 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $2,745.29 Cigna — Cigna: $3,880 Cigna C — 16: $3,243 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $2,244.06 Devoted Health Plan — Devoted Health Plan: $2,265.64
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,926	$1,755.60	$887 – $4,099.73
Cataract removal with lens implant: 10 of 33 insurance plan rates Aetna — Medicare: $2,157.75 AmBetter — AmBetter: $3,171.89 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $2,222.48 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $2,745.29 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $2,222.48 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $2,745.29 Cigna — Cigna: $3,880 Cigna C — 16: $3,243 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $2,244.06 Devoted Health Plan — Devoted Health Plan: $2,265.64

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC WITH CARD CATH WITH COMORBITY	Not listed in the file	Not listed in the file	$1,050 – $169,159.58
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 33 insurance plan rates Aetna — Medicare: $87,647.45 AmBetter — AmBetter: $156,012.46 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $90,276.87 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $94,159.45 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $90,276.87 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $98,806.28 Cigna — Cigna: $3,113 Cigna C — 16: $2,994 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $91,153.35 Devoted Health Plan — Devoted Health Plan: $92,029.82
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT COMORBITY	Not listed in the file	Not listed in the file	$1,050 – $35,251.72
Hip or knee replacement (major joint of the leg), without major complications: 10 of 33 insurance plan rates Aetna — Medicare: $18,265.14 AmBetter — AmBetter: $32,511.95 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $18,813.09 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $18,565.66 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $18,813.09 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $19,481.89 Cigna — Cigna: $3,113 Cigna C — 16: $2,994 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $18,995.75 Devoted Health Plan — Devoted Health Plan: $19,178.40
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT COMPLICATION/COMORBITY	Not listed in the file	Not listed in the file	$1,050 – $43,988.08
Neck (cervical) spinal fusion, without complications: 10 of 33 insurance plan rates Aetna — Medicare: $22,791.75 AmBetter — AmBetter: $40,569.32 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $23,475.50 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $23,497.51 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $23,475.50 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $24,657.13 Cigna — Cigna: $3,113 Cigna C — 16: $2,994 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $23,703.42 Devoted Health Plan — Devoted Health Plan: $23,931.34
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY WITHOUT COMPLICATION/COMORBITY	Not listed in the file	Not listed in the file	$1,050 – $23,518.02
Uterus and ovary surgery (not for cancer), without complications: 10 of 33 insurance plan rates Aetna — Medicare: $12,185.50 AmBetter — AmBetter: $21,690.19 Blue Cross Blue Shield Medicare Advantage — Blue Cross Blue Shield Medicare Advantage: $12,551.06 Blue Cross Blue Shield Metallic Plan — Blue Cross Blue Shield Metallic Plan: $11,941.74 Blue Cross Blue Shield Premium HMO — Blue Cross Blue Shield Premium HMO: $12,551.06 Blue Cross Blue Shield True Blue PPO — Blue Cross Blue Shield True Blue PPO: $12,531.07 Cigna — Cigna: $3,113 Cigna C — 16: $2,994 Cigna HealthSpring Medicare Advantage — Cigna HealthSpring Medicare Advantage: $12,672.92 Devoted Health Plan — Devoted Health Plan: $12,794.78

Source: University of Arkansas Medical Sciences’s standard charges file (apim.services.craneware.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 17, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	4301 West Markham Street Mail Slot 612, Little Rock, AR 72205
County	Pulaski County
State	Arkansas
Phone	(501) 686‑5000
Emergency services	Yes
Ownership	Government - State
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	040016
Profile level	Medicare data + hospital website
Name on the hospital’s website	UAMS Medical Center
Official website	uamshealth.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

UAMS Medical Center - UAMS Health — uamshealth.com
Neonatal Intensive Care Unit | Little Rock | UAMS Health — uamshealth.com
Emergency Department at the UAMS Medical Center | UAMS Health — uamshealth.com
Trauma Care | Area of Expertise | UAMS Health — uamshealth.com
Neurosurgery | Area of Expertise | UAMS Health — uamshealth.com