Does University of Michigan Health- Sparrow Clinton have an emergency room?

Yes. Medicare (CMS) data lists emergency services at University of Michigan Health- Sparrow Clinton. In a medical emergency, call 911.

Where is University of Michigan Health- Sparrow Clinton?

805 S Oakland, Saint Johns, MI 48879, in Clinton County, Michigan.

What is the phone number of University of Michigan Health- Sparrow Clinton?

(989) 227-3400, as listed by Medicare (CMS).

What is the Medicare star rating of University of Michigan Health- Sparrow Clinton?

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

University of Michigan Health- Sparrow Clinton

Quick answers

Does University of Michigan Health- Sparrow Clinton have an emergency room?: Yes. Medicare (CMS) data lists emergency services at University of Michigan Health- Sparrow Clinton. In a medical emergency, call 911.
Where is University of Michigan Health- Sparrow Clinton?: 805 S Oakland, Saint Johns, MI 48879, in Clinton County, Michigan.
What is the phone number of University of Michigan Health- Sparrow Clinton?: (989) 227-3400, as listed by Medicare (CMS).
What is the Medicare star rating of University of Michigan Health- Sparrow Clinton?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Conditions treated^[4]

Sleep apnea
Sleep disorders
Heart conditions
Lung diseases

Treatments^[4]

Cardiac rehabilitation
Wound care
Pulmonary services and diagnostics
Sleep center services
Transitional care (swing beds)
Infusion therapy
Joint replacement
Hand therapy
Pulmonary function testing
Respiratory therapy
CT scan
MRI
Ultrasound
Nuclear medicine
Bone density imaging
3D mammography

Procedures^[4]

Mammography, CT, MRI and ultrasound imaging

Programs and centers^[4]

Swing bed program
Emergency services department
Cardiac rehabilitation program
Sleep Center
Laboratory services
Pharmacy

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV

Visiting and practical information

Visiting	Visitor hours 8 a.m. to 8 p.m^[4]
Parking	On-site North, South and East parking lots close to services^[4]
Interpreters and languages	Free interpreter services^[4]

Recognition^[4]

Joint Commission accredited critical access hospital
ACR Mammography Accreditation
ACR Accreditation - Computed Tomography
ACR Accreditation - Breast Ultrasound
College of American Pathologists accreditation

Doctors and clinicians (303)

303 doctors and other clinicians list University of Michigan Health- Sparrow Clinton as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 279 more: the button below opens the full list.

Other emergency rooms nearby

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

Edward W Sparrow Hospital18 mi · Lansing, MI · Acute Care Hospital
Memorial Healthcare19 mi · Owosso, MI · Acute Care Hospital
University of Michigan Health-Sparrow Carson19 mi · Carson City, MI · Acute Care Hospital
McLaren Greater Lansing20 mi · Lansing, MI · Acute Care Hospital
Sparrow Ionia Hospital27 mi · Ionia, MI · Critical Access Hospital

Other hospitals nearby

Cedar Creek Hospital0.5 mi · Saint Johns, MI · Psychiatric Hospital
Brightwell Behavioral Health16 mi · East Lansing, MI · Psychiatric Hospital
University of Michigan Health-Sparrow Specialty Ho…18 mi · Lansing, MI · Long-Term Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Hazel I Findlay Country Manor0.6 mi · Saint Johns, MI · 5 of 5 stars
Ovid Healthcare Center9.0 mi · Ovid, MI · 4 of 5 stars
The Laurels of Fulton13 mi · Perrinton, MI · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Heart to Heart Hospice of Lansing, LLC17 mi · East Lansing, MI · 4 of 5 stars
Sparrow Hospice Services18 mi · Lansing, MI · 4 of 5 stars
Memorial Healthcare19 mi · Owosso, MI · 5 of 5 stars

All hospice providers in the state →

Home health agencies

Sparrow Home Care18 mi · Lansing, MI · 4 of 5 stars
Memorial Healthcare19 mi · Owosso, MI
McLaren Home Health19 mi · Lansing, MI · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

FMC - St Johns1.5 mi · Saint Johns, MI · 4 of 5 stars
DaVita Lansing Home Training (PD)17 mi · East Lansing, MI
DaVita Spartan Dialysis17 mi · East Lansing, MI · 3 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.

Grand River Surgery Center17 mi · East Lansing, MI
Michigan Surgical Center17 mi · East Lansing, MI
Midwest Vision Surgery Center of Lansing17 mi · East Lansing, MI

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

Ashley Community Schools14 mi · Ashley, MI · Community health center
Fulton Schools15 mi · Middleton, MI · Community health center
Pattengill Community Health Center17 mi · Lansing, MI · Community health center

Clinics and urgent care

Edward W. Sparrow Hospital Association17 mi · East Lansing, MI · Urgent care center
Health Service Consultants, P.C .18 mi · Haslett, MI · Urgent care center
MyMichigan Family Medicine19 mi · Ithaca, MI · Rural health clinic

Pharmacies

Kroger Co of Michigan1.5 mi · Saint Johns, MI · Community/retail pharmacy
Rite Health Pharmacy- St Johns LLC1.5 mi · Saint Johns, MI · Community/retail pharmacy
Sparrow Clinton Hospital1.5 mi · Saint Johns, MI · Community/retail pharmacy

Assisted living nearby

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

Bradford Home1.5 mi · St. Johns, MI
Grace Haven Assisted Living - Specialized Care1.5 mi · St. Johns, MI
Grace Haven Assisted Living - Supportive Care1.5 mi · St. Johns, MI
The Maples of St. Johns1.5 mi · St. Johns, MI

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	4 of 5 stars
Overall rating of the hospital	5 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	5 of 5 stars
Doctors communicated well	4 of 5 stars
Staff explained medicines	4 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	5 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	82%National average: 72%
Would definitely recommend the hospital	83%National average: 71%
Nurses “always” communicated well	83%National average: 80%
Doctors “always” communicated well	81%National average: 80%
Staff “always” explained medicines before giving them	68%National average: 62%
Were given information about recovery at home	90%National average: 86%
Room and bathroom “always” clean	82%National average: 74%
Area around the room “always” quiet at night	58%National average: 60%
Completed surveys	273Response rate: 37%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	10.2%
Deaths within 30 days: pneumonia patients	12.4%
Deaths within 30 days: COPD patients	7.7%
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	21.2%
Readmitted within 30 days: pneumonia	16%
Readmitted within 30 days: COPD	18.8%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

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)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	182 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Michigan Best hospitals in Michigan

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 79 common services exactly as University of Michigan Health- Sparrow Clinton lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: Office/Outpatient New Low Mdm 30 Minutes	$188	$47	$47 – $172.96
New patient office visit (about 30–44 minutes): 10 of 29 insurance plan rates Aetna — PPO: $141 Aetna Medicare Advantage — HMO: $47 AetnaMedicaid — HMO: $57.30 ASR — PPO: $172.96 BCN Medicare Advantage — HMO: $47 Blue Care Network — PPO: $159.80 Blue Cross Blue Shield — PPO: $93.85 Blue Cross CompleteMedicaid — HMO: $55.10 Cigna — PPO: $148.90 Cofinity — PPO: $152.28
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: HB Office/Outpt Visit,New,Levl III	$346	$86.50	$86.50 – $318.32
New patient office visit (about 30–44 minutes): 10 of 28 insurance plan rates Aetna Medicare Advantage — HMO: $86.50 AetnaMedicaid — HMO: $99.73 ASR — PPO: $318.32 BCN Medicare Advantage — HMO: $86.50 Blue Care Network — PPO: $294.10 Blue Cross Blue Shield — PPO: $172.72 Blue Cross CompleteMedicaid — HMO: $95.89 Cigna — PPO: $274.03 Cofinity — PPO: $280.26 Covenant Advantage — HMO: $86.50
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$188	$94	$71.78 – $117.35
New patient office visit (about 30–44 minutes): rates for 4 insurance plans BCBS — Professional: $117.35 Medicaid — Professional: $71.78 Medicaid — Professional Facility: $52.19 Medicare — Professional: $105.27
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: Office/Outpatient New Moderate Mdm 45 Minutes	$287	$71.75	$71.75 – $264.04
New patient office visit (about 45–59 minutes): 10 of 29 insurance plan rates Aetna — PPO: $215.25 Aetna Medicare Advantage — HMO: $71.75 AetnaMedicaid — HMO: $93.18 ASR — PPO: $264.04 BCN Medicare Advantage — HMO: $71.75 Blue Care Network — PPO: $243.95 Blue Cross Blue Shield — PPO: $143.27 Blue Cross CompleteMedicaid — HMO: $89.60 Cigna — PPO: $227.30 Cofinity — PPO: $232.47
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: HB Office/Outpatient Visit New Level IV	$398	$99.50	$95.89 – $366.16
New patient office visit (about 45–59 minutes): 10 of 28 insurance plan rates Aetna Medicare Advantage — HMO: $99.50 AetnaMedicaid — HMO: $99.73 ASR — PPO: $366.16 BCN Medicare Advantage — HMO: $99.50 Blue Care Network — PPO: $338.30 Blue Cross Blue Shield — PPO: $198.68 Blue Cross CompleteMedicaid — HMO: $95.89 Cigna — PPO: $315.22 Cofinity — PPO: $322.38 Covenant Advantage — HMO: $99.50
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$287	$143.50	$107.57 – $179.33
New patient office visit (about 45–59 minutes): rates for 4 insurance plans BCBS — Professional: $179.33 Medicaid — Professional: $107.57 Medicaid — Professional Facility: $84.99 Medicare — Professional: $158.33
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: Office/Outpatient New High Mdm 60 Minutes	$363	$90.75	$90.75 – $333.96
New patient office visit (about 60–74 minutes): 10 of 29 insurance plan rates Aetna — PPO: $272.25 Aetna Medicare Advantage — HMO: $90.75 AetnaMedicaid — HMO: $126.82 ASR — PPO: $333.96 BCN Medicare Advantage — HMO: $90.75 Blue Care Network — PPO: $308.55 Blue Cross Blue Shield — PPO: $181.21 Blue Cross CompleteMedicaid — HMO: $121.94 Cigna — PPO: $287.50 Cofinity — PPO: $294.03
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: HB Office/Outpatient Visit New Level V	$458	$114.50	$95.89 – $421.36
New patient office visit (about 60–74 minutes): 10 of 28 insurance plan rates Aetna Medicare Advantage — HMO: $114.50 AetnaMedicaid — HMO: $99.73 ASR — PPO: $421.36 BCN Medicare Advantage — HMO: $114.50 Blue Care Network — PPO: $389.30 Blue Cross Blue Shield — PPO: $228.63 Blue Cross CompleteMedicaid — HMO: $95.89 Cigna — PPO: $362.74 Cofinity — PPO: $370.98 Covenant Advantage — HMO: $114.50
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$363	$181.50	$142.07 – $226.59
New patient office visit (about 60–74 minutes): rates for 4 insurance plans BCBS — Professional: $226.59 Medicaid — Professional: $142.07 Medicaid — Professional Facility: $115.66 Medicare — Professional: $209.51
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Office/Outpatient Established Low Mdm 20 Min	$137	$34.25	$34.25 – $126.04
Established patient office visit (about 20–29 minutes): 10 of 29 insurance plan rates Aetna — PPO: $102.75 Aetna Medicare Advantage — HMO: $34.25 AetnaMedicaid — HMO: $45.93 ASR — PPO: $126.04 BCN Medicare Advantage — HMO: $34.25 Blue Care Network — PPO: $116.45 Blue Cross Blue Shield — PPO: $68.39 Blue Cross CompleteMedicaid — HMO: $44.16 Cigna — PPO: $108.50 Cofinity — PPO: $110.97
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: HB Office/Outpt Visit,Est,Levl III	$206	$51.50	$51.50 – $189.52
Established patient office visit (about 20–29 minutes): 10 of 28 insurance plan rates Aetna Medicare Advantage — HMO: $51.50 AetnaMedicaid — HMO: $99.73 ASR — PPO: $189.52 BCN Medicare Advantage — HMO: $51.50 Blue Care Network — PPO: $175.10 Blue Cross Blue Shield — PPO: $102.84 Blue Cross CompleteMedicaid — HMO: $95.89 Cigna — PPO: $163.15 Cofinity — PPO: $166.86 Covenant Advantage — HMO: $51.50
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$137	$68.50	$58.58 – $85.82
Established patient office visit (about 20–29 minutes): rates for 4 insurance plans BCBS — Professional: $85.82 Medicaid — Professional: $58.58 Medicaid — Professional Facility: $41.96 Medicare — Professional: $85.63
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Office/Outpatient Established Mod Mdm 30 Min	$199	$49.75	$49.75 – $183.08
Established patient office visit (about 30–39 minutes): 10 of 29 insurance plan rates Aetna — PPO: $149.25 Aetna Medicare Advantage — HMO: $49.75 AetnaMedicaid — HMO: $67.64 ASR — PPO: $183.08 BCN Medicare Advantage — HMO: $49.75 Blue Care Network — PPO: $169.15 Blue Cross Blue Shield — PPO: $99.34 Blue Cross CompleteMedicaid — HMO: $65.04 Cigna — PPO: $157.61 Cofinity — PPO: $161.19
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: HB Office/Outpt Visit,Est,Levl IV	$283	$70.75	$70.75 – $260.36
Established patient office visit (about 30–39 minutes): 10 of 28 insurance plan rates Aetna Medicare Advantage — HMO: $70.75 AetnaMedicaid — HMO: $99.73 ASR — PPO: $260.36 BCN Medicare Advantage — HMO: $70.75 Blue Care Network — PPO: $240.55 Blue Cross Blue Shield — PPO: $141.27 Blue Cross CompleteMedicaid — HMO: $95.89 Cigna — PPO: $224.14 Cofinity — PPO: $229.23 Covenant Advantage — HMO: $70.75
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$199	$99.50	$82.43 – $124.45
Established patient office visit (about 30–39 minutes): rates for 4 insurance plans BCBS — Professional: $124.45 Medicaid — Professional: $82.43 Medicaid — Professional Facility: $61.77 Medicare — Professional: $120.84
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: HB Office Consultation	$149	$37.25	$37.25 – $137.08
Office consultation with a specialist (moderate): 10 of 28 insurance plan rates Aetna Medicare Advantage — HMO: $37.25 AetnaMedicaid — HMO: $99.73 ASR — PPO: $137.08 BCN Medicare Advantage — HMO: $37.25 Blue Care Network — PPO: $126.65 Blue Cross Blue Shield — PPO: $74.38 Blue Cross CompleteMedicaid — HMO: $95.89 Cigna — PPO: $118.01 Cofinity — PPO: $120.69 Covenant Advantage — HMO: $37.25
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$225	$112.50	$71.99 – $180.02
Office consultation with a specialist (moderate): rates for 3 insurance plans BCBS — Professional: $180.02 Medicaid — Professional: $71.99 Medicaid — Professional Facility: $56.02
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · modifier F In the file: PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$175	$87.50	$140.07
Office consultation with a specialist (moderate): rates for 1 insurance plan BCBS — Professional Facility: $140.07
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: HB Office Consultation	$149	$37.25	$37.25 – $137.08
Office consultation with a specialist (moderate to high): 10 of 28 insurance plan rates Aetna Medicare Advantage — HMO: $37.25 AetnaMedicaid — HMO: $99.73 ASR — PPO: $137.08 BCN Medicare Advantage — HMO: $37.25 Blue Care Network — PPO: $126.65 Blue Cross Blue Shield — PPO: $74.38 Blue Cross CompleteMedicaid — HMO: $95.89 Cigna — PPO: $118.01 Cofinity — PPO: $120.69 Covenant Advantage — HMO: $37.25
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$320	$160	$102.45 – $256.18
Office consultation with a specialist (moderate to high): rates for 3 insurance plans BCBS — Professional: $256.18 Medicaid — Professional: $102.45 Medicaid — Professional Facility: $84.99
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · modifier F In the file: PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$266	$133	$212.51
Office consultation with a specialist (moderate to high): rates for 1 insurance plan BCBS — Professional Facility: $212.51
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: HB Prev Visit New Age 18-39	$149	$37.25	$37.25 – $137.08
Preventive checkup, new patient, age 18–39: 10 of 28 insurance plan rates Aetna Medicare Advantage — HMO: $37.25 AetnaMedicaid — HMO: $99.73 ASR — PPO: $137.08 BCN Medicare Advantage — HMO: $37.25 Blue Care Network — PPO: $126.65 Blue Cross Blue Shield — PPO: $74.38 Blue Cross CompleteMedicaid — HMO: $95.89 Cigna — PPO: $118.01 Cofinity — PPO: $120.69 Covenant Advantage — HMO: $37.25
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$242	$121	$99.37 – $151.52
Preventive checkup, new patient, age 18–39: rates for 3 insurance plans BCBS — Professional: $151.52 Medicaid — Professional: $99.37 Medicaid — Professional Facility: $69
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: HB Prev Visit New Age 40-64	$149	$37.25	$37.25 – $137.08
Preventive checkup, new patient, age 40–64: 10 of 28 insurance plan rates Aetna Medicare Advantage — HMO: $37.25 AetnaMedicaid — HMO: $99.73 ASR — PPO: $137.08 BCN Medicare Advantage — HMO: $37.25 Blue Care Network — PPO: $126.65 Blue Cross Blue Shield — PPO: $74.38 Blue Cross CompleteMedicaid — HMO: $95.89 Cigna — PPO: $118.01 Cofinity — PPO: $120.69 Covenant Advantage — HMO: $37.25
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$279	$139.50	$117.10 – $174.44
Preventive checkup, new patient, age 40–64: rates for 3 insurance plans BCBS — Professional: $174.44 Medicaid — Professional: $117.10 Medicaid — Professional Facility: $84.51
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency Department Visit Low Mdm	$140	$35	$12 – $536.36
Emergency room visit (moderate): 10 of 29 insurance plan rates Aetna — PPO: $105 Aetna Medicare Advantage — HMO: $35 AetnaMedicaid — HMO: $204.48 ASR — PPO: $128.80 BCN Medicare Advantage — HMO: $35 Blue Care Network — PPO: $119 Blue Cross Blue Shield — PPO: $69.89 Blue Cross CompleteMedicaid — HMO: $196.62 Cigna — PPO: $110.88 Cofinity — PPO: $113.40
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HB Emergency Dept Visit,Level III	$606	$151.50	$12 – $30,103
Emergency room visit (moderate): 10 of 29 insurance plan rates Aetna — PPO: $454.50 Aetna Medicare Advantage — HMO: $151.50 AetnaMedicaid — HMO: $204.48 ASR — PPO: $557.52 BCN Medicare Advantage — HMO: $151.50 Blue Care Network — PPO: $515.10 Blue Cross Blue Shield — PPO: $302.52 Blue Cross CompleteMedicaid — HMO: $196.62 Cigna — PPO: $479.95 Cofinity — PPO: $490.86
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: PR EMERGENCY DEPARTMENT VISIT LOW MDM	$140	$70	$112.38
Emergency room visit (moderate): rates for 4 insurance plans BCBS — Professional: $112.38 BCBS — Professional Facility: $112.38 Medicaid — Professional Facility: $44.94 Medicare — Professional: $68.14
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency Department Visit Moderate Mdm	$240	$60	$12 – $1,119.45
Emergency room visit (moderately high): 10 of 29 insurance plan rates Aetna — PPO: $180 Aetna Medicare Advantage — HMO: $60 AetnaMedicaid — HMO: $312.56 ASR — PPO: $220.80 BCN Medicare Advantage — HMO: $60 Blue Care Network — PPO: $204 Blue Cross Blue Shield — PPO: $119.81 Blue Cross CompleteMedicaid — HMO: $300.54 Cigna — PPO: $190.08 Cofinity — PPO: $194.40
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HB Emergency Dept Visit,Level IV	$1,317	$329.25	$12 – $1,317
Emergency room visit (moderately high): 10 of 29 insurance plan rates Aetna — PPO: $987.75 Aetna Medicare Advantage — HMO: $329.25 AetnaMedicaid — HMO: $312.56 ASR — PPO: $1,211.64 BCN Medicare Advantage — HMO: $329.25 Blue Care Network — PPO: $1,119.45 Blue Cross Blue Shield — PPO: $657.45 Blue Cross CompleteMedicaid — HMO: $300.54 Cigna — PPO: $1,043.06 Cofinity — PPO: $1,066.77
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$240	$120	$191.74
Emergency room visit (moderately high): rates for 4 insurance plans BCBS — Professional: $191.74 BCBS — Professional Facility: $191.74 Medicaid — Professional Facility: $76.68 Medicare — Professional: $116.43
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency Department Visit High Mdm	$348	$87	$31 – $1,717.64
Emergency room visit (high): 10 of 29 insurance plan rates Aetna — PPO: $261 Aetna Medicare Advantage — HMO: $87 AetnaMedicaid — HMO: $446.10 ASR — PPO: $320.16 BCN Medicare Advantage — HMO: $87 Blue Care Network — PPO: $295.80 Blue Cross Blue Shield — PPO: $173.72 Blue Cross CompleteMedicaid — HMO: $428.94 Cigna — PPO: $275.62 Cofinity — PPO: $281.88
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HB Emergency Dept Visit,Level V	$1,867	$466.75	$14 – $1,717.64
Emergency room visit (high): 10 of 29 insurance plan rates Aetna — PPO: $1,400.25 Aetna Medicare Advantage — HMO: $466.75 AetnaMedicaid — HMO: $446.10 ASR — PPO: $1,717.64 BCN Medicare Advantage — HMO: $466.75 Blue Care Network — PPO: $1,586.95 Blue Cross Blue Shield — PPO: $932.01 Blue Cross CompleteMedicaid — HMO: $428.94 Cigna — PPO: $1,478.66 Cofinity — PPO: $1,512.27
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$348	$174	$278.02
Emergency room visit (high): rates for 4 insurance plans BCBS — Professional: $278.02 BCBS — Professional Facility: $278.02 Medicaid — Professional Facility: $111.19 Medicare — Professional: $168.98

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: HB Comprehen Metabolic Panel	$13	$3.25	$3.25 – $522
Comprehensive metabolic panel (blood test): 10 of 29 insurance plan rates Aetna — PPO: $10.03 Aetna Medicare Advantage — HMO: $3.25 AetnaMedicaid — HMO: $7.74 ASR — PPO: $11.96 BCN Medicare Advantage — HMO: $3.25 Blue Care Network — PPO: $11.05 Blue Cross Blue Shield — PPO: $6.49 Blue Cross CompleteMedicaid — HMO: $7.44 Cigna — PPO: $10.30 Cofinity — PPO: $10.53
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: HB Advanced Lipid Panel, Cardio Iq	$83	$20.75	$9.44 – $76.36
Cholesterol panel (lipid panel): 10 of 29 insurance plan rates Aetna — PPO: $12.72 Aetna Medicare Advantage — HMO: $20.75 AetnaMedicaid — HMO: $9.82 ASR — PPO: $76.36 BCN Medicare Advantage — HMO: $20.75 Blue Care Network — PPO: $70.55 Blue Cross Blue Shield — PPO: $41.43 Blue Cross CompleteMedicaid — HMO: $9.44 Cigna — PPO: $65.74 Cofinity — PPO: $67.23
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HB POC Hepatic Panel	$50	$12.50	$5.76 – $372
Liver function panel: 10 of 29 insurance plan rates Aetna — PPO: $7.76 Aetna Medicare Advantage — HMO: $12.50 AetnaMedicaid — HMO: $5.99 ASR — PPO: $46 BCN Medicare Advantage — HMO: $12.50 Blue Care Network — PPO: $42.50 Blue Cross Blue Shield — PPO: $24.96 Blue Cross CompleteMedicaid — HMO: $5.76 Cigna — PPO: $39.60 Cofinity — PPO: $40.50
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: HB Urinalysis, Auto, W/Scope	$4	$1	$1 – $748
Urine test (automated, with microscope): 10 of 29 insurance plan rates Aetna — PPO: $3.01 Aetna Medicare Advantage — HMO: $1 AetnaMedicaid — HMO: $2.32 ASR — PPO: $3.68 BCN Medicare Advantage — HMO: $1 Blue Care Network — PPO: $3.40 Blue Cross Blue Shield — PPO: $2 Blue Cross CompleteMedicaid — HMO: $2.23 Cigna — PPO: $3.17 Cofinity — PPO: $3.24
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY	$4	$2	$2.62 – $3.17
Urine test (automated, with microscope): rates for 3 insurance plans BCBS — Professional: $3.17 BCBS — Professional Facility: $3.17 Medicaid — Professional: $2.62
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: HB Urinalysis Nonauto W/O Scope	$38	$9.50	$1.25 – $57
Urine test (manual, without microscope): 10 of 29 insurance plan rates Aetna — PPO: $3.31 Aetna Medicare Advantage — HMO: $9.50 AetnaMedicaid — HMO: $2.55 ASR — PPO: $34.96 BCN Medicare Advantage — HMO: $9.50 Blue Care Network — PPO: $32.30 Blue Cross Blue Shield — PPO: $18.97 Blue Cross CompleteMedicaid — HMO: $2.45 Cigna — PPO: $30.10 Cofinity — PPO: $30.78
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp	$4	$1	$1 – $57
Urine test (manual, without microscope): 10 of 29 insurance plan rates Aetna — PPO: $3.31 Aetna Medicare Advantage — HMO: $1 AetnaMedicaid — HMO: $2.55 ASR — PPO: $3.68 BCN Medicare Advantage — HMO: $1 Blue Care Network — PPO: $3.40 Blue Cross Blue Shield — PPO: $2 Blue Cross CompleteMedicaid — HMO: $2.45 Cigna — PPO: $3.17 Cofinity — PPO: $3.24
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$4	$2	$2.88 – $3.48
Urine test (manual, without microscope): rates for 3 insurance plans BCBS — Professional: $3.48 BCBS — Professional Facility: $3.48 Medicaid — Professional: $2.88
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HB POC Routine Urinalysis	$14	$3.50	$1.59 – $12.88
Urine test (automated, without microscope): 10 of 29 insurance plan rates Aetna — PPO: $2.14 Aetna Medicare Advantage — HMO: $3.50 AetnaMedicaid — HMO: $1.65 ASR — PPO: $12.88 BCN Medicare Advantage — HMO: $3.50 Blue Care Network — PPO: $11.90 Blue Cross Blue Shield — PPO: $6.99 Blue Cross CompleteMedicaid — HMO: $1.59 Cigna — PPO: $11.09 Cofinity — PPO: $11.34
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HB Urinalysis, Auto, W/O Scope	$3	$0.75	$0.75 – $2.76
Urine test (automated, without microscope): 10 of 29 insurance plan rates Aetna — PPO: $2.14 Aetna Medicare Advantage — HMO: $0.75 AetnaMedicaid — HMO: $1.65 ASR — PPO: $2.76 BCN Medicare Advantage — HMO: $0.75 Blue Care Network — PPO: $2.55 Blue Cross Blue Shield — PPO: $1.50 Blue Cross CompleteMedicaid — HMO: $1.59 Cigna — PPO: $2.38 Cofinity — PPO: $2.43
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy	$3	$0.75	$0.75 – $2.76
Urine test (automated, without microscope): 10 of 29 insurance plan rates Aetna — PPO: $2.14 Aetna Medicare Advantage — HMO: $0.75 AetnaMedicaid — HMO: $1.65 ASR — PPO: $2.76 BCN Medicare Advantage — HMO: $0.75 Blue Care Network — PPO: $2.55 Blue Cross Blue Shield — PPO: $1.50 Blue Cross CompleteMedicaid — HMO: $1.59 Cigna — PPO: $2.38 Cofinity — PPO: $2.43
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HB Complete Cbc Automated	$39.98	$10	$4.56 – $194.10
Complete blood count (CBC), automated: 10 of 29 insurance plan rates Aetna — PPO: $6.15 Aetna Medicare Advantage — HMO: $10 AetnaMedicaid — HMO: $4.74 ASR — PPO: $36.78 BCN Medicare Advantage — HMO: $10 Blue Care Network — PPO: $33.98 Blue Cross Blue Shield — PPO: $19.96 Blue Cross CompleteMedicaid — HMO: $4.56 Cigna — PPO: $31.66 Cofinity — PPO: $32.38
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HB Prothrombin Time	$5	$1.25	$1.25 – $390
Blood clotting time test (prothrombin time, PT): 10 of 29 insurance plan rates Aetna — PPO: $4.08 Aetna Medicare Advantage — HMO: $1.25 AetnaMedicaid — HMO: $3.14 ASR — PPO: $4.60 BCN Medicare Advantage — HMO: $1.25 Blue Care Network — PPO: $4.25 Blue Cross Blue Shield — PPO: $2.50 Blue Cross CompleteMedicaid — HMO: $3.02 Cigna — PPO: $3.96 Cofinity — PPO: $4.05
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: CHG PROTHROMBIN TIME	$5	$2.50	$3.55 – $4.29
Blood clotting time test (prothrombin time, PT): rates for 3 insurance plans BCBS — Professional: $4.29 BCBS — Professional Facility: $4.29 Medicaid — Professional: $3.55

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: HB CT Scan,Head/Brain,W/O Contrast Matl	$1,948	$487	$65 – $5,619
CT scan of the head or brain, without contrast: 10 of 29 insurance plan rates Aetna — PPO: $1,461 Aetna Medicare Advantage — HMO: $487 AetnaMedicaid — HMO: $78.31 ASR — PPO: $1,792.16 BCN Medicare Advantage — HMO: $487 Blue Care Network — PPO: $1,655.80 Blue Cross Blue Shield — PPO: $972.44 Blue Cross CompleteMedicaid — HMO: $75.30 Cigna — PPO: $1,542.82 Cofinity — PPO: $1,577.88
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT Head/Brain W/O Contrast Material	$216	$54	$54 – $198.72
CT scan of the head or brain, without contrast: 10 of 23 insurance plan rates Aetna — PPO: $162 Aetna Medicare Advantage — HMO: $54 ASR — PPO: $198.72 BCN Medicare Advantage — HMO: $54 Blue Care Network — PPO: $183.60 Blue Cross Blue Shield — PPO: $107.83 Cigna — PPO: $171.07 Cofinity — PPO: $174.96 Covenant Advantage — HMO: $54 Great West Health — PPO: $171.07
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL	$216	$108	$69.23 – $173.10
CT scan of the head or brain, without contrast: rates for 4 insurance plans BCBS — Professional: $173.10 BCBS — Professional Facility: $173.10 Medicaid — Professional: $69.23 Medicare — Professional: $98.64
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: HB MRI Brain Combo	$3,765	$941.25	$251.28 – $3,463.80
MRI of the brain, before and after contrast: 10 of 29 insurance plan rates Aetna — PPO: $2,823.75 Aetna Medicare Advantage — HMO: $941.25 AetnaMedicaid — HMO: $261.33 ASR — PPO: $3,463.80 BCN Medicare Advantage — HMO: $941.25 Blue Care Network — PPO: $386.70 Blue Cross Blue Shield — PPO: $1,879.49 Blue Cross CompleteMedicaid — HMO: $251.28 Cigna — PPO: $2,981.88 Cofinity — PPO: $3,049.65
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier 26 In the file: CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$216	$108	$69.01 – $172.56
MRI of the brain, before and after contrast: rates for 5 insurance plans BCBS — Professional: $172.56 BCBS — Professional Facility: $172.56 Medicaid — Professional: $69.01 Medicaid — Professional Facility: $69.01 Medicare — Professional: $103.17
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: HB X-Ray Exam Chest 2 Views	$188	$47	$11 – $1,185.37
Chest X-ray, 2 views: 10 of 29 insurance plan rates Aetna — PPO: $141 Aetna Medicare Advantage — HMO: $47 AetnaMedicaid — HMO: $65.19 ASR — PPO: $172.96 BCN Medicare Advantage — HMO: $47 Blue Care Network — PPO: $159.80 Blue Cross Blue Shield — PPO: $93.85 Blue Cross CompleteMedicaid — HMO: $62.68 Cigna — PPO: $148.90 Cofinity — PPO: $152.28
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiologic Exam Chest 2 Views	$67	$16.75	$16.75 – $61.64
Chest X-ray, 2 views: 10 of 23 insurance plan rates Aetna — PPO: $50.25 Aetna Medicare Advantage — HMO: $16.75 ASR — PPO: $61.64 BCN Medicare Advantage — HMO: $16.75 Blue Care Network — PPO: $56.95 Blue Cross Blue Shield — PPO: $33.45 Cigna — PPO: $53.06 Cofinity — PPO: $54.27 Covenant Advantage — HMO: $16.75 Great West Health — PPO: $53.06
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: CHG RADIOLOGIC EXAM CHEST 2 VIEWS	$67	$33.50	$21.51 – $53.79
Chest X-ray, 2 views: rates for 4 insurance plans BCBS — Professional: $53.79 BCBS — Professional Facility: $53.79 Medicaid — Professional: $21.51 Medicare — Professional: $30.57
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: HB X-Ray Exam of Lower Spine 4+ Views	$362	$90.50	$19 – $333.04
X-ray of the lower spine, at least 4 views: 10 of 29 insurance plan rates Aetna — PPO: $271.50 Aetna Medicare Advantage — HMO: $90.50 AetnaMedicaid — HMO: $78.31 ASR — PPO: $333.04 BCN Medicare Advantage — HMO: $90.50 Blue Care Network — PPO: $307.70 Blue Cross Blue Shield — PPO: $180.71 Blue Cross CompleteMedicaid — HMO: $75.30 Cigna — PPO: $286.70 Cofinity — PPO: $293.22
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$104	$52	$33.23 – $83.09
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans BCBS — Professional: $83.09 BCBS — Professional Facility: $83.09 Medicaid — Professional: $33.23 Medicare — Professional: $46.89
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier 26 In the file: CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$25	$12.50	$8.09 – $20.24
X-ray of the lower spine, at least 4 views: rates for 5 insurance plans BCBS — Professional: $20.24 BCBS — Professional Facility: $20.24 Medicaid — Professional: $8.09 Medicaid — Professional Facility: $8.09 Medicare — Professional: $12.03
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: HB MRI, Lumbar Spine	$2,512	$628	$171.86 – $2,311.04
MRI of the lower back (lumbar spine), without contrast: 10 of 29 insurance plan rates Aetna — PPO: $1,884 Aetna Medicare Advantage — HMO: $628 AetnaMedicaid — HMO: $178.73 ASR — PPO: $2,311.04 BCN Medicare Advantage — HMO: $628 Blue Care Network — PPO: $2,135.20 Blue Cross Blue Shield — PPO: $1,253.99 Blue Cross CompleteMedicaid — HMO: $171.86 Cigna — PPO: $1,989.50 Cofinity — PPO: $2,034.72
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier 26 In the file: CHG MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$139	$69.50	$44.52 – $111.31
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans BCBS — Professional: $111.31 BCBS — Professional Facility: $111.31 Medicaid — Professional: $44.52 Medicaid — Professional Facility: $44.52 Medicare — Professional: $66.44
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: HB CT Scan of Pelvis Contrast	$2,956	$739	$126.34 – $2,719.52
CT scan of the pelvis, with contrast: 10 of 29 insurance plan rates Aetna — PPO: $2,217 Aetna Medicare Advantage — HMO: $739 AetnaMedicaid — HMO: $131.39 ASR — PPO: $2,719.52 BCN Medicare Advantage — HMO: $739 Blue Care Network — PPO: $2,512.60 Blue Cross Blue Shield — PPO: $1,475.64 Blue Cross CompleteMedicaid — HMO: $126.34 Cigna — PPO: $2,341.15 Cofinity — PPO: $2,394.36
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CHG CT PELVIS W/CONTRAST MATERIAL	$459	$229.50	$146.97 – $367.49
CT scan of the pelvis, with contrast: rates for 4 insurance plans BCBS — Professional: $367.49 BCBS — Professional Facility: $367.49 Medicaid — Professional: $146.97 Medicare — Professional: $207.26
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · modifier 26 In the file: CHG CT PELVIS W/CONTRAST MATERIAL	$109	$54.50	$34.72 – $86.81
CT scan of the pelvis, with contrast: rates for 5 insurance plans BCBS — Professional: $86.81 BCBS — Professional Facility: $86.81 Medicaid — Professional: $34.72 Medicaid — Professional Facility: $34.72 Medicare — Professional: $51.80
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: HB MRI Lower Extrem Jt, W/O Contrast	$2,512	$628	$171.86 – $2,311.04
MRI of a leg joint (such as the knee), without contrast: 10 of 29 insurance plan rates Aetna — PPO: $1,884 Aetna Medicare Advantage — HMO: $628 AetnaMedicaid — HMO: $178.73 ASR — PPO: $2,311.04 BCN Medicare Advantage — HMO: $628 Blue Care Network — PPO: $2,135.20 Blue Cross Blue Shield — PPO: $1,253.99 Blue Cross CompleteMedicaid — HMO: $171.86 Cigna — PPO: $1,989.50 Cofinity — PPO: $2,034.72
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier 26 In the file: CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$127	$63.50	$40.68 – $101.73
MRI of a leg joint (such as the knee), without contrast: rates for 5 insurance plans BCBS — Professional: $101.73 BCBS — Professional Facility: $101.73 Medicaid — Professional: $40.68 Medicaid — Professional Facility: $40.68 Medicare — Professional: $60.68
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: HB CT Scan,Abdomen and Pelvis, W Contrast	$4,939	$1,234.75	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $14,247
CT scan of the abdomen and pelvis, with contrast: 10 of 29 insurance plan rates Aetna — PPO: $3,704.25 Aetna Medicare Advantage — HMO: $1,234.75 AetnaMedicaid — HMO: $261.33 ASR — PPO: $4,543.88 BCN Medicare Advantage — HMO: $1,234.75 Blue Care Network — PPO: $4,198.15 Blue Cross Blue Shield — PPO: $2,465.55 Blue Cross CompleteMedicaid — HMO: $251.28 Cigna — PPO: $3,911.69 Cofinity — PPO: $4,000.59
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier 26 In the file: CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$172	$86	$54.95 – $137.41
CT scan of the abdomen and pelvis, with contrast: rates for 5 insurance plans BCBS — Professional: $137.41 BCBS — Professional Facility: $137.41 Medicaid — Professional: $54.95 Medicaid — Professional Facility: $54.95 Medicare — Professional: $82.11
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: HB US, Abdom,B-Scan &/or Real Time,Complete	$969	$242.25	$26 – $891.48
Ultrasound of the abdomen, complete: 10 of 29 insurance plan rates Aetna — PPO: $726.75 Aetna Medicare Advantage — HMO: $242.25 AetnaMedicaid — HMO: $78.31 ASR — PPO: $891.48 BCN Medicare Advantage — HMO: $242.25 Blue Care Network — PPO: $823.65 Blue Cross Blue Shield — PPO: $483.72 Blue Cross CompleteMedicaid — HMO: $75.30 Cigna — PPO: $767.45 Cofinity — PPO: $784.89
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$230	$115	$73.70 – $184.28
Ultrasound of the abdomen, complete: rates for 4 insurance plans BCBS — Professional: $184.28 BCBS — Professional Facility: $184.28 Medicaid — Professional: $73.70 Medicare — Professional: $104.80
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier 26 In the file: CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$76	$38	$24.28 – $60.72
Ultrasound of the abdomen, complete: rates for 5 insurance plans BCBS — Professional: $60.72 BCBS — Professional Facility: $60.72 Medicaid — Professional: $24.28 Medicaid — Professional Facility: $24.28 Medicare — Professional: $36.26
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: HB US, OB >/= 14 Wks, Sngl Fetus	$626	$156.50	$75.30 – $575.92
Pregnancy ultrasound (after the first trimester): 10 of 29 insurance plan rates Aetna — PPO: $469.50 Aetna Medicare Advantage — HMO: $156.50 AetnaMedicaid — HMO: $78.31 ASR — PPO: $575.92 BCN Medicare Advantage — HMO: $156.50 Blue Care Network — PPO: $532.10 Blue Cross Blue Shield — PPO: $312.50 Blue Cross CompleteMedicaid — HMO: $75.30 Cigna — PPO: $495.79 Cofinity — PPO: $507.06
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$268	$134	$85.63 – $214.11
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans BCBS — Professional: $214.11 BCBS — Professional Facility: $214.11 Medicaid — Professional: $85.63 Medicare — Professional: $121.82
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · modifier 26 In the file: CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$94	$47	$30.03 – $75.10
Pregnancy ultrasound (after the first trimester): rates for 5 insurance plans BCBS — Professional: $75.10 BCBS — Professional Facility: $75.10 Medicaid — Professional: $30.03 Medicaid — Professional Facility: $30.03 Medicare — Professional: $44.74
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: HB Echography,Transvaginal	$521	$130.25	$40 – $1,190.37
Transvaginal ultrasound: 10 of 29 insurance plan rates Aetna — PPO: $390.75 Aetna Medicare Advantage — HMO: $130.25 AetnaMedicaid — HMO: $78.31 ASR — PPO: $479.32 BCN Medicare Advantage — HMO: $130.25 Blue Care Network — PPO: $442.85 Blue Cross Blue Shield — PPO: $260.08 Blue Cross CompleteMedicaid — HMO: $75.30 Cigna — PPO: $412.63 Cofinity — PPO: $422.01
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: CHG US TRANSVAGINAL	$235	$117.50	$75.19 – $188.01
Transvaginal ultrasound: rates for 4 insurance plans BCBS — Professional: $188.01 BCBS — Professional Facility: $188.01 Medicaid — Professional: $75.19 Medicare — Professional: $106.43
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier 26 In the file: CHG US TRANSVAGINAL	$65	$32.50	$20.87 – $52.19
Transvaginal ultrasound: rates for 5 insurance plans BCBS — Professional: $52.19 BCBS — Professional Facility: $52.19 Medicaid — Professional: $20.87 Medicaid — Professional Facility: $20.87 Medicare — Professional: $31.12
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: HB Mammo Diagnostic Uni Digital	$463	$115.75	$12 – $425.96
Diagnostic mammogram, one breast: 10 of 29 insurance plan rates Aetna — PPO: $347.25 Aetna Medicare Advantage — HMO: $115.75 AetnaMedicaid — HMO: $56.95 ASR — PPO: $425.96 BCN Medicare Advantage — HMO: $115.75 Blue Care Network — PPO: $393.55 Blue Cross Blue Shield — PPO: $231.13 Blue Cross CompleteMedicaid — HMO: $54.76 Cigna — PPO: $366.70 Cofinity — PPO: $375.03
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier 26 In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$76	$38	$24.28 – $60.72
Diagnostic mammogram, one breast: rates for 5 insurance plans BCBS — Professional: $60.72 BCBS — Professional Facility: $60.72 Medicaid — Professional: $24.28 Medicaid — Professional Facility: $24.28 Medicare — Professional: $36.26
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: HB Mammo Dx Bilat Digital	$583	$145.75	$16 – $536.36
Diagnostic mammogram, both breasts: 10 of 29 insurance plan rates Aetna — PPO: $437.25 Aetna Medicare Advantage — HMO: $145.75 AetnaMedicaid — HMO: $72.51 ASR — PPO: $536.36 BCN Medicare Advantage — HMO: $145.75 Blue Care Network — PPO: $495.55 Blue Cross Blue Shield — PPO: $291.03 Blue Cross CompleteMedicaid — HMO: $69.72 Cigna — PPO: $461.74 Cofinity — PPO: $472.23
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$316	$158	$101.18 – $252.99
Diagnostic mammogram, both breasts: rates for 4 insurance plans BCBS — Professional: $252.99 BCBS — Professional Facility: $252.99 Medicaid — Professional: $101.18 Medicare — Professional: $143.36
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier 26 In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$93	$46.50	$29.82 – $74.56
Diagnostic mammogram, both breasts: rates for 5 insurance plans BCBS — Professional: $74.56 BCBS — Professional Facility: $74.56 Medicaid — Professional: $29.82 Medicaid — Professional Facility: $29.82 Medicare — Professional: $44.47
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: HB Mammogram, Screening	$472	$118	$13 – $656
Screening mammogram, both breasts: 10 of 29 insurance plan rates Aetna — PPO: $354 Aetna Medicare Advantage — HMO: $118 AetnaMedicaid — HMO: $59.91 ASR — PPO: $434.24 BCN Medicare Advantage — HMO: $118 Blue Care Network — PPO: $401.20 Blue Cross Blue Shield — PPO: $235.62 Blue Cross CompleteMedicaid — HMO: $57.61 Cigna — PPO: $373.82 Cofinity — PPO: $382.32
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier 26 In the file: CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$72	$36	$23 – $57.52
Screening mammogram, both breasts: rates for 5 insurance plans BCBS — Professional: $57.52 BCBS — Professional Facility: $57.52 Medicaid — Professional: $23 Medicaid — Professional Facility: $23 Medicare — Professional: $34.35

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient In the file: PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$23	$11.50	$9.16 – $18.06
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans BCBS — Professional: $18.06 BCBS — Professional Facility: $18.06 Medicaid — Professional: $9.16 Medicare — Professional: $13.33
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$1,708	$854	$546.56 – $1,366.65
Left heart catheterization (diagnostic): rates for 4 insurance plans BCBS — Professional: $1,366.65 BCBS — Professional Facility: $1,366.65 Medicaid — Professional: $546.56 Medicare — Professional: $776.47
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · modifier 26 In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$459	$229.50	$146.76 – $366.96
Left heart catheterization (diagnostic): rates for 5 insurance plans BCBS — Professional: $366.96 BCBS — Professional Facility: $366.96 Medicaid — Professional: $146.76 Medicaid — Professional Facility: $146.76 Medicare — Professional: $223.02
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · modifier TC In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$1,250	$625	$399.80 – $999.69
Left heart catheterization (diagnostic): rates for 4 insurance plans BCBS — Professional: $999.69 BCBS — Professional Facility: $999.69 Medicaid — Professional: $399.80 Medicare — Professional: $553.45
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$744	$372	$468.83 – $595.46
Heart rhythm study (electrophysiology evaluation): rates for 4 insurance plans BCBS — Professional: $595.46 BCBS — Professional Facility: $595.46 Medicaid — Professional: $468.83 Medicare — Professional: $790.07
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · modifier 26 In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$744	$372	$238.13 – $595.45
Heart rhythm study (electrophysiology evaluation): rates for 5 insurance plans BCBS — Professional: $595.45 BCBS — Professional Facility: $595.45 Medicaid — Professional: $238.13 Medicaid — Professional Facility: $238.13 Medicare — Professional: $360.71
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · modifier TC In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$8,895	$4,447.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $194.62
Heart rhythm study (electrophysiology evaluation): rates for 4 insurance plans BCBS — Professional: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) BCBS — Professional Facility: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Medicaid — Professional: $194.62 Medicare — Professional: $327.98
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: PR COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$1,845	$922.50	$1,476.37
Heart rhythm study with ablation for atrial fibrillation: rates for 4 insurance plans BCBS — Professional: $1,476.37 BCBS — Professional Facility: $1,476.37 Medicaid — Professional Facility: $590.44 Medicare — Professional: $898.07
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: HB Polysom 6/>Yrs Sleep 4/> Addl Param Attnd	$4,546	$1,136.50	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,182.32
Sleep study (overnight, in a sleep lab): 10 of 29 insurance plan rates Aetna — PPO: $3,409.50 Aetna Medicare Advantage — HMO: $1,136.50 AetnaMedicaid — HMO: $643.26 ASR — PPO: $4,182.32 BCN Medicare Advantage — HMO: $1,136.50 Blue Care Network — PPO: $3,864.10 Blue Cross Blue Shield — PPO: $2,269.36 Blue Cross CompleteMedicaid — HMO: $618.52 Cigna — PPO: $3,600.43 Cofinity — PPO: $3,682.26
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysom 6/>Yrs Sleep 4/> Addl Param Attnd	$988	$247	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,182.32
Sleep study (overnight, in a sleep lab): 10 of 29 insurance plan rates Aetna — PPO: $741 Aetna Medicare Advantage — HMO: $247 AetnaMedicaid — HMO: $643.26 ASR — PPO: $908.96 BCN Medicare Advantage — HMO: $247 Blue Care Network — PPO: $839.80 Blue Cross Blue Shield — PPO: $493.21 Blue Cross CompleteMedicaid — HMO: $618.52 Cigna — PPO: $782.50 Cofinity — PPO: $800.28
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$988	$494	$400.65 – $790.02
Sleep study (overnight, in a sleep lab): rates for 4 insurance plans BCBS — Professional: $790.02 BCBS — Professional Facility: $790.02 Medicaid — Professional: $400.65 Medicare — Professional: $563.52

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: HB Therapeutic Exercises	$138	$34.50	$19.78 – $4,591
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 29 insurance plan rates Aetna — PPO: $99.75 Aetna Medicare Advantage — HMO: $34.50 AetnaMedicaid — HMO: $20.57 ASR — PPO: $126.96 BCN Medicare Advantage — HMO: $34.50 Blue Care Network — PPO: $72 Blue Cross Blue Shield — PPO: $68.89 Blue Cross CompleteMedicaid — HMO: $19.78 Cigna — PPO: $109.30 Cofinity — PPO: $111.78
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$40	$20	$18.96 – $31.77
Physical therapy: therapeutic exercise (each 15 minutes): rates for 4 insurance plans BCBS — Professional: $31.77 BCBS — Professional Facility: $31.77 Medicaid — Professional: $18.96 Medicare — Professional: $27.61
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HB Pt Eval Low Complex 20 Min	$233	$58.25	$58.25 – $214.36
Physical therapy evaluation (low complexity): 10 of 29 insurance plan rates Aetna — PPO: $168 Aetna Medicare Advantage — HMO: $58.25 AetnaMedicaid — HMO: $69.19 ASR — PPO: $214.36 BCN Medicare Advantage — HMO: $58.25 Blue Care Network — PPO: $198.05 Blue Cross Blue Shield — PPO: $116.31 Blue Cross CompleteMedicaid — HMO: $66.53 Cigna — PPO: $184.54 Cofinity — PPO: $188.73
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HB Pt Eval Mod Complex 30 Min	$287	$71.75	$66.53 – $264.04
Physical therapy evaluation (moderate complexity): 10 of 29 insurance plan rates Aetna — PPO: $207 Aetna Medicare Advantage — HMO: $71.75 AetnaMedicaid — HMO: $69.19 ASR — PPO: $264.04 BCN Medicare Advantage — HMO: $71.75 Blue Care Network — PPO: $243.95 Blue Cross Blue Shield — PPO: $143.27 Blue Cross CompleteMedicaid — HMO: $66.53 Cigna — PPO: $227.30 Cofinity — PPO: $232.47
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HB Pt Eval High Complex 45 Min	$348	$87	$12 – $320.16
Physical therapy evaluation (high complexity): 10 of 29 insurance plan rates Aetna — PPO: $251.25 Aetna Medicare Advantage — HMO: $87 AetnaMedicaid — HMO: $69.19 ASR — PPO: $320.16 BCN Medicare Advantage — HMO: $87 Blue Care Network — PPO: $295.80 Blue Cross Blue Shield — PPO: $173.72 Blue Cross CompleteMedicaid — HMO: $33.36 Cigna — PPO: $275.62 Cofinity — PPO: $281.88
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: HB Psychotherpy, Office (20-30)	$185	$46.25	$11 – $170.20
Psychotherapy, 30 minutes: 10 of 26 insurance plan rates Aetna — PPO: $138.75 Aetna Medicare Advantage — HMO: $46.25 AetnaMedicaid — HMO: $89.56 ASR — PPO: $170.20 BCN Medicare Advantage — HMO: $46.25 Blue Care Network — PPO: $157.25 Blue Cross Blue Shield — PPO: $92.35 Blue Cross CompleteMedicaid — HMO: $33.36 Cigna — PPO: $146.52 Cofinity — PPO: $149.85
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psychotherapy W/Patient 30 Minutes	$128	$32	$32 – $117.76
Psychotherapy, 30 minutes: 10 of 25 insurance plan rates Aetna — PPO: $96 Aetna Medicare Advantage — HMO: $32 AetnaMedicaid — HMO: $89.56 ASR — PPO: $117.76 BCN Medicare Advantage — HMO: $32 Blue Care Network — PPO: $108.80 Blue Cross Blue Shield — PPO: $63.90 Cigna — PPO: $101.38 Cofinity — PPO: $103.68 Covenant Advantage — HMO: $32
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$128	$64	$52.55 – $102.48
Psychotherapy, 30 minutes: rates for 4 insurance plans BCBS — Professional: $102.48 Medicaid — Professional: $52.55 Medicaid — Professional Facility: $46.37 Medicare — Professional: $77.59
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: HB Psychotherpy, Office (45-50)	$297	$74.25	$45.01 – $273.24
Psychotherapy, 45 minutes: 10 of 26 insurance plan rates Aetna — PPO: $222.75 Aetna Medicare Advantage — HMO: $74.25 AetnaMedicaid — HMO: $681 ASR — PPO: $273.24 BCN Medicare Advantage — HMO: $74.25 Blue Care Network — PPO: $252.45 Blue Cross Blue Shield — PPO: $148.26 Blue Cross CompleteMedicaid — HMO: $152.33 Cigna — PPO: $235.22 Cofinity — PPO: $240.57
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psychotherapy W/Patient 45 Minutes	$169	$42.25	$42.25 – $155.48
Psychotherapy, 45 minutes: 10 of 25 insurance plan rates Aetna — PPO: $126.75 Aetna Medicare Advantage — HMO: $42.25 AetnaMedicaid — HMO: $486 ASR — PPO: $155.48 BCN Medicare Advantage — HMO: $42.25 Blue Care Network — PPO: $143.65 Blue Cross Blue Shield — PPO: $84.36 Cigna — PPO: $133.85 Cofinity — PPO: $136.89 Covenant Advantage — HMO: $42.25
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$169	$84.50	$69.33 – $135.24
Psychotherapy, 45 minutes: rates for 4 insurance plans BCBS — Professional: $135.24 Medicaid — Professional: $69.33 Medicaid — Professional Facility: $61.15 Medicare — Professional: $102.36
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: HB Psychotherpy, Office (75-80)	$185	$46.25	$46.25 – $170.20
Psychotherapy, 60 minutes: 10 of 26 insurance plan rates Aetna — PPO: $138.75 Aetna Medicare Advantage — HMO: $46.25 AetnaMedicaid — HMO: $43.32 ASR — PPO: $170.20 BCN Medicare Advantage — HMO: $46.25 Blue Care Network — PPO: $157.25 Blue Cross Blue Shield — PPO: $92.35 Blue Cross CompleteMedicaid — HMO: $51.46 Cigna — PPO: $146.52 Cofinity — PPO: $149.85
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psychotherapy W/Patient 60 Minutes	$250	$62.50	$62.50 – $230
Psychotherapy, 60 minutes: 10 of 25 insurance plan rates Aetna — PPO: $187.50 Aetna Medicare Advantage — HMO: $62.50 AetnaMedicaid — HMO: $430.67 ASR — PPO: $230 BCN Medicare Advantage — HMO: $62.50 Blue Care Network — PPO: $212.50 Blue Cross Blue Shield — PPO: $124.80 Cigna — PPO: $198 Cofinity — PPO: $202.50 Covenant Advantage — HMO: $62.50
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$250	$125	$102.74 – $200.34
Psychotherapy, 60 minutes: rates for 4 insurance plans BCBS — Professional: $200.34 Medicaid — Professional: $102.74 Medicaid — Professional Facility: $90.56 Medicare — Professional: $151.69
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: HB Family Psychotherapy,No Pt	$185	$46.25	$46.25 – $170.20
Family psychotherapy, without the patient: 10 of 23 insurance plan rates Aetna — PPO: $138.75 Aetna Medicare Advantage — HMO: $46.25 ASR — PPO: $170.20 BCN Medicare Advantage — HMO: $46.25 Blue Care Network — PPO: $157.25 Blue Cross Blue Shield — PPO: $92.35 Cigna — PPO: $146.52 Cofinity — PPO: $149.85 Covenant Advantage — HMO: $46.25 Great West Health — PPO: $146.52
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient In the file: PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$203	$101.50	$162.44
Family psychotherapy, without the patient: rates for 2 insurance plans BCBS — Professional: $162.44 Medicare — Professional: $97.96
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · modifier F In the file: PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$202	$101	$161.91
Family psychotherapy, without the patient: rates for 1 insurance plan BCBS — Professional Facility: $161.91
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family Psychotherapy W/Patient Present 50 Mins	$167	$41.75	$41.75 – $153.64
Family psychotherapy, with the patient: 10 of 23 insurance plan rates Aetna — PPO: $125.25 Aetna Medicare Advantage — HMO: $41.75 ASR — PPO: $153.64 BCN Medicare Advantage — HMO: $41.75 Blue Care Network — PPO: $141.95 Blue Cross Blue Shield — PPO: $83.37 Cigna — PPO: $132.26 Cofinity — PPO: $135.27 Covenant Advantage — HMO: $41.75 Great West Health — PPO: $132.26
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: HB Family Psychotherapy W Phys	$185	$46.25	$46.25 – $170.20
Family psychotherapy, with the patient: 10 of 23 insurance plan rates Aetna — PPO: $138.75 Aetna Medicare Advantage — HMO: $46.25 ASR — PPO: $170.20 BCN Medicare Advantage — HMO: $46.25 Blue Care Network — PPO: $157.25 Blue Cross Blue Shield — PPO: $92.35 Cigna — PPO: $146.52 Cofinity — PPO: $149.85 Covenant Advantage — HMO: $46.25 Great West Health — PPO: $146.52
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$167	$83.50	$69.15 – $133.56
Family psychotherapy, with the patient: rates for 4 insurance plans BCBS — Professional: $133.56 Medicaid — Professional: $69.15 Medicaid — Professional Facility: $68.96 Medicare — Professional: $102.10
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: HB Group Psychotherapy	$107	$26.75	$26.75 – $98.44
Group psychotherapy: 10 of 23 insurance plan rates Aetna — PPO: $80.25 Aetna Medicare Advantage — HMO: $26.75 ASR — PPO: $98.44 BCN Medicare Advantage — HMO: $26.75 Blue Care Network — PPO: $90.95 Blue Cross Blue Shield — PPO: $53.41 Cigna — PPO: $84.74 Cofinity — PPO: $86.67 Covenant Advantage — HMO: $26.75 Great West Health — PPO: $84.74
Group psychotherapy CPT 90853 · Inpatient or outpatient In the file: PR GROUP PSYCHOTHERAPY	$46	$23	$18.75 – $36.54
Group psychotherapy: rates for 4 insurance plans BCBS — Professional: $36.54 Medicaid — Professional: $18.75 Medicaid — Professional Facility: $16.35 Medicare — Professional: $27.68
Group psychotherapy CPT 90853 · Inpatient or outpatient · modifier F In the file: PR GROUP PSYCHOTHERAPY	$46	$23	$31.50
Group psychotherapy: rates for 1 insurance plan BCBS — Professional Facility: $31.50

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: HB Removal of Breast Lesion 1+	$4,404	$1,101	$285.82 – $4,051.68
Removal of breast growth (open surgery): 10 of 28 insurance plan rates Aetna Medicare Advantage — HMO: $1,101 AetnaMedicaid — HMO: $297.25 ASR — PPO: $4,051.68 BCN Medicare Advantage — HMO: $1,101 Blue Care Network — PPO: $3,743.40 Blue Cross Blue Shield — PPO: $2,198.48 Blue Cross CompleteMedicaid — HMO: $285.82 Cigna — PPO: $3,487.97 Cofinity — PPO: $3,567.24 Covenant Advantage — HMO: $1,101
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$1,051	$525.50	$336.11 – $840.44
Removal of breast growth (open surgery): rates for 4 insurance plans BCBS — Professional: $840.44 Medicaid — Professional: $336.11 Medicaid — Professional Facility: $271.79 Medicare — Professional: $494.42
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · modifier F In the file: PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$850	$425	$679.60
Removal of breast growth (open surgery): rates for 1 insurance plan BCBS — Professional Facility: $679.60
Total hip replacement CPT 27130 · Inpatient or outpatient In the file: PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$2,847	$1,423.50	$2,277.79
Total hip replacement: rates for 4 insurance plans BCBS — Professional: $2,277.79 BCBS — Professional Facility: $2,277.79 Medicaid — Professional Facility: $829.21 Medicare — Professional: $1,237.42
Total hip replacement CPT 27130 · Inpatient or outpatient · modifier 80 In the file: PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$653	$326.50	Not listed in the file
Total hip replacement CPT 27130 · Inpatient or outpatient · modifier 82 In the file: PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$653	$326.50	Not listed in the file
Total knee replacement CPT 27447 · Inpatient or outpatient In the file: PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$2,844	$1,422	$2,274.87
Total knee replacement: rates for 4 insurance plans BCBS — Professional: $2,274.87 BCBS — Professional Facility: $2,274.87 Medicaid — Professional Facility: $828.14 Medicare — Professional: $1,235.86
Total knee replacement CPT 27447 · Inpatient or outpatient · modifier 80 In the file: PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$652	$326	Not listed in the file
Total knee replacement CPT 27447 · Inpatient or outpatient · modifier 82 In the file: PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$652	$326	Not listed in the file
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$270	$135	$216.30
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans BCBS — Professional: $216.30 BCBS — Professional Facility: $216.30 Medicaid — Professional Facility: $109.70 Medicare — Professional: $165.40
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier 80 In the file: PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$62	$31	Not listed in the file
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier 82 In the file: PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$62	$31	Not listed in the file
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$1,217	$608.50	$973.61
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 4 insurance plans BCBS — Professional: $973.61 BCBS — Professional Facility: $973.61 Medicaid — Professional Facility: $354.43 Medicare — Professional: $522.36
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · modifier 80 In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$279	$139.50	Not listed in the file
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · modifier 82 In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$279	$139.50	Not listed in the file
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient In the file: PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$592	$296	$473.48
Removal of tonsils and adenoids (under age 12): rates for 4 insurance plans BCBS — Professional: $473.48 BCBS — Professional Facility: $473.48 Medicaid — Professional Facility: $189.36 Medicare — Professional: $279.29
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · modifier 80 In the file: PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$136	$68	Not listed in the file
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · modifier 82 In the file: PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$136	$68	Not listed in the file
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy Transoral Diagnostic	$569	$142.25	$81.68 – $3,052.50
Upper GI endoscopy (diagnostic): 10 of 29 insurance plan rates Aetna — PPO: $426.75 Aetna Medicare Advantage — HMO: $142.25 AetnaMedicaid — HMO: $84.95 ASR — PPO: $523.48 BCN Medicare Advantage — HMO: $142.25 Blue Care Network — PPO: $483.65 Blue Cross Blue Shield — PPO: $284.04 Blue Cross CompleteMedicaid — HMO: $81.68 Cigna — PPO: $450.65 Cofinity — PPO: $460.89
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: HB Egd Diagnostic Brush Wash	$1,840	$460	$14 – $3,052.50
Upper GI endoscopy (diagnostic): 10 of 29 insurance plan rates Aetna — PPO: $1,380 Aetna Medicare Advantage — HMO: $460 AetnaMedicaid — HMO: $84.95 ASR — PPO: $1,692.80 BCN Medicare Advantage — HMO: $460 Blue Care Network — PPO: $1,564 Blue Cross Blue Shield — PPO: $918.53 Blue Cross CompleteMedicaid — HMO: $81.68 Cigna — PPO: $1,457.28 Cofinity — PPO: $1,490.40
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: HB Miscellaneous Endoscopy Px per Min	$110	$27.50	$14 – $3,052.50
Upper GI endoscopy (diagnostic): 10 of 29 insurance plan rates Aetna — PPO: $82.50 Aetna Medicare Advantage — HMO: $27.50 AetnaMedicaid — HMO: $84.95 ASR — PPO: $101.20 BCN Medicare Advantage — HMO: $27.50 Blue Care Network — PPO: $93.50 Blue Cross Blue Shield — PPO: $54.91 Blue Cross CompleteMedicaid — HMO: $81.68 Cigna — PPO: $87.12 Cofinity — PPO: $89.10
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd Transoral Biopsy Single/Multiple	$735	$183.75	$183.75 – $676.20
Upper GI endoscopy with biopsy: 10 of 23 insurance plan rates Aetna — PPO: $551.25 Aetna Medicare Advantage — HMO: $183.75 ASR — PPO: $676.20 BCN Medicare Advantage — HMO: $183.75 Blue Care Network — PPO: $624.75 Blue Cross Blue Shield — PPO: $366.91 Cigna — PPO: $582.12 Cofinity — PPO: $595.35 Covenant Advantage — HMO: $183.75 Great West Health — PPO: $582.12
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$735	$367.50	$235.15 – $587.99
Upper GI endoscopy with biopsy: rates for 4 insurance plans BCBS — Professional: $587.99 Medicaid — Professional: $235.15 Medicaid — Professional Facility: $87.33 Medicare — Professional: $334.66
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · modifier F In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$273	$136.50	$218.37
Upper GI endoscopy with biopsy: rates for 1 insurance plan BCBS — Professional Facility: $218.37
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$674	$168.50	$168.50 – $620.08
Colonoscopy (diagnostic): 10 of 23 insurance plan rates Aetna — PPO: $505.50 Aetna Medicare Advantage — HMO: $168.50 ASR — PPO: $620.08 BCN Medicare Advantage — HMO: $168.50 Blue Care Network — PPO: $572.90 Blue Cross Blue Shield — PPO: $336.46 Cigna — PPO: $533.81 Cofinity — PPO: $545.94 Covenant Advantage — HMO: $168.50 Great West Health — PPO: $533.81
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: HB Colonoscopy,Diagnostic	$1,888	$472	$472 – $1,736.96
Colonoscopy (diagnostic): 10 of 23 insurance plan rates Aetna — PPO: $1,416 Aetna Medicare Advantage — HMO: $472 ASR — PPO: $1,736.96 BCN Medicare Advantage — HMO: $472 Blue Care Network — PPO: $1,604.80 Blue Cross Blue Shield — PPO: $942.49 Cigna — PPO: $1,495.30 Cofinity — PPO: $1,529.28 Covenant Advantage — HMO: $472 Great West Health — PPO: $1,495.30
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$674	$337	$215.77 – $539.52
Colonoscopy (diagnostic): rates for 4 insurance plans BCBS — Professional: $539.52 Medicaid — Professional: $215.77 Medicaid — Professional Facility: $116.72 Medicare — Professional: $311.54
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy W/Biopsy Single/Multiple	$853	$213.25	$213.25 – $784.76
Colonoscopy with biopsy: 10 of 23 insurance plan rates Aetna — PPO: $639.75 Aetna Medicare Advantage — HMO: $213.25 ASR — PPO: $784.76 BCN Medicare Advantage — HMO: $213.25 Blue Care Network — PPO: $725.05 Blue Cross Blue Shield — PPO: $425.82 Cigna — PPO: $675.58 Cofinity — PPO: $690.93 Covenant Advantage — HMO: $213.25 Great West Health — PPO: $675.58
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$853	$426.50	$273.07 – $682.79
Colonoscopy with biopsy: rates for 4 insurance plans BCBS — Professional: $682.79 Medicaid — Professional: $273.07 Medicaid — Professional Facility: $126.95 Medicare — Professional: $392.01
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · modifier F In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$397	$198.50	$317.43
Colonoscopy with biopsy: rates for 1 insurance plan BCBS — Professional Facility: $317.43
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$896	$224	$224 – $824.32
Colonoscopy with removal of polyps (snare): 10 of 23 insurance plan rates Aetna — PPO: $672 Aetna Medicare Advantage — HMO: $224 ASR — PPO: $824.32 BCN Medicare Advantage — HMO: $224 Blue Care Network — PPO: $761.60 Blue Cross Blue Shield — PPO: $447.28 Cigna — PPO: $709.63 Cofinity — PPO: $725.76 Covenant Advantage — HMO: $224 Great West Health — PPO: $709.63
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$896	$448	$286.70 – $716.88
Colonoscopy with removal of polyps (snare): rates for 4 insurance plans BCBS — Professional: $716.88 Medicaid — Professional: $286.70 Medicaid — Professional Facility: $159.96 Medicare — Professional: $414.54
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · modifier F In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$500	$250	$399.98
Colonoscopy with removal of polyps (snare): rates for 1 insurance plan BCBS — Professional Facility: $399.98
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient In the file: PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$507	$253.50	$405.31
Ultrasound of the lower bowel by endoscope: rates for 4 insurance plans BCBS — Professional: $405.31 BCBS — Professional Facility: $405.31 Medicaid — Professional Facility: $162.09 Medicare — Professional: $242.18
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Colon ca scrn not hi rsk ind	$675	$168.75	$56 – $1,918.45
Screening colonoscopy (not high risk): 10 of 29 insurance plan rates Aetna — PPO: $506.25 Aetna Medicare Advantage — HMO: $168.75 AetnaMedicaid — HMO: $128.23 ASR — PPO: $621 BCN Medicare Advantage — HMO: $168.75 Blue Care Network — PPO: $573.75 Blue Cross Blue Shield — PPO: $336.96 Blue Cross CompleteMedicaid — HMO: $123.30 Cigna — PPO: $534.60 Cofinity — PPO: $546.75
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: PR COLON CA SCRN NOT HI RSK IND	$675	$337.50	$215.98 – $540.06
Screening colonoscopy (not high risk): rates for 4 insurance plans BCBS — Professional: $540.06 Medicaid — Professional: $215.98 Medicaid — Professional Facility: $116.94 Medicare — Professional: $311.92
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · modifier F In the file: PR COLON CA SCRN NOT HI RSK IND	$366	$183	$292.40
Screening colonoscopy (not high risk): rates for 1 insurance plan BCBS — Professional Facility: $292.40
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy Surg Cholecystectomy	$1,336	$334	$18 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $8,335.95
Gallbladder removal by laparoscope: 10 of 29 insurance plan rates Aetna — PPO: $1,002 Aetna Medicare Advantage — HMO: $334 AetnaMedicaid — HMO: $471.80 ASR — PPO: $1,229.12 BCN Medicare Advantage — HMO: $334 Blue Care Network — PPO: $1,135.60 Blue Cross Blue Shield — PPO: $666.93 Blue Cross CompleteMedicaid — HMO: $453.65 Cigna — PPO: $1,058.11 Cofinity — PPO: $1,082.16
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: PR LAPAROSCOPY SURG CHOLECYSTECTOMY	$1,336	$668	$1,068.40
Gallbladder removal by laparoscope: rates for 4 insurance plans BCBS — Professional: $1,068.40 BCBS — Professional Facility: $1,068.40 Medicaid — Professional Facility: $427.28 Medicare — Professional: $643.47
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · modifier 80 In the file: PR LAPAROSCOPY SURG CHOLECYSTECTOMY	$307	$153.50	Not listed in the file
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$1,061	$265.25	$265.25 – $976.12
Groin (inguinal) hernia repair, age 5 or older: 10 of 29 insurance plan rates Aetna — PPO: $795.75 Aetna Medicare Advantage — HMO: $265.25 AetnaMedicaid — HMO: $373.56 ASR — PPO: $976.12 BCN Medicare Advantage — HMO: $265.25 Blue Care Network — PPO: $901.85 Blue Cross Blue Shield — PPO: $529.65 Blue Cross CompleteMedicaid — HMO: $359.19 Cigna — PPO: $840.31 Cofinity — PPO: $859.41
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$1,061	$530.50	$848.96
Groin (inguinal) hernia repair, age 5 or older: rates for 4 insurance plans BCBS — Professional: $848.96 BCBS — Professional Facility: $848.96 Medicaid — Professional Facility: $339.52 Medicare — Professional: $509.49
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier 80 In the file: PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$244	$122	Not listed in the file
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: HB Biopsy of Prostate,Needle/Punch	$2,356	$589	$589 – $2,167.52
Prostate biopsy: 10 of 23 insurance plan rates Aetna — PPO: $1,767 Aetna Medicare Advantage — HMO: $589 ASR — PPO: $2,167.52 BCN Medicare Advantage — HMO: $589 Blue Care Network — PPO: $2,002.60 Blue Cross Blue Shield — PPO: $1,176.12 Cigna — PPO: $1,865.95 Cofinity — PPO: $1,908.36 Covenant Advantage — HMO: $589 Great West Health — PPO: $1,865.95
Prostate biopsy CPT 55700 · Inpatient or outpatient In the file: PR PROSTATE NEEDLE BIOPSY ANY APPROACH	$480	$240	$153.57 – $384
Prostate biopsy: rates for 4 insurance plans BCBS — Professional: $384 Medicaid — Professional: $153.57 Medicaid — Professional Facility: $82.22 Medicare — Professional: $222.12
Prostate biopsy CPT 55700 · Inpatient or outpatient · modifier F In the file: PR PROSTATE NEEDLE BIOPSY ANY APPROACH	$257	$128.50	$205.58
Prostate biopsy: rates for 1 insurance plan BCBS — Professional Facility: $205.58
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient In the file: PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT	$2,381	$1,190.50	$1,904.58
Prostate removal by laparoscope (radical prostatectomy): rates for 4 insurance plans BCBS — Professional: $1,904.58 BCBS — Professional Facility: $1,904.58 Medicaid — Professional Facility: $761.69 Medicare — Professional: $1,141.64
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · modifier 80 In the file: PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT	$547	$273.50	Not listed in the file
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · modifier 82 In the file: PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT	$547	$273.50	Not listed in the file
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$2,485	$1,242.50	$794.92 – $1,987.66
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans BCBS — Professional: $1,987.66 Medicaid — Professional: $794.92 Medicaid — Professional Facility: $147.82 Medicare — Professional: $1,117.75
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · modifier F In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$462	$231	$369.62
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan BCBS — Professional Facility: $369.62
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · modifier 80 In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$609	$304.50	Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn	$508	$127	$127 – $559.26
Spinal injection, lower back (epidural), with imaging guidance: 10 of 29 insurance plan rates Aetna — PPO: $381 Aetna Medicare Advantage — HMO: $127 AetnaMedicaid — HMO: $528.76 ASR — PPO: $467.36 BCN Medicare Advantage — HMO: $127 Blue Care Network — PPO: $431.80 Blue Cross Blue Shield — PPO: $253.59 Blue Cross CompleteMedicaid — HMO: $508.42 Cigna — PPO: $402.34 Cofinity — PPO: $411.48
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$508	$254	$162.52 – $406.37
Spinal injection, lower back (epidural), with imaging guidance: rates for 4 insurance plans BCBS — Professional: $406.37 Medicaid — Professional: $162.52 Medicaid — Professional Facility: $63.26 Medicare — Professional: $231.46
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier F In the file: PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$198	$99	$158.18
Spinal injection, lower back (epidural), with imaging guidance: rates for 1 insurance plan BCBS — Professional Facility: $158.18
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$486	$121.50	$121.50 – $700.77
Nerve root injection, lower back, with imaging guidance: 10 of 29 insurance plan rates Aetna — PPO: $364.50 Aetna Medicare Advantage — HMO: $121.50 AetnaMedicaid — HMO: $662.54 ASR — PPO: $447.12 BCN Medicare Advantage — HMO: $121.50 Blue Care Network — PPO: $413.10 Blue Cross Blue Shield — PPO: $242.61 Blue Cross CompleteMedicaid — HMO: $637.06 Cigna — PPO: $384.91 Cofinity — PPO: $393.66
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$486	$243	$155.49 – $388.80
Nerve root injection, lower back, with imaging guidance: rates for 4 insurance plans BCBS — Professional: $388.80 Medicaid — Professional: $155.49 Medicaid — Professional Facility: $70.93 Medicare — Professional: $221.94
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier F In the file: PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$222	$111	$177.36
Nerve root injection, lower back, with imaging guidance: rates for 1 insurance plan BCBS — Professional Facility: $177.36
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: HB Neuroplasty; Median Nerve at Carp Tunnel	$4,322	$1,080.50	$1,080.50 – $3,976.24
Carpal tunnel release: 10 of 29 insurance plan rates Aetna — PPO: $3,241.50 Aetna Medicare Advantage — HMO: $1,080.50 AetnaMedicaid — HMO: $1,462.75 ASR — PPO: $3,976.24 BCN Medicare Advantage — HMO: $1,080.50 Blue Care Network — PPO: $3,673.70 Blue Cross Blue Shield — PPO: $2,157.54 Blue Cross CompleteMedicaid — HMO: $1,406.49 Cigna — PPO: $3,423.02 Cofinity — PPO: $3,500.82
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne	$913	$228.25	$228.25 – $1,547.14
Carpal tunnel release: 10 of 29 insurance plan rates Aetna — PPO: $684.75 Aetna Medicare Advantage — HMO: $228.25 AetnaMedicaid — HMO: $1,462.75 ASR — PPO: $839.96 BCN Medicare Advantage — HMO: $228.25 Blue Care Network — PPO: $776.05 Blue Cross Blue Shield — PPO: $455.77 Blue Cross CompleteMedicaid — HMO: $1,406.49 Cigna — PPO: $723.10 Cofinity — PPO: $739.53
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$913	$456.50	$292.24 – $730.73
Carpal tunnel release: rates for 4 insurance plans BCBS — Professional: $730.73 Medicaid — Professional: $292.24 Medicaid — Professional Facility: $287.34 Medicare — Professional: $426.99
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: PR POST-CATARACT LASER SURGERY	$658	$329	$210.66 – $526.74
Laser treatment of clouding after cataract surgery: rates for 4 insurance plans BCBS — Professional: $526.74 Medicaid — Professional: $210.66 Medicaid — Professional Facility: $196.81 Medicare — Professional: $303.40
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · modifier F In the file: PR POST-CATARACT LASER SURGERY	$615	$307.50	$492.12
Laser treatment of clouding after cataract surgery: rates for 1 insurance plan BCBS — Professional Facility: $492.12
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · modifier 80 In the file: PR POST-CATARACT LASER SURGERY	$154	$77	Not listed in the file
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$1,074	$537	$859.08
Cataract removal with lens implant: rates for 4 insurance plans BCBS — Professional: $859.08 BCBS — Professional Facility: $859.08 Medicaid — Professional Facility: $343.57 Medicare — Professional: $501.13
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · modifier 80 In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$248	$124	Not listed in the file
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · modifier 82 In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$248	$124	Not listed in the file

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient In the file: PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$4,381	$2,190.50	$3,504.67
Vaginal delivery, with care before and after: rates for 4 insurance plans BCBS — Professional: $3,504.67 BCBS — Professional Facility: $3,504.67 Medicaid — Professional Facility: $2,220.73 Medicare — Professional: $2,337.61
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · modifier 80 In the file: PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$1,001	$500.50	Not listed in the file
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · modifier 82 In the file: PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$1,001	$500.50	Not listed in the file
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient In the file: PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$4,381	$2,190.50	$3,504.67
Cesarean delivery (C-section), with care before and after: rates for 4 insurance plans BCBS — Professional: $3,504.67 BCBS — Professional Facility: $3,504.67 Medicaid — Professional Facility: $2,475.76 Medicare — Professional: $2,606.06
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · modifier 80 In the file: PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$1,001	$500.50	Not listed in the file
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · modifier 82 In the file: PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$1,001	$500.50	Not listed in the file
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient In the file: PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$4,600	$2,300	$3,679.92
Vaginal delivery after a previous C-section, with care before and after: rates for 4 insurance plans BCBS — Professional: $3,679.92 BCBS — Professional Facility: $3,679.92 Medicaid — Professional Facility: $2,335.79 Medicare — Professional: $2,458.73
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · modifier 80 In the file: PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$1,051	$525.50	Not listed in the file
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · modifier 82 In the file: PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$1,051	$525.50	Not listed in the file

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With McC	$374,846.41	$93,711.60	$2,672 – $344,858.70
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 23 insurance plan rates Aetna — PPO: $281,134.81 Aetna Medicare Advantage — HMO: $2,672 ASR — PPO: $344,858.70 BCN Medicare Advantage — HMO: $2,672 Blue Care Network — PPO: $1,535 Blue Cross Blue Shield — PPO: $187,123.33 Cigna — PPO: $296,878.36 Cofinity — PPO: $303,625.59 Covenant Advantage — HMO: $2,672 Great West Health — PPO: $296,878.36
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without McC	$58,582.03	$14,645.51	$2,672 – $53,895.47
Hip or knee replacement (major joint of the leg), without major complications: 10 of 23 insurance plan rates Aetna — PPO: $43,936.52 Aetna Medicare Advantage — HMO: $2,672 ASR — PPO: $53,895.47 BCN Medicare Advantage — HMO: $2,672 Blue Care Network — PPO: $1,535 Blue Cross Blue Shield — PPO: $29,244.15 Cigna — PPO: $46,396.97 Cofinity — PPO: $47,451.44 Covenant Advantage — HMO: $2,672 Great West Health — PPO: $46,396.97
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: Cervical Spinal Fusion Without Cc/McC	$83,654.05	$20,913.51	$2,672 – $76,961.73
Neck (cervical) spinal fusion, without complications: 10 of 23 insurance plan rates Aetna — PPO: $62,740.54 Aetna Medicare Advantage — HMO: $2,672 ASR — PPO: $76,961.73 BCN Medicare Advantage — HMO: $2,672 Blue Care Network — PPO: $1,535 Blue Cross Blue Shield — PPO: $41,760.10 Cigna — PPO: $66,254.01 Cofinity — PPO: $67,759.78 Covenant Advantage — HMO: $2,672 Great West Health — PPO: $66,254.01
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: Uterine And Adnexa Procedures For Non-Malignancy Without Cc/McC	$40,080.91	$10,020.23	$2,672 – $36,874.44
Uterus and ovary surgery (not for cancer), without complications: 10 of 23 insurance plan rates Aetna — PPO: $30,060.68 Aetna Medicare Advantage — HMO: $2,672 ASR — PPO: $36,874.44 BCN Medicare Advantage — HMO: $2,672 Blue Care Network — PPO: $1,535 Blue Cross Blue Shield — PPO: $20,008.39 Cigna — PPO: $31,744.08 Cofinity — PPO: $32,465.54 Covenant Advantage — HMO: $2,672 Great West Health — PPO: $31,744.08

Source: University of Michigan Health- Sparrow Clinton’s standard charges file (uofmhealthsparrow.org, CSV, CMS template 3.1.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	805 S Oakland, Saint Johns, MI 48879
County	Clinton County
State	Michigan
Phone	(989) 227‑3400
Emergency services	Yes
Ownership	Proprietary
Medicare overall rating	4 of 5 stars
CMS Certification Number	231326
Name in Medicare records	UNIVERSITY OF MICHIGAN HEALTH- SPARROW CLINTON
Profile level	Medicare data + hospital website
Name on the hospital’s website	UM Health-Sparrow Clinton Hospital
Official website	uofmhealthsparrow.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

UM Health-Sparrow Clinton Hospital — uofmhealthsparrow.org