Quick answers
- Does Upper Valley Medical Center have an emergency room?
- Yes. Medicare (CMS) data lists emergency services at Upper Valley Medical Center. In a medical emergency, call 911.
- Where is Upper Valley Medical Center?
- 3130 N Dixie Highway, Troy, OH 45373, in Miami County, Ohio.
- What is the phone number of Upper Valley Medical Center?
- (937) 440-7853, as listed by Medicare (CMS).
- What is the Medicare star rating of Upper Valley Medical Center?
- 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
- Does Medicare reduce its payments to Upper Valley Medical Center for hospital-acquired conditions?
- No. For fiscal year 2026, CMS lists no Medicare payment reduction for Upper Valley Medical Center under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.3371; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).
Specialties and care areas[4][7]
- Cancer care
- Heart care
- Behavioral health
- Wound care
Conditions treated[4][7]
Treatments[7]
- Hyperbaric treatment
Procedures[4]
Programs and centers[7][10]
- Upper Valley Wound & Hyperbaric Center
- TeleStroke Network (stroke assessment from the emergency department)
- Emergency department behavioral health rooms and staff
Emergency care (hospital website)[4][5][7][9][10]
| Emergency room | Yes |
|---|---|
| Open 24/7 | Yes |
| Trauma designation | Level III |
| Stroke designation | Primary Stroke Center |
Visiting and practical information
| Parking | Visitor parking in Lots B and C; maternity patients and families in Lot D; employees in Lot A[6] |
|---|
Recognition[4][5][7]
- Primary Stroke Center (Joint Commission Advanced Certification)
- Joint Commission accreditation (highest level stated)
- Joint Commission Primary Stroke Center
- Healthgrades Patient Safety Excellence Award 2026
- Healthgrades Five-Star Recipient for Treatment of Stroke 2026
Doctors and clinicians (700)
700 doctors and other clinicians list Upper Valley Medical Center as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.
Main specialties
- Nurse Practitioner134
- Physician Assistant74
- Family Practice67
- Internal Medicine67
- Diagnostic Radiology47
- Emergency Medicine35
- Orthopedic Surgery26
- General Surgery22
- Certified Registered Nurse Anesthetist (CRNA)19
- Cardiovascular Disease (Cardiology)18
- Interventional Cardiology15
- Neurology15
Doctors with a page on this site (700)
- Aaron Harju, MDFamily Practice
- Aaron J. Kaibas, DOCardiovascular Disease (Cardiology)
- Aaron R. Shaver, MDNeurology
- Aaron RogersCertified Registered Nurse Anesthetist (CRNA)
- Abdelfatah S. Abou IssaInternal Medicine
- Abdelhamed I. Abdelhamed, MDInterventional Cardiology
- Abdul Ghanem, MDHospitalist
- Abdul N. Butman, MDInternal Medicine
- Abeth J. Baskar, PAPhysician Assistant
- Abigail C. SprockelPhysician Assistant
- Aderemi B. Alli, MDHospitalist
- Adriana Saldan, DODiagnostic Radiology
- Ahmad Abdul-Karim, MDCardiovascular Disease (Cardiology)
- Akpezi Oshobe, MDInternal Medicine
- Al-Mouthanna Rajab, MDAnesthesiology
- Alaina HostetlerCertified Registered Nurse Anesthetist (CRNA)
- Alan Prok, MDPathology
- Aleksander Rekhtman, MDDiagnostic Radiology
- Alexander B. Long, MDFamily Practice
- Alexander E. Link, NPNurse Practitioner
- Alexander Kobzik, MDCritical Care (Intensivists)
- Alexandra J. Jordan, MDInternal Medicine
- Ali A. Saab, DOCardiovascular Disease (Cardiology)
- Ali Usmani, MDInterventional Cardiology
And 676 more: the button below opens the full list.
Names link to the doctor’s page on this site when there is one, otherwise to the official NPI Registry record (U.S. Department of Health and Human Services). Find a doctor · Source: CMS Facility Affiliation Data
Other emergency rooms nearby
Hospitals that list emergency services, by straight-line distance (not driving distance).
- Kettering Health Troy0.9 mi · Troy, OH · Acute Care Hospital
- Wilson Memorial Hospital18 mi · Sidney, OH · Acute Care Hospital
- 88th Medical Group (Wright-Patterson AFB)18 mi · Wright-Patterson Afb, OH · Military Hospital (Department of Defense)
- Dayton Childrens Hospital18 mi · Dayton, OH · Children's Hospital
- Kettering Health Dayton18 mi · Dayton, OH · Acute Care Hospital
Find the closest emergency room to where you are → · Compare ER wait times
Other hospitals near Troy
- Shriners Hospitals for Children18 mi · Dayton, OH · Children's Hospital
All hospitals in Troy · Hospitals in Miami County · Hospitals near me
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
- Troy Rehabilitation and Healthcare Center1.4 mi · Troy, OH · 3 of 5 stars
- Otterbein Tipp City3.9 mi · Tipp City, OH · 3 of 5 stars
- Vancrest-Upper Valley4.3 mi · Troy, OH · 3 of 5 stars
All nursing homes in the state →
Hospice providers
- Hospice of Miami County Inc0.0 mi · Troy, OH · 5 of 5 stars
- Interim Healthcare Hospice of Dayton13 mi · Huber Heights, OH
- Wilson Hospice Care17 mi · Sidney, OH
All hospice providers in the state →
Home health agencies
- Horizon Home Healthcare, LLC9.0 mi · Vandalia, OH · 4 of 5 stars
- Ohioans Home Healthcare, Inc9.0 mi · Vandalia, OH · 4 of 5 stars
- Heritage Health Care9.1 mi · Piqua, OH · 2.5 of 5 stars
All home health agencies in the state →
Dialysis facilities
- DaVita Upper Valley Kidney Center0.0 mi · Troy, OH · 2 of 5 stars
- DaVita Huber Heights Dialysis13 mi · Huber Heights, OH · 3 of 5 stars
- Fresenius Medical Care Dayton Regional Dialysis North13 mi · Dayton, OH · 2 of 5 stars
Outpatient surgery centers nearby
Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.
- Valley Regional Surgery Center9.1 mi · Piqua, OH
- Digestive Endoscopy Center13 mi · Huber Heights, OH
- Endoscopy Center of Dayton North14 mi · Dayton, OH
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
- New Carlisle Community Health Center11 mi · New Carlisle, OH · Community health center
- Union Elementary11 mi · Englewood, OH · Community health center
- Rushmore Elementary12 mi · Dayton, OH · Community health center
Clinics and urgent care
- Premier Health Urgent Care, Inc.13 mi · Dayton, OH · Urgent care center
- Alliance Physicians Inc13 mi · Huber Heights, OH · Urgent care center
- American Current Care of Ohio, P.A., Co.13 mi · Huber Heights, OH · Urgent care center
Pharmacies
- Kroger Limited Partnership I0.0 mi · Troy, OH · Community/retail pharmacy
- Premier Health Pharmacy-Uvmc0.0 mi · Troy, OH · Community/retail pharmacy
- Wal-Mart Stores East LP0.0 mi · Troy, OH · Community/retail pharmacy
Assisted living nearby
Licensed homes from the official state license list, by straight-line distance.
- Brookdale Troy0.0 mi · Troy, OH
- Story Point of Troy0.0 mi · Troy, OH
- The Courtyard at Troy0.0 mi · Troy, OH
- Huber Heights Danbury6.6 mi · Tipp City, OH
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 Upper Valley Medical Center reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.
What patients said (patient survey)
What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.
| Summary star rating (all survey topics) | 3 of 5 stars |
|---|---|
| Overall rating of the hospital | 3 of 5 stars |
| Would recommend the hospital | 4 of 5 stars |
| Nurses communicated well | 4 of 5 stars |
| Doctors communicated well | 3 of 5 stars |
| Patients got help quickly from staff | 4 of 5 stars |
| Staff explained medicines | 2 of 5 stars |
| Information about recovery at home | 4 of 5 stars |
| Room and bathroom kept clean | 4 of 5 stars |
| Restfulness of Environment | 2 of 5 stars |
| Care Coordination | 3 of 5 stars |
| Symptoms After Stay | 3 of 5 stars |
| Rated the hospital 9 or 10 out of 10 | 70%National average: 72% |
| Would definitely recommend the hospital | 68%National average: 71% |
| Nurses “always” communicated well | 79%National average: 80% |
| Doctors “always” communicated well | 74%National average: 80% |
| “Always” got help as soon as they wanted | 64%National average: 64% |
| Staff “always” explained medicines before giving them | 56%National average: 62% |
| Were given information about recovery at home | 88%National average: 86% |
| Room and bathroom “always” clean | 72%National average: 73% |
| Completed surveys | 921Response rate: 24% |
Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 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) | 0.624No different from the national benchmark |
|---|---|
| Catheter-associated urinary tract infections (CAUTI) | 0No different from the national benchmark |
| Surgical site infections after colon surgery | 0.752No different from the national benchmark |
| MRSA bloodstream infections | 1.408No different from the national benchmark |
| Clostridioides difficile (C. diff) intestinal infections | 0.68No different from the national benchmark |
| Not reported to Medicare | Surgical site infections after abdominal hysterectomy |
Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.
Complications and deaths
What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.
| Deaths within 30 days: heart attack patients | 11.7% |
|---|---|
| Deaths within 30 days: heart failure patients | 11.5% |
| Deaths within 30 days: pneumonia patients | 13.7% |
| Deaths within 30 days: COPD patients | 7.9% |
| Deaths within 30 days: stroke patients | 11% |
| Serious complications (patient safety indicator PSI-90) | 0.82No different from the national rate |
| Not reported to Medicare | Deaths within 30 days: coronary bypass surgery (CABG) |
| Too few cases to report | Complications after hip or knee replacement |
Source: Complications and Deaths - Hospital — CMS, released October 20, 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) | 16.6% |
|---|---|
| Readmitted within 30 days: heart attack | 13.7% |
| Readmitted within 30 days: heart failure | 22.4% |
| Readmitted within 30 days: pneumonia | 16.4% |
| Readmitted within 30 days: COPD | 20.2% |
| Too few cases to report | Readmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement |
Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.
Emergency room times and sepsis care
What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.
| Emergency room volume (patients per year) | Medium (20,000–39,999) |
|---|---|
| Average (median) time patients spent in the emergency room before leaving (OP-18b) | 159 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) | 76%National average: 66% |
Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.
Medicare payment programs
Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Upper Valley Medical Center, fiscal year 2026 (October 2025 to September 2026).
Show the Medicare payment program results
Hospital-Acquired Condition Reduction Program
What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.
CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.
| Medicare payment reduction, fiscal year 2026 | NoCMS lists no payment reduction for this hospital. |
|---|---|
| Total HAC Score | -0.3371Lower is better. Hospitals above the 75th percentile of all scores get the reduction. |
Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.
Hospital Readmissions Reduction Program
What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.
CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).
| Heart attack | 1.0513More readmissions than expected |
|---|---|
| Heart failure | 1.0754More readmissions than expected |
| Pneumonia | 0.9614Fewer readmissions than expected |
| COPD (chronic lung disease) | 1.0597More readmissions than expected |
| No result published | Hip or knee replacement; Coronary bypass surgery (CABG) (not reported, or too few cases) |
Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.
Hospital Value-Based Purchasing Program
What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.
CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.
| Total Performance Score | 31.12 out of 100Median of the 2,455 hospitals in the program: 29.50 |
|---|---|
| Clinical outcomes (deaths and complications) | 27.50 out of 100 |
| Person and community engagement (patient survey) | 32.00 out of 100 |
| Safety (infections and sepsis care) | 45.00 out of 100 |
| Efficiency and cost reduction (Medicare spending) | 20.00 out of 100 |
Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.
Medicare spending per patient (MSPB)
What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.
CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.
| Medicare spending per patient, ratio | 0.95Below the national median hospital (1.00): Medicare spent less |
|---|
Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.
ER wait times and Medicare ratings nearby
How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.
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 Upper Valley Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.
What the prices mean
- Hospital charge
- The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
- Cash price
- The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
- Insurance rates
- The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
- Hospital and doctor fees
- A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.
How to use hospital prices: estimates, financial assistance and your rights →
Show the prices of 79 common services
Office and emergency visits
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new | Not listed in the file | Not listed in the file | $450 |
New patient office visit (about 30–44 minutes): rates for 1 insurance plan
| |||
| New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: HC NEW PATIENT LEVEL 3 | $433 | $433 | Not listed in the file |
| New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: HC NEW PT EVAL - LEVEL 3 | $433 | $433 | Not listed in the file |
| New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new | Not listed in the file | Not listed in the file | $406 |
New patient office visit (about 45–59 minutes): rates for 1 insurance plan
| |||
| New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC NEW PATIENT LEVEL 4 | $541 | $541 | Not listed in the file |
| New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC NEW PT EVAL - LEVEL 4 | $541 | $541 | Not listed in the file |
| New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new | Not listed in the file | Not listed in the file | $442 |
New patient office visit (about 60–74 minutes): rates for 1 insurance plan
| |||
| New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: HC NEW PATIENT LEVEL 5 | $649 | $649 | Not listed in the file |
| New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: HC NEW PT EVAL - LEVEL 5 | $649 | $649 | Not listed in the file |
| Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est | Not listed in the file | Not listed in the file | $208 |
Established patient office visit (about 20–29 minutes): rates for 1 insurance plan
| |||
| Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ESTABLISHED PATIENT LEVEL 3 | $379 | $379 | Not listed in the file |
| Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EST PT EVAL - LEVEL 3 | $379 | $379 | Not listed in the file |
| Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est | Not listed in the file | Not listed in the file | $269 |
Established patient office visit (about 30–39 minutes): rates for 1 insurance plan
| |||
| Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ESTABLISHED PATIENT LEVEL 4 | $487 | $487 | Not listed in the file |
| Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EST PT EVAL - LEVEL 4 | $487 | $487 | Not listed in the file |
| Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit | Not listed in the file | Not listed in the file | $267.53 – $825.97 |
Emergency room visit (moderate): rates for 9 insurance plans
| |||
| Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC HS LEVEL 3 | $1,812 | $1,812 | Not listed in the file |
| Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit | Not listed in the file | Not listed in the file | $408.93 – $1,262.54 |
Emergency room visit (moderately high): rates for 9 insurance plans
| |||
| Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC HS LEVEL 4 | $3,716 | $3,716 | Not listed in the file |
| Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit | Not listed in the file | Not listed in the file | $583.64 – $1,801.94 |
Emergency room visit (high): rates for 9 insurance plans
| |||
| Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC HS LEVEL 5 | $6,078 | $6,078 | Not listed in the file |
Lab tests
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca | Not listed in the file | Not listed in the file | $6.77 – $26.12 |
Basic metabolic panel (blood test): 10 of 17 insurance plan rates
| |||
| Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL | $106 | $106 | Not listed in the file |
| Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel | Not listed in the file | Not listed in the file | $8.45 – $32.60 |
Comprehensive metabolic panel (blood test): 10 of 17 insurance plan rates
| |||
| Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COMP METABOLIC PANEL | $152 | $152 | Not listed in the file |
| Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel | Not listed in the file | Not listed in the file | $38.25 – $147.61 |
Obstetric blood test panel: 10 of 17 insurance plan rates
| |||
| Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OBSTETRIC PANEL | $237 | $237 | Not listed in the file |
| Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel | Not listed in the file | Not listed in the file | $10.71 – $41.34 |
Cholesterol panel (lipid panel): 10 of 17 insurance plan rates
| |||
| Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LIPID PANEL | $139 | $139 | Not listed in the file |
| Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel | Not listed in the file | Not listed in the file | $6.94 – $26.80 |
Kidney function panel: 10 of 17 insurance plan rates
| |||
| Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL | $109 | $109 | Not listed in the file |
| Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel | Not listed in the file | Not listed in the file | $6.54 – $25.22 |
Liver function panel: 10 of 17 insurance plan rates
| |||
| Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL | $70 | $70 | Not listed in the file |
| Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope | Not listed in the file | Not listed in the file | $2.54 – $9.79 |
Urine test (automated, with microscope): 10 of 17 insurance plan rates
| |||
| Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC 81001 URINALYSIS W/MICRO | $45 | $45 | Not listed in the file |
| Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope | Not listed in the file | Not listed in the file | $2.78 – $10.74 |
Urine test (manual, without microscope): 10 of 17 insurance plan rates
| |||
| Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC 81002 URINDIPNON AUTO W O MIC | $32 | $32 | Not listed in the file |
| Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/o scope | Not listed in the file | Not listed in the file | $1.80 – $6.95 |
Urine test (automated, without microscope): 10 of 17 insurance plan rates
| |||
| Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINDIPAUTO W O MIC | $32 | $32 | Not listed in the file |
| Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINALYSIS | $32 | $32 | Not listed in the file |
| PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay of psa total | Not listed in the file | Not listed in the file | $14.71 – $56.78 |
PSA (prostate specific antigen) blood test: 10 of 17 insurance plan rates
| |||
| PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSA DIAGNOSTIC | $260 | $260 | Not listed in the file |
| PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSA | $260 | $260 | Not listed in the file |
| Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay thyroid stim hormone | Not listed in the file | Not listed in the file | $13.44 – $51.87 |
Thyroid stimulating hormone (TSH) test: 10 of 17 insurance plan rates
| |||
| Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE | $237 | $237 | Not listed in the file |
| Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc | Not listed in the file | Not listed in the file | $6.22 – $23.99 |
Complete blood count (CBC) with differential: 10 of 17 insurance plan rates
| |||
| Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CBC AND DIFFERENTIAL, AUTO | $137 | $137 | Not listed in the file |
| Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated | Not listed in the file | Not listed in the file | $5.18 – $19.98 |
Complete blood count (CBC), automated: 10 of 17 insurance plan rates
| |||
| Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CBC AUTOMATED | $115 | $115 | Not listed in the file |
| Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time | Not listed in the file | Not listed in the file | $3.43 – $13.24 |
Blood clotting time test (prothrombin time, PT): 10 of 17 insurance plan rates
| |||
| Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PROTHROMBIN TIME | $71 | $71 | Not listed in the file |
| Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PROTHROMBIN TIME POCT | $71 | $71 | Not listed in the file |
| Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time partial | Not listed in the file | Not listed in the file | $4.81 – $18.56 |
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates
| |||
| Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PART THROMBIN TIME | $107 | $107 | Not listed in the file |
Imaging (X-ray, CT, MRI, ultrasound, mammogram)
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye | Not listed in the file | Not listed in the file | $102.46 – $326.21 |
CT scan of the head or brain, without contrast: 10 of 18 insurance plan rates
| |||
| CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT HEAD W/O CONTRAST | $1,396 | $1,396 | Not listed in the file |
| CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT HEAD FOR MRGFUS WO CONTRAST | $1,396 | $1,396 | Not listed in the file |
| MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye | Not listed in the file | Not listed in the file | $341.91 – $1,055.61 |
MRI of the brain, before and after contrast: 10 of 18 insurance plan rates
| |||
| MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI BRAIN W/O+W CON | $3,687 | $3,687 | Not listed in the file |
| Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views | Not listed in the file | Not listed in the file | $85.29 – $263.32 |
Chest X-ray, 2 views: 10 of 17 insurance plan rates
| |||
| Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CHEST; 2 VIEWS | $765 | $765 | Not listed in the file |
| X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws | Not listed in the file | Not listed in the file | $102.46 – $316.33 |
X-ray of the lower spine, at least 4 views: 10 of 18 insurance plan rates
| |||
| X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC SPINE, L/S MIN 4 VIEWS | $1,057 | $1,057 | Not listed in the file |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye | Not listed in the file | Not listed in the file | $233.84 – $721.95 |
MRI of the lower back (lumbar spine), without contrast: 10 of 18 insurance plan rates
| |||
| MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR W/O CONT | $2,048 | $2,048 | Not listed in the file |
| CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye | Not listed in the file | Not listed in the file | $171.90 – $530.72 |
CT scan of the pelvis, with contrast: 10 of 18 insurance plan rates
| |||
| CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT PELVIS W CONTRAST | $2,682 | $2,682 | Not listed in the file |
| MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye | Not listed in the file | Not listed in the file | $233.84 – $721.95 |
MRI of a leg joint (such as the knee), without contrast: 10 of 18 insurance plan rates
| |||
| MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI LOW EXTRM JOINT W/O CONT BIL | $4,093 | $4,093 | Not listed in the file |
| MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI LOW EXTRM JOINT W/O CONT LT | $2,048 | $2,048 | Not listed in the file |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelv w/contrast | Not listed in the file | Not listed in the file | $341.91 – $1,055.61 |
CT scan of the abdomen and pelvis, with contrast: 10 of 18 insurance plan rates
| |||
| CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT ABDOMEN AND PELVIS WITH CONTRAST | $3,941 | $3,941 | Not listed in the file |
| Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete | Not listed in the file | Not listed in the file | $102.46 – $316.33 |
Ultrasound of the abdomen, complete: 10 of 18 insurance plan rates
| |||
| Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US - ABDOMEN COMPLETE | $1,806 | $1,806 | Not listed in the file |
| Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us >/= 14 wks sngl fetus | Not listed in the file | Not listed in the file | $102.46 – $316.33 |
Pregnancy ultrasound (after the first trimester): 10 of 18 insurance plan rates
| |||
| Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US-PREG >=14 WKS FIRST GESTATION | $1,806 | $1,806 | Not listed in the file |
| Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob | Not listed in the file | Not listed in the file | $102.46 – $316.33 |
Transvaginal ultrasound: 10 of 18 insurance plan rates
| |||
| Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US NON-OB TRANSVAGINAL | $1,806 | $1,806 | Not listed in the file |
| Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POCUS TRANSVAGINAL NON-OB | $1,463 | $1,463 | Not listed in the file |
| Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni | Not listed in the file | Not listed in the file | $105.18 |
Diagnostic mammogram, one breast: rates for 8 insurance plans
| |||
| Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DIGITAL MAMMO DIAG UNILATERAL INCLUDING CAD | $468 | $468 | Not listed in the file |
| Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DIGITAL MAMMO DIAG UNITLAT SAME DAY AS SCRN INCLUDING CAD | $468 | $468 | Not listed in the file |
| Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi | Not listed in the file | Not listed in the file | $134.07 |
Diagnostic mammogram, both breasts: rates for 8 insurance plans
| |||
| Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DIGITAL MAMMO DIAG BILATERAL INCLUDING CAD | $569 | $569 | Not listed in the file |
| Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Dx mammo incl cad bi | Not listed in the file | Not listed in the file | $101 – $311.83 |
Diagnostic mammogram, both breasts: rates for 9 insurance plans
| |||
| Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad | Not listed in the file | Not listed in the file | $110.79 |
Screening mammogram, both breasts: rates for 8 insurance plans
| |||
| Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DIGITAL MAMMO SCREEN INCLUDING CAD | $420 | $420 | Not listed in the file |
| Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DIGITAL MAMMO SCREEN INCLUDING CAD UNILATERAL | $420 | $420 | Not listed in the file |
Heart tests and sleep study
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left hrt cath w/ventrclgrphy | Not listed in the file | Not listed in the file | $3,177.21 – $10,075 |
Left heart catheterization (diagnostic): 10 of 17 insurance plan rates
| |||
| Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LEFT HEART CATHETERIZATION | $8,296 | $8,296 | Not listed in the file |
| Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrophysiology evaluation | Not listed in the file | Not listed in the file | $7,643.96 – $23,599.96 |
Heart rhythm study (electrophysiology evaluation): 10 of 17 insurance plan rates
| |||
| Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EP RT A/V PACING W/O ARRTHYMIA IND | $44,102 | $44,102 | Not listed in the file |
| Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tx atrial fib pulm vein isol | Not listed in the file | Not listed in the file | $16,056 – $79,087.05 |
Heart rhythm study with ablation for atrial fibrillation: 10 of 17 insurance plan rates
| |||
| Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COMP EP W TRANS SEPT PUNC W AFIB ABL BY PULM VN ISOL | $50,327 | $50,327 | Not listed in the file |
| Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param | Not listed in the file | Not listed in the file | $841.60 – $2,598.35 |
Sleep study (overnight, in a sleep lab): rates for 9 insurance plans
| |||
| Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POLYSOMNOG 4+PARAMETER W TECH | $4,840 | $4,840 | Not listed in the file |
Physical therapy and mental health
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic exercises | Not listed in the file | Not listed in the file | $27.87 – $86.05 |
Physical therapy: therapeutic exercise (each 15 minutes): rates for 9 insurance plans
| |||
| Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THERAPEUTIC PX 1/> AREAS EA 15 MIN EXERCISES | $218 | $218 | Not listed in the file |
| Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min | Not listed in the file | Not listed in the file | $93.86 – $289.78 |
Physical therapy evaluation (low complexity): rates for 9 insurance plans
| |||
| Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEX 20 MINS | $140 | $140 | Not listed in the file |
| Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min | Not listed in the file | Not listed in the file | $93.86 – $289.78 |
Physical therapy evaluation (moderate complexity): rates for 9 insurance plans
| |||
| Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEX 30 MINS | $282 | $282 | Not listed in the file |
| Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min | Not listed in the file | Not listed in the file | $93.86 – $289.78 |
Physical therapy evaluation (high complexity): rates for 9 insurance plans
| |||
| Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEX 45 MINS | $450 | $450 | Not listed in the file |
| Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 30 minutes | Not listed in the file | Not listed in the file | $173.95 – $537.06 |
Psychotherapy, 30 minutes: rates for 9 insurance plans
| |||
| Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCOTHERAPY, 30 MIN WITH PATIENT | $244 | $244 | Not listed in the file |
| Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 45 minutes | Not listed in the file | Not listed in the file | $173.95 – $537.06 |
Psychotherapy, 45 minutes: rates for 9 insurance plans
| |||
| Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCOTHERAPY, 45 MIN WITH PATIENT | $502 | $502 | Not listed in the file |
| Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 60 minutes | Not listed in the file | Not listed in the file | $173.95 – $537.06 |
Psychotherapy, 60 minutes: rates for 9 insurance plans
| |||
| Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCOTHERAPY, 60 MIN WITH PATIENT | $543 | $543 | Not listed in the file |
| Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/o pt 50 min | Not listed in the file | Not listed in the file | $173.95 – $537.06 |
Family psychotherapy, without the patient: rates for 9 insurance plans
| |||
| Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC FAMILY PSYCHTX WO PATIENT-PSYCH | $407 | $407 | Not listed in the file |
| Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/pt 50 min | Not listed in the file | Not listed in the file | $173.95 – $537.06 |
Family psychotherapy, with the patient: rates for 9 insurance plans
| |||
| Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCHTHERAPY FAMILY W/PAT | $574 | $574 | Not listed in the file |
| Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCHTHERAPY GROUP (HOURLY) | $181 | $181 | Not listed in the file |
Procedures and surgery
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion | Not listed in the file | Not listed in the file | $3,837.27 – $11,847.19 |
Removal of breast growth (open surgery): 10 of 17 insurance plan rates
| |||
| Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty | Not listed in the file | Not listed in the file | $12,582.38 – $38,846.85 |
Total hip replacement: 10 of 17 insurance plan rates
| |||
| Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty | Not listed in the file | Not listed in the file | $12,582.38 – $38,846.85 |
Total knee replacement: 10 of 17 insurance plan rates
| |||
| Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Shoulder arthroscopy/surgery | Not listed in the file | Not listed in the file | $2,304 |
Shoulder arthroscopy: shaving of shoulder bone: rates for 8 insurance plans
| |||
| Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery | Not listed in the file | Not listed in the file | $3,206.68 – $9,900.31 |
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 17 insurance plan rates
| |||
| Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids | Not listed in the file | Not listed in the file | $5,801.65 – $17,912.02 |
Removal of tonsils and adenoids (under age 12): 10 of 17 insurance plan rates
| |||
| Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash | Not listed in the file | Not listed in the file | $888.88 – $4,951 |
Upper GI endoscopy (diagnostic): 10 of 17 insurance plan rates
| |||
| Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple | Not listed in the file | Not listed in the file | $888.88 – $4,951 |
Upper GI endoscopy with biopsy: 10 of 17 insurance plan rates
| |||
| Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy | Not listed in the file | Not listed in the file | $911.39 – $4,951 |
Colonoscopy (diagnostic): 10 of 17 insurance plan rates
| |||
| Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy | Not listed in the file | Not listed in the file | $1,172.75 – $4,951 |
Colonoscopy with biopsy: 10 of 17 insurance plan rates
| |||
| Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal | Not listed in the file | Not listed in the file | $1,172.75 – $4,951 |
Colonoscopy with removal of polyps (snare): 10 of 17 insurance plan rates
| |||
| Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us | Not listed in the file | Not listed in the file | $1,172.75 – $4,951 |
Ultrasound of the lower bowel by endoscope: 10 of 17 insurance plan rates
| |||
| Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind | Not listed in the file | Not listed in the file | $911.39 – $4,067 |
Screening colonoscopy (not high risk): 10 of 17 insurance plan rates
| |||
| Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy | Not listed in the file | Not listed in the file | $5,924.84 – $18,292.35 |
Gallbladder removal by laparoscope: 10 of 17 insurance plan rates
| |||
| Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr | Not listed in the file | Not listed in the file | $3,508.93 – $10,833.46 |
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates
| |||
| Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate | Not listed in the file | Not listed in the file | $4,951 |
Prostate biopsy: rates for 8 insurance plans
| |||
| Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparo radical prostatectomy | Not listed in the file | Not listed in the file | $10,417.63 – $32,163.39 |
Prostate removal by laparoscope (radical prostatectomy): 10 of 17 insurance plan rates
| |||
| Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy | Not listed in the file | Not listed in the file | $3,172.50 – $9,794.79 |
Hysteroscopy with biopsy of the uterus lining: 10 of 17 insurance plan rates
| |||
| Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac | Not listed in the file | Not listed in the file | $691.79 – $4,067 |
Spinal injection, lower back (epidural), with imaging guidance: 10 of 17 insurance plan rates
| |||
| Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INJ DIAG/THERA LUM/SAC SI EPI INC IM GUIDE | $2,978 | $2,978 | Not listed in the file |
| Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj foramen epidural l/s | Not listed in the file | Not listed in the file | $866.82 – $4,067 |
Nerve root injection, lower back, with imaging guidance: 10 of 17 insurance plan rates
| |||
| Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INJ ANS EPI TRANSFRM L/S SIN LVL BIL | $16,646 | $16,646 | Not listed in the file |
| Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INJ ANS EPI TRANSFRM L/S SIN LVL LT | $8,324 | $8,324 | Not listed in the file |
| Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery | Not listed in the file | Not listed in the file | $1,913.74 – $6,522 |
Carpal tunnel release: 10 of 17 insurance plan rates
| |||
| Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery | Not listed in the file | Not listed in the file | $539.02 – $4,067 |
Laser treatment of clouding after cataract surgery: 10 of 17 insurance plan rates
| |||
| Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cataract surg w/iol 1 stage | Not listed in the file | Not listed in the file | $2,261.75 – $6,982.94 |
Cataract removal with lens implant: 10 of 17 insurance plan rates
| |||
Hospital stays (whole stay, MS-DRG)
| Service | Hospital charge | Cash price | Insurance rates (lowest – highest) |
|---|---|---|---|
| Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc | Not listed in the file | Not listed in the file | $13,465.86 – $303,070.81 |
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 47 insurance plan rates
| |||
| Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal Fusion Except Cervical Without Mcc | Not listed in the file | Not listed in the file | Not listed in the file |
Spinal fusion (not neck), without major complications: rates for 9 insurance plans
| |||
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc | Not listed in the file | Not listed in the file | $14,359.60 – $59,214.13 |
Hip or knee replacement (major joint of the leg), without major complications: 10 of 46 insurance plan rates
| |||
| Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cervical Spinal Fusion Without Cc/Mcc | Not listed in the file | Not listed in the file | $18,035.88 – $74,341.92 |
Neck (cervical) spinal fusion, without complications: 10 of 47 insurance plan rates
| |||
| Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc | Not listed in the file | Not listed in the file | $9,422.01 – $37,642.03 |
Uterus and ovary surgery (not for cancer), without complications: 10 of 46 insurance plan rates
| |||
Source: Upper Valley Medical Center’s standard charges file (premierhealth.com, JSON, CMS template 3.0.0; 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 | Acute Care Hospital |
|---|---|
| Address | 3130 N Dixie Highway, Troy, OH 45373 |
| County | Miami County |
| State | Ohio |
| Phone | (937) 440‑7853 |
| Emergency services | Yes |
| Ownership | Voluntary non-profit - Private |
| Medicare overall rating | 4 of 5 stars |
| CMS Certification Number | 360174 |
| Name in Medicare records | UPPER VALLEY MEDICAL CENTER |
| Profile level | Medicare data + hospital website |
| Main phone on the hospital’s website | (937) 440‑4000[4][5] |
| Official website | premierhealth.com |
| Corrections | Report an error or suggest an update → |
Sources
- Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
- Medicare Care Compare — official Medicare profile of this hospital
- U.S. Census Bureau ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances
From the hospital’s website
Numbers match the citations above. Checked 2026-10-30.
- Upper Valley Medical Center — premierhealth.com
- Emergency and Trauma - Upper Valley Medical Center — premierhealth.com
- Maps and Parking - Upper Valley Medical Center | Premier Health — premierhealth.com
- Upper Valley Medical Center - Awards and Recognition | Premier Health — premierhealth.com
- Emergency and Trauma - ER Locations and Wait Times | Premier Health — premierhealth.com
- Emergency Room and Trauma - Upper Valley Medical Center l Premier Health | Premier Health — premierhealth.com