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Critical Access Hospital

Uvalde Memorial Hospital

Uvalde, Texas · Uvalde County · Emergency services listed

Uvalde Memorial Hospital is a critical access hospital at 1025 Garner Field Road, Uvalde, TX 78801. Phone: (830) 278-6251. It has an emergency department. Medicare overall rating: 3 of 5 stars (CMS, October 2026).

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked October 30, 2026).

Summary

Uvalde Memorial Hospital is a critical access hospital in Uvalde, Texas. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 39 services, specialties and programs. Medicare lists 164 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is a critical access hospital?

A small rural hospital with 24-hour emergency care, designated by Medicare to keep care available far from big cities. More about hospital types

Compare

Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
39Services listed

Quick answers

Does Uvalde Memorial Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Uvalde Memorial Hospital. In a medical emergency, call 911.
Where is Uvalde Memorial Hospital?
1025 Garner Field Road, Uvalde, TX 78801, in Uvalde County, Texas.
What is the phone number of Uvalde Memorial Hospital?
(830) 278-6251, as listed by Medicare (CMS).
What is the Medicare star rating of Uvalde Memorial Hospital?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Specialties and care areas[6][8][10][17]

Treatments[6][15]

Procedures[14][16]

  • Stress tests
  • Echocardiograms
  • Holter monitoring
  • EKGs
  • Pulmonary function testing
  • Ambulatory blood pressure testing
  • CT scans
  • MRI/MRA imaging
  • Digital mammography
  • Bone densitometry (DEXA)
  • Nuclear medicine studies
  • Ultrasound imaging
  • Stereotactic biopsies

Programs and centers[4][5][14][16]

  • Kate Marmion Regional Cancer Center
  • Women's Imaging Center
  • Cardiac programs for heart and respiratory patients

Emergency care (hospital website)[6][7][13]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

VisitingMain entrance 8 a.m. to 8 p.m.; Emergency Room entrance open 24 hours, 7 days a week. Visitors per room may be limited[7]

Recognition[5][9]

  • Critical Access Hospital
  • Joint Commission Gold Seal of Approval
  • American College of Radiology Accredited Facility: CT, MRI, Mammography
  • Governance Achievement Award 2026

Doctors and clinicians (164)

164 doctors and other clinicians list Uvalde Memorial Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (164)

And 140 more: the button below opens the full list.

Other emergency rooms nearby

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

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Uvalde

Hospitals in Uvalde 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

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Dialysis facilities

All dialysis facilities in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

What Uvalde Memorial Hospital 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 hospital4 of 5 stars
Would recommend the hospital4 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well4 of 5 stars
Patients got help quickly from staff4 of 5 stars
Staff explained medicines5 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean5 of 5 stars
Restfulness of Environment5 of 5 stars
Care Coordination4 of 5 stars
Symptoms After Stay4 of 5 stars
Rated the hospital 9 or 10 out of 1074%National average: 72%
Would definitely recommend the hospital77%National average: 71%
Nurses “always” communicated well79%National average: 80%
Doctors “always” communicated well82%National average: 80%
“Always” got help as soon as they wanted64%National average: 64%
Staff “always” explained medicines before giving them70%National average: 62%
Were given information about recovery at home90%National average: 86%
Room and bathroom “always” clean88%National average: 73%
Completed surveys148Response rate: 12%

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.

Clostridioides difficile (C. diff) intestinal infections1.77No different from the national benchmark
Not reported to MedicareCentral line bloodstream infections (CLABSI); Catheter-associated urinary tract infections (CAUTI); Surgical site infections after colon surgery; Surgical site infections after abdominal hysterectomy; MRSA bloodstream infections

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 failure patients10.7%
Deaths within 30 days: pneumonia patients15.5%
Deaths within 30 days: COPD patients8.1%
Deaths within 30 days: stroke patients11.5%
Complications after hip or knee replacement5.3%
Not reported to MedicareDeaths within 30 days: coronary bypass surgery (CABG); Serious complications (patient safety indicator PSI-90)
Too few cases to reportDeaths within 30 days: heart attack patients

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%
Readmitted within 30 days: heart failure20.5%
Readmitted within 30 days: pneumonia17.6%
Readmitted within 30 days: COPD20.6%
Readmitted within 30 days: hip or knee replacement6.8%
Not reported to MedicareReadmitted within 30 days: coronary bypass surgery
Too few cases to reportReadmitted within 30 days: heart attack

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.

Average (median) time patients spent in the emergency room before leaving (OP-18b)162 minutesNational average: 162 minutes
Sepsis patients who got all the recommended early care (SEP-1)87%National average: 66%
Not reported to MedicarePatients who left the emergency room before being seen (OP-22)

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

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.

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 74 common services exactly as Uvalde Memorial Hospital 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 74 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Hemonc tc ov o/p new l3 30 min $377.61 Not listed in the file Not listed in the file
New patient office visit (about 30–44 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Office/outpatient visit new $377.61 Not listed in the file Not listed in the file
New patient office visit (about 30–44 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Prof office o/p new low 30 min $344 Not listed in the file Not listed in the file
New patient office visit (about 30–44 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: Hemonc tc ov o/p new l4 45 min $468.32 Not listed in the file Not listed in the file
New patient office visit (about 45–59 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: Office/outpatient visit new $468.32 Not listed in the file Not listed in the file
New patient office visit (about 45–59 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: Prof office o/p new mod 45 min $318.60 Not listed in the file Not listed in the file
New patient office visit (about 45–59 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Hemonc tc ov o/p new l5 60 min $1,670.06 Not listed in the file Not listed in the file
New patient office visit (about 60–74 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Office/outpatient visit new $1,670.06 Not listed in the file Not listed in the file
New patient office visit (about 60–74 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Prof office o/p new hi 60 min $433.20 Not listed in the file Not listed in the file
New patient office visit (about 60–74 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Eval/asess establishedexpand $266.85 Not listed in the file Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Office/outpatient visit est $266.85 Not listed in the file Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Prof off outpt visit 15 min $160.83 Not listed in the file Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Office/outpatient visit est $316 Not listed in the file Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Prof off outpt visit 25 min $237.65 Not listed in the file Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Radonc pro o/p est l4 30-39mi $316 Not listed in the file Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: Office cons new/estab 40min-tc $275.84 Not listed in the file Not listed in the file
Office consultation with a specialist (moderate): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: Office consultation $275.84 Not listed in the file Not listed in the file
Office consultation with a specialist (moderate): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: Prof phys off cons new/est 40m $336.80 Not listed in the file Not listed in the file
Office consultation with a specialist (moderate): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: Office consultation $421.05 Not listed in the file Not listed in the file
Office consultation with a specialist (moderate to high): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: Office visit 60min-tc $421.05 Not listed in the file Not listed in the file
Office consultation with a specialist (moderate to high): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: Prof phys office consult 60min $433.30 Not listed in the file Not listed in the file
Office consultation with a specialist (moderate to high): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: Prev visit new age 18-39 $200 Not listed in the file Not listed in the file
Preventive checkup, new patient, age 18–39: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: Prev visit new age 40-64 $250 Not listed in the file Not listed in the file
Preventive checkup, new patient, age 40–64: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: Emergency dept visit $1,501.14 Not listed in the file $283.09
Emergency room visit (moderate): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $283.09
  • TRI.WEST — TRI.WEST_1: $283.09
  • Tricare_East_Region — TRI.EAST_1: $283.09
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $283.09
  • VHA_Office_of_Community_Care — CHAMPVA_1: $283.09
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $283.09
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: Emergency dept visit lvl 3 $1,501.14 Not listed in the file $283.09
Emergency room visit (moderate): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $283.09
  • TRI.WEST — TRI.WEST_1: $283.09
  • Tricare_East_Region — TRI.EAST_1: $283.09
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $283.09
  • VHA_Office_of_Community_Care — CHAMPVA_1: $283.09
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $283.09
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: Prof ed dialysis consult lvl 3 $420 Not listed in the file $283.09
Emergency room visit (moderate): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $283.09
  • TRI.WEST — TRI.WEST_1: $283.09
  • Tricare_East_Region — TRI.EAST_1: $283.09
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $283.09
  • VHA_Office_of_Community_Care — CHAMPVA_1: $283.09
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $283.09
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Emergency dept visit $2,398.55 Not listed in the file $432.72
Emergency room visit (moderately high): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $432.72
  • TRI.WEST — TRI.WEST_1: $432.72
  • Tricare_East_Region — TRI.EAST_1: $432.72
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $432.72
  • VHA_Office_of_Community_Care — CHAMPVA_1: $432.72
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $432.72
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Emergency dept visit lvl 4 $2,398.55 Not listed in the file $432.72
Emergency room visit (moderately high): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $432.72
  • TRI.WEST — TRI.WEST_1: $432.72
  • Tricare_East_Region — TRI.EAST_1: $432.72
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $432.72
  • VHA_Office_of_Community_Care — CHAMPVA_1: $432.72
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $432.72
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Prof ed dialysis consult lvl 4 $470 Not listed in the file $432.72
Emergency room visit (moderately high): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $432.72
  • TRI.WEST — TRI.WEST_1: $432.72
  • Tricare_East_Region — TRI.EAST_1: $432.72
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $432.72
  • VHA_Office_of_Community_Care — CHAMPVA_1: $432.72
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $432.72
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: Emergency dept visit $3,624.42 Not listed in the file $617.59
Emergency room visit (high): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $617.59
  • TRI.WEST — TRI.WEST_1: $617.59
  • Tricare_East_Region — TRI.EAST_1: $617.59
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $617.59
  • VHA_Office_of_Community_Care — CHAMPVA_1: $617.59
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $617.59
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: Emergency dept visit lvl 5 $3,624.42 Not listed in the file $617.59
Emergency room visit (high): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $617.59
  • TRI.WEST — TRI.WEST_1: $617.59
  • Tricare_East_Region — TRI.EAST_1: $617.59
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $617.59
  • VHA_Office_of_Community_Care — CHAMPVA_1: $617.59
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $617.59
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: Prof ed dialysis consult lvl 5 $520 Not listed in the file $617.59
Emergency room visit (high): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $617.59
  • TRI.WEST — TRI.WEST_1: $617.59
  • Tricare_East_Region — TRI.EAST_1: $617.59
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $617.59
  • VHA_Office_of_Community_Care — CHAMPVA_1: $617.59
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $617.59
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Basic metabolic panel $317.89 Not listed in the file Not listed in the file
Basic metabolic panel (blood test): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Metabolic panel total ca $317.89 Not listed in the file Not listed in the file
Basic metabolic panel (blood test): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Comprehen metabolic panel $361.49 Not listed in the file Not listed in the file
Comprehensive metabolic panel (blood test): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Comprehensive metabolic panel $361.49 Not listed in the file Not listed in the file
Comprehensive metabolic panel (blood test): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: Lipid panel $425.18 Not listed in the file $13.39
Cholesterol panel (lipid panel): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $13.39
  • TRI.WEST — TRI.WEST_1: $13.39
  • Tricare_East_Region — TRI.EAST_1: $13.39
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $13.39
  • VHA_Office_of_Community_Care — CHAMPVA_1: $13.39
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $13.39
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: Nmr lipid panel so $425.18 Not listed in the file $13.39
Cholesterol panel (lipid panel): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $13.39
  • TRI.WEST — TRI.WEST_1: $13.39
  • Tricare_East_Region — TRI.EAST_1: $13.39
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $13.39
  • VHA_Office_of_Community_Care — CHAMPVA_1: $13.39
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $13.39
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: Renal function panel $469.45 Not listed in the file Not listed in the file
Kidney function panel: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Inpatient or outpatient In the file: Hepatic function panel $523.92 Not listed in the file Not listed in the file
Liver function panel: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: Ua automated with microscopy $166.33 Not listed in the file Not listed in the file
Urine test (automated, with microscope): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: Urinalysis auto w/scope $166.33 Not listed in the file Not listed in the file
Urine test (automated, with microscope): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: Urinalysis nonauto w/o scope $16.74 Not listed in the file Not listed in the file
Urine test (manual, without microscope): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: Urine ketone $16.74 Not listed in the file Not listed in the file
Urine test (manual, without microscope): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: Autom urinalysis wo micro $110.69 Not listed in the file Not listed in the file
Urine test (automated, without microscope): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: Urinalysis auto w/o scope $110.69 Not listed in the file Not listed in the file
Urine test (automated, without microscope): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Assay of psa total $406.77 Not listed in the file Not listed in the file
PSA (prostate specific antigen) blood test: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Sk psa total - so $406.77 Not listed in the file Not listed in the file
PSA (prostate specific antigen) blood test: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: Assay thyroid stim hormone $352.69 Not listed in the file Not listed in the file
Thyroid stimulating hormone (TSH) test: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: Thyroid stimulating hormone $352.69 Not listed in the file Not listed in the file
Thyroid stimulating hormone (TSH) test: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: Cbcad citrated blood $284.14 Not listed in the file Not listed in the file
Complete blood count (CBC) with differential: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: Complete cbc w/auto diff wbc $284.14 Not listed in the file Not listed in the file
Complete blood count (CBC) with differential: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Cbc hemagram/plts $176.81 Not listed in the file Not listed in the file
Complete blood count (CBC), automated: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Complete cbc automated $176.81 Not listed in the file Not listed in the file
Complete blood count (CBC), automated: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: Prothrombin time $153.53 Not listed in the file Not listed in the file
Blood clotting time test (prothrombin time, PT): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: Pt-so $153.53 Not listed in the file Not listed in the file
Blood clotting time test (prothrombin time, PT): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Aptt $472 Not listed in the file Not listed in the file
Blood clotting test (partial thromboplastin time, PTT): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Thromboplastin time partial $472 Not listed in the file Not listed in the file
Blood clotting test (partial thromboplastin time, PTT): 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: Ct brain wo $2,100.37 Not listed in the file $229.47
CT scan of the head or brain, without contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $229.47
  • TRI.WEST — TRI.WEST_1: $229.47
  • Tricare_East_Region — TRI.EAST_1: $229.47
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $229.47
  • VHA_Office_of_Community_Care — CHAMPVA_1: $229.47
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $229.47
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: Ct head/brain w/o dye $2,100.37 Not listed in the file $229.47
CT scan of the head or brain, without contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $229.47
  • TRI.WEST — TRI.WEST_1: $229.47
  • Tricare_East_Region — TRI.EAST_1: $229.47
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $229.47
  • VHA_Office_of_Community_Care — CHAMPVA_1: $229.47
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $229.47
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: Prof ct brain wo $163 Not listed in the file $229.47
CT scan of the head or brain, without contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $229.47
  • TRI.WEST — TRI.WEST_1: $229.47
  • Tricare_East_Region — TRI.EAST_1: $229.47
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $229.47
  • VHA_Office_of_Community_Care — CHAMPVA_1: $229.47
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $229.47
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Mri brain stem w/o & w/dye $4,831.19 Not listed in the file $880.14
MRI of the brain, before and after contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $880.14
  • TRI.WEST — TRI.WEST_1: $880.14
  • Tricare_East_Region — TRI.EAST_1: $880.14
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $880.14
  • VHA_Office_of_Community_Care — CHAMPVA_1: $880.14
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $880.14
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Mri brain w & w/o $4,831.19 Not listed in the file $880.14
MRI of the brain, before and after contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $880.14
  • TRI.WEST — TRI.WEST_1: $880.14
  • Tricare_East_Region — TRI.EAST_1: $880.14
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $880.14
  • VHA_Office_of_Community_Care — CHAMPVA_1: $880.14
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $880.14
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Prof mri brain w & w/o $439 Not listed in the file $880.14
MRI of the brain, before and after contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $880.14
  • TRI.WEST — TRI.WEST_1: $880.14
  • Tricare_East_Region — TRI.EAST_1: $880.14
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $880.14
  • VHA_Office_of_Community_Care — CHAMPVA_1: $880.14
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $880.14
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: Chest lat decubitus $624.48 Not listed in the file $856.63
Chest X-ray, 2 views: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $856.63
  • TRI.WEST — TRI.WEST_1: $856.63
  • Tricare_East_Region — TRI.EAST_1: $856.63
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $856.63
  • VHA_Office_of_Community_Care — CHAMPVA_1: $856.63
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $856.63
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: Prof chest x-ray 2 views pa&la $78.15 Not listed in the file $856.63
Chest X-ray, 2 views: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $856.63
  • TRI.WEST — TRI.WEST_1: $856.63
  • Tricare_East_Region — TRI.EAST_1: $856.63
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $856.63
  • VHA_Office_of_Community_Care — CHAMPVA_1: $856.63
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $856.63
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-ray exam chest 2 views $624.48 Not listed in the file $856.63
Chest X-ray, 2 views: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $856.63
  • TRI.WEST — TRI.WEST_1: $856.63
  • Tricare_East_Region — TRI.EAST_1: $856.63
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $856.63
  • VHA_Office_of_Community_Care — CHAMPVA_1: $856.63
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $856.63
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: Mob spine lumbar complete $1,102.07 Not listed in the file $108.42
X-ray of the lower spine, at least 4 views: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $108.42
  • TRI.WEST — TRI.WEST_1: $108.42
  • Tricare_East_Region — TRI.EAST_1: $108.42
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $108.42
  • VHA_Office_of_Community_Care — CHAMPVA_1: $108.42
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $108.42
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: Prof spine lumbar complete $58 Not listed in the file $108.42
X-ray of the lower spine, at least 4 views: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $108.42
  • TRI.WEST — TRI.WEST_1: $108.42
  • Tricare_East_Region — TRI.EAST_1: $108.42
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $108.42
  • VHA_Office_of_Community_Care — CHAMPVA_1: $108.42
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $108.42
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: X-ray exam l-2 spine 4/>vws $1,102.07 Not listed in the file $108.42
X-ray of the lower spine, at least 4 views: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $108.42
  • TRI.WEST — TRI.WEST_1: $108.42
  • Tricare_East_Region — TRI.EAST_1: $108.42
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $108.42
  • VHA_Office_of_Community_Care — CHAMPVA_1: $108.42
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $108.42
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: Mri lumbar spine w/o $4,642.50 Not listed in the file $545.95
MRI of the lower back (lumbar spine), without contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $545.95
  • TRI.WEST — TRI.WEST_1: $545.95
  • Tricare_East_Region — TRI.EAST_1: $545.95
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $545.95
  • VHA_Office_of_Community_Care — CHAMPVA_1: $545.95
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $545.95
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: Mri lumbar spine w/o dye $4,642.50 Not listed in the file $545.95
MRI of the lower back (lumbar spine), without contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $545.95
  • TRI.WEST — TRI.WEST_1: $545.95
  • Tricare_East_Region — TRI.EAST_1: $545.95
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $545.95
  • VHA_Office_of_Community_Care — CHAMPVA_1: $545.95
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $545.95
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: Prof mri lumbar spine w/o $285 Not listed in the file $545.95
MRI of the lower back (lumbar spine), without contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $545.95
  • TRI.WEST — TRI.WEST_1: $545.95
  • Tricare_East_Region — TRI.EAST_1: $545.95
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $545.95
  • VHA_Office_of_Community_Care — CHAMPVA_1: $545.95
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $545.95
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: Ct pelvis w $2,857.07 Not listed in the file $445.51
CT scan of the pelvis, with contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $445.51
  • TRI.WEST — TRI.WEST_1: $445.51
  • Tricare_East_Region — TRI.EAST_1: $445.51
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $445.51
  • VHA_Office_of_Community_Care — CHAMPVA_1: $445.51
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $445.51
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: Ct pelvis w/dye $2,857.07 Not listed in the file $445.51
CT scan of the pelvis, with contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $445.51
  • TRI.WEST — TRI.WEST_1: $445.51
  • Tricare_East_Region — TRI.EAST_1: $445.51
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $445.51
  • VHA_Office_of_Community_Care — CHAMPVA_1: $445.51
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $445.51
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: Prof ct pelvis w $215 Not listed in the file $445.51
CT scan of the pelvis, with contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $445.51
  • TRI.WEST — TRI.WEST_1: $445.51
  • Tricare_East_Region — TRI.EAST_1: $445.51
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $445.51
  • VHA_Office_of_Community_Care — CHAMPVA_1: $445.51
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $445.51
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: Mri hip lt wo $3,711.50 Not listed in the file $545.95
MRI of a leg joint (such as the knee), without contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $545.95
  • TRI.WEST — TRI.WEST_1: $545.95
  • Tricare_East_Region — TRI.EAST_1: $545.95
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $545.95
  • VHA_Office_of_Community_Care — CHAMPVA_1: $545.95
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $545.95
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: Mri jnt of lwr extre w/o dye $3,711.50 Not listed in the file $545.95
MRI of a leg joint (such as the knee), without contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $545.95
  • TRI.WEST — TRI.WEST_1: $545.95
  • Tricare_East_Region — TRI.EAST_1: $545.95
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $545.95
  • VHA_Office_of_Community_Care — CHAMPVA_1: $545.95
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $545.95
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: Prof fee mri hip lt wo $478.95 Not listed in the file $545.95
MRI of a leg joint (such as the knee), without contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $545.95
  • TRI.WEST — TRI.WEST_1: $545.95
  • Tricare_East_Region — TRI.EAST_1: $545.95
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $545.95
  • VHA_Office_of_Community_Care — CHAMPVA_1: $545.95
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $545.95
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Ct abd & pelv w/contrast $4,422.47 Not listed in the file $445.51
CT scan of the abdomen and pelvis, with contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $445.51
  • TRI.WEST — TRI.WEST_1: $445.51
  • Tricare_East_Region — TRI.EAST_1: $445.51
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $445.51
  • VHA_Office_of_Community_Care — CHAMPVA_1: $445.51
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $445.51
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Ct abd/pel w $4,422.47 Not listed in the file $445.51
CT scan of the abdomen and pelvis, with contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $445.51
  • TRI.WEST — TRI.WEST_1: $445.51
  • Tricare_East_Region — TRI.EAST_1: $445.51
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $445.51
  • VHA_Office_of_Community_Care — CHAMPVA_1: $445.51
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $445.51
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Prof ct abd/pel w $313.63 Not listed in the file $445.51
CT scan of the abdomen and pelvis, with contrast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $445.51
  • TRI.WEST — TRI.WEST_1: $445.51
  • Tricare_East_Region — TRI.EAST_1: $445.51
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $445.51
  • VHA_Office_of_Community_Care — CHAMPVA_1: $445.51
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $445.51
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: Prof us exam abdom complete $152 Not listed in the file $305.10
Ultrasound of the abdomen, complete: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $305.10
  • TRI.WEST — TRI.WEST_1: $305.10
  • Tricare_East_Region — TRI.EAST_1: $305.10
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $305.10
  • VHA_Office_of_Community_Care — CHAMPVA_1: $305.10
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $305.10
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: Us exam abdom complete $2,110.62 Not listed in the file $305.10
Ultrasound of the abdomen, complete: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $305.10
  • TRI.WEST — TRI.WEST_1: $305.10
  • Tricare_East_Region — TRI.EAST_1: $305.10
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $305.10
  • VHA_Office_of_Community_Care — CHAMPVA_1: $305.10
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $305.10
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: Ob us >= 14 wks sngl fetus $1,412.40 Not listed in the file $108.42
Pregnancy ultrasound (after the first trimester): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $108.42
  • TRI.WEST — TRI.WEST_1: $108.42
  • Tricare_East_Region — TRI.EAST_1: $108.42
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $108.42
  • VHA_Office_of_Community_Care — CHAMPVA_1: $108.42
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $108.42
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: Prof us preg complete grt 14w $184 Not listed in the file $108.42
Pregnancy ultrasound (after the first trimester): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $108.42
  • TRI.WEST — TRI.WEST_1: $108.42
  • Tricare_East_Region — TRI.EAST_1: $108.42
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $108.42
  • VHA_Office_of_Community_Care — CHAMPVA_1: $108.42
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $108.42
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: Us preg complete grt 14wk $1,412.40 Not listed in the file $108.42
Pregnancy ultrasound (after the first trimester): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $108.42
  • TRI.WEST — TRI.WEST_1: $108.42
  • Tricare_East_Region — TRI.EAST_1: $108.42
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $108.42
  • VHA_Office_of_Community_Care — CHAMPVA_1: $108.42
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $108.42
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Prof us transvaginal non ob $130 Not listed in the file $108.42
Transvaginal ultrasound: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $108.42
  • TRI.WEST — TRI.WEST_1: $108.42
  • Tricare_East_Region — TRI.EAST_1: $108.42
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $108.42
  • VHA_Office_of_Community_Care — CHAMPVA_1: $108.42
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $108.42
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Transvaginal us non-ob $1,429.96 Not listed in the file $108.42
Transvaginal ultrasound: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $108.42
  • TRI.WEST — TRI.WEST_1: $108.42
  • Tricare_East_Region — TRI.EAST_1: $108.42
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $108.42
  • VHA_Office_of_Community_Care — CHAMPVA_1: $108.42
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $108.42
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Us transvaginal non ob $1,429.96 Not listed in the file $108.42
Transvaginal ultrasound: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $108.42
  • TRI.WEST — TRI.WEST_1: $108.42
  • Tricare_East_Region — TRI.EAST_1: $108.42
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $108.42
  • VHA_Office_of_Community_Care — CHAMPVA_1: $108.42
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $108.42
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: Dx mammo incl cad uni $524.54 Not listed in the file $118.85
Diagnostic mammogram, one breast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $118.85
  • TRI.WEST — TRI.WEST_1: $118.85
  • Tricare_East_Region — TRI.EAST_1: $118.85
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $118.85
  • VHA_Office_of_Community_Care — CHAMPVA_1: $118.85
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $118.85
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: Dx mammo incl cad uni left $524.54 Not listed in the file $118.85
Diagnostic mammogram, one breast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $118.85
  • TRI.WEST — TRI.WEST_1: $118.85
  • Tricare_East_Region — TRI.EAST_1: $118.85
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $118.85
  • VHA_Office_of_Community_Care — CHAMPVA_1: $118.85
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $118.85
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: Prof dx mam incl cad uni lt 2d $291.65 Not listed in the file $118.85
Diagnostic mammogram, one breast: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $118.85
  • TRI.WEST — TRI.WEST_1: $118.85
  • Tricare_East_Region — TRI.EAST_1: $118.85
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $118.85
  • VHA_Office_of_Community_Care — CHAMPVA_1: $118.85
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $118.85
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: Dx mammo incl cad bi $682.08 Not listed in the file $150.52
Diagnostic mammogram, both breasts: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $150.52
  • TRI.WEST — TRI.WEST_1: $150.52
  • Tricare_East_Region — TRI.EAST_1: $150.52
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $150.52
  • VHA_Office_of_Community_Care — CHAMPVA_1: $150.52
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $150.52
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: Prof dx mammo incl cad bi $142 Not listed in the file $150.52
Diagnostic mammogram, both breasts: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $150.52
  • TRI.WEST — TRI.WEST_1: $150.52
  • Tricare_East_Region — TRI.EAST_1: $150.52
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $150.52
  • VHA_Office_of_Community_Care — CHAMPVA_1: $150.52
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $150.52
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: Cad scr mammo $502.25 Not listed in the file $121
Screening mammogram, both breasts: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $121
  • TRI.WEST — TRI.WEST_1: $121
  • Tricare_East_Region — TRI.EAST_1: $121
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $121
  • VHA_Office_of_Community_Care — CHAMPVA_1: $121
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $121
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: Prof scr mammo bi incl cad $130 Not listed in the file $121
Screening mammogram, both breasts: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $121
  • TRI.WEST — TRI.WEST_1: $121
  • Tricare_East_Region — TRI.EAST_1: $121
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $121
  • VHA_Office_of_Community_Care — CHAMPVA_1: $121
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $121
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: Scr mammo bi incl cad $502.25 Not listed in the file $121
Screening mammogram, both breasts: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $121
  • TRI.WEST — TRI.WEST_1: $121
  • Tricare_East_Region — TRI.EAST_1: $121
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $121
  • VHA_Office_of_Community_Care — CHAMPVA_1: $121
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $121
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient In the file: Electrocardiogram complete $410.51 Not listed in the file Not listed in the file
Electrocardiogram (ECG/EKG) with reading: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient In the file: Prof ecg 12 lead w/ intrep/rep $37.28 Not listed in the file Not listed in the file
Electrocardiogram (ECG/EKG) with reading: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: Left hrt cath w/ventrclgrphy $1,674 Not listed in the file $3,362.04
Left heart catheterization (diagnostic): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $3,362.04
  • TRI.WEST — TRI.WEST_1: $3,362.04
  • Tricare_East_Region — TRI.EAST_1: $3,362.04
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $3,362.04
  • VHA_Office_of_Community_Care — CHAMPVA_1: $3,362.04
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $3,362.04
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: Exercises 1+area ea 15 min $207.65 Not listed in the file $28.33
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $28.33
  • TRI.WEST — TRI.WEST_1: $28.33
  • Tricare_East_Region — TRI.EAST_1: $28.33
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $28.33
  • VHA_Office_of_Community_Care — CHAMPVA_1: $28.33
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $28.33
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: Therapeutic exercises $207.65 Not listed in the file $28.33
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $28.33
  • TRI.WEST — TRI.WEST_1: $28.33
  • Tricare_East_Region — TRI.EAST_1: $28.33
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $28.33
  • VHA_Office_of_Community_Care — CHAMPVA_1: $28.33
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $28.33
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: Eval initial l-1 $284.09 Not listed in the file $95.48
Physical therapy evaluation (low complexity): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $95.48
  • TRI.WEST — TRI.WEST_1: $95.48
  • Tricare_East_Region — TRI.EAST_1: $95.48
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $95.48
  • VHA_Office_of_Community_Care — CHAMPVA_1: $95.48
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $95.48
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: Pt eval low complex 20 min $284.09 Not listed in the file $95.48
Physical therapy evaluation (low complexity): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $95.48
  • TRI.WEST — TRI.WEST_1: $95.48
  • Tricare_East_Region — TRI.EAST_1: $95.48
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $95.48
  • VHA_Office_of_Community_Care — CHAMPVA_1: $95.48
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $95.48
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: Eval initial l-2 $360.66 Not listed in the file $95.48
Physical therapy evaluation (moderate complexity): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $95.48
  • TRI.WEST — TRI.WEST_1: $95.48
  • Tricare_East_Region — TRI.EAST_1: $95.48
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $95.48
  • VHA_Office_of_Community_Care — CHAMPVA_1: $95.48
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $95.48
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: Pt eval mod complex 30 min $360.66 Not listed in the file $95.48
Physical therapy evaluation (moderate complexity): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $95.48
  • TRI.WEST — TRI.WEST_1: $95.48
  • Tricare_East_Region — TRI.EAST_1: $95.48
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $95.48
  • VHA_Office_of_Community_Care — CHAMPVA_1: $95.48
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $95.48
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: Eval initial l-3 $405.75 Not listed in the file $95.48
Physical therapy evaluation (high complexity): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $95.48
  • TRI.WEST — TRI.WEST_1: $95.48
  • Tricare_East_Region — TRI.EAST_1: $95.48
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $95.48
  • VHA_Office_of_Community_Care — CHAMPVA_1: $95.48
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $95.48
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: Pt eval high complex 45 min $405.75 Not listed in the file $95.48
Physical therapy evaluation (high complexity): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $95.48
  • TRI.WEST — TRI.WEST_1: $95.48
  • Tricare_East_Region — TRI.EAST_1: $95.48
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $95.48
  • VHA_Office_of_Community_Care — CHAMPVA_1: $95.48
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $95.48
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: Iop individual therapy 1/2 hr $231.66 Not listed in the file $424.75
Psychotherapy, 30 minutes: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $424.75
  • TRI.WEST — TRI.WEST_1: $424.75
  • Tricare_East_Region — TRI.EAST_1: $424.75
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $424.75
  • VHA_Office_of_Community_Care — CHAMPVA_1: $424.75
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $424.75
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: Psytx w pt 30 minutes $231.66 Not listed in the file $424.75
Psychotherapy, 30 minutes: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $424.75
  • TRI.WEST — TRI.WEST_1: $424.75
  • Tricare_East_Region — TRI.EAST_1: $424.75
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $424.75
  • VHA_Office_of_Community_Care — CHAMPVA_1: $424.75
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $424.75
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: Iop individual therapy w/other $367.49 Not listed in the file $424.75
Psychotherapy, 45 minutes: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $424.75
  • TRI.WEST — TRI.WEST_1: $424.75
  • Tricare_East_Region — TRI.EAST_1: $424.75
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $424.75
  • VHA_Office_of_Community_Care — CHAMPVA_1: $424.75
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $424.75
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: Psytx w pt 45 minutes $367.49 Not listed in the file $424.75
Psychotherapy, 45 minutes: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $424.75
  • TRI.WEST — TRI.WEST_1: $424.75
  • Tricare_East_Region — TRI.EAST_1: $424.75
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $424.75
  • VHA_Office_of_Community_Care — CHAMPVA_1: $424.75
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $424.75
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: Psytx w pt 60 minutes $460.20 Not listed in the file $424.75
Psychotherapy, 60 minutes: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $424.75
  • TRI.WEST — TRI.WEST_1: $424.75
  • Tricare_East_Region — TRI.EAST_1: $424.75
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $424.75
  • VHA_Office_of_Community_Care — CHAMPVA_1: $424.75
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $424.75
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient In the file: Family psytx w/o pt 50 min $363.91 Not listed in the file $424.75
Family psychotherapy, without the patient: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $424.75
  • TRI.WEST — TRI.WEST_1: $424.75
  • Tricare_East_Region — TRI.EAST_1: $424.75
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $424.75
  • VHA_Office_of_Community_Care — CHAMPVA_1: $424.75
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $424.75
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: Family psytx w/pt 50 min $386.99 Not listed in the file $424.75
Family psychotherapy, with the patient: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $424.75
  • TRI.WEST — TRI.WEST_1: $424.75
  • Tricare_East_Region — TRI.EAST_1: $424.75
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $424.75
  • VHA_Office_of_Community_Care — CHAMPVA_1: $424.75
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $424.75
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: Family therapy init w/oth ther $386.99 Not listed in the file $424.75
Family psychotherapy, with the patient: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $424.75
  • TRI.WEST — TRI.WEST_1: $424.75
  • Tricare_East_Region — TRI.EAST_1: $424.75
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $424.75
  • VHA_Office_of_Community_Care — CHAMPVA_1: $424.75
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $424.75
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Group psychotherapy CPT 90853 · Inpatient or outpatient In the file: Group psychotherapy $379.78 Not listed in the file $424.75
Group psychotherapy: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $424.75
  • TRI.WEST — TRI.WEST_1: $424.75
  • Tricare_East_Region — TRI.EAST_1: $424.75
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $424.75
  • VHA_Office_of_Community_Care — CHAMPVA_1: $424.75
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $424.75
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: Removal of breast lesion $18,306.69 Not listed in the file $4,060.49
Removal of breast growth (open surgery): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $4,060.49
  • TRI.WEST — TRI.WEST_1: $4,060.49
  • Tricare_East_Region — TRI.EAST_1: $4,060.49
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $4,060.49
  • VHA_Office_of_Community_Care — CHAMPVA_1: $4,060.49
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $4,060.49
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · modifier LT In the file: Removal of breast lesion $11,686.11 Not listed in the file $4,060.49
Removal of breast growth (open surgery): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $4,060.49
  • TRI.WEST — TRI.WEST_1: $4,060.49
  • Tricare_East_Region — TRI.EAST_1: $4,060.49
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $4,060.49
  • VHA_Office_of_Community_Care — CHAMPVA_1: $4,060.49
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $4,060.49
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Inpatient (hospital stay) In the file: Total hip arthroplasty $32,875.47 Not listed in the file $13,314.32
Total hip replacement: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $13,314.32
  • TRI.WEST — TRI.WEST_1: $13,314.32
  • Tricare_East_Region — TRI.EAST_1: $13,314.32
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $13,314.32
  • VHA_Office_of_Community_Care — CHAMPVA_1: $13,314.32
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $13,314.32
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Total hip arthroplasty $86,900.18 Not listed in the file $13,314.32
Total hip replacement: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $13,314.32
  • TRI.WEST — TRI.WEST_1: $13,314.32
  • Tricare_East_Region — TRI.EAST_1: $13,314.32
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $13,314.32
  • VHA_Office_of_Community_Care — CHAMPVA_1: $13,314.32
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $13,314.32
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Inpatient or outpatient · modifier LT In the file: Total hip arthroplasty $86,900.18 Not listed in the file $13,314.32
Total hip replacement: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $13,314.32
  • TRI.WEST — TRI.WEST_1: $13,314.32
  • Tricare_East_Region — TRI.EAST_1: $13,314.32
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $13,314.32
  • VHA_Office_of_Community_Care — CHAMPVA_1: $13,314.32
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $13,314.32
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Inpatient (hospital stay) In the file: Total knee arthroplasty $18,201.59 Not listed in the file $13,314.32
Total knee replacement: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $13,314.32
  • TRI.WEST — TRI.WEST_1: $13,314.32
  • Tricare_East_Region — TRI.EAST_1: $13,314.32
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $13,314.32
  • VHA_Office_of_Community_Care — CHAMPVA_1: $13,314.32
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $13,314.32
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Total knee arthroplasty $58,856.87 Not listed in the file $13,314.32
Total knee replacement: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $13,314.32
  • TRI.WEST — TRI.WEST_1: $13,314.32
  • Tricare_East_Region — TRI.EAST_1: $13,314.32
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $13,314.32
  • VHA_Office_of_Community_Care — CHAMPVA_1: $13,314.32
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $13,314.32
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Inpatient or outpatient · modifier LT In the file: Total knee arthroplasty $58,187.64 Not listed in the file $13,314.32
Total knee replacement: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $13,314.32
  • TRI.WEST — TRI.WEST_1: $13,314.32
  • Tricare_East_Region — TRI.EAST_1: $13,314.32
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $13,314.32
  • VHA_Office_of_Community_Care — CHAMPVA_1: $13,314.32
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $13,314.32
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: Shoulder arthroscopy/surgery $43,186.02 Not listed in the file Not listed in the file
Shoulder arthroscopy: shaving of shoulder bone: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier RT In the file: Shoulder arthroscopy/surgery $43,186.02 Not listed in the file Not listed in the file
Shoulder arthroscopy: shaving of shoulder bone: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) In the file: Knee arthroscopy/surgery $33,789.03 Not listed in the file $3,393.22
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $3,393.22
  • TRI.WEST — TRI.WEST_1: $3,393.22
  • Tricare_East_Region — TRI.EAST_1: $3,393.22
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $3,393.22
  • VHA_Office_of_Community_Care — CHAMPVA_1: $3,393.22
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $3,393.22
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Knee arthroscopy/surgery $20,046.01 Not listed in the file $3,393.22
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $3,393.22
  • TRI.WEST — TRI.WEST_1: $3,393.22
  • Tricare_East_Region — TRI.EAST_1: $3,393.22
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $3,393.22
  • VHA_Office_of_Community_Care — CHAMPVA_1: $3,393.22
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $3,393.22
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · modifier LT In the file: Knee arthroscopy/surgery $71,454.77 Not listed in the file $3,393.22
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $3,393.22
  • TRI.WEST — TRI.WEST_1: $3,393.22
  • Tricare_East_Region — TRI.EAST_1: $3,393.22
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $3,393.22
  • VHA_Office_of_Community_Care — CHAMPVA_1: $3,393.22
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $3,393.22
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: Egd diagnostic brush wash $27,793 Not listed in the file $940.59
Upper GI endoscopy (diagnostic): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $940.59
  • TRI.WEST — TRI.WEST_1: $940.59
  • Tricare_East_Region — TRI.EAST_1: $940.59
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $940.59
  • VHA_Office_of_Community_Care — CHAMPVA_1: $940.59
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $940.59
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Egd diagnostic brush wash $1,160 Not listed in the file $940.59
Upper GI endoscopy (diagnostic): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $940.59
  • TRI.WEST — TRI.WEST_1: $940.59
  • Tricare_East_Region — TRI.EAST_1: $940.59
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $940.59
  • VHA_Office_of_Community_Care — CHAMPVA_1: $940.59
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $940.59
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: Uppr gi endoscopy diagnosis $1,160 Not listed in the file $940.59
Upper GI endoscopy (diagnostic): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $940.59
  • TRI.WEST — TRI.WEST_1: $940.59
  • Tricare_East_Region — TRI.EAST_1: $940.59
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $940.59
  • VHA_Office_of_Community_Care — CHAMPVA_1: $940.59
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $940.59
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) In the file: Egd biopsy single/multiple $13,978.84 Not listed in the file $940.59
Upper GI endoscopy with biopsy: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $940.59
  • TRI.WEST — TRI.WEST_1: $940.59
  • Tricare_East_Region — TRI.EAST_1: $940.59
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $940.59
  • VHA_Office_of_Community_Care — CHAMPVA_1: $940.59
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $940.59
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd biopsy single/multiple $5,147.15 Not listed in the file $940.59
Upper GI endoscopy with biopsy: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $940.59
  • TRI.WEST — TRI.WEST_1: $940.59
  • Tricare_East_Region — TRI.EAST_1: $940.59
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $940.59
  • VHA_Office_of_Community_Care — CHAMPVA_1: $940.59
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $940.59
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: Diagnostic colonoscopy $2,143.41 Not listed in the file $964.41
Colonoscopy (diagnostic): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $964.41
  • TRI.WEST — TRI.WEST_1: $964.41
  • Tricare_East_Region — TRI.EAST_1: $964.41
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $964.41
  • VHA_Office_of_Community_Care — CHAMPVA_1: $964.41
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $964.41
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: Colonoscopy and biopsy $3,365.89 Not listed in the file $1,240.97
Colonoscopy with biopsy: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $1,240.97
  • TRI.WEST — TRI.WEST_1: $1,240.97
  • Tricare_East_Region — TRI.EAST_1: $1,240.97
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $1,240.97
  • VHA_Office_of_Community_Care — CHAMPVA_1: $1,240.97
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $1,240.97
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: Colonoscopy w/lesion removal $3,814.72 Not listed in the file $1,240.97
Colonoscopy with removal of polyps (snare): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $1,240.97
  • TRI.WEST — TRI.WEST_1: $1,240.97
  • Tricare_East_Region — TRI.EAST_1: $1,240.97
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $1,240.97
  • VHA_Office_of_Community_Care — CHAMPVA_1: $1,240.97
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $1,240.97
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: Colon ca scrn not hi rsk ind $2,176.63 Not listed in the file $964.41
Screening colonoscopy (not high risk): 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $964.41
  • TRI.WEST — TRI.WEST_1: $964.41
  • Tricare_East_Region — TRI.EAST_1: $964.41
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $964.41
  • VHA_Office_of_Community_Care — CHAMPVA_1: $964.41
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $964.41
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) In the file: Laparoscopic cholecystectomy $42,039.75 Not listed in the file $6,269.50
Gallbladder removal by laparoscope: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $6,269.50
  • TRI.WEST — TRI.WEST_1: $6,269.50
  • Tricare_East_Region — TRI.EAST_1: $6,269.50
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $6,269.50
  • VHA_Office_of_Community_Care — CHAMPVA_1: $6,269.50
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $6,269.50
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopic cholecystectomy $26,933.55 Not listed in the file $6,269.50
Gallbladder removal by laparoscope: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $6,269.50
  • TRI.WEST — TRI.WEST_1: $6,269.50
  • Tricare_East_Region — TRI.EAST_1: $6,269.50
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $6,269.50
  • VHA_Office_of_Community_Care — CHAMPVA_1: $6,269.50
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $6,269.50
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: Prp i/hern init reduc >5 yr $26,574.90 Not listed in the file $3,713.04
Groin (inguinal) hernia repair, age 5 or older: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $3,713.04
  • TRI.WEST — TRI.WEST_1: $3,713.04
  • Tricare_East_Region — TRI.EAST_1: $3,713.04
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $3,713.04
  • VHA_Office_of_Community_Care — CHAMPVA_1: $3,713.04
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $3,713.04
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier LT In the file: Prp i/hern init reduc >5 yr $22,605.67 Not listed in the file $3,713.04
Groin (inguinal) hernia repair, age 5 or older: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $3,713.04
  • TRI.WEST — TRI.WEST_1: $3,713.04
  • Tricare_East_Region — TRI.EAST_1: $3,713.04
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $3,713.04
  • VHA_Office_of_Community_Care — CHAMPVA_1: $3,713.04
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $3,713.04
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: Njx interlaminar lmbr/sac $2,341.58 Not listed in the file $732.03
Spinal injection, lower back (epidural), with imaging guidance: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $732.03
  • TRI.WEST — TRI.WEST_1: $732.03
  • Tricare_East_Region — TRI.EAST_1: $732.03
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $732.03
  • VHA_Office_of_Community_Care — CHAMPVA_1: $732.03
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $732.03
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: Inj foramen epidural l/s $2,341.58 Not listed in the file $917.24
Nerve root injection, lower back, with imaging guidance: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $917.24
  • TRI.WEST — TRI.WEST_1: $917.24
  • Tricare_East_Region — TRI.EAST_1: $917.24
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $917.24
  • VHA_Office_of_Community_Care — CHAMPVA_1: $917.24
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $917.24
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: Lum/sac trans epi inj $2,341.58 Not listed in the file $917.24
Nerve root injection, lower back, with imaging guidance: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $917.24
  • TRI.WEST — TRI.WEST_1: $917.24
  • Tricare_East_Region — TRI.EAST_1: $917.24
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $917.24
  • VHA_Office_of_Community_Care — CHAMPVA_1: $917.24
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $917.24
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: Carpal tunnel surgery $10,363.65 Not listed in the file $2,025.07
Carpal tunnel release: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $2,025.07
  • TRI.WEST — TRI.WEST_1: $2,025.07
  • Tricare_East_Region — TRI.EAST_1: $2,025.07
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $2,025.07
  • VHA_Office_of_Community_Care — CHAMPVA_1: $2,025.07
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $2,025.07
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Inpatient or outpatient · modifier RT In the file: Carpal tunnel surgery $10,363.65 Not listed in the file $2,025.07
Carpal tunnel release: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $2,025.07
  • TRI.WEST — TRI.WEST_1: $2,025.07
  • Tricare_East_Region — TRI.EAST_1: $2,025.07
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $2,025.07
  • VHA_Office_of_Community_Care — CHAMPVA_1: $2,025.07
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $2,025.07
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: After cataract laser surgery $1,390.72 Not listed in the file $570.37
Laser treatment of clouding after cataract surgery: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $570.37
  • TRI.WEST — TRI.WEST_1: $570.37
  • Tricare_East_Region — TRI.EAST_1: $570.37
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $570.37
  • VHA_Office_of_Community_Care — CHAMPVA_1: $570.37
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $570.37
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · modifier RT In the file: After cataract laser surgery $1,390.72 Not listed in the file $570.37
Laser treatment of clouding after cataract surgery: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $570.37
  • TRI.WEST — TRI.WEST_1: $570.37
  • Tricare_East_Region — TRI.EAST_1: $570.37
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $570.37
  • VHA_Office_of_Community_Care — CHAMPVA_1: $570.37
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $570.37
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient In the file: Xcapsl ctrc rmvl w/o ecp $13,976.70 Not listed in the file $2,393.32
Cataract removal with lens implant: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $2,393.32
  • TRI.WEST — TRI.WEST_1: $2,393.32
  • Tricare_East_Region — TRI.EAST_1: $2,393.32
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $2,393.32
  • VHA_Office_of_Community_Care — CHAMPVA_1: $2,393.32
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $2,393.32
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · modifier 50 In the file: Xcapsl ctrc rmvl w/o ecp $17,757.90 Not listed in the file $2,393.32
Cataract removal with lens implant: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $2,393.32
  • TRI.WEST — TRI.WEST_1: $2,393.32
  • Tricare_East_Region — TRI.EAST_1: $2,393.32
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $2,393.32
  • VHA_Office_of_Community_Care — CHAMPVA_1: $2,393.32
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $2,393.32
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · modifier LT In the file: Xcapsl ctrc rmvl w/o ecp $12,884.53 Not listed in the file $2,393.32
Cataract removal with lens implant: 10 of 66 insurance plan rates
  • HUMANA_MILITARY_HLTHCAR — HUM.TRI_1: $2,393.32
  • TRI.WEST — TRI.WEST_1: $2,393.32
  • Tricare_East_Region — TRI.EAST_1: $2,393.32
  • VETERAN_EVALUATION_SERVICES — VET.EVAL_1: $2,393.32
  • VHA_Office_of_Community_Care — CHAMPVA_1: $2,393.32
  • VHA_OFFICE_OF_COMMUNITY_CARE — DEPAR.VA_1: $2,393.32
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) In the file: Obstetrical care $12,463.77 Not listed in the file Not listed in the file
Vaginal delivery, with care before and after: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: Obstetrical care $8,105 Not listed in the file Not listed in the file
Vaginal delivery, with care before and after: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient In the file: Prof fee obstetrical care $5,720.43 Not listed in the file Not listed in the file
Vaginal delivery, with care before and after: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) In the file: Cesarean delivery $25,826.36 Not listed in the file Not listed in the file
Cesarean delivery (C-section), with care before and after: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Cesarean delivery $8,957 Not listed in the file Not listed in the file
Cesarean delivery (C-section), with care before and after: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient In the file: Prof fee vbac delivery $5,990.93 Not listed in the file Not listed in the file
Vaginal delivery after a previous C-section, with care before and after: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) In the file: Vbac delivery $12,492.09 Not listed in the file Not listed in the file
Vaginal delivery after a previous C-section, with care before and after: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Vbac delivery $5,990.93 Not listed in the file Not listed in the file
Vaginal delivery after a previous C-section, with care before and after: 10 of 60 insurance plan rates
  • 90_Degree_Benefits_UMH — 90DEG.UMH: 95% (a percentage in the contract, not a dollar amount)
  • 90_Degree_Benefits_UMH — 90DEG.UMH_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER: 95% (a percentage in the contract, not a dollar amount)
  • AETNA — AET.OTHER_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_LIFE_INS_CO_TRS_CARE — AET.20_1: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61: 95% (a percentage in the contract, not a dollar amount)
  • AETNA_U_S_HEALTHCARE_SENIOR — AET.61_1: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED: 95% (a percentage in the contract, not a dollar amount)
  • BCBS_Federal_Employees — BCBS.FED_1: 95% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
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 $11,419.72 Not listed in the file $5,724
Hip or knee replacement (major joint of the leg), without major complications: rates for 4 insurance plans
  • MEDICARE — MCR_1: $5,724
  • MEDICARE_APC — MCRAPC_1: $5,724
  • RAILROAD_MEDICARE — MCR.RR_1: $5,724
  • RAILROAD_MEDICARE_APC — MCRAPC.RR_1: $5,724

Source: Uvalde Memorial Hospital’s standard charges file (cdn.accureg.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on August 20, 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 typeCritical Access Hospital
Address1025 Garner Field Road, Uvalde, TX 78801
CountyUvalde County
StateTexas
Phone(830) 278‑6251
Emergency servicesYes
OwnershipGovernment - Hospital District or Authority
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number451387
Name in Medicare recordsUVALDE MEMORIAL HOSPITAL
Profile levelMedicare data + hospital website
Official websiteumhtx.org
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

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

  1. Patients & Visitors - Uvalde Memorial Hospital — umhtx.org
  2. About UMH — umhtx.org
  3. Medical Services - Uvalde Memorial Hospital — umhtx.org
  4. Visitor Information - Uvalde Memorial Hospital — umhtx.org
  5. Home - Uvalde Memorial Hospital — umhtx.org
  6. Awards and Recognition - Uvalde Memorial Hospital — umhtx.org
  7. Kate Marmion Regional Cancer Center - Uvalde Memorial Hospital — umhtx.org
  8. Emergency Room - Uvalde Memorial Hospital — umhtx.org
  9. Cardiopulmonary - Uvalde Memorial Hospital — umhtx.org
  10. Rehabilitation Center - Uvalde Memorial Hospital — umhtx.org
  11. Imaging - Uvalde Memorial Hospital — umhtx.org
  12. Surgical Services - Uvalde Memorial Hospital — umhtx.org