Does Washington County Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Washington County Hospital. In a medical emergency, call 911.

Where is Washington County Hospital?

705 S Grand Ave, Nashville, IL 62263, in Washington County, Illinois.

What is the phone number of Washington County Hospital?

(618) 327-8236, as listed by Medicare (CMS).

What is the Medicare star rating of Washington County Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Washington County Hospital — Nashville, IL

Quick answers

Does Washington County Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Washington County Hospital. In a medical emergency, call 911.
Where is Washington County Hospital?: 705 S Grand Ave, Nashville, IL 62263, in Washington County, Illinois.
What is the phone number of Washington County Hospital?: (618) 327-8236, as listed by Medicare (CMS).
What is the Medicare star rating of Washington County Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4]

Cardiac Rehabilitation
Diagnostic Imaging
Emergency Services
Inpatient Services
Laboratory
Mental Health
Nutritional Counseling
Respiratory Therapy
Specialty Clinics
Surgery
Therapy Services
Wound Center
Walk-In Clinic
Rural Health Clinic / Medical Group

Emergency care (hospital website)^[4]

Emergency room	Yes

Doctors and clinicians (72)

72 doctors and other clinicians list Washington County 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

And 48 more: the button below opens the full list.

Other emergency rooms nearby

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

Pinckneyville Community Hospital17 mi · Pinckneyville, IL · Critical Access Hospital
SSM Health St Mary's Hospital -Centralia20 mi · Centralia, IL · Acute Care Hospital
St Josephs Hospital21 mi · Breese, IL · Acute Care Hospital
Sparta Community Hospital22 mi · Sparta, IL · Critical Access Hospital
Marshall Browning Hospital23 mi · Du Quoin, IL · Critical Access Hospital

Other hospitals nearby

Deaconess Illinois Crossroads25 mi · Mount Vernon, IL · Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Axiom Gardens of Nashville0.2 mi · Nashville, IL · 1 of 5 stars
Coulterville Rehab & HCC16 mi · Coulterville, IL · 2 of 5 stars
Pinckneyville Nursing and Rehab18 mi · Pinckneyville, IL · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Maple Creek Hospice Inc23 mi · Sparta, IL

All hospice providers in the state →

Home health agencies

Perry County Health Department17 mi · Pinckneyville, IL
At Home Health Care23 mi · Sparta, IL

All home health agencies in the state →

Dialysis facilities

DaVita Centralia Dialysis18 mi · Centralia, IL · 3 of 5 stars
FMC - Breese Dialysis22 mi · Breese, IL · 1 of 5 stars
FMC - Duquoin24 mi · Du Quoin, IL · 1 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Surgery Center of Centralia18 mi · Centralia, IL

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Mt. Vernon Health & Wellness Center24 mi · Mount Vernon, IL · Community health center

Clinics and urgent care

Washington County Hospital Walk in Clinic1.5 mi · Nashville, IL · Rural health clinic
Washington County Rural Health Clinic1.5 mi · Nashville, IL · Rural health clinic
Ast Primary Care Hoyleton9.4 mi · Hoyleton, IL · Rural health clinic

Pharmacies

Nashville Pharmacy, Inc.1.5 mi · Nashville, IL · Community/retail pharmacy
TJD Enterprises LLC1.5 mi · Nashville, IL · Community/retail pharmacy
H&S Pharmacies, LLC9.9 mi · Okawville, IL · Community/retail pharmacy

About the Medicare star rating

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

Medicare quality data

What Washington County 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)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	72%National average: 72%
Would definitely recommend the hospital	69%National average: 71%
Nurses “always” communicated well	86%National average: 80%
Doctors “always” communicated well	87%National average: 80%
Staff “always” explained medicines before giving them	65%National average: 62%
Were given information about recovery at home	79%National average: 86%
Room and bathroom “always” clean	84%National average: 74%
Area around the room “always” quiet at night	65%National average: 60%
Completed surveys	32Response rate: 38%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

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

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

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

Return visits to the hospital (readmissions)

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

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

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026.

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	84 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Illinois Best hospitals in Illinois

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 82 common services exactly as Washington County 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 →

$ 3 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: HP OFFICE/OUTPT VISIT NEW LEVEL III	$288	$230.40	$55.95 – $259.20
New patient office visit (about 30–44 minutes): 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $75.88 Aetna — HMO/PPO: $64.53 Aetna — Medicare Advantage: $75.88 Aetna Better Health — Medicaid: $55.95 Ambetter — ACA Exchange: $75.88 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $75.88 Blue Cross Blue Shield of Illinois — Medicaid: $55.95 Blue Cross Blue Shield of Illinois — Medicare Advantage: $75.88 Blue Cross Blue Shield of Illinois — PPO: $87.03 Cigna — HMO/PPO: $104.82
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 3	$255	$204	$114.75 – $229.50
New patient office visit (about 30–44 minutes): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $114.75 Aetna — HMO/PPO: $197.88 Aetna — Medicare Advantage: $114.75 Ambetter — ACA Exchange: $114.75 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $145.35 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $114.75 Blue Cross Blue Shield of Illinois — Medicare Advantage: $114.75 Blue Cross Blue Shield of Illinois — PPO: $153 Cigna — HMO/PPO: $186.15 HealthLink — HMO: $191.25
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 3	$255	$204	$145.35 – $216.75
New patient office visit (about 30–44 minutes): rates for 4 insurance plans Aetna — HMO/PPO: $197.88 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $145.35 HFN — PPO: $216.75 Medica — All Commercial: $158.10
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: HP OFFICE/OUTPT VISIT NEW LEVEL IV	$457	$365.60	$90.81 – $411.30
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $123.27 Aetna — HMO/PPO: $103.41 Aetna — Medicare Advantage: $123.27 Aetna Better Health — Medicaid: $90.81 Ambetter — ACA Exchange: $123.27 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $123.27 Blue Cross Blue Shield of Illinois — Medicaid: $90.81 Blue Cross Blue Shield of Illinois — Medicare Advantage: $123.27 Blue Cross Blue Shield of Illinois — PPO: $141.38 Cigna — HMO/PPO: $170.27
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 4	$368	$294.40	$165.60 – $331.20
New patient office visit (about 45–59 minutes): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $165.60 Aetna — HMO/PPO: $285.57 Aetna — Medicare Advantage: $165.60 Ambetter — ACA Exchange: $165.60 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $209.76 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $165.60 Blue Cross Blue Shield of Illinois — Medicare Advantage: $165.60 Blue Cross Blue Shield of Illinois — PPO: $220.80 Cigna — HMO/PPO: $268.64 HealthLink — HMO: $276
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 4	$368	$294.40	$209.76 – $312.80
New patient office visit (about 45–59 minutes): rates for 4 insurance plans Aetna — HMO/PPO: $285.57 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $209.76 HFN — PPO: $312.80 Medica — All Commercial: $228.16
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: HP OFFICE/OUTPT VISIT NEW LEVEL V	$647	$517.60	$123.49 – $582.30
New patient office visit (about 60–74 minutes): 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $170.01 Aetna — HMO/PPO: $140.32 Aetna — Medicare Advantage: $170.01 Aetna Better Health — Medicaid: $123.49 Ambetter — ACA Exchange: $170.01 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $170.01 Blue Cross Blue Shield of Illinois — Medicaid: $123.49 Blue Cross Blue Shield of Illinois — Medicare Advantage: $170.01 Blue Cross Blue Shield of Illinois — PPO: $192.50 Cigna — HMO/PPO: $231.84
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 5	$590	$472	$265.50 – $531
New patient office visit (about 60–74 minutes): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $265.50 Aetna — HMO/PPO: $457.84 Aetna — Medicare Advantage: $265.50 Ambetter — ACA Exchange: $265.50 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $336.30 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $265.50 Blue Cross Blue Shield of Illinois — Medicare Advantage: $265.50 Blue Cross Blue Shield of Illinois — PPO: $354 Cigna — HMO/PPO: $430.70 HealthLink — HMO: $442.50
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FACLTY OP NEW LEVEL 5	$590	$472	$336.30 – $501.50
New patient office visit (about 60–74 minutes): rates for 4 insurance plans Aetna — HMO/PPO: $457.84 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $336.30 HFN — PPO: $501.50 Medica — All Commercial: $365.80
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: HP OFFICE OUTPT VISIT EST LEVL III	$232	$185.60	$44.67 – $208.80
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $59.62 Aetna — HMO/PPO: $51.07 Aetna — Medicare Advantage: $59.62 Aetna Better Health — Medicaid: $44.67 Ambetter — ACA Exchange: $59.62 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $59.62 Blue Cross Blue Shield of Illinois — Medicaid: $44.67 Blue Cross Blue Shield of Illinois — Medicare Advantage: $59.62 Blue Cross Blue Shield of Illinois — PPO: $69.55 Cigna — HMO/PPO: $83.75
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FACLTY OP EST PT LEVEL 3	$201	$160.80	$90.45 – $180.90
Established patient office visit (about 20–29 minutes): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $90.45 Aetna — HMO/PPO: $155.98 Aetna — Medicare Advantage: $90.45 Ambetter — ACA Exchange: $90.45 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $114.57 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $90.45 Blue Cross Blue Shield of Illinois — Medicare Advantage: $90.45 Blue Cross Blue Shield of Illinois — PPO: $120.60 Cigna — HMO/PPO: $146.73 HealthLink — HMO: $150.75
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FACLTY OP EST PT LEVEL 3	$201	$160.80	$114.57 – $170.85
Established patient office visit (about 20–29 minutes): rates for 4 insurance plans Aetna — HMO/PPO: $155.98 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $114.57 HFN — PPO: $170.85 Medica — All Commercial: $124.62
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: HP OFFICE/OUTPT VISIT EST LEVEL IV	$306	$244.80	$65.79 – $275.40
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $87.99 Aetna — HMO/PPO: $75.36 Aetna — Medicare Advantage: $87.99 Aetna Better Health — Medicaid: $65.79 Ambetter — ACA Exchange: $87.99 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $87.99 Blue Cross Blue Shield of Illinois — Medicaid: $65.79 Blue Cross Blue Shield of Illinois — Medicare Advantage: $87.99 Blue Cross Blue Shield of Illinois — PPO: $102.44 Cigna — HMO/PPO: $123.37
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE OUTPT VISIT EST LEVEL 4	$563	$450.40	$253.35 – $506.70
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $253.35 Aetna — HMO/PPO: $436.89 Aetna — Medicare Advantage: $253.35 Ambetter — ACA Exchange: $253.35 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $320.91 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $253.35 Blue Cross Blue Shield of Illinois — Medicare Advantage: $253.35 Blue Cross Blue Shield of Illinois — PPO: $337.80 Cigna — HMO/PPO: $410.99 HealthLink — HMO: $422.25
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FACLTY OP EST PT LEVEL 4	$251	$200.80	$112.95 – $225.90
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $112.95 Aetna — HMO/PPO: $194.78 Aetna — Medicare Advantage: $112.95 Ambetter — ACA Exchange: $112.95 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $143.07 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $112.95 Blue Cross Blue Shield of Illinois — Medicare Advantage: $112.95 Blue Cross Blue Shield of Illinois — PPO: $150.60 Cigna — HMO/PPO: $183.23 HealthLink — HMO: $188.25
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$51.30 – $111.79
Office consultation with a specialist (moderate): rates for 9 insurance plans Aetna — HMO/PPO: $100.35 Aetna Better Health — Medicaid: $51.30 Blue Cross Blue Shield of Illinois — Medicaid: $51.30 Cigna — HMO/PPO: $111.79 HealthLink — HMO: $94.14 HealthLink — PPO: $100.86 Meridian — HealthChoice Medicaid: $51.30 Molina — HealthChoice Medicaid: $51.30 United Healthcare — All Commercial: $102.31
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$5.75
Office consultation with a specialist (moderate): rates for 1 insurance plan Cigna — HMO/PPO: $5.75
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$71.40 – $169
Office consultation with a specialist (moderate to high): rates for 9 insurance plans Aetna — HMO/PPO: $153.03 Aetna Better Health — Medicaid: $71.40 Blue Cross Blue Shield of Illinois — Medicaid: $71.40 Cigna — HMO/PPO: $169 HealthLink — HMO: $151.34 HealthLink — PPO: $162.15 Meridian — HealthChoice Medicaid: $71.40 Molina — HealthChoice Medicaid: $71.40 United Healthcare — All Commercial: $151.26
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$5.75
Office consultation with a specialist (moderate to high): rates for 1 insurance plan Cigna — HMO/PPO: $5.75
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PHYSCN PREVENT NEW PT 18-39YRS	$271	$216.80	$121.95 – $243.90
Preventive checkup, new patient, age 18–39: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $121.95 Aetna — HMO/PPO: $210.30 Aetna — Medicare Advantage: $121.95 Ambetter — ACA Exchange: $121.95 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $154.47 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $121.95 Blue Cross Blue Shield of Illinois — Medicare Advantage: $121.95 Blue Cross Blue Shield of Illinois — PPO: $162.60 Cigna — HMO/PPO: $197.83 HealthLink — HMO: $203.25
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: HP PHYSCN PREVENT NEW PT 18-39YRS	$282	$225.60	$32.15 – $253.80
Preventive checkup, new patient, age 18–39: 10 of 14 insurance plan rates Aetna — HMO/PPO: $84.02 Aetna Better Health — Medicaid: $32.15 Ambetter — ACA Exchange: $84.60 Blue Cross Blue Shield of Illinois — Medicaid: $32.15 Blue Cross Blue Shield of Illinois — PPO: $136.03 Cigna — HMO/PPO: $119.07 HealthLink — HMO: $96.20 HealthLink — PPO: $103.07 HFN — PPO: $253.80 Meridian — Dual Medicare Medicaid: $84.60
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PHYSCN PREVENT NEW PT 18-39YRS	$271	$216.80	$154.47 – $230.35
Preventive checkup, new patient, age 18–39: rates for 4 insurance plans Aetna — HMO/PPO: $210.30 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $154.47 HFN — PPO: $230.35 Medica — All Commercial: $168.02
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PREVENTIVE VISIT NEW AGE 40-64	$322	$257.60	$144.90 – $289.80
Preventive checkup, new patient, age 40–64: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $144.90 Aetna — HMO/PPO: $249.87 Aetna — Medicare Advantage: $144.90 Ambetter — ACA Exchange: $144.90 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $183.54 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $144.90 Blue Cross Blue Shield of Illinois — Medicare Advantage: $144.90 Blue Cross Blue Shield of Illinois — PPO: $193.20 Cigna — HMO/PPO: $235.06 HealthLink — HMO: $241.50
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: HP PHYSCN PREVENT NEW PT 40-64YRS	$335	$268	$66.40 – $301.50
Preventive checkup, new patient, age 40–64: 10 of 14 insurance plan rates Aetna — HMO/PPO: $101.79 Aetna Better Health — Medicaid: $66.40 Ambetter — ACA Exchange: $100.50 Blue Cross Blue Shield of Illinois — Medicaid: $66.40 Blue Cross Blue Shield of Illinois — PPO: $164.55 Cigna — HMO/PPO: $144.04 HealthLink — HMO: $117.15 HealthLink — PPO: $125.52 HFN — PPO: $301.50 Meridian — Dual Medicare Medicaid: $100.50
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PREVENTIVE VISIT NEW AGE 40-64	$322	$257.60	$183.54 – $273.70
Preventive checkup, new patient, age 40–64: rates for 4 insurance plans Aetna — HMO/PPO: $249.87 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $183.54 HFN — PPO: $273.70 Medica — All Commercial: $199.64
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL III	$703	$562.40	$316.35 – $632.70
Emergency room visit (moderate): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $316.35 Aetna — HMO/PPO: $545.53 Aetna — Medicare Advantage: $316.35 Ambetter — ACA Exchange: $316.35 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $400.71 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $316.35 Blue Cross Blue Shield of Illinois — Medicare Advantage: $316.35 Blue Cross Blue Shield of Illinois — PPO: $421.80 Cigna — HMO/PPO: $513.19 HealthLink — HMO: $527.25
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: HP EMERGENCY DEPT VISIT LEVEL 3	$546	$436.80	$49.16 – $491.40
Emergency room visit (moderate): 10 of 21 insurance plan rates Aetna — Dual Medicare Medicaid: $75.50 Aetna — HMO/PPO: $56.90 Aetna — Medicare Advantage: $75.50 Aetna Better Health — Medicaid: $49.16 Ambetter — ACA Exchange: $75.50 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $75.50 Blue Cross Blue Shield of Illinois — Medicaid: $49.16 Blue Cross Blue Shield of Illinois — Medicare Advantage: $75.50 Cigna — HMO/PPO: $91.55 HFN — PPO: $491.40
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL III	$703	$562.40	$400.71 – $597.55
Emergency room visit (moderate): rates for 4 insurance plans Aetna — HMO/PPO: $545.53 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $400.71 HFN — PPO: $597.55 Medica — All Commercial: $435.86
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL IV	$973	$778.40	$437.85 – $875.70
Emergency room visit (moderately high): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $437.85 Aetna — HMO/PPO: $755.05 Aetna — Medicare Advantage: $437.85 Ambetter — ACA Exchange: $437.85 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $554.61 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $437.85 Blue Cross Blue Shield of Illinois — Medicare Advantage: $437.85 Blue Cross Blue Shield of Illinois — PPO: $583.80 Cigna — HMO/PPO: $710.29 HealthLink — HMO: $729.75
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: HP EMERGENCY DEPT VISIT LEVEL 4	$781	$624.80	$83.69 – $702.90
Emergency room visit (moderately high): 10 of 21 insurance plan rates Aetna — Dual Medicare Medicaid: $128.89 Aetna — HMO/PPO: $95.44 Aetna — Medicare Advantage: $128.89 Aetna Better Health — Medicaid: $83.69 Ambetter — ACA Exchange: $128.89 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $128.89 Blue Cross Blue Shield of Illinois — Medicaid: $83.69 Blue Cross Blue Shield of Illinois — Medicare Advantage: $128.89 Cigna — HMO/PPO: $156.58 HFN — PPO: $702.90
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL IV	$973	$778.40	$554.61 – $827.05
Emergency room visit (moderately high): rates for 4 insurance plans Aetna — HMO/PPO: $755.05 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $554.61 HFN — PPO: $827.05 Medica — All Commercial: $603.26
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL V	$1,352	$1,081.60	$450 – $1,216.80
Emergency room visit (high): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $608.40 Aetna — HMO/PPO: $1,049.15 Aetna — Medicare Advantage: $608.40 Ambetter — ACA Exchange: $608.40 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $770.64 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $608.40 Blue Cross Blue Shield of Illinois — Medicare Advantage: $608.40 Blue Cross Blue Shield of Illinois — PPO: $811.20 Cigna — HMO/PPO: $986.96 HealthLink — HMO: $1,014
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: HP EMERGENCY DEPT VISIT LEVEL 5	$1,238	$990.40	$121.28 – $1,114.20
Emergency room visit (high): 10 of 21 insurance plan rates Aetna — Dual Medicare Medicaid: $185.87 Aetna — HMO/PPO: $139.18 Aetna — Medicare Advantage: $185.87 Aetna Better Health — Medicaid: $121.28 Ambetter — ACA Exchange: $185.87 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $185.87 Blue Cross Blue Shield of Illinois — Medicaid: $121.28 Blue Cross Blue Shield of Illinois — Medicare Advantage: $185.87 Cigna — HMO/PPO: $227.33 HFN — PPO: $1,114.20
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ED EMERGENT LEVEL V	$1,352	$1,081.60	$770.64 – $1,149.20
Emergency room visit (high): rates for 4 insurance plans Aetna — HMO/PPO: $1,049.15 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $770.64 HFN — PPO: $1,149.20 Medica — All Commercial: $838.24

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG BASIC METABOLIC PANEL (CA TOTAL)	$222	$177.60	$14.38 – $199.80
Basic metabolic panel (blood test): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $99.90 Aetna — HMO/PPO: $172.27 Aetna — Medicare Advantage: $99.90 Ambetter — ACA Exchange: $99.90 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $126.54 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $99.90 Blue Cross Blue Shield of Illinois — Medicare Advantage: $99.90 Blue Cross Blue Shield of Illinois — PPO: $133.20 Cigna — HMO/PPO: $162.06 HealthLink — HMO: $166.50
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG BASIC METABOLIC PANEL (CA TOTAL)	$222	$177.60	$126.54 – $188.70
Basic metabolic panel (blood test): rates for 4 insurance plans Aetna — HMO/PPO: $172.27 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $126.54 HFN — PPO: $188.70 Medica — All Commercial: $137.64
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Doctor (professional) fee In the file: BASIC METABOLIC PNL TOTAL CA	Not listed in the file	Not listed in the file	$3.50 – $8.28
Basic metabolic panel (blood test): rates for 8 insurance plans Aetna — HMO/PPO: $8.01 Aetna Better Health — Medicaid: $8.28 Blue Cross Blue Shield of Illinois — Medicaid: $8.28 Blue Cross Blue Shield of Illinois — PPO: $3.50 Cigna — HMO/PPO: $7.06 Meridian — HealthChoice Medicaid: $8.28 Molina — HealthChoice Medicaid: $8.28 United Healthcare — All Commercial: $7.19
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG COMPREHENSIVE METABOLIC PANEL	$308	$246.40	$17.96 – $277.20
Comprehensive metabolic panel (blood test): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $138.60 Aetna — HMO/PPO: $239.01 Aetna — Medicare Advantage: $138.60 Ambetter — ACA Exchange: $138.60 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $175.56 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $138.60 Blue Cross Blue Shield of Illinois — Medicare Advantage: $138.60 Blue Cross Blue Shield of Illinois — PPO: $184.80 Cigna — HMO/PPO: $224.84 HealthLink — HMO: $231
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG COMPREHENSIVE METABOLIC PANEL	$308	$246.40	$175.56 – $261.80
Comprehensive metabolic panel (blood test): rates for 4 insurance plans Aetna — HMO/PPO: $239.01 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $175.56 HFN — PPO: $261.80 Medica — All Commercial: $190.96
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPREHEN METABOLIC PANEL	Not listed in the file	Not listed in the file	$3.50 – $10.36
Comprehensive metabolic panel (blood test): rates for 8 insurance plans Aetna — HMO/PPO: $9.99 Aetna Better Health — Medicaid: $10.36 Blue Cross Blue Shield of Illinois — Medicaid: $10.36 Blue Cross Blue Shield of Illinois — PPO: $3.50 Cigna — HMO/PPO: $5.60 Meridian — HealthChoice Medicaid: $10.36 Molina — HealthChoice Medicaid: $10.36 United Healthcare — All Commercial: $8.98
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$3.50 – $45.23
Obstetric blood test panel: rates for 4 insurance plans Aetna — HMO/PPO: $45.23 Blue Cross Blue Shield of Illinois — PPO: $3.50 Cigna — HMO/PPO: $25.10 United Healthcare — All Commercial: $33.27
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$5.75
Obstetric blood test panel: rates for 1 insurance plan Cigna — HMO/PPO: $5.75
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$25.10
Obstetric blood test panel: rates for 1 insurance plan Cigna — HMO/PPO: $25.10
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG LIPID PROFILE	$249	$199.20	$22.76 – $224.10
Cholesterol panel (lipid panel): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $112.05 Aetna — HMO/PPO: $193.22 Aetna — Medicare Advantage: $112.05 Ambetter — ACA Exchange: $112.05 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $141.93 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $112.05 Blue Cross Blue Shield of Illinois — Medicare Advantage: $112.05 Blue Cross Blue Shield of Illinois — PPO: $149.40 Cigna — HMO/PPO: $181.77 HealthLink — HMO: $186.75
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG LIPID PROFILE I	$249	$199.20	$22.76 – $224.10
Cholesterol panel (lipid panel): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $112.05 Aetna — HMO/PPO: $193.22 Aetna — Medicare Advantage: $112.05 Ambetter — ACA Exchange: $112.05 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $141.93 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $112.05 Blue Cross Blue Shield of Illinois — Medicare Advantage: $112.05 Blue Cross Blue Shield of Illinois — PPO: $149.40 Cigna — HMO/PPO: $181.77 HealthLink — HMO: $186.75
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG LIPID PROFILE	$249	$199.20	$141.93 – $211.65
Cholesterol panel (lipid panel): rates for 4 insurance plans Aetna — HMO/PPO: $193.22 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $141.93 HFN — PPO: $211.65 Medica — All Commercial: $154.38
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG RENAL FUNCTION PANEL	$187	$149.60	$14.76 – $168.30
Kidney function panel: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $84.15 Aetna — HMO/PPO: $145.11 Aetna — Medicare Advantage: $84.15 Ambetter — ACA Exchange: $84.15 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $106.59 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $84.15 Blue Cross Blue Shield of Illinois — Medicare Advantage: $84.15 Blue Cross Blue Shield of Illinois — PPO: $112.20 Cigna — HMO/PPO: $136.51 HealthLink — HMO: $140.25
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG RENAL FUNCTION PANEL	$187	$149.60	$106.59 – $158.95
Kidney function panel: rates for 4 insurance plans Aetna — HMO/PPO: $145.11 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $106.59 HFN — PPO: $158.95 Medica — All Commercial: $115.94
Kidney function panel CPT 80069 · Inpatient or outpatient · Doctor (professional) fee In the file: RENAL FUNCTION PANEL	Not listed in the file	Not listed in the file	$3.50 – $8.52
Kidney function panel: rates for 8 insurance plans Aetna — HMO/PPO: $8.21 Aetna Better Health — Medicaid: $8.52 Blue Cross Blue Shield of Illinois — Medicaid: $8.52 Blue Cross Blue Shield of Illinois — PPO: $3.50 Cigna — HMO/PPO: $4.58 Meridian — HealthChoice Medicaid: $8.52 Molina — HealthChoice Medicaid: $8.52 United Healthcare — All Commercial: $7.38
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG HEPATIC FUNCTION PANEL	$224	$179.20	$13.88 – $201.60
Liver function panel: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $100.80 Aetna — HMO/PPO: $173.82 Aetna — Medicare Advantage: $100.80 Ambetter — ACA Exchange: $100.80 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $127.68 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $100.80 Blue Cross Blue Shield of Illinois — Medicare Advantage: $100.80 Blue Cross Blue Shield of Illinois — PPO: $134.40 Cigna — HMO/PPO: $163.52 HealthLink — HMO: $168
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG HEPATIC FUNCTION PANEL	$224	$179.20	$127.68 – $190.40
Liver function panel: rates for 4 insurance plans Aetna — HMO/PPO: $173.82 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $127.68 HFN — PPO: $190.40 Medica — All Commercial: $138.88
Liver function panel CPT 80076 · Inpatient or outpatient · Doctor (professional) fee In the file: HEPATIC FUNCTION PANEL	Not listed in the file	Not listed in the file	$3.50 – $7.98
Liver function panel: rates for 8 insurance plans Aetna — HMO/PPO: $7.73 Aetna Better Health — Medicaid: $7.98 Blue Cross Blue Shield of Illinois — Medicaid: $7.98 Blue Cross Blue Shield of Illinois — PPO: $3.50 Cigna — HMO/PPO: $4.24 Meridian — HealthChoice Medicaid: $7.98 Molina — HealthChoice Medicaid: $7.98 United Healthcare — All Commercial: $6.94
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG URINALYSIS ROUTINE AUTO	$119	$95.20	$7.04 – $107.10
Urine test (automated, with microscope): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $53.55 Aetna — HMO/PPO: $92.34 Aetna — Medicare Advantage: $53.55 Ambetter — ACA Exchange: $53.55 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $67.83 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $53.55 Blue Cross Blue Shield of Illinois — Medicare Advantage: $53.55 Blue Cross Blue Shield of Illinois — PPO: $71.40 Cigna — HMO/PPO: $86.87 HealthLink — HMO: $89.25
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG URINALYSIS ROUTINE AUTO W MICROSCOPIC	$119	$95.20	$7.04 – $107.10
Urine test (automated, with microscope): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $53.55 Aetna — HMO/PPO: $92.34 Aetna — Medicare Advantage: $53.55 Ambetter — ACA Exchange: $53.55 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $67.83 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $53.55 Blue Cross Blue Shield of Illinois — Medicare Advantage: $53.55 Blue Cross Blue Shield of Illinois — PPO: $71.40 Cigna — HMO/PPO: $86.87 HealthLink — HMO: $89.25
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG URINALYSIS ROUTINE AUTO	$119	$95.20	$67.83 – $101.15
Urine test (automated, with microscope): rates for 4 insurance plans Aetna — HMO/PPO: $92.34 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $67.83 HFN — PPO: $101.15 Medica — All Commercial: $73.78
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LAB URINALYSIS POCT	$35	$28	$5.68 – $31.50
Urine test (manual, without microscope): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $15.75 Aetna — HMO/PPO: $27.16 Aetna — Medicare Advantage: $15.75 Ambetter — ACA Exchange: $15.75 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $19.95 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $15.75 Blue Cross Blue Shield of Illinois — Medicare Advantage: $15.75 Blue Cross Blue Shield of Illinois — PPO: $21 Cigna — HMO/PPO: $25.55 HealthLink — HMO: $26.25
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LAB URINALYSIS POCT (IP) BEAKER	$35	$28	$5.68 – $31.50
Urine test (manual, without microscope): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $15.75 Aetna — HMO/PPO: $27.16 Aetna — Medicare Advantage: $15.75 Ambetter — ACA Exchange: $15.75 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $19.95 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $15.75 Blue Cross Blue Shield of Illinois — Medicare Advantage: $15.75 Blue Cross Blue Shield of Illinois — PPO: $21 Cigna — HMO/PPO: $25.55 HealthLink — HMO: $26.25
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LAB URINALYSIS POCT	$35	$28	$19.95 – $29.75
Urine test (manual, without microscope): rates for 4 insurance plans Aetna — HMO/PPO: $27.16 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $19.95 HFN — PPO: $29.75 Medica — All Commercial: $21.70
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PH URINE AUTO	$61	$48.80	$5 – $54.90
Urine test (automated, without microscope): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $27.45 Aetna — HMO/PPO: $47.34 Aetna — Medicare Advantage: $27.45 Ambetter — ACA Exchange: $27.45 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $34.77 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $27.45 Blue Cross Blue Shield of Illinois — Medicare Advantage: $27.45 Blue Cross Blue Shield of Illinois — PPO: $36.60 Cigna — HMO/PPO: $44.53 HealthLink — HMO: $45.75
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG URINALYSIS DIPSTICK AUTO	$61	$48.80	$5 – $54.90
Urine test (automated, without microscope): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $27.45 Aetna — HMO/PPO: $47.34 Aetna — Medicare Advantage: $27.45 Ambetter — ACA Exchange: $27.45 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $34.77 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $27.45 Blue Cross Blue Shield of Illinois — Medicare Advantage: $27.45 Blue Cross Blue Shield of Illinois — PPO: $36.60 Cigna — HMO/PPO: $44.53 HealthLink — HMO: $45.75
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG PH URINE AUTO	$61	$48.80	$34.77 – $51.85
Urine test (automated, without microscope): rates for 4 insurance plans Aetna — HMO/PPO: $47.34 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $34.77 HFN — PPO: $51.85 Medica — All Commercial: $37.82
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PROSTATE SPECIFIC ANTIGEN DIAG	$179	$143.20	$31.28 – $161.10
PSA (prostate specific antigen) blood test: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $80.55 Aetna — HMO/PPO: $138.90 Aetna — Medicare Advantage: $80.55 Ambetter — ACA Exchange: $80.55 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $102.03 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $80.55 Blue Cross Blue Shield of Illinois — Medicare Advantage: $80.55 Blue Cross Blue Shield of Illinois — PPO: $107.40 Cigna — HMO/PPO: $130.67 HealthLink — HMO: $134.25
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PSA TOTAL	$179	$143.20	$31.28 – $161.10
PSA (prostate specific antigen) blood test: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $80.55 Aetna — HMO/PPO: $138.90 Aetna — Medicare Advantage: $80.55 Ambetter — ACA Exchange: $80.55 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $102.03 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $80.55 Blue Cross Blue Shield of Illinois — Medicare Advantage: $80.55 Blue Cross Blue Shield of Illinois — PPO: $107.40 Cigna — HMO/PPO: $130.67 HealthLink — HMO: $134.25
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG PROSTATE SPECIFIC ANTIGEN DIAG	$179	$143.20	$102.03 – $152.15
PSA (prostate specific antigen) blood test: rates for 4 insurance plans Aetna — HMO/PPO: $138.90 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $102.03 HFN — PPO: $152.15 Medica — All Commercial: $110.98
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG TSH	$233	$186.40	$28.56 – $209.70
Thyroid stimulating hormone (TSH) test: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $104.85 Aetna — HMO/PPO: $180.81 Aetna — Medicare Advantage: $104.85 Ambetter — ACA Exchange: $104.85 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $132.81 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $104.85 Blue Cross Blue Shield of Illinois — Medicare Advantage: $104.85 Blue Cross Blue Shield of Illinois — PPO: $139.80 Cigna — HMO/PPO: $170.09 HealthLink — HMO: $174.75
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG TSH	$233	$186.40	$132.81 – $198.05
Thyroid stimulating hormone (TSH) test: rates for 4 insurance plans Aetna — HMO/PPO: $180.81 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $132.81 HFN — PPO: $198.05 Medica — All Commercial: $144.46
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Doctor (professional) fee In the file: ASSAY THYROID STIM HORMONE	Not listed in the file	Not listed in the file	$3.50 – $16.42
Thyroid stimulating hormone (TSH) test: rates for 8 insurance plans Aetna — HMO/PPO: $15.90 Aetna Better Health — Medicaid: $16.42 Blue Cross Blue Shield of Illinois — Medicaid: $16.42 Blue Cross Blue Shield of Illinois — PPO: $3.50 Cigna — HMO/PPO: $14.11 Meridian — HealthChoice Medicaid: $16.42 Molina — HealthChoice Medicaid: $16.42 United Healthcare — All Commercial: $14.28
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG CBC W AUTO DIFFERENTIAL	$153	$122.40	$13.22 – $137.70
Complete blood count (CBC) with differential: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $68.85 Aetna — HMO/PPO: $118.73 Aetna — Medicare Advantage: $68.85 Ambetter — ACA Exchange: $68.85 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $87.21 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $68.85 Blue Cross Blue Shield of Illinois — Medicare Advantage: $68.85 Blue Cross Blue Shield of Illinois — PPO: $91.80 Cigna — HMO/PPO: $111.69 HealthLink — HMO: $114.75
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG CBC W AUTO DIFFERENTIAL	$153	$122.40	$87.21 – $130.05
Complete blood count (CBC) with differential: rates for 4 insurance plans Aetna — HMO/PPO: $118.73 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $87.21 HFN — PPO: $130.05 Medica — All Commercial: $94.86
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPLETE CBC W/AUTO DIFF WBC	Not listed in the file	Not listed in the file	$3.50 – $7.35
Complete blood count (CBC) with differential: rates for 8 insurance plans Aetna — HMO/PPO: $7.35 Aetna Better Health — Medicaid: $5.74 Blue Cross Blue Shield of Illinois — Medicaid: $5.74 Blue Cross Blue Shield of Illinois — PPO: $3.50 Cigna — HMO/PPO: $6.51 Meridian — HealthChoice Medicaid: $5.74 Molina — HealthChoice Medicaid: $5.74 United Healthcare — All Commercial: $6.61
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG CBC W/O AUTO DIFFERENTIAL	$77	$61.60	$11 – $69.30
Complete blood count (CBC), automated: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $34.65 Aetna — HMO/PPO: $59.75 Aetna — Medicare Advantage: $34.65 Ambetter — ACA Exchange: $34.65 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $43.89 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $34.65 Blue Cross Blue Shield of Illinois — Medicare Advantage: $34.65 Blue Cross Blue Shield of Illinois — PPO: $46.20 Cigna — HMO/PPO: $56.21 HealthLink — HMO: $57.75
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG CBC W/O AUTO DIFFERENTIAL	$77	$61.60	$43.89 – $65.45
Complete blood count (CBC), automated: rates for 4 insurance plans Aetna — HMO/PPO: $59.75 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $43.89 HFN — PPO: $65.45 Medica — All Commercial: $47.74
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPLETE CBC AUTOMATED	Not listed in the file	Not listed in the file	$2.11 – $6.12
Complete blood count (CBC), automated: rates for 8 insurance plans Aetna — HMO/PPO: $6.12 Aetna Better Health — Medicaid: $2.11 Blue Cross Blue Shield of Illinois — Medicaid: $2.11 Blue Cross Blue Shield of Illinois — PPO: $3.50 Cigna — HMO/PPO: $5.43 Meridian — HealthChoice Medicaid: $2.11 Molina — HealthChoice Medicaid: $2.11 United Healthcare — All Commercial: $5.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PT-INR	$81	$64.80	$8.72 – $72.90
Blood clotting time test (prothrombin time, PT): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $36.45 Aetna — HMO/PPO: $62.86 Aetna — Medicare Advantage: $36.45 Ambetter — ACA Exchange: $36.45 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $46.17 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $36.45 Blue Cross Blue Shield of Illinois — Medicare Advantage: $36.45 Blue Cross Blue Shield of Illinois — PPO: $48.60 Cigna — HMO/PPO: $59.13 HealthLink — HMO: $60.75
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG PT-INR	$81	$64.80	$46.17 – $68.85
Blood clotting time test (prothrombin time, PT): rates for 4 insurance plans Aetna — HMO/PPO: $62.86 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $46.17 HFN — PPO: $68.85 Medica — All Commercial: $50.22
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Doctor (professional) fee In the file: PROTHROMBIN TIME	Not listed in the file	Not listed in the file	$3.50 – $4.36
Blood clotting time test (prothrombin time, PT): rates for 8 insurance plans Aetna — HMO/PPO: $4.06 Aetna Better Health — Medicaid: $3.82 Blue Cross Blue Shield of Illinois — Medicaid: $3.82 Blue Cross Blue Shield of Illinois — PPO: $3.50 Cigna — HMO/PPO: $3.53 Meridian — HealthChoice Medicaid: $3.82 Molina — HealthChoice Medicaid: $3.82 United Healthcare — All Commercial: $4.36
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LCHG PTT	$111	$88.80	$10.20 – $99.90
Blood clotting test (partial thromboplastin time, PTT): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $49.95 Aetna — HMO/PPO: $86.14 Aetna — Medicare Advantage: $49.95 Ambetter — ACA Exchange: $49.95 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $63.27 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $49.95 Blue Cross Blue Shield of Illinois — Medicare Advantage: $49.95 Blue Cross Blue Shield of Illinois — PPO: $66.60 Cigna — HMO/PPO: $81.03 HealthLink — HMO: $83.25
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LCHG PTT	$111	$88.80	$63.27 – $94.35
Blood clotting test (partial thromboplastin time, PTT): rates for 4 insurance plans Aetna — HMO/PPO: $86.14 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $63.27 HFN — PPO: $94.35 Medica — All Commercial: $68.82
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Doctor (professional) fee In the file: THROMBOPLASTIN TIME PARTIAL	Not listed in the file	Not listed in the file	$3.22 – $5.88
Blood clotting test (partial thromboplastin time, PTT): rates for 8 insurance plans Aetna — HMO/PPO: $5.69 Aetna Better Health — Medicaid: $5.88 Blue Cross Blue Shield of Illinois — Medicaid: $5.88 Blue Cross Blue Shield of Illinois — PPO: $3.50 Cigna — HMO/PPO: $3.22 Meridian — HealthChoice Medicaid: $5.88 Molina — HealthChoice Medicaid: $5.88 United Healthcare — All Commercial: $5.10

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT HEAD NON CONTRAST	$2,380	$1,904	$1,071 – $2,142
CT scan of the head or brain, without contrast: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $1,071 Aetna — HMO/PPO: $1,846.88 Aetna — Medicare Advantage: $1,071 Ambetter — ACA Exchange: $1,071 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,356.60 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $1,071 Blue Cross Blue Shield of Illinois — Medicare Advantage: $1,071 Blue Cross Blue Shield of Illinois — PPO: $1,428 Cigna — HMO/PPO: $1,737.40 HealthLink — HMO: $1,785
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT HEAD NON CONTRAST	$2,380	$1,904	$1,356.60 – $2,023
CT scan of the head or brain, without contrast: rates for 4 insurance plans Aetna — HMO/PPO: $1,846.88 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,356.60 HFN — PPO: $2,023 Medica — All Commercial: $1,475.60
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee In the file: CT HEAD/BRAIN W/O DYE	Not listed in the file	Not listed in the file	$38.60 – $198.39
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $102.44 Aetna — HMO/PPO: $123.40 Aetna — Medicare Advantage: $102.44 Aetna Better Health — Medicaid: $38.60 Ambetter — ACA Exchange: $102.44 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $102.44 Blue Cross Blue Shield of Illinois — Medicaid: $38.60 Blue Cross Blue Shield of Illinois — Medicare Advantage: $102.44 Cigna — HMO/PPO: $131 Humana — Dual Medicare Medicaid: $102.44
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN WITH & WITHOUT CONTRAST	$4,326	$3,460.80	$1,946.70 – $3,893.40
MRI of the brain, before and after contrast: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $1,946.70 Aetna — HMO/PPO: $3,356.98 Aetna — Medicare Advantage: $1,946.70 Ambetter — ACA Exchange: $1,946.70 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,465.82 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $1,946.70 Blue Cross Blue Shield of Illinois — Medicare Advantage: $1,946.70 Blue Cross Blue Shield of Illinois — PPO: $2,595.60 Cigna — HMO/PPO: $3,157.98 HealthLink — HMO: $3,244.50
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI BRAIN WITH & WITHOUT CONTRAST	$4,326	$3,460.80	$2,465.82 – $3,677.10
MRI of the brain, before and after contrast: rates for 4 insurance plans Aetna — HMO/PPO: $3,356.98 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,465.82 HFN — PPO: $3,677.10 Medica — All Commercial: $2,682.12
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI BRAIN STEM W/O & W/DYE	Not listed in the file	Not listed in the file	$303.42 – $765.59
MRI of the brain, before and after contrast: 10 of 16 insurance plan rates Aetna — Dual Medicare Medicaid: $303.42 Aetna — HMO/PPO: $431.92 Aetna — Medicare Advantage: $303.42 Ambetter — ACA Exchange: $303.42 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $303.42 Blue Cross Blue Shield of Illinois — Medicare Advantage: $303.42 Cigna — HMO/PPO: $390.66 Humana — Dual Medicare Medicaid: $303.42 Humana — Medicare Advantage: $303.42 Medica — All Commercial: $379.28
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC XRAY CHEST 2 VIEWS	$368	$294.40	$165.60 – $331.20
Chest X-ray, 2 views: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $165.60 Aetna — HMO/PPO: $285.57 Aetna — Medicare Advantage: $165.60 Ambetter — ACA Exchange: $165.60 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $209.76 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $165.60 Blue Cross Blue Shield of Illinois — Medicare Advantage: $165.60 Blue Cross Blue Shield of Illinois — PPO: $220.80 Cigna — HMO/PPO: $268.64 HealthLink — HMO: $276
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC XRAY CHEST 2 VIEWS	$368	$294.40	$209.76 – $312.80
Chest X-ray, 2 views: rates for 4 insurance plans Aetna — HMO/PPO: $285.57 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $209.76 HFN — PPO: $312.80 Medica — All Commercial: $228.16
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: X-RAY EXAM CHEST 2 VIEWS	Not listed in the file	Not listed in the file	$7.03 – $40.63
Chest X-ray, 2 views: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $31.71 Aetna — HMO/PPO: $31.45 Aetna — Medicare Advantage: $31.71 Aetna Better Health — Medicaid: $7.03 Ambetter — ACA Exchange: $31.71 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $31.71 Blue Cross Blue Shield of Illinois — Medicaid: $7.03 Blue Cross Blue Shield of Illinois — Medicare Advantage: $31.71 Cigna — HMO/PPO: $40.63 Humana — Dual Medicare Medicaid: $31.71
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LUMBAR SPINE 4+ VW	$595	$476	$267.75 – $535.50
X-ray of the lower spine, at least 4 views: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $267.75 Aetna — HMO/PPO: $461.72 Aetna — Medicare Advantage: $267.75 Ambetter — ACA Exchange: $267.75 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $339.15 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $267.75 Blue Cross Blue Shield of Illinois — Medicare Advantage: $267.75 Blue Cross Blue Shield of Illinois — PPO: $357 Cigna — HMO/PPO: $434.35 HealthLink — HMO: $446.25
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LUMBAR SPINE 4+ VW	$595	$476	$339.15 – $505.75
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans Aetna — HMO/PPO: $461.72 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $339.15 HFN — PPO: $505.75 Medica — All Commercial: $368.90
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	Not listed in the file	$37.90 – $63.66
X-ray of the lower spine, at least 4 views: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $50.93 Aetna — HMO/PPO: $47.60 Aetna — Medicare Advantage: $50.93 Aetna Better Health — Medicaid: $37.90 Ambetter — ACA Exchange: $50.93 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $50.93 Blue Cross Blue Shield of Illinois — Medicaid: $37.90 Blue Cross Blue Shield of Illinois — Medicare Advantage: $50.93 Cigna — HMO/PPO: $62.24 Humana — Dual Medicare Medicaid: $50.93
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR NON CONTRAST	$3,623	$2,898.40	$1,630.35 – $3,260.70
MRI of the lower back (lumbar spine), without contrast: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $1,630.35 Aetna — HMO/PPO: $2,811.45 Aetna — Medicare Advantage: $1,630.35 Ambetter — ACA Exchange: $1,630.35 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,065.11 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $1,630.35 Blue Cross Blue Shield of Illinois — Medicare Advantage: $1,630.35 Blue Cross Blue Shield of Illinois — PPO: $2,173.80 Cigna — HMO/PPO: $2,644.79 HealthLink — HMO: $2,717.25
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR NON CONTRAST	$3,623	$2,898.40	$2,065.11 – $3,079.55
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans Aetna — HMO/PPO: $2,811.45 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,065.11 HFN — PPO: $3,079.55 Medica — All Commercial: $2,246.26
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	Not listed in the file	$67.91 – $502.30
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $183.89 Aetna — HMO/PPO: $258.97 Aetna — Medicare Advantage: $183.89 Aetna Better Health — Medicaid: $67.91 Ambetter — ACA Exchange: $183.89 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $183.89 Blue Cross Blue Shield of Illinois — Medicaid: $67.91 Blue Cross Blue Shield of Illinois — Medicare Advantage: $183.89 Cigna — HMO/PPO: $234.44 Humana — Dual Medicare Medicaid: $183.89
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT PELVIS WITH IV CONTRAST	$2,634	$2,107.20	$1,185.30 – $2,370.60
CT scan of the pelvis, with contrast: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $1,185.30 Aetna — HMO/PPO: $2,043.98 Aetna — Medicare Advantage: $1,185.30 Ambetter — ACA Exchange: $1,185.30 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,501.38 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $1,185.30 Blue Cross Blue Shield of Illinois — Medicare Advantage: $1,185.30 Blue Cross Blue Shield of Illinois — PPO: $1,580.40 Cigna — HMO/PPO: $1,922.82 HealthLink — HMO: $1,975.50
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT PELVIS WITH IV CONTRAST	$2,634	$2,107.20	$1,501.38 – $2,238.90
CT scan of the pelvis, with contrast: rates for 4 insurance plans Aetna — HMO/PPO: $2,043.98 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,501.38 HFN — PPO: $2,238.90 Medica — All Commercial: $1,633.08
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee In the file: CT PELVIS W/DYE	Not listed in the file	Not listed in the file	$75.29 – $297.82
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $214.03 Aetna — HMO/PPO: $258.42 Aetna — Medicare Advantage: $214.03 Aetna Better Health — Medicaid: $75.29 Ambetter — ACA Exchange: $214.03 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $214.03 Blue Cross Blue Shield of Illinois — Medicaid: $75.29 Blue Cross Blue Shield of Illinois — Medicare Advantage: $214.03 Cigna — HMO/PPO: $274.97 Humana — Dual Medicare Medicaid: $214.03
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LOWER EXT ANY JOINT NON CONTRAST	$3,786	$3,028.80	$1,703.70 – $3,407.40
MRI of a leg joint (such as the knee), without contrast: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $1,703.70 Aetna — HMO/PPO: $2,937.94 Aetna — Medicare Advantage: $1,703.70 Ambetter — ACA Exchange: $1,703.70 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,158.02 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $1,703.70 Blue Cross Blue Shield of Illinois — Medicare Advantage: $1,703.70 Blue Cross Blue Shield of Illinois — PPO: $2,271.60 Cigna — HMO/PPO: $2,763.78 HealthLink — HMO: $2,839.50
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI LOWER EXT ANY JOINT NON CONTRAST	$3,786	$3,028.80	$2,158.02 – $3,218.10
MRI of a leg joint (such as the knee), without contrast: rates for 4 insurance plans Aetna — HMO/PPO: $2,937.94 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $2,158.02 HFN — PPO: $3,218.10 Medica — All Commercial: $2,347.32
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	Not listed in the file	Not listed in the file	$194.88 – $541.08
MRI of a leg joint (such as the knee), without contrast: 10 of 16 insurance plan rates Aetna — Dual Medicare Medicaid: $194.88 Aetna — HMO/PPO: $273.03 Aetna — Medicare Advantage: $194.88 Ambetter — ACA Exchange: $194.88 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $194.88 Blue Cross Blue Shield of Illinois — Medicare Advantage: $194.88 Cigna — HMO/PPO: $248.39 Humana — Dual Medicare Medicaid: $194.88 Humana — Medicare Advantage: $194.88 Medica — All Commercial: $243.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT ABDOMEN PELVIS W CONTRAST	$5,624	$4,499.20	$2,530.80 – $5,061.60
CT scan of the abdomen and pelvis, with contrast: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $2,530.80 Aetna — HMO/PPO: $4,364.22 Aetna — Medicare Advantage: $2,530.80 Ambetter — ACA Exchange: $2,530.80 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $3,205.68 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $2,530.80 Blue Cross Blue Shield of Illinois — Medicare Advantage: $2,530.80 Blue Cross Blue Shield of Illinois — PPO: $3,374.40 Cigna — HMO/PPO: $4,105.52 HealthLink — HMO: $4,218
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT ABDOMEN PELVIS W CONTRAST	$5,624	$4,499.20	$3,205.68 – $4,780.40
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans Aetna — HMO/PPO: $4,364.22 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $3,205.68 HFN — PPO: $4,780.40 Medica — All Commercial: $3,486.88
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: CT ABD & PELVIS W/CONTRAST	Not listed in the file	Not listed in the file	$57.95 – $384.99
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $285.73 Aetna — HMO/PPO: $354.45 Aetna — Medicare Advantage: $285.73 Aetna Better Health — Medicaid: $57.95 Ambetter — ACA Exchange: $285.73 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $285.73 Blue Cross Blue Shield of Illinois — Medicaid: $57.95 Blue Cross Blue Shield of Illinois — Medicare Advantage: $285.73 Cigna — HMO/PPO: $367.79 Humana — Dual Medicare Medicaid: $285.73
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US ABDOMEN COMPLETE	$1,406	$1,124.80	$632.70 – $1,265.40
Ultrasound of the abdomen, complete: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $632.70 Aetna — HMO/PPO: $1,091.06 Aetna — Medicare Advantage: $632.70 Ambetter — ACA Exchange: $632.70 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $801.42 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $632.70 Blue Cross Blue Shield of Illinois — Medicare Advantage: $632.70 Blue Cross Blue Shield of Illinois — PPO: $843.60 Cigna — HMO/PPO: $1,026.38 HealthLink — HMO: $1,054.50
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US ABDOMEN COMPLETE	$1,406	$1,124.80	$801.42 – $1,195.10
Ultrasound of the abdomen, complete: rates for 4 insurance plans Aetna — HMO/PPO: $1,091.06 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $801.42 HFN — PPO: $1,195.10 Medica — All Commercial: $871.72
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: US EXAM ABDOM COMPLETE	Not listed in the file	Not listed in the file	$26.56 – $139.24
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $109.40 Aetna — HMO/PPO: $109.18 Aetna — Medicare Advantage: $109.40 Aetna Better Health — Medicaid: $26.56 Ambetter — ACA Exchange: $109.40 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $109.40 Blue Cross Blue Shield of Illinois — Medicaid: $26.56 Blue Cross Blue Shield of Illinois — Medicare Advantage: $109.40 Cigna — HMO/PPO: $139.24 Humana — Dual Medicare Medicaid: $109.40
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US OB 14+ WKS SINGLE GEST	$928	$742.40	$417.60 – $835.20
Pregnancy ultrasound (after the first trimester): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $417.60 Aetna — HMO/PPO: $720.13 Aetna — Medicare Advantage: $417.60 Ambetter — ACA Exchange: $417.60 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $528.96 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $417.60 Blue Cross Blue Shield of Illinois — Medicare Advantage: $417.60 Blue Cross Blue Shield of Illinois — PPO: $556.80 Cigna — HMO/PPO: $677.44 HealthLink — HMO: $696
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US OB 14+ WKS SINGLE GEST	$928	$742.40	$528.96 – $788.80
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans Aetna — HMO/PPO: $720.13 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $528.96 HFN — PPO: $788.80 Medica — All Commercial: $575.36
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: OB US >/= 14 WKS SNGL FETUS	Not listed in the file	Not listed in the file	$87.72 – $162.78
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $130.22 Aetna — HMO/PPO: $127.07 Aetna — Medicare Advantage: $130.22 Aetna Better Health — Medicaid: $87.72 Ambetter — ACA Exchange: $130.22 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $130.22 Blue Cross Blue Shield of Illinois — Medicaid: $87.72 Blue Cross Blue Shield of Illinois — Medicare Advantage: $130.22 Cigna — HMO/PPO: $161.77 Humana — Dual Medicare Medicaid: $130.22
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US TRANSVAGINAL NON OB	$973	$778.40	$437.85 – $875.70
Transvaginal ultrasound: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $437.85 Aetna — HMO/PPO: $755.05 Aetna — Medicare Advantage: $437.85 Ambetter — ACA Exchange: $437.85 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $554.61 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $437.85 Blue Cross Blue Shield of Illinois — Medicare Advantage: $437.85 Blue Cross Blue Shield of Illinois — PPO: $583.80 Cigna — HMO/PPO: $710.29 HealthLink — HMO: $729.75
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US TRANSVAGINAL NON OB	$973	$778.40	$554.61 – $827.05
Transvaginal ultrasound: rates for 4 insurance plans Aetna — HMO/PPO: $755.05 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $554.61 HFN — PPO: $827.05 Medica — All Commercial: $603.26
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: TRANSVAGINAL US NON-OB	Not listed in the file	Not listed in the file	$76.76 – $141.32
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $112.15 Aetna — HMO/PPO: $111.85 Aetna — Medicare Advantage: $112.15 Aetna Better Health — Medicaid: $76.76 Ambetter — ACA Exchange: $112.15 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $112.15 Blue Cross Blue Shield of Illinois — Medicaid: $76.76 Blue Cross Blue Shield of Illinois — Medicare Advantage: $112.15 Cigna — HMO/PPO: $141.32 Humana — Dual Medicare Medicaid: $112.15
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMM DX UNILATERAL INCLUDES CAD/AI	$337	$269.60	$151.65 – $303.30
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $151.65 Aetna — HMO/PPO: $261.51 Aetna — Medicare Advantage: $151.65 Ambetter — ACA Exchange: $151.65 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $192.09 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $151.65 Blue Cross Blue Shield of Illinois — Medicare Advantage: $151.65 Blue Cross Blue Shield of Illinois — PPO: $202.20 Cigna — HMO/PPO: $246.01 HealthLink — HMO: $252.75
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAMM DX UNILATERAL INCLUDES CAD/AI	$337	$269.60	$192.09 – $286.45
Diagnostic mammogram, one breast: rates for 4 insurance plans Aetna — HMO/PPO: $261.51 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $192.09 HFN — PPO: $286.45 Medica — All Commercial: $208.94
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$116.74 – $151.34
Diagnostic mammogram, one breast: 10 of 16 insurance plan rates Aetna — Dual Medicare Medicaid: $118.31 Aetna — HMO/PPO: $116.74 Aetna — Medicare Advantage: $118.31 Ambetter — ACA Exchange: $118.31 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $118.31 Blue Cross Blue Shield of Illinois — Medicare Advantage: $118.31 Cigna — HMO/PPO: $151.34 Humana — Dual Medicare Medicaid: $118.31 Humana — Medicare Advantage: $118.31 Medica — All Commercial: $147.89
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMM DX BILATERAL INCLUDES CAD/AI	$506	$404.80	$227.70 – $455.40
Diagnostic mammogram, both breasts: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $227.70 Aetna — HMO/PPO: $392.66 Aetna — Medicare Advantage: $227.70 Ambetter — ACA Exchange: $227.70 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $288.42 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $227.70 Blue Cross Blue Shield of Illinois — Medicare Advantage: $227.70 Blue Cross Blue Shield of Illinois — PPO: $303.60 Cigna — HMO/PPO: $369.38 HealthLink — HMO: $379.50
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAMM DX BILATERAL INCLUDES CAD/AI	$506	$404.80	$288.42 – $430.10
Diagnostic mammogram, both breasts: rates for 4 insurance plans Aetna — HMO/PPO: $392.66 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $288.42 HFN — PPO: $430.10 Medica — All Commercial: $313.72
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$146.95 – $190.28
Diagnostic mammogram, both breasts: 10 of 16 insurance plan rates Aetna — Dual Medicare Medicaid: $149.97 Aetna — HMO/PPO: $146.95 Aetna — Medicare Advantage: $149.97 Ambetter — ACA Exchange: $149.97 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $149.97 Blue Cross Blue Shield of Illinois — Medicare Advantage: $149.97 Cigna — HMO/PPO: $190.28 Humana — Dual Medicare Medicaid: $149.97 Humana — Medicare Advantage: $149.97 Medica — All Commercial: $187.46
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMM SCREEN BILAT INCLUDES CAD/AI	$461	$368.80	$207.45 – $414.90
Screening mammogram, both breasts: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $207.45 Aetna — HMO/PPO: $357.74 Aetna — Medicare Advantage: $207.45 Ambetter — ACA Exchange: $207.45 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $262.77 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $207.45 Blue Cross Blue Shield of Illinois — Medicare Advantage: $207.45 Blue Cross Blue Shield of Illinois — PPO: $276.60 Cigna — HMO/PPO: $336.53 HealthLink — HMO: $345.75
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMM SCREEN UNILAT INCLUDES CAD/AI	$461	$368.80	$207.45 – $414.90
Screening mammogram, both breasts: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $207.45 Aetna — HMO/PPO: $357.74 Aetna — Medicare Advantage: $207.45 Ambetter — ACA Exchange: $207.45 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $262.77 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $207.45 Blue Cross Blue Shield of Illinois — Medicare Advantage: $207.45 Blue Cross Blue Shield of Illinois — PPO: $276.60 Cigna — HMO/PPO: $336.53 HealthLink — HMO: $345.75
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: HP MAMM SCREEN UNILAT INCLUDES CAD/AI	$88	$70.40	$79.20 – $154.07
Screening mammogram, both breasts: 10 of 17 insurance plan rates Aetna — Dual Medicare Medicaid: $119.96 Aetna — HMO/PPO: $119.32 Aetna — Medicare Advantage: $119.96 Ambetter — ACA Exchange: $119.96 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $119.96 Blue Cross Blue Shield of Illinois — Medicare Advantage: $119.96 Cigna — HMO/PPO: $154.07 HFN — PPO: $79.20 Humana — Dual Medicare Medicaid: $119.96 Humana — Medicare Advantage: $119.96

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$13.64 – $19.15
Electrocardiogram (ECG/EKG) with reading: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $15.32 Aetna — HMO/PPO: $16.69 Aetna — Medicare Advantage: $15.32 Aetna Better Health — Medicaid: $13.64 Ambetter — ACA Exchange: $15.32 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $15.32 Blue Cross Blue Shield of Illinois — Medicaid: $13.64 Blue Cross Blue Shield of Illinois — Medicare Advantage: $15.32 Cigna — HMO/PPO: $17.81 Humana — Dual Medicare Medicaid: $15.32
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$850.63 – $1,428.18
Left heart catheterization (diagnostic): 10 of 16 insurance plan rates Aetna — Dual Medicare Medicaid: $850.63 Aetna — HMO/PPO: $1,019.77 Aetna — Medicare Advantage: $850.63 Ambetter — ACA Exchange: $850.63 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $850.63 Blue Cross Blue Shield of Illinois — Medicare Advantage: $850.63 Cigna — HMO/PPO: $1,035.48 Humana — Dual Medicare Medicaid: $850.63 Humana — Medicare Advantage: $850.63 Medica — All Commercial: $1,063.29
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$162.24 – $426.89
Left heart catheterization (diagnostic): 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $255.43 Aetna — HMO/PPO: $279.73 Aetna — Medicare Advantage: $255.43 Aetna Better Health — Medicaid: $162.24 Ambetter — ACA Exchange: $255.43 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $255.43 Blue Cross Blue Shield of Illinois — Medicaid: $162.24 Blue Cross Blue Shield of Illinois — Medicare Advantage: $255.43 Cigna — HMO/PPO: $302.39 Humana — Dual Medicare Medicaid: $255.43
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$595.20 – $1,001.29
Left heart catheterization (diagnostic): 10 of 16 insurance plan rates Aetna — Dual Medicare Medicaid: $595.20 Aetna — HMO/PPO: $740.05 Aetna — Medicare Advantage: $595.20 Ambetter — ACA Exchange: $595.20 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $595.20 Blue Cross Blue Shield of Illinois — Medicare Advantage: $595.20 Cigna — HMO/PPO: $733.09 Humana — Dual Medicare Medicaid: $595.20 Humana — Medicare Advantage: $595.20 Medica — All Commercial: $744
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$452.87 – $1,319.07
Heart rhythm study (electrophysiology evaluation): 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $751.05 Aetna — HMO/PPO: $777.81 Aetna — Medicare Advantage: $751.05 Aetna Better Health — Medicaid: $452.87 Ambetter — ACA Exchange: $751.05 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $751.05 Blue Cross Blue Shield of Illinois — Medicaid: $452.87 Blue Cross Blue Shield of Illinois — Medicare Advantage: $751.05 Cigna — HMO/PPO: $825.94 Humana — Dual Medicare Medicaid: $751.05
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$262.66 – $680.75
Heart rhythm study (electrophysiology evaluation): 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $412.68 Aetna — HMO/PPO: $458.59 Aetna — Medicare Advantage: $412.68 Aetna Better Health — Medicaid: $262.66 Ambetter — ACA Exchange: $412.68 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $412.68 Blue Cross Blue Shield of Illinois — Medicaid: $262.66 Blue Cross Blue Shield of Illinois — Medicare Advantage: $412.68 Cigna — HMO/PPO: $488.64 Humana — Dual Medicare Medicaid: $412.68
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$319.22 – $638.32
Heart rhythm study (electrophysiology evaluation): 10 of 16 insurance plan rates Aetna — Dual Medicare Medicaid: $338.37 Aetna — HMO/PPO: $319.22 Aetna — Medicare Advantage: $338.37 Ambetter — ACA Exchange: $338.37 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $338.37 Blue Cross Blue Shield of Illinois — Medicare Advantage: $338.37 Cigna — HMO/PPO: $337.32 Humana — Dual Medicare Medicaid: $338.37 Humana — Medicare Advantage: $338.37 Medica — All Commercial: $422.96
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$709.43 – $1,592.90
Heart rhythm study with ablation for atrial fibrillation: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $929.28 Aetna — HMO/PPO: $1,144.92 Aetna — Medicare Advantage: $929.28 Aetna Better Health — Medicaid: $709.43 Ambetter — ACA Exchange: $929.28 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $929.28 Blue Cross Blue Shield of Illinois — Medicaid: $709.43 Blue Cross Blue Shield of Illinois — Medicare Advantage: $929.28 Cigna — HMO/PPO: $1,221.90 Humana — Dual Medicare Medicaid: $929.28
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$398.94 – $794.78
Sleep study (overnight, in a sleep lab): 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $635.82 Aetna — HMO/PPO: $622.25 Aetna — Medicare Advantage: $635.82 Aetna Better Health — Medicaid: $398.94 Ambetter — ACA Exchange: $635.82 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $635.82 Blue Cross Blue Shield of Illinois — Medicaid: $398.94 Blue Cross Blue Shield of Illinois — Medicare Advantage: $635.82 Cigna — HMO/PPO: $748.08 Humana — Dual Medicare Medicaid: $635.82
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$78.55 – $150.69
Sleep study (overnight, in a sleep lab): 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $120.55 Aetna — HMO/PPO: $126.27 Aetna — Medicare Advantage: $120.55 Aetna Better Health — Medicaid: $78.55 Ambetter — ACA Exchange: $120.55 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $120.55 Blue Cross Blue Shield of Illinois — Medicaid: $78.55 Blue Cross Blue Shield of Illinois — Medicare Advantage: $120.55 Cigna — HMO/PPO: $146.40 Humana — Dual Medicare Medicaid: $120.55
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee · modifier TC In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$320.40 – $644.09
Sleep study (overnight, in a sleep lab): 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $515.27 Aetna — HMO/PPO: $495.98 Aetna — Medicare Advantage: $515.27 Aetna Better Health — Medicaid: $320.40 Ambetter — ACA Exchange: $515.27 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $515.27 Blue Cross Blue Shield of Illinois — Medicaid: $320.40 Blue Cross Blue Shield of Illinois — Medicare Advantage: $515.27 Cigna — HMO/PPO: $601.68 Humana — Dual Medicare Medicaid: $515.27

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THER EXERCISE EA 15 MIN PT	$189	$151.20	$85.05 – $170.10
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $85.05 Aetna — HMO/PPO: $146.66 Aetna — Medicare Advantage: $85.05 Ambetter — ACA Exchange: $85.05 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $107.73 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $85.05 Blue Cross Blue Shield of Illinois — Medicare Advantage: $85.05 Blue Cross Blue Shield of Illinois — PPO: $113.40 Cigna — HMO/PPO: $137.97 HealthLink — HMO: $141.75
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THER EXERCISE EA 15 MIN OT	$189	$151.20	$85.05 – $170.10
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $85.05 Aetna — HMO/PPO: $146.66 Aetna — Medicare Advantage: $85.05 Ambetter — ACA Exchange: $85.05 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $107.73 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $85.05 Blue Cross Blue Shield of Illinois — Medicare Advantage: $85.05 Blue Cross Blue Shield of Illinois — PPO: $113.40 Cigna — HMO/PPO: $137.97 HealthLink — HMO: $141.75
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THER EXERCISE EA 15 MIN PT	$189	$151.20	$107.73 – $160.65
Physical therapy: therapeutic exercise (each 15 minutes): rates for 4 insurance plans Aetna — HMO/PPO: $146.66 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $107.73 HFN — PPO: $160.65 Medica — All Commercial: $117.18
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEXITY 1 RVU	$277	$221.60	$124.65 – $249.30
Physical therapy evaluation (low complexity): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $124.65 Aetna — HMO/PPO: $214.95 Aetna — Medicare Advantage: $124.65 Ambetter — ACA Exchange: $124.65 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $157.89 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $124.65 Blue Cross Blue Shield of Illinois — Medicare Advantage: $124.65 Blue Cross Blue Shield of Illinois — PPO: $166.20 Cigna — HMO/PPO: $202.21 HealthLink — HMO: $207.75
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEXITY 1 RVU	$277	$221.60	$157.89 – $235.45
Physical therapy evaluation (low complexity): rates for 4 insurance plans Aetna — HMO/PPO: $214.95 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $157.89 HFN — PPO: $235.45 Medica — All Commercial: $171.74
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL LOW COMPLEX 20 MIN	Not listed in the file	Not listed in the file	$61.30 – $124.81
Physical therapy evaluation (low complexity): 10 of 16 insurance plan rates Aetna — Dual Medicare Medicaid: $94.52 Aetna — HMO/PPO: $80.70 Aetna — Medicare Advantage: $94.52 Ambetter — ACA Exchange: $94.52 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $94.52 Blue Cross Blue Shield of Illinois — Medicare Advantage: $94.52 Cigna — HMO/PPO: $124.81 Humana — Dual Medicare Medicaid: $94.52 Humana — Medicare Advantage: $94.52 Medica — All Commercial: $118.15
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEXITY 2 RVU	$382	$305.60	$171.90 – $343.80
Physical therapy evaluation (moderate complexity): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $171.90 Aetna — HMO/PPO: $296.43 Aetna — Medicare Advantage: $171.90 Ambetter — ACA Exchange: $171.90 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $217.74 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $171.90 Blue Cross Blue Shield of Illinois — Medicare Advantage: $171.90 Blue Cross Blue Shield of Illinois — PPO: $229.20 Cigna — HMO/PPO: $278.86 HealthLink — HMO: $286.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEXITY 2 RVU	$382	$305.60	$217.74 – $324.70
Physical therapy evaluation (moderate complexity): rates for 4 insurance plans Aetna — HMO/PPO: $296.43 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $217.74 HFN — PPO: $324.70 Medica — All Commercial: $236.84
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL MOD COMPLEX 30 MIN	Not listed in the file	Not listed in the file	$61.30 – $124.81
Physical therapy evaluation (moderate complexity): 10 of 16 insurance plan rates Aetna — Dual Medicare Medicaid: $94.52 Aetna — HMO/PPO: $80.70 Aetna — Medicare Advantage: $94.52 Ambetter — ACA Exchange: $94.52 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $94.52 Blue Cross Blue Shield of Illinois — Medicare Advantage: $94.52 Cigna — HMO/PPO: $124.81 Humana — Dual Medicare Medicaid: $94.52 Humana — Medicare Advantage: $94.52 Medica — All Commercial: $118.15
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEXITY 3 RVU	$432	$345.60	$194.40 – $388.80
Physical therapy evaluation (high complexity): 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $194.40 Aetna — HMO/PPO: $335.23 Aetna — Medicare Advantage: $194.40 Ambetter — ACA Exchange: $194.40 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $246.24 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $194.40 Blue Cross Blue Shield of Illinois — Medicare Advantage: $194.40 Blue Cross Blue Shield of Illinois — PPO: $259.20 Cigna — HMO/PPO: $315.36 HealthLink — HMO: $324
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEXITY 3 RVU	$432	$345.60	$246.24 – $367.20
Physical therapy evaluation (high complexity): rates for 4 insurance plans Aetna — HMO/PPO: $335.23 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $246.24 HFN — PPO: $367.20 Medica — All Commercial: $267.84
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	Not listed in the file	Not listed in the file	$61.30 – $124.81
Physical therapy evaluation (high complexity): 10 of 16 insurance plan rates Aetna — Dual Medicare Medicaid: $94.52 Aetna — HMO/PPO: $80.70 Aetna — Medicare Advantage: $94.52 Ambetter — ACA Exchange: $94.52 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $94.52 Blue Cross Blue Shield of Illinois — Medicare Advantage: $94.52 Cigna — HMO/PPO: $124.81 Humana — Dual Medicare Medicaid: $94.52 Humana — Medicare Advantage: $94.52 Medica — All Commercial: $118.15
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$46.98 – $90.91
Psychotherapy, 30 minutes: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $69.47 Aetna — HMO/PPO: $72.77 Aetna — Medicare Advantage: $69.47 Aetna Better Health — Medicaid: $46.98 Ambetter — ACA Exchange: $69.47 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $69.47 Blue Cross Blue Shield of Illinois — Medicaid: $46.98 Blue Cross Blue Shield of Illinois — Medicare Advantage: $69.47 Cigna — HMO/PPO: $90.91 HealthLink — HMO: $78.99
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$62.03 – $119.85
Psychotherapy, 45 minutes: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $92.08 Aetna — HMO/PPO: $96.57 Aetna — Medicare Advantage: $92.08 Aetna Better Health — Medicaid: $62.03 Ambetter — ACA Exchange: $92.08 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $92.08 Blue Cross Blue Shield of Illinois — Medicaid: $62.03 Blue Cross Blue Shield of Illinois — Medicare Advantage: $92.08 Cigna — HMO/PPO: $119.85 HealthLink — HMO: $105.50
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$91.58 – $177.57
Psychotherapy, 60 minutes: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $135.28 Aetna — HMO/PPO: $141.82 Aetna — Medicare Advantage: $135.28 Aetna Better Health — Medicaid: $91.58 Ambetter — ACA Exchange: $135.28 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $135.28 Blue Cross Blue Shield of Illinois — Medicaid: $91.58 Blue Cross Blue Shield of Illinois — Medicare Advantage: $135.28 Cigna — HMO/PPO: $177.57 HealthLink — HMO: $158.53
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $138.16
Family psychotherapy, without the patient: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $99.68 Aetna — HMO/PPO: $104.37 Aetna — Medicare Advantage: $99.68 Aetna Better Health — Medicaid: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Ambetter — ACA Exchange: $99.68 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $99.68 Blue Cross Blue Shield of Illinois — Medicaid: $0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Blue Cross Blue Shield of Illinois — Medicare Advantage: $99.68 Cigna — HMO/PPO: $129.71 HealthLink — HMO: $127.93
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$69.80 – $143.46
Family psychotherapy, with the patient: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $103.02 Aetna — HMO/PPO: $108.77 Aetna — Medicare Advantage: $103.02 Aetna Better Health — Medicaid: $69.80 Ambetter — ACA Exchange: $103.02 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $103.02 Blue Cross Blue Shield of Illinois — Medicaid: $69.80 Blue Cross Blue Shield of Illinois — Medicare Advantage: $103.02 Cigna — HMO/PPO: $135.19 HealthLink — HMO: $132.84
Group psychotherapy CPT 90853 · Inpatient or outpatient · Doctor (professional) fee In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$24.59 – $33.90
Group psychotherapy: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $24.59 Aetna — HMO/PPO: $25.66 Aetna — Medicare Advantage: $24.59 Aetna Better Health — Medicaid: $33.70 Ambetter — ACA Exchange: $24.59 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $24.59 Blue Cross Blue Shield of Illinois — Medicaid: $33.70 Blue Cross Blue Shield of Illinois — Medicare Advantage: $24.59 Cigna — HMO/PPO: $32.11 HealthLink — HMO: $31.39

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$292.39 – $744.11
Removal of breast growth (open surgery): 10 of 23 insurance plan rates Aetna — Dual Medicare Medicaid: $443.60 Aetna — HMO/PPO: $395.75 Aetna — Medicare Advantage: $443.60 Aetna Better Health — Medicaid: $292.39 Ambetter — ACA Exchange: $443.60 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $443.60 Blue Cross Blue Shield of Illinois — Medicaid: $292.39 Blue Cross Blue Shield of Illinois — Medicare Advantage: $443.60 Blue Cross Blue Shield of Illinois — PPO: $744.11 Cigna — HMO/PPO: $549.39
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,268.11 – $1,672.64
Total hip replacement: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $1,268.11 Aetna — HMO/PPO: $1,324.07 Aetna — Medicare Advantage: $1,268.11 Aetna Better Health — Medicaid: $1,271.96 Ambetter — ACA Exchange: $1,268.11 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $1,268.11 Blue Cross Blue Shield of Illinois — Medicaid: $1,271.96 Blue Cross Blue Shield of Illinois — Medicare Advantage: $1,268.11 Cigna — HMO/PPO: $1,672.64 Humana — Dual Medicare Medicaid: $1,268.11
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,264.55 – $1,777.98
Total knee replacement: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $1,264.55 Aetna — HMO/PPO: $1,322.67 Aetna — Medicare Advantage: $1,264.55 Aetna Better Health — Medicaid: $1,269.86 Ambetter — ACA Exchange: $1,264.55 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $1,264.55 Blue Cross Blue Shield of Illinois — Medicaid: $1,269.86 Blue Cross Blue Shield of Illinois — Medicare Advantage: $1,264.55 Cigna — HMO/PPO: $1,670.49 Humana — Dual Medicare Medicaid: $1,264.55
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$164.84 – $224.05
Shoulder arthroscopy: shaving of shoulder bone: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $164.84 Aetna — HMO/PPO: $178.15 Aetna — Medicare Advantage: $164.84 Aetna Better Health — Medicaid: $169.85 Ambetter — ACA Exchange: $164.84 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $164.84 Blue Cross Blue Shield of Illinois — Medicaid: $169.85 Blue Cross Blue Shield of Illinois — Medicare Advantage: $164.84 Cigna — HMO/PPO: $224.05 Humana — Dual Medicare Medicaid: $164.84
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$534.49 – $703.54
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $543.91 Aetna — HMO/PPO: $555.18 Aetna — Medicare Advantage: $543.91 Aetna Better Health — Medicaid: $534.49 Ambetter — ACA Exchange: $543.91 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $543.91 Blue Cross Blue Shield of Illinois — Medicaid: $534.49 Blue Cross Blue Shield of Illinois — Medicare Advantage: $543.91 Cigna — HMO/PPO: $703.54 Humana — Dual Medicare Medicaid: $543.91
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$200.07 – $406.74
Removal of tonsils and adenoids (under age 12): 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $272.53 Aetna — HMO/PPO: $313.39 Aetna — Medicare Advantage: $272.53 Aetna Better Health — Medicaid: $200.07 Ambetter — ACA Exchange: $272.53 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $272.53 Blue Cross Blue Shield of Illinois — Medicaid: $200.07 Blue Cross Blue Shield of Illinois — Medicare Advantage: $272.53 Cigna — HMO/PPO: $374.96 Humana — Dual Medicare Medicaid: $272.53
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: HP EGD FLEX TRANSORAL DX	$2,210	$1,768	$115.93 – $1,989
Upper GI endoscopy (diagnostic): 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $115.93 Aetna — HMO/PPO: $130.17 Aetna — Medicare Advantage: $115.93 Aetna Better Health — Medicaid: $118.42 Ambetter — ACA Exchange: $115.93 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $115.93 Blue Cross Blue Shield of Illinois — Medicaid: $118.42 Blue Cross Blue Shield of Illinois — Medicare Advantage: $115.93 Blue Cross Blue Shield of Illinois — PPO: $218.80 Cigna — HMO/PPO: $155.69
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: HP EGD FLEX TRANSORAL W BX SNGL OR MULT	$2,965	$2,372	$129.79 – $2,668.50
Upper GI endoscopy with biopsy: 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $129.79 Aetna — HMO/PPO: $146.86 Aetna — Medicare Advantage: $129.79 Aetna Better Health — Medicaid: $133.93 Ambetter — ACA Exchange: $129.79 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $129.79 Blue Cross Blue Shield of Illinois — Medicaid: $133.93 Blue Cross Blue Shield of Illinois — Medicare Advantage: $129.79 Blue Cross Blue Shield of Illinois — PPO: $242.44 Cigna — HMO/PPO: $174.78
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: HP COLONOSCOPY FLEX DIAGNOSTIC	$2,415	$1,932	$174.97 – $2,173.50
Colonoscopy (diagnostic): 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $174.97 Aetna — HMO/PPO: $196.72 Aetna — Medicare Advantage: $174.97 Aetna Better Health — Medicaid: $178.60 Ambetter — ACA Exchange: $174.97 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $174.97 Blue Cross Blue Shield of Illinois — Medicaid: $178.60 Blue Cross Blue Shield of Illinois — Medicare Advantage: $174.97 Blue Cross Blue Shield of Illinois — PPO: $380.09 Cigna — HMO/PPO: $234.69
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$1,825 – $2,200
Colonoscopy (diagnostic): rates for 2 insurance plans HealthLink — HMO: $1,825 HealthLink — PPO: $2,200
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$87.82 – $109.78
Colonoscopy (diagnostic): 10 of 14 insurance plan rates Aetna — Dual Medicare Medicaid: $87.82 Aetna — HMO/PPO: $98.36 Aetna — Medicare Advantage: $87.82 Ambetter — ACA Exchange: $87.82 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $87.82 Blue Cross Blue Shield of Illinois — Medicare Advantage: $87.82 Humana — Dual Medicare Medicaid: $87.82 Humana — Medicare Advantage: $87.82 Medica — All Commercial: $109.78 Medica — Medicare Advantage: $87.82
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: HP COLONOSCOPY FLEX WITH BIOPSY	$2,832	$2,265.60	$188.10 – $2,548.80
Colonoscopy with biopsy: 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $188.10 Aetna — HMO/PPO: $213.62 Aetna — Medicare Advantage: $188.10 Aetna Better Health — Medicaid: $193.80 Ambetter — ACA Exchange: $188.10 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $188.10 Blue Cross Blue Shield of Illinois — Medicaid: $193.80 Blue Cross Blue Shield of Illinois — Medicare Advantage: $188.10 Blue Cross Blue Shield of Illinois — PPO: $414.44 Cigna — HMO/PPO: $255.36
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$1,825 – $2,200
Colonoscopy with biopsy: rates for 2 insurance plans HealthLink — HMO: $1,825 HealthLink — PPO: $2,200
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: HP COLONOSCOPY FLEX W REMV LES SNARE	$3,127	$2,501.60	$236.13 – $2,814.30
Colonoscopy with removal of polyps (snare): 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $236.13 Aetna — HMO/PPO: $270.33 Aetna — Medicare Advantage: $236.13 Aetna Better Health — Medicaid: $245.44 Ambetter — ACA Exchange: $236.13 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $236.13 Blue Cross Blue Shield of Illinois — Medicaid: $245.44 Blue Cross Blue Shield of Illinois — Medicare Advantage: $236.13 Blue Cross Blue Shield of Illinois — PPO: $521.69 Cigna — HMO/PPO: $321.44
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$1,825 – $2,200
Colonoscopy with removal of polyps (snare): rates for 2 insurance plans HealthLink — HMO: $1,825 HealthLink — PPO: $2,200
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$204 – $410.96
Ultrasound of the lower bowel by endoscope: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $238.02 Aetna — HMO/PPO: $274.09 Aetna — Medicare Advantage: $238.02 Aetna Better Health — Medicaid: $204 Ambetter — ACA Exchange: $238.02 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $238.02 Blue Cross Blue Shield of Illinois — Medicaid: $204 Blue Cross Blue Shield of Illinois — Medicare Advantage: $238.02 Cigna — HMO/PPO: $325.20 Humana — Dual Medicare Medicaid: $238.02
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$1,825 – $2,200
Ultrasound of the lower bowel by endoscope: rates for 2 insurance plans HealthLink — HMO: $1,825 HealthLink — PPO: $2,200
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$174.14 – $544.69
Screening colonoscopy (not high risk): 10 of 21 insurance plan rates Aetna — Dual Medicare Medicaid: $175.64 Aetna — HMO/PPO: $201.22 Aetna — Medicare Advantage: $175.64 Aetna Better Health — Medicaid: $179.05 Ambetter — ACA Exchange: $175.64 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $175.64 Blue Cross Blue Shield of Illinois — Medicaid: $179.05 Blue Cross Blue Shield of Illinois — Medicare Advantage: $175.64 HealthLink — HMO: $174.14 HealthLink — PPO: $193.49
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$1,825 – $2,200
Screening colonoscopy (not high risk): rates for 2 insurance plans HealthLink — HMO: $1,825 HealthLink — PPO: $2,200
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$87.82 – $109.78
Screening colonoscopy (not high risk): 10 of 14 insurance plan rates Aetna — Dual Medicare Medicaid: $87.82 Aetna — HMO/PPO: $100.85 Aetna — Medicare Advantage: $87.82 Ambetter — ACA Exchange: $87.82 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $87.82 Blue Cross Blue Shield of Illinois — Medicare Advantage: $87.82 Humana — Dual Medicare Medicaid: $87.82 Humana — Medicare Advantage: $87.82 Medica — All Commercial: $109.78 Medica — Medicare Advantage: $87.82
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$647.90 – $1,020.92
Gallbladder removal by laparoscope: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $706.23 Aetna — HMO/PPO: $726.58 Aetna — Medicare Advantage: $706.23 Aetna Better Health — Medicaid: $647.90 Ambetter — ACA Exchange: $706.23 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $706.23 Blue Cross Blue Shield of Illinois — Medicaid: $647.90 Blue Cross Blue Shield of Illinois — Medicare Advantage: $706.23 Cigna — HMO/PPO: $874.60 Humana — Dual Medicare Medicaid: $706.23
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$387.05 – $707.26
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $563.03 Aetna — HMO/PPO: $575.61 Aetna — Medicare Advantage: $563.03 Aetna Better Health — Medicaid: $387.05 Ambetter — ACA Exchange: $563.03 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $563.03 Blue Cross Blue Shield of Illinois — Medicaid: $387.05 Blue Cross Blue Shield of Illinois — Medicare Advantage: $563.03 Cigna — HMO/PPO: $691.77 Humana — Dual Medicare Medicaid: $563.03
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: Professional Services	Not listed in the file	Not listed in the file	$113.60 – $227.35
Prostate biopsy: rates for 9 insurance plans Aetna — HMO/PPO: $141.87 Aetna Better Health — Medicaid: $113.60 Blue Cross Blue Shield of Illinois — Medicaid: $113.60 Blue Cross Blue Shield of Illinois — PPO: $227.35 Cigna — HMO/PPO: $165.82 HealthLink — HMO: $151.17 HealthLink — PPO: $157.91 Meridian — HealthChoice Medicaid: $113.60 Molina — HealthChoice Medicaid: $113.60
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$990.55 – $1,943.95
Prostate removal by laparoscope (radical prostatectomy): 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $1,157.23 Aetna — HMO/PPO: $1,306.60 Aetna — Medicare Advantage: $1,157.23 Aetna Better Health — Medicaid: $990.55 Ambetter — ACA Exchange: $1,157.23 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $1,157.23 Blue Cross Blue Shield of Illinois — Medicaid: $990.55 Blue Cross Blue Shield of Illinois — Medicare Advantage: $1,157.23 Cigna — HMO/PPO: $1,534.65 Humana — Dual Medicare Medicaid: $1,157.23
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$160.70 – $490.64
Hysteroscopy with biopsy of the uterus lining: 10 of 23 insurance plan rates Aetna — Dual Medicare Medicaid: $225.24 Aetna — HMO/PPO: $221.39 Aetna — Medicare Advantage: $225.24 Aetna Better Health — Medicaid: $160.70 Ambetter — ACA Exchange: $225.24 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $225.24 Blue Cross Blue Shield of Illinois — Medicaid: $160.70 Blue Cross Blue Shield of Illinois — Medicare Advantage: $225.24 Blue Cross Blue Shield of Illinois — PPO: $490.64 Cigna — HMO/PPO: $300.70
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$67.44 – $360.39
Spinal injection, lower back (epidural), with imaging guidance: 10 of 23 insurance plan rates Aetna — Dual Medicare Medicaid: $92.96 Aetna — HMO/PPO: $92.59 Aetna — Medicare Advantage: $92.96 Aetna Better Health — Medicaid: $67.44 Ambetter — ACA Exchange: $92.96 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $92.96 Blue Cross Blue Shield of Illinois — Medicaid: $67.44 Blue Cross Blue Shield of Illinois — Medicare Advantage: $92.96 Blue Cross Blue Shield of Illinois — PPO: $182.29 Cigna — HMO/PPO: $126.06
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$88.25 – $369.61
Nerve root injection, lower back, with imaging guidance: 10 of 23 insurance plan rates Aetna — Dual Medicare Medicaid: $102.73 Aetna — HMO/PPO: $103.10 Aetna — Medicare Advantage: $102.73 Aetna Better Health — Medicaid: $88.25 Ambetter — ACA Exchange: $102.73 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $102.73 Blue Cross Blue Shield of Illinois — Medicaid: $88.25 Blue Cross Blue Shield of Illinois — Medicare Advantage: $102.73 Blue Cross Blue Shield of Illinois — PPO: $197.74 Cigna — HMO/PPO: $140.28
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$411.44 – $816.83
Carpal tunnel release: 10 of 23 insurance plan rates Aetna — Dual Medicare Medicaid: $438.47 Aetna — HMO/PPO: $411.44 Aetna — Medicare Advantage: $438.47 Aetna Better Health — Medicaid: $429.10 Ambetter — ACA Exchange: $438.47 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $438.47 Blue Cross Blue Shield of Illinois — Medicaid: $429.10 Blue Cross Blue Shield of Illinois — Medicare Advantage: $438.47 Blue Cross Blue Shield of Illinois — PPO: $816.83 Cigna — HMO/PPO: $564.87
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee In the file: HP DISCISSION 2ND CATARACT LASER	$54	$43.20	$48.60 – $522.30
Laser treatment of clouding after cataract surgery: 10 of 24 insurance plan rates Aetna — Dual Medicare Medicaid: $271.24 Aetna — HMO/PPO: $336.90 Aetna — Medicare Advantage: $271.24 Aetna Better Health — Medicaid: $291.12 Ambetter — ACA Exchange: $271.24 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $271.24 Blue Cross Blue Shield of Illinois — Medicaid: $291.12 Blue Cross Blue Shield of Illinois — Medicare Advantage: $271.24 Blue Cross Blue Shield of Illinois — PPO: $522.30 Cigna — HMO/PPO: $378.37
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC YAG LASER SURGERY	$2,912	$2,329.60	$1,310.40 – $2,620.80
Laser treatment of clouding after cataract surgery: 10 of 22 insurance plan rates Aetna — Dual Medicare Medicaid: $1,310.40 Aetna — HMO/PPO: $2,259.71 Aetna — Medicare Advantage: $1,310.40 Ambetter — ACA Exchange: $1,310.40 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,659.84 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $1,310.40 Blue Cross Blue Shield of Illinois — Medicare Advantage: $1,310.40 Blue Cross Blue Shield of Illinois — PPO: $1,747.20 Cigna — HMO/PPO: $2,125.76 HealthLink — HMO: $2,184
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC YAG LASER SURGERY	$2,912	$2,329.60	$1,659.84 – $2,475.20
Laser treatment of clouding after cataract surgery: rates for 4 insurance plans Aetna — HMO/PPO: $2,259.71 Blue Cross Blue Shield of Illinois — Blue Choice PPO: $1,659.84 HFN — PPO: $2,475.20 Medica — All Commercial: $1,805.44
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$464.48 – $693.97
Cataract removal with lens implant: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $464.48 Aetna — HMO/PPO: $592.55 Aetna — Medicare Advantage: $464.48 Aetna Better Health — Medicaid: $511.61 Ambetter — ACA Exchange: $464.48 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $464.48 Blue Cross Blue Shield of Illinois — Medicaid: $511.61 Blue Cross Blue Shield of Illinois — Medicare Advantage: $464.48 Cigna — HMO/PPO: $668 Humana — Dual Medicare Medicaid: $464.48

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$1,840.25 – $3,182.11
Vaginal delivery, with care before and after: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $2,521.33 Aetna — HMO/PPO: $1,970.30 Aetna — Medicare Advantage: $2,521.33 Aetna Better Health — Medicaid: $1,840.25 Ambetter — ACA Exchange: $2,521.33 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $2,521.33 Blue Cross Blue Shield of Illinois — Medicaid: $1,840.25 Blue Cross Blue Shield of Illinois — Medicare Advantage: $2,521.33 Cigna — HMO/PPO: $3,182.11 Humana — Dual Medicare Medicaid: $2,521.33
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$2,046.31 – $3,575.24
Cesarean delivery (C-section), with care before and after: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $2,860.19 Aetna — HMO/PPO: $2,190.91 Aetna — Medicare Advantage: $2,860.19 Aetna Better Health — Medicaid: $2,046.31 Ambetter — ACA Exchange: $2,860.19 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $2,860.19 Blue Cross Blue Shield of Illinois — Medicaid: $2,046.31 Blue Cross Blue Shield of Illinois — Medicare Advantage: $2,860.19 Cigna — HMO/PPO: $3,557.13 Humana — Dual Medicare Medicaid: $2,860.19
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$1,938.17 – $3,377.83
Vaginal delivery after a previous C-section, with care before and after: 10 of 20 insurance plan rates Aetna — Dual Medicare Medicaid: $2,702.26 Aetna — HMO/PPO: $2,075.13 Aetna — Medicare Advantage: $2,702.26 Aetna Better Health — Medicaid: $1,938.17 Ambetter — ACA Exchange: $2,702.26 Blue Cross Blue Shield of Illinois — Dual Medicare Medicaid: $2,702.26 Blue Cross Blue Shield of Illinois — Medicaid: $1,938.17 Blue Cross Blue Shield of Illinois — Medicare Advantage: $2,702.26 Cigna — HMO/PPO: $3,357.23 Humana — Dual Medicare Medicaid: $2,702.26

Source: Washington County Hospital’s standard charges file (sthpiprd.blob.core.windows.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 1, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	705 S Grand Ave, Nashville, IL 62263
County	Washington County
State	Illinois
Phone	(618) 327‑8236
Emergency services	Yes
Ownership	Government - Hospital District or Authority
Medicare overall rating	Not rated by CMS
CMS Certification Number	141308
Name in Medicare records	WASHINGTON COUNTY HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	Washington County Hospital & Medical Group
Official website	washingtoncountyhospital.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

Numbers match the citations above. Checked 2026-11-02.

Washington County Hospital — washingtoncountyhospital.org

Washington County Hospital

Summary

Profile from official sources

At a glance