Waverly Health Center is a critical access hospital in Waverly, Iowa. Medicare data lists emergency services. CMS overall star rating: 5 of 5 stars. Its official website lists 133 services, specialties and programs. Medicare lists 258 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.
What is a critical access hospital?
A small rural hospital with 24-hour emergency care, designated by Medicare to keep care available far from big cities. More about hospital types
Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.
The Joint Commission accreditation (hospital and clinic services)
Laboratory accreditation (The Joint Commission, CLIA, Medicare)
ICAVL accreditation for vascular laboratory
ICAEL accreditation for echocardiography laboratory
Doctors and clinicians (258)
258 doctors and other clinicians list Waverly Health Center as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.
And 234 more: the button below opens the full list.
Names link to the doctor’s page on this site when there is one, otherwise to the official NPI Registry record (U.S. Department of Health and Human Services). Find a doctor · Source: CMS Facility Affiliation Data
Other emergency rooms nearby
Hospitals that list emergency services, by straight-line distance (not driving distance).
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.
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 Waverly Health Center reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.
What patients said (patient survey)
What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.
Summary star rating (all survey topics)
★★★★★5 of 5 stars
Overall rating of the hospital
5 of 5 stars
Would recommend the hospital
5 of 5 stars
Nurses communicated well
5 of 5 stars
Doctors communicated well
4 of 5 stars
Staff explained medicines
4 of 5 stars
Information about recovery at home
5 of 5 stars
Room and bathroom kept clean
5 of 5 stars
Quiet at night
5 of 5 stars
Rated the hospital 9 or 10 out of 10
86%National average: 72%
Would definitely recommend the hospital
81%National average: 71%
Nurses “always” communicated well
83%National average: 80%
Doctors “always” communicated well
82%National average: 80%
Staff “always” explained medicines before giving them
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.
What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.
Deaths within 30 days: heart attack patients
Too few cases to report
Deaths within 30 days: heart failure patients
13.5%
Deaths within 30 days: pneumonia patients
16.1%
Deaths within 30 days: COPD patients
Too few cases to report
Deaths within 30 days: stroke patients
Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)
What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.
Returned to any hospital within 30 days (all patients)
Not reported to Medicare
Readmitted within 30 days: heart attack
Too few cases to report
Readmitted within 30 days: heart failure
21.3%
Readmitted within 30 days: pneumonia
16.7%
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
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)
157 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)
2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)
Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 77 common services exactly as Waverly Health Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.
What the prices mean
Hospital charge
The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price
The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates
The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees
A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
$404
$210.08
$67.18 – $343.40
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $343.40
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $67.18
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $67.18
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $124.13
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $283.20
UHC MEDICARE — UHC MEDICARE: $101
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
$624
$324.48
$110.20 – $530.40
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $530.40
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $110.20
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $110.20
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $202.10
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $437.42
UHC MEDICARE — UHC MEDICARE: $156
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more
$788
$409.76
$150.40 – $669.80
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $669.80
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $150.40
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $150.40
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $274.42
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $552.39
UHC MEDICARE — UHC MEDICARE: $197
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more
$275
$143
$54.70 – $233.75
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $233.75
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $54.70
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $54.70
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $100.02
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $192.78
UHC MEDICARE — UHC MEDICARE: $68.75
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
$411
$213.72
$80.35 – $349.35
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $349.35
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $80.35
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $80.35
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $147.72
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $288.11
UHC MEDICARE — UHC MEDICARE: $102.75
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Office or other outpatient consultation with low level of medical decision making, if using time, 30 minutes or more
$546
$283.92
$124.70 – $464.10
Office consultation with a specialist (moderate): rates for 7 insurance plans
HLTH PARTNERS OPEN NTWRK - ALL OTHER PLANS — HLTH PARTNERS OPEN NTWRK - ALL OTHER PLANS: $379.47
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $382.75
UHC MEDICARE — UHC MEDICARE: $136.50
WELLMARK HMO — WELLMARK HMO: $124.70
WELLMARK PPO - ALL OTHER PLANS — WELLMARK PPO - ALL OTHER PLANS: $124.70
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Office or other outpatient consultation with moderate level of medical decision making, if using time, 40 minutes or more
$811
$421.72
$189.90 – $689.35
Office consultation with a specialist (moderate to high): rates for 7 insurance plans
HLTH PARTNERS OPEN NTWRK - ALL OTHER PLANS — HLTH PARTNERS OPEN NTWRK - ALL OTHER PLANS: $563.65
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $568.51
UHC MEDICARE — UHC MEDICARE: $202.75
WELLMARK HMO — WELLMARK HMO: $189.90
WELLMARK PPO - ALL OTHER PLANS — WELLMARK PPO - ALL OTHER PLANS: $189.90
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: Initial new patient preventive medicine evaluation (18-39 years)
$345
$179.40
$86.25 – $293.25
Preventive checkup, new patient, age 18–39: rates for 8 insurance plans
HLTH PARTNERS OPEN NTWRK - ALL OTHER PLANS — HLTH PARTNERS OPEN NTWRK - ALL OTHER PLANS: $239.78
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $122.56
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $241.85
UHC MEDICARE — UHC MEDICARE: $86.25
WELLMARK HMO — WELLMARK HMO: $155.70
WELLMARK PPO - ALL OTHER PLANS — WELLMARK PPO - ALL OTHER PLANS: $155.70
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: Initial new patient preventive medicine evaluation (40-64 years)
$371
$192.92
$92.75 – $315.35
Preventive checkup, new patient, age 40–64: rates for 8 insurance plans
HLTH PARTNERS OPEN NTWRK - ALL OTHER PLANS — HLTH PARTNERS OPEN NTWRK - ALL OTHER PLANS: $257.85
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $149.16
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $260.07
UHC MEDICARE — UHC MEDICARE: $92.75
WELLMARK HMO — WELLMARK HMO: $188.70
WELLMARK PPO - ALL OTHER PLANS — WELLMARK PPO - ALL OTHER PLANS: $188.70
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency department visit with low level of medical decision making
$278
$144.56
$58.19 – $236.30
Emergency room visit (moderate): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $236.30
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $64.65
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $64.65
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $499.50
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $389.06
UHC MEDICARE — UHC MEDICARE: $210.90
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency department visit with moderate level of medical decision making
$521
$270.92
$98.92 – $442.85
Emergency room visit (moderately high): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $442.85
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $109.91
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $109.91
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $182.09
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $365.22
UHC MEDICARE — UHC MEDICARE: $98.92
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Emergency department visit with moderate level of medical decision making
$915
$475.80
$347.70 – $823.50
Emergency room visit (moderately high): rates for 10 insurance plans
AETNA-ALL PLANS — AETNA-ALL PLANS: $777.75
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $351.18
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $823.50
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $823.50
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $641.42
UHC MEDICARE — UHC MEDICARE: $347.70
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency department visit with high level of medical decision making
$770
$400.40
$143.85 – $654.50
Emergency room visit (high): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $654.50
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $159.83
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $159.83
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $100.80
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $78.51
UHC MEDICARE — UHC MEDICARE: $42.56
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Manual urinalysis test with examination using microscope, automated
$61
$31.72
$23.18 – $54.90
Urine test (automated, with microscope): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $51.85
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $23.41
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $54.90
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $162
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $126.18
UHC MEDICARE — UHC MEDICARE: $68.40
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
$109
$56.68
$27.64 – $98.10
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $92.65
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $41.83
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $98.10
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $71.93
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $18.93
UHC MEDICARE — UHC MEDICARE: $1.16
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Coagulation assessment blood test, plasma or whole blood
$109
$56.68
$29.88 – $98.10
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $92.65
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $41.83
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $98.10
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $493.20
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $384.15
UHC MEDICARE — UHC MEDICARE: $208.24
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI scan of lower spinal canal without contrast
$3,553
$1,847.56
$720.11 – $3,197.70
MRI of the lower back (lumbar spine), without contrast: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $3,020.05
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $1,363.64
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $3,197.70
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $1,097.10
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $854.52
UHC MEDICARE — UHC MEDICARE: $463.22
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus
$1,102
$573.04
$269.67 – $991.80
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $936.70
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $422.95
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $991.80
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $991.80
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $772.50
UHC MEDICARE — UHC MEDICARE: $418.76
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina
$575
$299
$21.60 – $488.75
Transvaginal ultrasound: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $488.75
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $30.86
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $30.86
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $530.10
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $412.89
UHC MEDICARE — UHC MEDICARE: $223.82
Heart tests and sleep study
Service
Hospital charge
Cash price
Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: Routine electrocardiogram (ECG) using at least 12 leads with interpretation and report
$97
$50.44
$12.78 – $82.45
Electrocardiogram (ECG/EKG) with reading: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $82.45
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $14.20
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $14.20
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $242.86
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $2,223.57
UHC MEDICARE — UHC MEDICARE: $103
Physical therapy and mental health
Service
Hospital charge
Cash price
Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes
$130
$67.60
$24.92 – $110.50
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $110.50
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $27.69
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $27.69
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $33.70
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $91.13
UHC MEDICARE — UHC MEDICARE: $24.92
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Evaluation for physical therapy, typically 20 minutes
$260
$135.20
$98.80 – $248.76
Physical therapy evaluation (low complexity): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $221
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $99.79
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $234
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $234
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $182.26
UHC MEDICARE — UHC MEDICARE: $98.80
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Evaluation for physical therapy, typically 30 minutes
$290
$150.80
$110.20 – $261
Physical therapy evaluation (moderate complexity): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $246.50
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $111.30
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $261
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $261
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $203.29
UHC MEDICARE — UHC MEDICARE: $110.20
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Evaluation for physical therapy, typically 45 minutes
$319
$165.88
$121.22 – $287.10
Physical therapy evaluation (high complexity): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $271.15
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $122.43
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $287.10
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $48.16
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $102.35
UHC MEDICARE — UHC MEDICARE: $21.64
Procedures and surgery
Service
Hospital charge
Cash price
Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Removal of growth and tissue of breast, duct, or nipple
$926
$481.52
$328.01 – $905.20
Removal of breast growth (open surgery): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $787.10
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $364.45
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $364.45
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $2,641.40
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $4,324.47
UHC MEDICARE — UHC MEDICARE: $940.95
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Shaving of part of shoulder bone and repair of ligament using an endoscope
$786
$408.72
$120.03 – $668.10
Shoulder arthroscopy: shaving of shoulder bone: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $668.10
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $133.37
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $133.37
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $356.60
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $550.99
UHC MEDICARE — UHC MEDICARE: $120.03
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Removal of knee cartilage using an endoscope
$2,503
$1,301.56
$420.39 – $2,127.55
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $2,127.55
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $467.10
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $467.10
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $1,119.38
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $1,754.60
UHC MEDICARE — UHC MEDICARE: $420.39
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Removal of tonsils and adenoid glands (younger than 12 years)
$1,175
$611
$216.14 – $998.75
Removal of tonsils and adenoids (under age 12): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $998.75
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $240.15
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $240.15
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $589
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $823.68
UHC MEDICARE — UHC MEDICARE: $216.14
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope
$1,179
$613.08
$92.52 – $1,002.15
Upper GI endoscopy (diagnostic): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $1,002.15
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $102.80
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $102.80
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $249.14
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $826.48
UHC MEDICARE — UHC MEDICARE: $92.52
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope
$1,370
$712.40
$103.52 – $1,164.50
Upper GI endoscopy with biopsy: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $1,164.50
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $115.02
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $115.02
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $408.24
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $1,318.58
UHC MEDICARE — UHC MEDICARE: $148.65
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Removal of polyps or growths of large bowel using an endoscope with mechanical snare
$2,127
$1,106.04
$187.47 – $1,807.95
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $1,807.95
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $208.30
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $208.30
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $515.72
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $1,491.03
UHC MEDICARE — UHC MEDICARE: $187.47
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK
$1,568
$815.36
$152.74 – $1,332.80
Screening colonoscopy (not high risk): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $1,332.80
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $152.74
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $152.74
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $1,080.30
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $1,395.69
UHC MEDICARE — UHC MEDICARE: $406.27
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Surgical removal of prostate and surrounding lymph nodes using an endoscope
$7,933
$4,125.16
$902.80 – $6,743.05
Prostate removal by laparoscope (radical prostatectomy): 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $6,743.05
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $1,003.11
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $1,003.11
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $2,927.54
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $5,561.03
UHC MEDICARE — UHC MEDICARE: $902.80
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Biopsy of lining of uterus and/or removal of polyp using an endoscope
$1,334
$693.68
$167.53 – $1,133.90
Hysteroscopy with biopsy of the uterus lining: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $1,133.90
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $186.14
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $186.14
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $260.24
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $935.13
UHC MEDICARE — UHC MEDICARE: $167.53
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Injection of substance into lower spine canal using imaging guidance
$811
$421.72
$308.18 – $1,541.02
Spinal injection, lower back (epidural), with imaging guidance: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $689.35
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $311.26
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $729.90
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $729.90
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $568.51
UHC MEDICARE — UHC MEDICARE: $308.18
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level
$1,045
$543.40
$84.05 – $888.25
Nerve root injection, lower back, with imaging guidance: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $888.25
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $93.39
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $93.39
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $892.05
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $1,120.20
UHC MEDICARE — UHC MEDICARE: $345.47
Pregnancy and childbirth
Service
Hospital charge
Cash price
Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: Vaginal delivery with care before and after delivery
$7,100
$3,692
$1,754.05 – $6,035
Vaginal delivery, with care before and after: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $6,035
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $1,948.94
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $1,948.94
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $3,402.89
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $4,977.10
UHC MEDICARE — UHC MEDICARE: $1,754.05
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Cesarean delivery with care before and after delivery
$8,041
$4,181.32
$1,939.26 – $6,834.85
Cesarean delivery (C-section), with care before and after: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $6,834.85
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $2,154.73
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $2,154.73
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $3,782.30
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $5,636.74
UHC MEDICARE — UHC MEDICARE: $1,939.26
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Vaginal delivery and care before and after delivery after previous cesarean delivery
$7,474
$3,886.48
$1,824.54 – $6,352.90
Vaginal delivery after a previous C-section, with care before and after: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $6,352.90
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $2,027.27
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $2,027.27
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $3,584.80
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $5,239.27
UHC MEDICARE — UHC MEDICARE: $1,824.54
Hospital stays (whole stay, MS-DRG)
Service
Hospital charge
Cash price
Insurance rates (lowest – highest)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
$36,667
$19,066.84
$17,141.82 – $33,000.30
Hip or knee replacement (major joint of the leg), without major complications: rates for 8 insurance plans
AETNA-ALL PLANS — AETNA-ALL PLANS: $31,166.95
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $33,000.30
HLTH PARTNERS OPEN NTWRK - ALL OTHER PLANS — HLTH PARTNERS OPEN NTWRK - ALL OTHER PLANS: $31,166.95
MIDLANDS CHOICE-ALL OTHER PLANS — MIDLANDS CHOICE-ALL OTHER PLANS: $33,000.30
UHC COMM-ALL OTHER PLANS — UHC COMM-ALL OTHER PLANS: $25,703.57
WELLMARK HMO — WELLMARK HMO: $17,141.82
WELLMARK PPO - ALL OTHER PLANS — WELLMARK PPO - ALL OTHER PLANS: $17,141.82
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC
$16,833.40
$8,753.37
$4,031 – $15,150.06
Uterus and ovary surgery (not for cancer), without complications: 10 of 12 insurance plan rates
AETNA-ALL PLANS — AETNA-ALL PLANS: $14,308.39
CHOICECARE NETWORK - ALL PLANS — CHOICECARE NETWORK - ALL PLANS: $4,031
HEALTH ALLIANCE-ALL PLANS — HEALTH ALLIANCE-ALL PLANS: $15,150.06
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.