Medical emergency?Emergency? Call 911. Nearest emergency roomsNearest ERs

Acute Care Hospital

Wheeling Hospital, Inc

Also listed as: Wheeling Hospital (WVU Medicine)

Wheeling, West Virginia · Ohio County · Emergency services listed

Wheeling Hospital, Inc is an acute care hospital at 1 Medical Park, Wheeling, WV 26003. Phone: (304) 243-3000. It has an emergency department. Medicare overall rating: 2 of 5 stars (CMS, October 2026).

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

Summary

Wheeling Hospital, Inc is an acute care hospital in Wheeling, West Virginia. Medicare data lists emergency services. CMS overall star rating: 2 of 5 stars. Its official website lists 26 services, specialties and programs. Medicare lists 769 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

A general hospital for short-term care: emergencies, surgery, illness and injury. Most patients stay a few days. More about hospital types

Compare

Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
2 of 5 stars2 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
26Services listed

Quick answers

Does Wheeling Hospital, Inc have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Wheeling Hospital, Inc. In a medical emergency, call 911.
Where is Wheeling Hospital, Inc?
1 Medical Park, Wheeling, WV 26003, in Ohio County, West Virginia.
What is the phone number of Wheeling Hospital, Inc?
(304) 243-3000, as listed by Medicare (CMS).
What is the Medicare star rating of Wheeling Hospital, Inc?
2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Wheeling Hospital, Inc for hospital-acquired conditions?
No. For fiscal year 2026, CMS lists no Medicare payment reduction for Wheeling Hospital, Inc under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.0290; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4][10]

Treatments[5]

  • Acute cardiac care (STEMI)
  • Stroke patient management

Programs and centers[5][9][10][11][12][13]

  • Emergency Medicine Fellowship
  • Foot and Ankle Advanced Surgical Fellowship
  • Family Medicine Residency
  • Podiatric Medicine and Surgery Residency
  • Family Medicine Rural Scholars Program

Emergency care (hospital website)[4][5][7]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

VisitingGeneral visiting hours 10 am–9 pm daily; up to two visitors at a time per patient; no overnight visitors on adult inpatient units[8]
ParkingPrimary lot directly in front of the hospital; additional lots behind; valet parking at Tower 4 entrance[7]
Interpreters and languagesFree language services, including qualified interpreting and information in other languages[6]
Patient portalMyWVUChart

Doctors and clinicians (769)

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

Main specialties

Doctors with a page on this site (769)

And 745 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Wheeling

All hospitals in Wheeling · Hospitals in Ohio County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

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

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

What Wheeling Hospital, Inc 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) 2 of 5 stars
Overall rating of the hospital2 of 5 stars
Would recommend the hospital2 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well2 of 5 stars
Patients got help quickly from staff2 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean3 of 5 stars
Restfulness of Environment2 of 5 stars
Care Coordination2 of 5 stars
Symptoms After Stay2 of 5 stars
Rated the hospital 9 or 10 out of 1061%National average: 72%
Would definitely recommend the hospital57%National average: 71%
Nurses “always” communicated well78%National average: 80%
Doctors “always” communicated well74%National average: 80%
“Always” got help as soon as they wanted56%National average: 64%
Staff “always” explained medicines before giving them57%National average: 62%
Were given information about recovery at home83%National average: 86%
Room and bathroom “always” clean69%National average: 73%
Completed surveys1,658Response rate: 23%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.206No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.722No different from the national benchmark
Surgical site infections after colon surgery0.312No different from the national benchmark
MRSA bloodstream infections0.299No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections1.11No different from the national benchmark
Not reported to MedicareSurgical site infections after abdominal hysterectomy

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

Complications and deaths

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

Deaths within 30 days: heart attack patients11.7%
Deaths within 30 days: heart failure patients10.8%
Deaths within 30 days: pneumonia patients16.3%
Deaths within 30 days: COPD patients11.1%
Deaths within 30 days: stroke patients10.4%
Deaths within 30 days: coronary bypass surgery (CABG)1.9%
Serious complications (patient safety indicator PSI-90)0.87No different from the national rate
Complications after hip or knee replacement4.3%

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)17.4%
Readmitted within 30 days: heart attack13.1%
Readmitted within 30 days: heart failure24.3%
Readmitted within 30 days: pneumonia20%
Readmitted within 30 days: COPD22.1%
Readmitted within 30 days: coronary bypass surgery9.1%
Readmitted within 30 days: hip or knee replacement4.9%

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

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

Emergency room volume (patients per year)High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)204 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)87%National average: 66%

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Wheeling Hospital, Inc, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026NoCMS lists no payment reduction for this hospital.
Total HAC Score0.0290Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart attack1.0725More readmissions than expected
Heart failure0.9929Fewer readmissions than expected
Pneumonia1.0994More readmissions than expected
COPD (chronic lung disease)1.0685More readmissions than expected
Hip or knee replacement1.1134More readmissions than expected
Coronary bypass surgery (CABG)0.8983Fewer readmissions than expected

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Hospital Value-Based Purchasing Program

What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.

CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.

Total Performance Score33.33 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)28.33 out of 100
Person and community engagement (patient survey)20.00 out of 100
Safety (infections and sepsis care)65.00 out of 100
Efficiency and cost reduction (Medicare spending)20.00 out of 100

Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio0.99Below the national median hospital (1.00): Medicare spent less

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

ER wait times and Medicare ratings nearby

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

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 71 common services exactly as Wheeling Hospital, Inc 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 →

$ 2 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.

Show the prices of 71 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES $144 $72 $46.88 – $305.54
New patient office visit (about 30–44 minutes): 10 of 59 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $62.94
  • Aetna Better Health PA — CHIP: $54.25
  • Aetna Better Health WV — CHIP: $62.94
  • Aetna Medicare Advantage — All Plans: $75.73
  • Anthem OH Medicare Advantage — HMO: $74.28
  • Anthem Pathway — Anthem Pathway: $72.12
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $305.54
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $305.54
  • Buckeye Commercial — Exchange Plan: $108.18
  • Buckeye OH Medicare Advantage — All Plans: $75.73
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES $144 $72 $46.88 – $305.54
New patient office visit (about 30–44 minutes): 10 of 47 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $75.73
  • Anthem OH Medicare Advantage — HMO: $74.28
  • Anthem Pathway — Anthem Pathway: $72.12
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $305.54
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $305.54
  • Buckeye Commercial — Exchange Plan: $108.18
  • Buckeye OH Medicare Advantage — All Plans: $75.73
  • CareSource OH Exchange — CareSource OH Exchange: $79.33
  • CareSource OH Medicare Advantage — All Plans: $72.12
  • Coventry Health Care — Worker's Compensation: $113.95
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES $145 $72.50 $76.36 – $497.66
New patient office visit (about 45–59 minutes): 10 of 47 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $123.34
  • Anthem OH Medicare Advantage — HMO: $120.99
  • Anthem Pathway — Anthem Pathway: $117.47
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $497.66
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $497.66
  • Buckeye Commercial — Exchange Plan: $176.20
  • Buckeye OH Medicare Advantage — All Plans: $123.34
  • CareSource OH Exchange — CareSource OH Exchange: $129.22
  • CareSource OH Medicare Advantage — All Plans: $117.47
  • Coventry Health Care — Worker's Compensation: $185.60
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES $144 $72 $37.24 – $242.75
Established patient office visit (about 20–29 minutes): 10 of 59 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $50.35
  • Aetna Better Health PA — CHIP: $40
  • Aetna Better Health WV — CHIP: $50.35
  • Aetna Medicare Advantage — All Plans: $60.16
  • Anthem OH Medicare Advantage — HMO: $59.02
  • Anthem Pathway — Anthem Pathway: $57.30
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $242.75
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $242.75
  • Buckeye Commercial — Exchange Plan: $85.95
  • Buckeye OH Medicare Advantage — All Plans: $60.16
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES $144 $72 $37.24 – $242.75
Established patient office visit (about 20–29 minutes): 10 of 47 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $60.16
  • Anthem OH Medicare Advantage — HMO: $59.02
  • Anthem Pathway — Anthem Pathway: $57.30
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $242.75
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $242.75
  • Buckeye Commercial — Exchange Plan: $85.95
  • Buckeye OH Medicare Advantage — All Plans: $60.16
  • CareSource OH Exchange — CareSource OH Exchange: $63.03
  • CareSource OH Medicare Advantage — All Plans: $57.30
  • Coventry Health Care — Worker's Compensation: $90.53
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_27 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES $144 $72 $37.24 – $242.75
Established patient office visit (about 20–29 minutes): 10 of 47 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $60.16
  • Anthem OH Medicare Advantage — HMO: $59.02
  • Anthem Pathway — Anthem Pathway: $57.30
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $242.75
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $242.75
  • Buckeye Commercial — Exchange Plan: $85.95
  • Buckeye OH Medicare Advantage — All Plans: $60.16
  • CareSource OH Exchange — CareSource OH Exchange: $63.03
  • CareSource OH Medicare Advantage — All Plans: $57.30
  • Coventry Health Care — Worker's Compensation: $90.53
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES $145 $72.50 $54.42 – $357.81
Established patient office visit (about 30–39 minutes): 10 of 59 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $74.48
  • Aetna Better Health PA — CHIP: $54.42
  • Aetna Better Health WV — CHIP: $74.48
  • Aetna Medicare Advantage — All Plans: $88.68
  • Anthem OH Medicare Advantage — HMO: $86.99
  • Anthem Pathway — Anthem Pathway: $84.46
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $357.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $357.81
  • Buckeye Commercial — Exchange Plan: $126.69
  • Buckeye OH Medicare Advantage — All Plans: $88.68
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES $145 $72.50 $54.90 – $357.81
Established patient office visit (about 30–39 minutes): 10 of 47 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $88.68
  • Anthem OH Medicare Advantage — HMO: $86.99
  • Anthem Pathway — Anthem Pathway: $84.46
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $357.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $357.81
  • Buckeye Commercial — Exchange Plan: $126.69
  • Buckeye OH Medicare Advantage — All Plans: $88.68
  • CareSource OH Exchange — CareSource OH Exchange: $92.91
  • CareSource OH Medicare Advantage — All Plans: $84.46
  • Coventry Health Care — Worker's Compensation: $133.45
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_XU In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES $144 $72 $54.90 – $357.81
Established patient office visit (about 30–39 minutes): 10 of 47 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $88.68
  • Anthem OH Medicare Advantage — HMO: $86.99
  • Anthem Pathway — Anthem Pathway: $84.46
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $357.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $357.81
  • Buckeye Commercial — Exchange Plan: $126.69
  • Buckeye OH Medicare Advantage — All Plans: $88.68
  • CareSource OH Exchange — CareSource OH Exchange: $92.91
  • CareSource OH Medicare Advantage — All Plans: $84.46
  • Coventry Health Care — Worker's Compensation: $133.45
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39 $151 $75.50 $70.52 – $339.60
Preventive checkup, new patient, age 18–39: 10 of 33 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $71.86
  • Aetna Better Health PA — CHIP: $283
  • Aetna Better Health WV — CHIP: $71.86
  • Geisinger Pennsylvania — Mgd Medicaid: $339.60
  • Highmark Health Options — CHIP: $70.52
  • Highmark Health Options West VA — Mgd MCaid: $70.52
  • Pennsylvania Health & Wellness — Medicaid: $311.30
  • The Health Plan WV — CHIP: $71.86
  • The Health Plan WV — Mgd MCaid: $71.53
  • UHC Community PA CHIP — Unison Kids: $291.49
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS) $140 $70 $70.52 – $339.60
Preventive checkup, new patient, age 18–39: 10 of 33 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $71.86
  • Aetna Better Health PA — CHIP: $283
  • Aetna Better Health WV — CHIP: $71.86
  • Geisinger Pennsylvania — Mgd Medicaid: $339.60
  • Highmark Health Options — CHIP: $70.52
  • Highmark Health Options West VA — Mgd MCaid: $70.52
  • Pennsylvania Health & Wellness — Medicaid: $311.30
  • The Health Plan WV — CHIP: $71.86
  • The Health Plan WV — Mgd MCaid: $71.53
  • UHC Community PA CHIP — Unison Kids: $291.49
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS) $140 $70 Not listed in the file
Preventive checkup, new patient, age 18–39: 10 of 21 insurance plan rates
  • 4 Most Zelis Stratose — 4 Most Zelis Stratose: 95% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 93.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Better Health: 60% (a percentage in the contract, not a dollar amount)
  • Aetna — Student: 80% (a percentage in the contract, not a dollar amount)
  • Aetna Rental — First Health: 95% (a percentage in the contract, not a dollar amount)
  • American Correctional Healthcare, Inc. — FBOP: 100% (a percentage in the contract, not a dollar amount)
  • AMPS — Direct Agreements: 95% (a percentage in the contract, not a dollar amount)
  • BRMS — Direct Agreements: 94% (a percentage in the contract, not a dollar amount)
  • CareSource — CareSource: 90% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 91.6% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64 $79 $39.50 $85.19 – $339.60
Preventive checkup, new patient, age 40–64: 10 of 33 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $86.81
  • Aetna Better Health PA — CHIP: $283
  • Aetna Better Health WV — CHIP: $86.81
  • Geisinger Pennsylvania — Mgd Medicaid: $339.60
  • Highmark Health Options — CHIP: $85.19
  • Highmark Health Options West VA — Mgd MCaid: $85.19
  • Pennsylvania Health & Wellness — Medicaid: $311.30
  • The Health Plan WV — CHIP: $86.81
  • The Health Plan WV — Mgd MCaid: $86.40
  • UHC Community PA CHIP — Unison Kids: $291.49
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS) $73 $36.50 $85.19 – $339.60
Preventive checkup, new patient, age 40–64: 10 of 33 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $86.81
  • Aetna Better Health PA — CHIP: $283
  • Aetna Better Health WV — CHIP: $86.81
  • Geisinger Pennsylvania — Mgd Medicaid: $339.60
  • Highmark Health Options — CHIP: $85.19
  • Highmark Health Options West VA — Mgd MCaid: $85.19
  • Pennsylvania Health & Wellness — Medicaid: $311.30
  • The Health Plan WV — CHIP: $86.81
  • The Health Plan WV — Mgd MCaid: $86.40
  • UHC Community PA CHIP — Unison Kids: $291.49
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS) $73 $36.50 Not listed in the file
Preventive checkup, new patient, age 40–64: 10 of 21 insurance plan rates
  • 4 Most Zelis Stratose — 4 Most Zelis Stratose: 95% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna: 93.6% (a percentage in the contract, not a dollar amount)
  • Aetna — Better Health: 60% (a percentage in the contract, not a dollar amount)
  • Aetna — Student: 80% (a percentage in the contract, not a dollar amount)
  • Aetna Rental — First Health: 95% (a percentage in the contract, not a dollar amount)
  • American Correctional Healthcare, Inc. — FBOP: 100% (a percentage in the contract, not a dollar amount)
  • AMPS — Direct Agreements: 95% (a percentage in the contract, not a dollar amount)
  • BRMS — Direct Agreements: 94% (a percentage in the contract, not a dollar amount)
  • CareSource — CareSource: 90% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 91.6% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM $1,629 $814.50 $25 – $1,200
Emergency room visit (moderate): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $104.59
  • Aetna Better Health PA — CHIP: $56.65
  • Aetna Better Health WV — CHIP: $104.59
  • Aetna Medicare Advantage — All Plans: $275.90
  • Alliance Coal — Alliance Coal: $459.83
  • Anthem OH Medicare Advantage — HMO: $270.64
  • Anthem Pathway — Anthem Pathway: $262.76
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,113.18
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,113.18
  • Buckeye Commercial — Exchange Plan: $394.14
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $1,404 $702 $25 – $1,200
Emergency room visit (moderate): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $104.59
  • Aetna Better Health PA — CHIP: $56.65
  • Aetna Better Health WV — CHIP: $104.59
  • Aetna Medicare Advantage — All Plans: $275.90
  • Alliance Coal — Alliance Coal: $459.83
  • Anthem OH Medicare Advantage — HMO: $270.64
  • Anthem Pathway — Anthem Pathway: $262.76
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,113.18
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,113.18
  • Buckeye Commercial — Exchange Plan: $394.14
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $1,404 $702 $25 – $1,200
Emergency room visit (moderate): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $275.90
  • Alliance Coal — Alliance Coal: $459.83
  • Anthem OH Medicare Advantage — HMO: $270.64
  • Anthem Pathway — Anthem Pathway: $262.76
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,113.18
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,113.18
  • Buckeye Commercial — Exchange Plan: $394.14
  • Buckeye OH Medicare Advantage — All Plans: $275.90
  • CareSource OH Exchange — CareSource OH Exchange: $289.04
  • CareSource OH Medicare Advantage — All Plans: $262.76
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM $2,449 $1,224.50 $25 – $1,701.51
Emergency room visit (moderately high): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $205.23
  • Aetna Better Health PA — CHIP: $95.33
  • Aetna Better Health WV — CHIP: $205.23
  • Aetna Medicare Advantage — All Plans: $421.71
  • Alliance Coal — Alliance Coal: $702.85
  • Anthem OH Medicare Advantage — HMO: $413.68
  • Anthem Pathway — Anthem Pathway: $401.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,701.51
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,701.51
  • Buckeye Commercial — Exchange Plan: $602.45
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $2,111 $1,055.50 $25 – $1,701.51
Emergency room visit (moderately high): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $205.23
  • Aetna Better Health PA — CHIP: $95.33
  • Aetna Better Health WV — CHIP: $205.23
  • Aetna Medicare Advantage — All Plans: $421.71
  • Alliance Coal — Alliance Coal: $702.85
  • Anthem OH Medicare Advantage — HMO: $413.68
  • Anthem Pathway — Anthem Pathway: $401.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,701.51
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,701.51
  • Buckeye Commercial — Exchange Plan: $602.45
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $2,111 $1,055.50 $25 – $1,701.51
Emergency room visit (moderately high): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $421.71
  • Alliance Coal — Alliance Coal: $702.85
  • Anthem OH Medicare Advantage — HMO: $413.68
  • Anthem Pathway — Anthem Pathway: $401.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,701.51
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,701.51
  • Buckeye Commercial — Exchange Plan: $602.45
  • Buckeye OH Medicare Advantage — All Plans: $421.71
  • CareSource OH Exchange — CareSource OH Exchange: $441.79
  • CareSource OH Medicare Advantage — All Plans: $401.63
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM $3,179 $1,589.50 $25 – $2,428.49
Emergency room visit (high): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $620.92
  • Aetna Better Health PA — CHIP: $138.74
  • Aetna Better Health WV — CHIP: $620.92
  • Aetna Medicare Advantage — All Plans: $601.89
  • Alliance Coal — Alliance Coal: $1,003.15
  • Anthem OH Medicare Advantage — HMO: $590.43
  • Anthem Pathway — Anthem Pathway: $573.23
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,428.49
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,428.49
  • Buckeye Commercial — Exchange Plan: $859.84
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $2,740 $1,370 $25 – $2,428.49
Emergency room visit (high): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $620.92
  • Aetna Better Health PA — CHIP: $138.74
  • Aetna Better Health WV — CHIP: $620.92
  • Aetna Medicare Advantage — All Plans: $601.89
  • Alliance Coal — Alliance Coal: $1,003.15
  • Anthem OH Medicare Advantage — HMO: $590.43
  • Anthem Pathway — Anthem Pathway: $573.23
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,428.49
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,428.49
  • Buckeye Commercial — Exchange Plan: $859.84
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $2,740 $1,370 $25 – $2,428.49
Emergency room visit (high): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $601.89
  • Alliance Coal — Alliance Coal: $1,003.15
  • Anthem OH Medicare Advantage — HMO: $590.43
  • Anthem Pathway — Anthem Pathway: $573.23
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,428.49
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,428.49
  • Buckeye Commercial — Exchange Plan: $859.84
  • Buckeye OH Medicare Advantage — All Plans: $601.89
  • CareSource OH Exchange — CareSource OH Exchange: $630.55
  • CareSource OH Medicare Advantage — All Plans: $573.23

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $76 $38 $5.50 – $35.84
Basic metabolic panel (blood test): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $8.14
  • Aetna Better Health PA — CHIP: $9.36
  • Aetna Better Health WV — CHIP: $8.14
  • Aetna Medicare Advantage — All Plans: $8.88
  • Alliance Coal — Alliance Coal: $10.58
  • Anthem OH Medicare Advantage — HMO: $8.71
  • Anthem Pathway — Anthem Pathway: $8.46
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $35.84
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $35.84
  • Buckeye Commercial — Exchange Plan: $12.69
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $76 $38 $5.50 – $35.84
Basic metabolic panel (blood test): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $8.88
  • Alliance Coal — Alliance Coal: $10.58
  • Anthem OH Medicare Advantage — HMO: $8.71
  • Anthem Pathway — Anthem Pathway: $8.46
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $35.84
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $35.84
  • Buckeye Commercial — Exchange Plan: $12.69
  • Buckeye OH Medicare Advantage — All Plans: $8.88
  • CareSource OH Exchange — CareSource OH Exchange: $9.31
  • CareSource OH Medicare Advantage — All Plans: $8.46
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier EP In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $76 $38 $5.50 – $35.84
Basic metabolic panel (blood test): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $8.88
  • Alliance Coal — Alliance Coal: $10.58
  • Anthem OH Medicare Advantage — HMO: $8.71
  • Anthem Pathway — Anthem Pathway: $8.46
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $35.84
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $35.84
  • Buckeye Commercial — Exchange Plan: $12.69
  • Buckeye OH Medicare Advantage — All Plans: $8.88
  • CareSource OH Exchange — CareSource OH Exchange: $9.31
  • CareSource OH Medicare Advantage — All Plans: $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $95 $47.50 $6.86 – $44.74
Comprehensive metabolic panel (blood test): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $10.17
  • Aetna Better Health PA — CHIP: $11.69
  • Aetna Better Health WV — CHIP: $10.17
  • Aetna Medicare Advantage — All Plans: $11.09
  • Alliance Coal — Alliance Coal: $13.20
  • Anthem OH Medicare Advantage — HMO: $10.88
  • Anthem Pathway — Anthem Pathway: $10.56
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $44.74
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $44.74
  • Buckeye Commercial — Exchange Plan: $15.84
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL $98 $49 $6.86 – $44.74
Comprehensive metabolic panel (blood test): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $10.17
  • Aetna Better Health PA — CHIP: $11.69
  • Aetna Better Health WV — CHIP: $10.17
  • Aetna Medicare Advantage — All Plans: $11.09
  • Alliance Coal — Alliance Coal: $13.20
  • Anthem OH Medicare Advantage — HMO: $10.88
  • Anthem Pathway — Anthem Pathway: $10.56
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $44.74
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $44.74
  • Buckeye Commercial — Exchange Plan: $15.84
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $95 $47.50 $6.86 – $44.74
Comprehensive metabolic panel (blood test): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $11.09
  • Alliance Coal — Alliance Coal: $13.20
  • Anthem OH Medicare Advantage — HMO: $10.88
  • Anthem Pathway — Anthem Pathway: $10.56
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $44.74
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $44.74
  • Buckeye Commercial — Exchange Plan: $15.84
  • Buckeye OH Medicare Advantage — All Plans: $11.09
  • CareSource OH Exchange — CareSource OH Exchange: $11.62
  • CareSource OH Medicare Advantage — All Plans: $10.56
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL $430 $215 $12 – $202.55
Obstetric blood test panel: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $46.04
  • Aetna Better Health PA — CHIP: $12
  • Aetna Better Health WV — CHIP: $46.04
  • Aetna Medicare Advantage — All Plans: $50.20
  • Alliance Coal — Alliance Coal: $59.76
  • Anthem OH Medicare Advantage — HMO: $49.24
  • Anthem Pathway — Anthem Pathway: $47.81
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $202.55
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $202.55
  • Buckeye Commercial — Exchange Plan: $71.72
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $121 $60.50 $8.70 – $56.73
Cholesterol panel (lipid panel): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $12.89
  • Aetna Better Health PA — CHIP: $14
  • Aetna Better Health WV — CHIP: $12.89
  • Aetna Medicare Advantage — All Plans: $14.06
  • Alliance Coal — Alliance Coal: $16.74
  • Anthem OH Medicare Advantage — HMO: $13.79
  • Anthem Pathway — Anthem Pathway: $13.39
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $56.73
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $56.73
  • Buckeye Commercial — Exchange Plan: $20.08
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL $125 $62.50 $8.70 – $56.73
Cholesterol panel (lipid panel): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $12.89
  • Aetna Better Health PA — CHIP: $14
  • Aetna Better Health WV — CHIP: $12.89
  • Aetna Medicare Advantage — All Plans: $14.06
  • Alliance Coal — Alliance Coal: $16.74
  • Anthem OH Medicare Advantage — HMO: $13.79
  • Anthem Pathway — Anthem Pathway: $13.39
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $56.73
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $56.73
  • Buckeye Commercial — Exchange Plan: $20.08
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $36 $18 $8.70 – $56.73
Cholesterol panel (lipid panel): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $14.06
  • Alliance Coal — Alliance Coal: $16.74
  • Anthem OH Medicare Advantage — HMO: $13.79
  • Anthem Pathway — Anthem Pathway: $13.39
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $56.73
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $56.73
  • Buckeye Commercial — Exchange Plan: $20.08
  • Buckeye OH Medicare Advantage — All Plans: $14.06
  • CareSource OH Exchange — CareSource OH Exchange: $14.73
  • CareSource OH Medicare Advantage — All Plans: $13.39
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL $78 $39 $5.64 – $36.77
Kidney function panel: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $8.36
  • Aetna Better Health PA — CHIP: $9.60
  • Aetna Better Health WV — CHIP: $8.36
  • Aetna Medicare Advantage — All Plans: $9.11
  • Alliance Coal — Alliance Coal: $10.85
  • Anthem OH Medicare Advantage — HMO: $8.94
  • Anthem Pathway — Anthem Pathway: $8.68
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $36.77
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $36.77
  • Buckeye Commercial — Exchange Plan: $13.02
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: KIDNEY FUNCTION BLOOD TEST PANEL $78 $39 $5.64 – $36.77
Kidney function panel: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $9.11
  • Alliance Coal — Alliance Coal: $10.85
  • Anthem OH Medicare Advantage — HMO: $8.94
  • Anthem Pathway — Anthem Pathway: $8.68
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $36.77
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $36.77
  • Buckeye Commercial — Exchange Plan: $13.02
  • Buckeye OH Medicare Advantage — All Plans: $9.11
  • CareSource OH Exchange — CareSource OH Exchange: $9.55
  • CareSource OH Medicare Advantage — All Plans: $8.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL $74 $37 $5.31 – $34.61
Liver function panel: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $7.86
  • Aetna Better Health PA — CHIP: $9.03
  • Aetna Better Health WV — CHIP: $7.86
  • Aetna Medicare Advantage — All Plans: $8.58
  • Alliance Coal — Alliance Coal: $10.21
  • Anthem OH Medicare Advantage — HMO: $8.42
  • Anthem Pathway — Anthem Pathway: $8.17
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $34.61
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $34.61
  • Buckeye Commercial — Exchange Plan: $12.26
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE $66 $33 $2.06 – $13.43
Urine test (automated, with microscope): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $3.05
  • Aetna Better Health PA — CHIP: $3
  • Aetna Better Health WV — CHIP: $3.05
  • Aetna Medicare Advantage — All Plans: $3.33
  • Alliance Coal — Alliance Coal: $3.96
  • Anthem OH Medicare Advantage — HMO: $3.27
  • Anthem Pathway — Anthem Pathway: $3.17
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13.43
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13.43
  • Buckeye Commercial — Exchange Plan: $4.76
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $61 $30.50 $2.06 – $13.43
Urine test (automated, with microscope): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $3.05
  • Aetna Better Health PA — CHIP: $3
  • Aetna Better Health WV — CHIP: $3.05
  • Aetna Medicare Advantage — All Plans: $3.33
  • Alliance Coal — Alliance Coal: $3.96
  • Anthem OH Medicare Advantage — HMO: $3.27
  • Anthem Pathway — Anthem Pathway: $3.17
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13.43
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13.43
  • Buckeye Commercial — Exchange Plan: $4.76
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $61 $30.50 $2.06 – $13.43
Urine test (automated, with microscope): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3.33
  • Alliance Coal — Alliance Coal: $3.96
  • Anthem OH Medicare Advantage — HMO: $3.27
  • Anthem Pathway — Anthem Pathway: $3.17
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13.43
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13.43
  • Buckeye Commercial — Exchange Plan: $4.76
  • Buckeye OH Medicare Advantage — All Plans: $3.33
  • CareSource OH Exchange — CareSource OH Exchange: $3.49
  • CareSource OH Medicare Advantage — All Plans: $3.17
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS; MANUAL TEST $30 $15 $2.26 – $14.74
Urine test (manual, without microscope): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $3.35
  • Aetna Better Health PA — CHIP: $3.57
  • Aetna Better Health WV — CHIP: $3.35
  • Aetna Medicare Advantage — All Plans: $3.65
  • Alliance Coal — Alliance Coal: $4.35
  • Anthem OH Medicare Advantage — HMO: $3.58
  • Anthem Pathway — Anthem Pathway: $3.48
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $14.74
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $14.74
  • Buckeye Commercial — Exchange Plan: $5.22
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: URINALYSIS; MANUAL TEST $30 $15 $2.26 – $14.74
Urine test (manual, without microscope): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3.65
  • Alliance Coal — Alliance Coal: $4.35
  • Anthem OH Medicare Advantage — HMO: $3.58
  • Anthem Pathway — Anthem Pathway: $3.48
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $14.74
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $14.74
  • Buckeye Commercial — Exchange Plan: $5.22
  • Buckeye OH Medicare Advantage — All Plans: $3.65
  • CareSource OH Exchange — CareSource OH Exchange: $3.83
  • CareSource OH Medicare Advantage — All Plans: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: URINALYSIS; MANUAL TEST $30 $15 $2.26 – $14.74
Urine test (manual, without microscope): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3.65
  • Alliance Coal — Alliance Coal: $4.35
  • Anthem OH Medicare Advantage — HMO: $3.58
  • Anthem Pathway — Anthem Pathway: $3.48
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $14.74
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $14.74
  • Buckeye Commercial — Exchange Plan: $5.22
  • Buckeye OH Medicare Advantage — All Plans: $3.65
  • CareSource OH Exchange — CareSource OH Exchange: $3.83
  • CareSource OH Medicare Advantage — All Plans: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE $48 $24 $1.46 – $9.53
Urine test (automated, without microscope): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $2.17
  • Aetna Better Health PA — CHIP: $3.10
  • Aetna Better Health WV — CHIP: $2.17
  • Aetna Medicare Advantage — All Plans: $2.36
  • Alliance Coal — Alliance Coal: $2.81
  • Anthem OH Medicare Advantage — HMO: $2.32
  • Anthem Pathway — Anthem Pathway: $2.25
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $9.53
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $9.53
  • Buckeye Commercial — Exchange Plan: $3.38
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST $44 $22 $1.46 – $9.53
Urine test (automated, without microscope): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $2.17
  • Aetna Better Health PA — CHIP: $3.10
  • Aetna Better Health WV — CHIP: $2.17
  • Aetna Medicare Advantage — All Plans: $2.36
  • Alliance Coal — Alliance Coal: $2.81
  • Anthem OH Medicare Advantage — HMO: $2.32
  • Anthem Pathway — Anthem Pathway: $2.25
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $9.53
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $9.53
  • Buckeye Commercial — Exchange Plan: $3.38
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: AUTOMATED URINALYSIS TEST $44 $22 $1.46 – $9.53
Urine test (automated, without microscope): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $2.36
  • Alliance Coal — Alliance Coal: $2.81
  • Anthem OH Medicare Advantage — HMO: $2.32
  • Anthem Pathway — Anthem Pathway: $2.25
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $9.53
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $9.53
  • Buckeye Commercial — Exchange Plan: $3.38
  • Buckeye OH Medicare Advantage — All Plans: $2.36
  • CareSource OH Exchange — CareSource OH Exchange: $2.48
  • CareSource OH Medicare Advantage — All Plans: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL $61 $30.50 $11.95 – $77.91
PSA (prostate specific antigen) blood test: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $17.71
  • Aetna Better Health PA — CHIP: $24.36
  • Aetna Better Health WV — CHIP: $17.71
  • Aetna Medicare Advantage — All Plans: $19.31
  • Alliance Coal — Alliance Coal: $22.99
  • Anthem OH Medicare Advantage — HMO: $18.94
  • Anthem Pathway — Anthem Pathway: $18.39
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $77.91
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $77.91
  • Buckeye Commercial — Exchange Plan: $27.58
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL $146 $73 $11.95 – $77.91
PSA (prostate specific antigen) blood test: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $17.71
  • Aetna Better Health PA — CHIP: $24.36
  • Aetna Better Health WV — CHIP: $17.71
  • Aetna Medicare Advantage — All Plans: $19.31
  • Alliance Coal — Alliance Coal: $22.99
  • Anthem OH Medicare Advantage — HMO: $18.94
  • Anthem Pathway — Anthem Pathway: $18.39
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $77.91
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $77.91
  • Buckeye Commercial — Exchange Plan: $27.58
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL $139 $69.50 $11.95 – $77.91
PSA (prostate specific antigen) blood test: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $19.31
  • Alliance Coal — Alliance Coal: $22.99
  • Anthem OH Medicare Advantage — HMO: $18.94
  • Anthem Pathway — Anthem Pathway: $18.39
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $77.91
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $77.91
  • Buckeye Commercial — Exchange Plan: $27.58
  • Buckeye OH Medicare Advantage — All Plans: $19.31
  • CareSource OH Exchange — CareSource OH Exchange: $20.23
  • CareSource OH Medicare Advantage — All Plans: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE $44 $22 $10.92 – $71.17
Thyroid stimulating hormone (TSH) test: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $16.18
  • Aetna Better Health PA — CHIP: $23.21
  • Aetna Better Health WV — CHIP: $16.18
  • Aetna Medicare Advantage — All Plans: $17.64
  • Alliance Coal — Alliance Coal: $21
  • Anthem OH Medicare Advantage — HMO: $17.30
  • Anthem Pathway — Anthem Pathway: $16.80
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $71.17
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $71.17
  • Buckeye Commercial — Exchange Plan: $25.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $169 $84.50 $10.92 – $71.17
Thyroid stimulating hormone (TSH) test: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $16.18
  • Aetna Better Health PA — CHIP: $23.21
  • Aetna Better Health WV — CHIP: $16.18
  • Aetna Medicare Advantage — All Plans: $17.64
  • Alliance Coal — Alliance Coal: $21
  • Anthem OH Medicare Advantage — HMO: $17.30
  • Anthem Pathway — Anthem Pathway: $16.80
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $71.17
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $71.17
  • Buckeye Commercial — Exchange Plan: $25.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier EP In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $169 $84.50 $10.92 – $71.17
Thyroid stimulating hormone (TSH) test: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $17.64
  • Alliance Coal — Alliance Coal: $21
  • Anthem OH Medicare Advantage — HMO: $17.30
  • Anthem Pathway — Anthem Pathway: $16.80
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $71.17
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $71.17
  • Buckeye Commercial — Exchange Plan: $25.20
  • Buckeye OH Medicare Advantage — All Plans: $17.64
  • CareSource OH Exchange — CareSource OH Exchange: $18.48
  • CareSource OH Medicare Advantage — All Plans: $16.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC $100 $50 $5.05 – $32.92
Complete blood count (CBC) with differential: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $7.48
  • Aetna Better Health PA — CHIP: $6
  • Aetna Better Health WV — CHIP: $7.48
  • Aetna Medicare Advantage — All Plans: $8.16
  • Alliance Coal — Alliance Coal: $9.71
  • Anthem OH Medicare Advantage — HMO: $8
  • Anthem Pathway — Anthem Pathway: $7.77
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $32.92
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $32.92
  • Buckeye Commercial — Exchange Plan: $11.66
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $93 $46.50 $5.05 – $32.92
Complete blood count (CBC) with differential: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $7.48
  • Aetna Better Health PA — CHIP: $6
  • Aetna Better Health WV — CHIP: $7.48
  • Aetna Medicare Advantage — All Plans: $8.16
  • Alliance Coal — Alliance Coal: $9.71
  • Anthem OH Medicare Advantage — HMO: $8
  • Anthem Pathway — Anthem Pathway: $7.77
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $32.92
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $32.92
  • Buckeye Commercial — Exchange Plan: $11.66
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $93 $46.50 $5.05 – $32.92
Complete blood count (CBC) with differential: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $8.16
  • Alliance Coal — Alliance Coal: $9.71
  • Anthem OH Medicare Advantage — HMO: $8
  • Anthem Pathway — Anthem Pathway: $7.77
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $32.92
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $32.92
  • Buckeye Commercial — Exchange Plan: $11.66
  • Buckeye OH Medicare Advantage — All Plans: $8.16
  • CareSource OH Exchange — CareSource OH Exchange: $8.55
  • CareSource OH Medicare Advantage — All Plans: $7.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED $74 $37 $4.21 – $27.41
Complete blood count (CBC), automated: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $6.23
  • Aetna Better Health PA — CHIP: $7.52
  • Aetna Better Health WV — CHIP: $6.23
  • Aetna Medicare Advantage — All Plans: $6.79
  • Alliance Coal — Alliance Coal: $8.09
  • Anthem OH Medicare Advantage — HMO: $6.66
  • Anthem Pathway — Anthem Pathway: $6.47
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $27.41
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $27.41
  • Buckeye Commercial — Exchange Plan: $9.70
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $68 $34 $4.21 – $27.41
Complete blood count (CBC), automated: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $6.23
  • Aetna Better Health PA — CHIP: $7.52
  • Aetna Better Health WV — CHIP: $6.23
  • Aetna Medicare Advantage — All Plans: $6.79
  • Alliance Coal — Alliance Coal: $8.09
  • Anthem OH Medicare Advantage — HMO: $6.66
  • Anthem Pathway — Anthem Pathway: $6.47
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $27.41
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $27.41
  • Buckeye Commercial — Exchange Plan: $9.71
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $68 $34 $4.21 – $27.41
Complete blood count (CBC), automated: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $6.79
  • Alliance Coal — Alliance Coal: $8.09
  • Anthem OH Medicare Advantage — HMO: $6.66
  • Anthem Pathway — Anthem Pathway: $6.47
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $27.41
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $27.41
  • Buckeye Commercial — Exchange Plan: $9.71
  • Buckeye OH Medicare Advantage — All Plans: $6.79
  • CareSource OH Exchange — CareSource OH Exchange: $7.12
  • CareSource OH Medicare Advantage — All Plans: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $69 $34.50 $2.79 – $18.17
Blood clotting time test (prothrombin time, PT): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $4.13
  • Aetna Better Health PA — CHIP: $4
  • Aetna Better Health WV — CHIP: $4.13
  • Aetna Medicare Advantage — All Plans: $4.50
  • Alliance Coal — Alliance Coal: $5.36
  • Anthem OH Medicare Advantage — HMO: $4.42
  • Anthem Pathway — Anthem Pathway: $4.29
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $18.17
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $18.17
  • Buckeye Commercial — Exchange Plan: $6.44
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME $64 $32 $2.79 – $18.17
Blood clotting time test (prothrombin time, PT): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $4.13
  • Aetna Better Health PA — CHIP: $4
  • Aetna Better Health WV — CHIP: $4.13
  • Aetna Medicare Advantage — All Plans: $4.50
  • Alliance Coal — Alliance Coal: $5.36
  • Anthem OH Medicare Advantage — HMO: $4.42
  • Anthem Pathway — Anthem Pathway: $4.29
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $18.17
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $18.17
  • Buckeye Commercial — Exchange Plan: $6.44
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: BLOOD TEST; CLOTTING TIME $64 $32 $2.79 – $18.17
Blood clotting time test (prothrombin time, PT): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $4.50
  • Alliance Coal — Alliance Coal: $5.36
  • Anthem OH Medicare Advantage — HMO: $4.42
  • Anthem Pathway — Anthem Pathway: $4.29
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $18.17
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $18.17
  • Buckeye Commercial — Exchange Plan: $6.44
  • Buckeye OH Medicare Advantage — All Plans: $4.50
  • CareSource OH Exchange — CareSource OH Exchange: $4.72
  • CareSource OH Medicare Advantage — All Plans: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL $84 $42 $3.91 – $25.46
Blood clotting test (partial thromboplastin time, PTT): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $5.79
  • Aetna Better Health PA — CHIP: $7.50
  • Aetna Better Health WV — CHIP: $5.79
  • Aetna Medicare Advantage — All Plans: $6.31
  • Alliance Coal — Alliance Coal: $7.51
  • Anthem OH Medicare Advantage — HMO: $6.19
  • Anthem Pathway — Anthem Pathway: $6.01
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $25.46
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $25.46
  • Buckeye Commercial — Exchange Plan: $9.02
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $78 $39 $3.91 – $25.46
Blood clotting test (partial thromboplastin time, PTT): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $5.79
  • Aetna Better Health PA — CHIP: $7.50
  • Aetna Better Health WV — CHIP: $5.79
  • Aetna Medicare Advantage — All Plans: $6.31
  • Alliance Coal — Alliance Coal: $7.51
  • Anthem OH Medicare Advantage — HMO: $6.19
  • Anthem Pathway — Anthem Pathway: $6.01
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $25.46
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $25.46
  • Buckeye Commercial — Exchange Plan: $9.02
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $78 $39 $3.91 – $25.46
Blood clotting test (partial thromboplastin time, PTT): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $6.31
  • Alliance Coal — Alliance Coal: $7.51
  • Anthem OH Medicare Advantage — HMO: $6.19
  • Anthem Pathway — Anthem Pathway: $6.01
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $25.46
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $25.46
  • Buckeye Commercial — Exchange Plan: $9.02
  • Buckeye OH Medicare Advantage — All Plans: $6.31
  • CareSource OH Exchange — CareSource OH Exchange: $6.61
  • CareSource OH Medicare Advantage — All Plans: $6.01

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE $1,688 $844 $30.11 – $426.32
CT scan of the head or brain, without contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $30.69
  • Aetna Better Health PA — CHIP: $77.50
  • Aetna Better Health WV — CHIP: $30.69
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $1,570 $785 $30.11 – $426.32
CT scan of the head or brain, without contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $30.69
  • Aetna Better Health PA — CHIP: $77.50
  • Aetna Better Health WV — CHIP: $30.69
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $1,570 $785 $65.41 – $426.32
CT scan of the head or brain, without contrast: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
  • Buckeye OH Medicare Advantage — All Plans: $105.66
  • CareSource OH Exchange — CareSource OH Exchange: $110.69
  • CareSource OH Medicare Advantage — All Plans: $100.63
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE $4,124 $2,062 $81.59 – $1,422.66
MRI of the brain, before and after contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $83.14
  • Aetna Better Health PA — CHIP: $269
  • Aetna Better Health WV — CHIP: $83.14
  • Aetna Medicare Advantage — All Plans: $352.60
  • Alliance Coal — Alliance Coal: $587.67
  • Anthem OH Medicare Advantage — HMO: $345.88
  • Anthem Pathway — Anthem Pathway: $335.81
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,422.66
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,422.66
  • Buckeye Commercial — Exchange Plan: $503.72
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST $3,735 $1,867.50 $81.59 – $1,422.66
MRI of the brain, before and after contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $83.14
  • Aetna Better Health PA — CHIP: $269
  • Aetna Better Health WV — CHIP: $83.14
  • Aetna Medicare Advantage — All Plans: $352.60
  • Alliance Coal — Alliance Coal: $587.67
  • Anthem OH Medicare Advantage — HMO: $345.88
  • Anthem Pathway — Anthem Pathway: $335.81
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,422.66
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,422.66
  • Buckeye Commercial — Exchange Plan: $503.72
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST $3,735 $1,867.50 $218.28 – $1,422.66
MRI of the brain, before and after contrast: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $352.60
  • Alliance Coal — Alliance Coal: $587.67
  • Anthem OH Medicare Advantage — HMO: $345.88
  • Anthem Pathway — Anthem Pathway: $335.81
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,422.66
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,422.66
  • Buckeye Commercial — Exchange Plan: $503.72
  • Buckeye OH Medicare Advantage — All Plans: $352.60
  • CareSource OH Exchange — CareSource OH Exchange: $369.39
  • CareSource OH Medicare Advantage — All Plans: $335.81
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS $369 $184.50 $7.72 – $354.89
Chest X-ray, 2 views: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $7.86
  • Aetna Better Health PA — CHIP: $14.85
  • Aetna Better Health WV — CHIP: $7.86
  • Aetna Medicare Advantage — All Plans: $87.96
  • Alliance Coal — Alliance Coal: $146.60
  • Anthem OH Medicare Advantage — HMO: $86.28
  • Anthem Pathway — Anthem Pathway: $83.77
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $354.89
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $354.89
  • Buckeye Commercial — Exchange Plan: $125.66
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF CHEST; 2 VIEWS $351 $175.50 $7.72 – $354.89
Chest X-ray, 2 views: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $7.86
  • Aetna Better Health PA — CHIP: $14.85
  • Aetna Better Health WV — CHIP: $7.86
  • Aetna Medicare Advantage — All Plans: $87.96
  • Alliance Coal — Alliance Coal: $146.60
  • Anthem OH Medicare Advantage — HMO: $86.28
  • Anthem Pathway — Anthem Pathway: $83.77
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $354.89
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $354.89
  • Buckeye Commercial — Exchange Plan: $125.66
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_PO_TC In the file: X-RAY OF CHEST; 2 VIEWS $351 $175.50 $54.45 – $354.89
Chest X-ray, 2 views: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $87.96
  • Alliance Coal — Alliance Coal: $146.60
  • Anthem OH Medicare Advantage — HMO: $86.28
  • Anthem Pathway — Anthem Pathway: $83.77
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $354.89
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $354.89
  • Buckeye Commercial — Exchange Plan: $125.66
  • Buckeye OH Medicare Advantage — All Plans: $87.96
  • CareSource OH Exchange — CareSource OH Exchange: $92.15
  • CareSource OH Medicare Advantage — All Plans: $83.77
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS $606 $303 $9.26 – $426.32
X-ray of the lower spine, at least 4 views: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $9.44
  • Aetna Better Health PA — CHIP: $22.50
  • Aetna Better Health WV — CHIP: $9.44
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS $563 $281.50 $9.26 – $426.32
X-ray of the lower spine, at least 4 views: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $9.44
  • Aetna Better Health PA — CHIP: $22.50
  • Aetna Better Health WV — CHIP: $9.44
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS $563 $281.50 $65.41 – $426.32
X-ray of the lower spine, at least 4 views: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
  • Buckeye OH Medicare Advantage — All Plans: $105.66
  • CareSource OH Exchange — CareSource OH Exchange: $110.69
  • CareSource OH Medicare Advantage — All Plans: $100.63
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE $3,104 $1,552 $52.50 – $973
MRI of the lower back (lumbar spine), without contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $53.50
  • Aetna Better Health PA — CHIP: $187.20
  • Aetna Better Health WV — CHIP: $53.50
  • Aetna Medicare Advantage — All Plans: $241.15
  • Alliance Coal — Alliance Coal: $401.92
  • Anthem OH Medicare Advantage — HMO: $236.56
  • Anthem Pathway — Anthem Pathway: $229.67
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $973
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $973
  • Buckeye Commercial — Exchange Plan: $344.50
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST $2,887 $1,443.50 $52.50 – $973
MRI of the lower back (lumbar spine), without contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $53.50
  • Aetna Better Health PA — CHIP: $187.20
  • Aetna Better Health WV — CHIP: $53.50
  • Aetna Medicare Advantage — All Plans: $241.15
  • Alliance Coal — Alliance Coal: $401.92
  • Anthem OH Medicare Advantage — HMO: $236.56
  • Anthem Pathway — Anthem Pathway: $229.67
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $973
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $973
  • Buckeye Commercial — Exchange Plan: $344.50
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST $2,887 $1,443.50 $149.29 – $973
MRI of the lower back (lumbar spine), without contrast: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $241.15
  • Alliance Coal — Alliance Coal: $401.92
  • Anthem OH Medicare Advantage — HMO: $236.56
  • Anthem Pathway — Anthem Pathway: $229.67
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $973
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $973
  • Buckeye Commercial — Exchange Plan: $344.50
  • Buckeye OH Medicare Advantage — All Plans: $241.15
  • CareSource OH Exchange — CareSource OH Exchange: $252.64
  • CareSource OH Medicare Advantage — All Plans: $229.67
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE $2,274 $1,137 $40.92 – $715.25
CT scan of the pelvis, with contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $41.70
  • Aetna Better Health PA — CHIP: $86.50
  • Aetna Better Health WV — CHIP: $41.70
  • Aetna Medicare Advantage — All Plans: $177.27
  • Alliance Coal — Alliance Coal: $295.45
  • Anthem OH Medicare Advantage — HMO: $173.89
  • Anthem Pathway — Anthem Pathway: $168.83
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $715.25
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $715.25
  • Buckeye Commercial — Exchange Plan: $253.25
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF PELVIS WITH CONTRAST $2,115 $1,057.50 $40.92 – $715.25
CT scan of the pelvis, with contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $41.70
  • Aetna Better Health PA — CHIP: $86.50
  • Aetna Better Health WV — CHIP: $41.70
  • Aetna Medicare Advantage — All Plans: $177.27
  • Alliance Coal — Alliance Coal: $295.45
  • Anthem OH Medicare Advantage — HMO: $173.89
  • Anthem Pathway — Anthem Pathway: $168.83
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $715.25
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $715.25
  • Buckeye Commercial — Exchange Plan: $253.25
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: CT SCAN OF PELVIS WITH CONTRAST $2,115 $1,057.50 $109.74 – $715.25
CT scan of the pelvis, with contrast: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $177.27
  • Alliance Coal — Alliance Coal: $295.45
  • Anthem OH Medicare Advantage — HMO: $173.89
  • Anthem Pathway — Anthem Pathway: $168.83
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $715.25
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $715.25
  • Buckeye Commercial — Exchange Plan: $253.25
  • Buckeye OH Medicare Advantage — All Plans: $177.27
  • CareSource OH Exchange — CareSource OH Exchange: $185.71
  • CareSource OH Medicare Advantage — All Plans: $168.83
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE $3,152 $1,576 $47.87 – $973
MRI of a leg joint (such as the knee), without contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $48.78
  • Aetna Better Health PA — CHIP: $269
  • Aetna Better Health WV — CHIP: $48.78
  • Aetna Medicare Advantage — All Plans: $241.15
  • Alliance Coal — Alliance Coal: $401.92
  • Anthem OH Medicare Advantage — HMO: $236.56
  • Anthem Pathway — Anthem Pathway: $229.67
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $973
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $973
  • Buckeye Commercial — Exchange Plan: $344.50
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST $5,864 $2,932 $329.37 – $2,146.76
MRI of a leg joint (such as the knee), without contrast: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $532.07
  • Alliance Coal — Alliance Coal: $886.78
  • Anthem OH Medicare Advantage — HMO: $521.93
  • Anthem Pathway — Anthem Pathway: $506.73
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,146.76
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,146.76
  • Buckeye Commercial — Exchange Plan: $760.10
  • Buckeye OH Medicare Advantage — All Plans: $532.07
  • CareSource OH Exchange — CareSource OH Exchange: $557.40
  • CareSource OH Medicare Advantage — All Plans: $506.73
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST $2,932 $1,466 $149.29 – $973
MRI of a leg joint (such as the knee), without contrast: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $241.15
  • Alliance Coal — Alliance Coal: $401.92
  • Anthem OH Medicare Advantage — HMO: $236.56
  • Anthem Pathway — Anthem Pathway: $229.67
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $973
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $973
  • Buckeye Commercial — Exchange Plan: $344.50
  • Buckeye OH Medicare Advantage — All Plans: $241.15
  • CareSource OH Exchange — CareSource OH Exchange: $252.64
  • CareSource OH Medicare Advantage — All Plans: $229.67
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST $3,489 $1,744.50 $64.86 – $1,422.66
CT scan of the abdomen and pelvis, with contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $66.09
  • Aetna Better Health PA — CHIP: $192.73
  • Aetna Better Health WV — CHIP: $66.09
  • Aetna Medicare Advantage — All Plans: $352.60
  • Alliance Coal — Alliance Coal: $587.67
  • Anthem OH Medicare Advantage — HMO: $345.88
  • Anthem Pathway — Anthem Pathway: $335.81
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,422.66
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,422.66
  • Buckeye Commercial — Exchange Plan: $503.71
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $3,139 $1,569.50 $64.86 – $1,422.66
CT scan of the abdomen and pelvis, with contrast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $66.09
  • Aetna Better Health PA — CHIP: $192.73
  • Aetna Better Health WV — CHIP: $66.09
  • Aetna Medicare Advantage — All Plans: $352.60
  • Alliance Coal — Alliance Coal: $587.67
  • Anthem OH Medicare Advantage — HMO: $345.88
  • Anthem Pathway — Anthem Pathway: $335.81
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,422.66
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,422.66
  • Buckeye Commercial — Exchange Plan: $503.71
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $3,139 $1,569.50 $218.28 – $1,422.66
CT scan of the abdomen and pelvis, with contrast: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $352.60
  • Alliance Coal — Alliance Coal: $587.67
  • Anthem OH Medicare Advantage — HMO: $345.88
  • Anthem Pathway — Anthem Pathway: $335.81
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,422.66
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,422.66
  • Buckeye Commercial — Exchange Plan: $503.71
  • Buckeye OH Medicare Advantage — All Plans: $352.60
  • CareSource OH Exchange — CareSource OH Exchange: $369.39
  • CareSource OH Medicare Advantage — All Plans: $335.81
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE $1,295 $647.50 $28.57 – $426.32
Ultrasound of the abdomen, complete: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $29.11
  • Aetna Better Health PA — CHIP: $57.50
  • Aetna Better Health WV — CHIP: $29.11
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $1,204 $602 $28.57 – $426.32
Ultrasound of the abdomen, complete: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $29.11
  • Aetna Better Health PA — CHIP: $57.50
  • Aetna Better Health WV — CHIP: $29.11
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $1,204 $602 $65.41 – $426.32
Ultrasound of the abdomen, complete: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
  • Buckeye OH Medicare Advantage — All Plans: $105.66
  • CareSource OH Exchange — CareSource OH Exchange: $110.69
  • CareSource OH Medicare Advantage — All Plans: $100.63
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >= 14 WKS SNGL FETUS $1,490 $745 $35.26 – $426.32
Pregnancy ultrasound (after the first trimester): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $35.93
  • Aetna Better Health PA — CHIP: $46.50
  • Aetna Better Health WV — CHIP: $35.93
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS $1,386 $693 $35.26 – $426.32
Pregnancy ultrasound (after the first trimester): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $35.93
  • Aetna Better Health PA — CHIP: $46.50
  • Aetna Better Health WV — CHIP: $35.93
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS $1,386 $693 $65.41 – $426.32
Pregnancy ultrasound (after the first trimester): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
  • Buckeye OH Medicare Advantage — All Plans: $105.66
  • CareSource OH Exchange — CareSource OH Exchange: $110.69
  • CareSource OH Medicare Advantage — All Plans: $100.63
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL US NON-OB $1,040 $520 $24.44 – $426.32
Transvaginal ultrasound: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $24.91
  • Aetna Better Health PA — CHIP: $46.50
  • Aetna Better Health WV — CHIP: $24.91
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.94
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA $967 $483.50 $24.44 – $426.32
Transvaginal ultrasound: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $24.91
  • Aetna Better Health PA — CHIP: $46.50
  • Aetna Better Health WV — CHIP: $24.91
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.95
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA $967 $483.50 $65.41 – $426.32
Transvaginal ultrasound: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $105.66
  • Alliance Coal — Alliance Coal: $176.10
  • Anthem OH Medicare Advantage — HMO: $103.65
  • Anthem Pathway — Anthem Pathway: $100.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $426.32
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $426.32
  • Buckeye Commercial — Exchange Plan: $150.95
  • Buckeye OH Medicare Advantage — All Plans: $105.66
  • CareSource OH Exchange — CareSource OH Exchange: $110.69
  • CareSource OH Medicare Advantage — All Plans: $100.63
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI $590 $295 $24.18 – $157.60
Diagnostic mammogram, one breast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $29.11
  • Aetna Better Health PA — CHIP: $71.01
  • Aetna Better Health WV — CHIP: $29.11
  • Aetna Medicare Advantage — All Plans: $39.06
  • Alliance Coal — Alliance Coal: $65.10
  • Anthem OH Medicare Advantage — HMO: $38.32
  • Anthem Pathway — Anthem Pathway: $37.20
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $157.60
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $157.60
  • Buckeye Commercial — Exchange Plan: $55.80
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST $548 $274 $24.18 – $157.60
Diagnostic mammogram, one breast: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $29.11
  • Aetna Better Health PA — CHIP: $71.01
  • Aetna Better Health WV — CHIP: $29.11
  • Aetna Medicare Advantage — All Plans: $39.06
  • Alliance Coal — Alliance Coal: $65.10
  • Anthem OH Medicare Advantage — HMO: $38.32
  • Anthem Pathway — Anthem Pathway: $37.20
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $157.60
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $157.60
  • Buckeye Commercial — Exchange Plan: $55.80
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST $548 $274 $24.18 – $157.60
Diagnostic mammogram, one breast: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $39.06
  • Alliance Coal — Alliance Coal: $65.10
  • Anthem OH Medicare Advantage — HMO: $38.32
  • Anthem Pathway — Anthem Pathway: $37.20
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $157.60
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $157.60
  • Buckeye Commercial — Exchange Plan: $55.80
  • Buckeye OH Medicare Advantage — All Plans: $39.06
  • CareSource OH Exchange — CareSource OH Exchange: $40.92
  • CareSource OH Medicare Advantage — All Plans: $37.20
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI $1,144 $572 $29.74 – $193.86
Diagnostic mammogram, both breasts: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $35.66
  • Aetna Better Health PA — CHIP: $90.83
  • Aetna Better Health WV — CHIP: $35.66
  • Aetna Medicare Advantage — All Plans: $48.05
  • Alliance Coal — Alliance Coal: $80.08
  • Anthem OH Medicare Advantage — HMO: $47.13
  • Anthem Pathway — Anthem Pathway: $45.76
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $193.86
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $193.86
  • Buckeye Commercial — Exchange Plan: $68.64
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS $1,064 $532 $29.74 – $193.86
Diagnostic mammogram, both breasts: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $35.66
  • Aetna Better Health PA — CHIP: $90.83
  • Aetna Better Health WV — CHIP: $35.66
  • Aetna Medicare Advantage — All Plans: $48.05
  • Alliance Coal — Alliance Coal: $80.08
  • Anthem OH Medicare Advantage — HMO: $47.13
  • Anthem Pathway — Anthem Pathway: $45.76
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $193.86
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $193.86
  • Buckeye Commercial — Exchange Plan: $68.64
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS $2,128 $1,064 $29.74 – $193.86
Diagnostic mammogram, both breasts: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $48.05
  • Alliance Coal — Alliance Coal: $80.08
  • Anthem OH Medicare Advantage — HMO: $47.13
  • Anthem Pathway — Anthem Pathway: $45.76
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $193.86
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $193.86
  • Buckeye Commercial — Exchange Plan: $68.64
  • Buckeye OH Medicare Advantage — All Plans: $48.05
  • CareSource OH Exchange — CareSource OH Exchange: $50.34
  • CareSource OH Medicare Advantage — All Plans: $45.76
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD $943 $471.50 $22.40 – $145.99
Screening mammogram, both breasts: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $27.54
  • Aetna Better Health PA — CHIP: $75.02
  • Aetna Better Health WV — CHIP: $27.54
  • Aetna Medicare Advantage — All Plans: $36.18
  • Alliance Coal — Alliance Coal: $60.31
  • Anthem OH Medicare Advantage — HMO: $35.49
  • Anthem Pathway — Anthem Pathway: $34.46
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $145.99
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $145.99
  • Buckeye Commercial — Exchange Plan: $51.69
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY $877 $438.50 $22.40 – $145.99
Screening mammogram, both breasts: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $27.54
  • Aetna Better Health PA — CHIP: $75.02
  • Aetna Better Health WV — CHIP: $27.54
  • Aetna Medicare Advantage — All Plans: $36.18
  • Alliance Coal — Alliance Coal: $60.30
  • Anthem OH Medicare Advantage — HMO: $35.49
  • Anthem Pathway — Anthem Pathway: $34.46
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $145.99
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $145.99
  • Buckeye Commercial — Exchange Plan: $51.69
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: SCREENING MAMMOGRAPHY $828 $414 $22.40 – $145.99
Screening mammogram, both breasts: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $36.18
  • Alliance Coal — Alliance Coal: $60.30
  • Anthem OH Medicare Advantage — HMO: $35.49
  • Anthem Pathway — Anthem Pathway: $34.46
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $145.99
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $145.99
  • Buckeye Commercial — Exchange Plan: $51.69
  • Buckeye OH Medicare Advantage — All Plans: $36.18
  • CareSource OH Exchange — CareSource OH Exchange: $37.91
  • CareSource OH Medicare Advantage — All Plans: $34.46

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB $38,226 $19,113 $721.62 – $106,585.72
Heart rhythm study with ablation for atrial fibrillation: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $735.37
  • Aetna Better Health PA — CHIP: $776
  • Aetna Better Health WV — CHIP: $735.37
  • Aetna Medicare Advantage — All Plans: $26,416.86
  • Alliance Coal — Alliance Coal: $44,028.09
  • Anthem OH Medicare Advantage — HMO: $25,913.68
  • Anthem Pathway — Anthem Pathway: $25,158.91
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $106,585.72
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $106,585.72
  • Buckeye Commercial — Exchange Plan: $37,738.36
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY CAUSING ATRIAL FIBRILLATION (UNCOORDINATED CONTRACTION $25,484 $12,742 $721.62 – $106,585.72
Heart rhythm study with ablation for atrial fibrillation: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $735.37
  • Aetna Better Health PA — CHIP: $776
  • Aetna Better Health WV — CHIP: $735.37
  • Aetna Medicare Advantage — All Plans: $26,416.86
  • Alliance Coal — Alliance Coal: $44,028.09
  • Anthem OH Medicare Advantage — HMO: $25,913.68
  • Anthem Pathway — Anthem Pathway: $25,158.91
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $106,585.72
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $106,585.72
  • Buckeye Commercial — Exchange Plan: $37,738.36
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY CAUSING ATRIAL FIBRILLATION (UNCOORDINATED CONTRACTION $25,484 $12,742 $16,353.29 – $106,585.72
Heart rhythm study with ablation for atrial fibrillation: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $26,416.86
  • Alliance Coal — Alliance Coal: $44,028.09
  • Anthem OH Medicare Advantage — HMO: $25,913.68
  • Anthem Pathway — Anthem Pathway: $25,158.91
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $106,585.72
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $106,585.72
  • Buckeye Commercial — Exchange Plan: $37,738.36
  • Buckeye OH Medicare Advantage — All Plans: $26,416.86
  • CareSource OH Exchange — CareSource OH Exchange: $27,674.80
  • CareSource OH Medicare Advantage — All Plans: $25,158.91
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/> YRS 4/> PARAM $6,161 $3,080.50 $86.98 – $3,501.81
Sleep study (overnight, in a sleep lab): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $88.64
  • Aetna Better Health PA — CHIP: $270.32
  • Aetna Better Health WV — CHIP: $88.64
  • Aetna Medicare Advantage — All Plans: $867.91
  • Alliance Coal — Alliance Coal: $1,446.52
  • Anthem OH Medicare Advantage — HMO: $851.38
  • Anthem Pathway — Anthem Pathway: $826.58
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,501.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,501.81
  • Buckeye Commercial — Exchange Plan: $1,239.87
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) $5,731 $2,865.50 $86.98 – $3,501.81
Sleep study (overnight, in a sleep lab): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $88.64
  • Aetna Better Health PA — CHIP: $270.32
  • Aetna Better Health WV — CHIP: $88.64
  • Aetna Medicare Advantage — All Plans: $867.91
  • Alliance Coal — Alliance Coal: $1,446.52
  • Anthem OH Medicare Advantage — HMO: $851.38
  • Anthem Pathway — Anthem Pathway: $826.58
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,501.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,501.81
  • Buckeye Commercial — Exchange Plan: $1,239.87
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) $5,731 $2,865.50 $214.91 – $1,400.71
Sleep study (overnight, in a sleep lab): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $347.16
  • Alliance Coal — Alliance Coal: $578.60
  • Anthem OH Medicare Advantage — HMO: $340.55
  • Anthem Pathway — Anthem Pathway: $330.63
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,400.71
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,400.71
  • Buckeye Commercial — Exchange Plan: $495.94
  • Buckeye OH Medicare Advantage — All Plans: $347.16
  • CareSource OH Exchange — CareSource OH Exchange: $363.69
  • CareSource OH Medicare Advantage — All Plans: $330.63

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES $178 $89 $17.82 – $184
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 56 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $21.76
  • Aetna Better Health WV — CHIP: $21.76
  • Aetna Medicare Advantage — All Plans: $28.78
  • Alliance Coal — Alliance Coal: $37
  • Anthem OH Medicare Advantage — HMO: $28.23
  • Anthem Pathway — Anthem Pathway: $27.41
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $116.12
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $116.12
  • Buckeye Commercial — Exchange Plan: $41.12
  • Buckeye OH Medicare Advantage — All Plans: $28.78
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_CQ_GP In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES $330 $165 $17.82 – $184
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $28.78
  • Alliance Coal — Alliance Coal: $37
  • Anthem OH Medicare Advantage — HMO: $28.23
  • Anthem Pathway — Anthem Pathway: $27.41
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $116.12
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $116.12
  • Buckeye Commercial — Exchange Plan: $41.12
  • Buckeye OH Medicare Advantage — All Plans: $28.78
  • CareSource OH Exchange — CareSource OH Exchange: $30.15
  • CareSource OH Medicare Advantage — All Plans: $27.41
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES $330 $165 $17.82 – $184
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $28.78
  • Alliance Coal — Alliance Coal: $37
  • Anthem OH Medicare Advantage — HMO: $28.23
  • Anthem Pathway — Anthem Pathway: $27.41
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $116.12
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $116.12
  • Buckeye Commercial — Exchange Plan: $41.12
  • Buckeye OH Medicare Advantage — All Plans: $28.78
  • CareSource OH Exchange — CareSource OH Exchange: $30.15
  • CareSource OH Medicare Advantage — All Plans: $27.41
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN $428 $214 $59.78 – $389.63
Physical therapy evaluation (low complexity): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $74.48
  • Aetna Better Health PA — CHIP: $63.61
  • Aetna Better Health WV — CHIP: $74.48
  • Aetna Medicare Advantage — All Plans: $96.57
  • Alliance Coal — Alliance Coal: $124.16
  • Anthem OH Medicare Advantage — HMO: $94.73
  • Anthem Pathway — Anthem Pathway: $91.97
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $389.63
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $389.63
  • Buckeye Commercial — Exchange Plan: $137.96
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES $407 $203.50 $59.78 – $389.63
Physical therapy evaluation (low complexity): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $96.57
  • Alliance Coal — Alliance Coal: $124.16
  • Anthem OH Medicare Advantage — HMO: $94.73
  • Anthem Pathway — Anthem Pathway: $91.97
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $389.63
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $389.63
  • Buckeye Commercial — Exchange Plan: $137.96
  • Buckeye OH Medicare Advantage — All Plans: $96.57
  • CareSource OH Exchange — CareSource OH Exchange: $101.17
  • CareSource OH Medicare Advantage — All Plans: $91.97
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_GZ In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES $407 $203.50 $59.78 – $389.63
Physical therapy evaluation (low complexity): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $96.57
  • Alliance Coal — Alliance Coal: $124.16
  • Anthem OH Medicare Advantage — HMO: $94.73
  • Anthem Pathway — Anthem Pathway: $91.97
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $389.63
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $389.63
  • Buckeye Commercial — Exchange Plan: $137.96
  • Buckeye OH Medicare Advantage — All Plans: $96.57
  • CareSource OH Exchange — CareSource OH Exchange: $101.17
  • CareSource OH Medicare Advantage — All Plans: $91.97
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN $428 $214 $59.78 – $389.63
Physical therapy evaluation (moderate complexity): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $74.48
  • Aetna Better Health PA — CHIP: $63.61
  • Aetna Better Health WV — CHIP: $74.48
  • Aetna Medicare Advantage — All Plans: $96.57
  • Alliance Coal — Alliance Coal: $124.16
  • Anthem OH Medicare Advantage — HMO: $94.73
  • Anthem Pathway — Anthem Pathway: $91.97
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $389.63
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $389.63
  • Buckeye Commercial — Exchange Plan: $137.96
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES $407 $203.50 $59.78 – $389.63
Physical therapy evaluation (moderate complexity): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $96.57
  • Alliance Coal — Alliance Coal: $124.16
  • Anthem OH Medicare Advantage — HMO: $94.73
  • Anthem Pathway — Anthem Pathway: $91.97
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $389.63
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $389.63
  • Buckeye Commercial — Exchange Plan: $137.96
  • Buckeye OH Medicare Advantage — All Plans: $96.57
  • CareSource OH Exchange — CareSource OH Exchange: $101.17
  • CareSource OH Medicare Advantage — All Plans: $91.97
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_PO In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES $407 $203.50 $59.78 – $389.63
Physical therapy evaluation (moderate complexity): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $96.57
  • Alliance Coal — Alliance Coal: $124.16
  • Anthem OH Medicare Advantage — HMO: $94.73
  • Anthem Pathway — Anthem Pathway: $91.97
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $389.63
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $389.63
  • Buckeye Commercial — Exchange Plan: $137.96
  • Buckeye OH Medicare Advantage — All Plans: $96.57
  • CareSource OH Exchange — CareSource OH Exchange: $101.17
  • CareSource OH Medicare Advantage — All Plans: $91.97
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN $368 $184 $59.78 – $389.63
Physical therapy evaluation (high complexity): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $74.48
  • Aetna Better Health PA — CHIP: $63.61
  • Aetna Better Health WV — CHIP: $74.48
  • Aetna Medicare Advantage — All Plans: $96.57
  • Alliance Coal — Alliance Coal: $124.16
  • Anthem OH Medicare Advantage — HMO: $94.73
  • Anthem Pathway — Anthem Pathway: $91.97
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $389.63
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $389.63
  • Buckeye Commercial — Exchange Plan: $137.96
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES $247 $123.50 $54.31 – $723.81
Psychotherapy, 30 minutes: 10 of 55 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $55.34
  • Aetna Better Health WV — CHIP: $55.34
  • Aetna Medicare Advantage — All Plans: $179.39
  • Alliance Coal — Alliance Coal: $298.99
  • Anthem OH Medicare Advantage — HMO: $175.98
  • Anthem Pathway — Anthem Pathway: $170.85
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $723.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $723.81
  • Buckeye Commercial — Exchange Plan: $256.27
  • Buckeye OH Medicare Advantage — All Plans: $179.39
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY; 30 MINUTES $229 $114.50 $54.31 – $723.81
Psychotherapy, 30 minutes: 10 of 55 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $55.34
  • Aetna Better Health WV — CHIP: $55.34
  • Aetna Medicare Advantage — All Plans: $179.39
  • Alliance Coal — Alliance Coal: $298.99
  • Anthem OH Medicare Advantage — HMO: $175.98
  • Anthem Pathway — Anthem Pathway: $170.85
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $723.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $723.81
  • Buckeye Commercial — Exchange Plan: $256.27
  • Buckeye OH Medicare Advantage — All Plans: $179.39
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES $305 $152.50 $71.80 – $723.81
Psychotherapy, 45 minutes: 10 of 55 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $73.17
  • Aetna Better Health WV — CHIP: $73.17
  • Aetna Medicare Advantage — All Plans: $179.39
  • Alliance Coal — Alliance Coal: $298.99
  • Anthem OH Medicare Advantage — HMO: $175.98
  • Anthem Pathway — Anthem Pathway: $170.85
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $723.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $723.81
  • Buckeye Commercial — Exchange Plan: $256.27
  • Buckeye OH Medicare Advantage — All Plans: $179.39
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY; 45 MINUTES $283 $141.50 $71.80 – $723.81
Psychotherapy, 45 minutes: 10 of 55 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $73.17
  • Aetna Better Health WV — CHIP: $73.17
  • Aetna Medicare Advantage — All Plans: $179.39
  • Alliance Coal — Alliance Coal: $298.99
  • Anthem OH Medicare Advantage — HMO: $175.98
  • Anthem Pathway — Anthem Pathway: $170.85
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $723.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $723.81
  • Buckeye Commercial — Exchange Plan: $256.27
  • Buckeye OH Medicare Advantage — All Plans: $179.39
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: PSYCHOTHERAPY; 45 MINUTES $283 $141.50 $111.05 – $723.81
Psychotherapy, 45 minutes: 10 of 47 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $179.39
  • Alliance Coal — Alliance Coal: $298.99
  • Anthem OH Medicare Advantage — HMO: $175.98
  • Anthem Pathway — Anthem Pathway: $170.85
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $723.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $723.81
  • Buckeye Commercial — Exchange Plan: $256.27
  • Buckeye OH Medicare Advantage — All Plans: $179.39
  • CareSource OH Exchange — CareSource OH Exchange: $187.94
  • CareSource OH Medicare Advantage — All Plans: $170.85
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY; 1 HOUR $567 $283.50 $106.29 – $723.81
Psychotherapy, 60 minutes: 10 of 55 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $108.32
  • Aetna Better Health WV — CHIP: $108.32
  • Aetna Medicare Advantage — All Plans: $179.39
  • Alliance Coal — Alliance Coal: $298.99
  • Anthem OH Medicare Advantage — HMO: $175.98
  • Anthem Pathway — Anthem Pathway: $170.85
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $723.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $723.81
  • Buckeye Commercial — Exchange Plan: $256.27
  • Buckeye OH Medicare Advantage — All Plans: $179.39
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier GZ In the file: PSYCHOTHERAPY; 1 HOUR $567 $283.50 $111.05 – $723.81
Psychotherapy, 60 minutes: 10 of 47 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $179.39
  • Alliance Coal — Alliance Coal: $298.99
  • Anthem OH Medicare Advantage — HMO: $175.98
  • Anthem Pathway — Anthem Pathway: $170.85
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $723.81
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $723.81
  • Buckeye Commercial — Exchange Plan: $256.27
  • Buckeye OH Medicare Advantage — All Plans: $179.39
  • CareSource OH Exchange — CareSource OH Exchange: $187.94
  • CareSource OH Medicare Advantage — All Plans: $170.85

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $28,298 $14,149 $2,449.71 – $15,966.48
Removal of breast growth (open surgery): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3,957.23
  • Alliance Coal — Alliance Coal: $6,595.38
  • Anthem OH Medicare Advantage — HMO: $3,881.85
  • Anthem Pathway — Anthem Pathway: $3,768.79
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $15,966.48
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $15,966.48
  • Buckeye Commercial — Exchange Plan: $5,653.18
  • Buckeye OH Medicare Advantage — All Plans: $3,957.23
  • CareSource OH Exchange — CareSource OH Exchange: $4,145.67
  • CareSource OH Medicare Advantage — All Plans: $3,768.79
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT_XS In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $2,297.33 $1,148.67 $2,449.71 – $15,966.48
Removal of breast growth (open surgery): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3,957.23
  • Alliance Coal — Alliance Coal: $6,595.38
  • Anthem OH Medicare Advantage — HMO: $3,881.85
  • Anthem Pathway — Anthem Pathway: $3,768.79
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $15,966.48
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $15,966.48
  • Buckeye Commercial — Exchange Plan: $5,653.18
  • Buckeye OH Medicare Advantage — All Plans: $3,957.23
  • CareSource OH Exchange — CareSource OH Exchange: $4,145.67
  • CareSource OH Medicare Advantage — All Plans: $3,768.79
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $6,732 $3,366 $2,449.71 – $15,966.48
Removal of breast growth (open surgery): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3,957.23
  • Alliance Coal — Alliance Coal: $6,595.38
  • Anthem OH Medicare Advantage — HMO: $3,881.85
  • Anthem Pathway — Anthem Pathway: $3,768.79
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $15,966.48
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $15,966.48
  • Buckeye Commercial — Exchange Plan: $5,653.19
  • Buckeye OH Medicare Advantage — All Plans: $3,957.23
  • CareSource OH Exchange — CareSource OH Exchange: $4,145.67
  • CareSource OH Medicare Advantage — All Plans: $3,768.79
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $24,438 $12,219 $776 – $52,353.99
Total hip replacement: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $1,000.25
  • Aetna Better Health PA — CHIP: $776
  • Aetna Better Health WV — CHIP: $1,000.25
  • Aetna Medicare Advantage — All Plans: $12,975.73
  • Alliance Coal — Alliance Coal: $21,626.22
  • Anthem OH Medicare Advantage — HMO: $12,728.58
  • Anthem Pathway — Anthem Pathway: $12,357.84
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $52,353.99
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $52,353.99
  • Buckeye Commercial — Exchange Plan: $18,536.76
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $22,110 $11,055 $8,032.60 – $52,353.99
Total hip replacement: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $12,975.73
  • Alliance Coal — Alliance Coal: $21,626.22
  • Anthem OH Medicare Advantage — HMO: $12,728.58
  • Anthem Pathway — Anthem Pathway: $12,357.84
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $52,353.99
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $52,353.99
  • Buckeye Commercial — Exchange Plan: $18,536.76
  • Buckeye OH Medicare Advantage — All Plans: $12,975.73
  • CareSource OH Exchange — CareSource OH Exchange: $13,593.62
  • CareSource OH Medicare Advantage — All Plans: $12,357.84
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $22,498 $11,249 $8,032.60 – $52,353.99
Total hip replacement: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $12,975.73
  • Alliance Coal — Alliance Coal: $21,626.22
  • Anthem OH Medicare Advantage — HMO: $12,728.58
  • Anthem Pathway — Anthem Pathway: $12,357.84
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $52,353.99
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $52,353.99
  • Buckeye Commercial — Exchange Plan: $18,536.76
  • Buckeye OH Medicare Advantage — All Plans: $12,975.73
  • CareSource OH Exchange — CareSource OH Exchange: $13,593.62
  • CareSource OH Medicare Advantage — All Plans: $12,357.84
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE $21,140 $10,570 $205.80 – $52,353.99
Total knee replacement: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $776
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $12,975.73
  • Alliance Coal — Alliance Coal: $21,626.22
  • Anthem OH Medicare Advantage — HMO: $12,728.58
  • Anthem Pathway — Anthem Pathway: $12,357.84
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $52,353.99
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $52,353.99
  • Buckeye Commercial — Exchange Plan: $18,536.76
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE $24,438 $12,219 $8,032.60 – $52,353.99
Total knee replacement: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $12,975.73
  • Alliance Coal — Alliance Coal: $21,626.22
  • Anthem OH Medicare Advantage — HMO: $12,728.58
  • Anthem Pathway — Anthem Pathway: $12,357.84
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $52,353.99
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $52,353.99
  • Buckeye Commercial — Exchange Plan: $18,536.76
  • Buckeye OH Medicare Advantage — All Plans: $12,975.73
  • CareSource OH Exchange — CareSource OH Exchange: $13,593.62
  • CareSource OH Medicare Advantage — All Plans: $12,357.84
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE $24,632 $12,316 $8,032.60 – $52,353.99
Total knee replacement: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $12,975.73
  • Alliance Coal — Alliance Coal: $21,626.22
  • Anthem OH Medicare Advantage — HMO: $12,728.58
  • Anthem Pathway — Anthem Pathway: $12,357.84
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $52,353.99
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $52,353.99
  • Buckeye Commercial — Exchange Plan: $18,536.76
  • Buckeye OH Medicare Advantage — All Plans: $12,975.73
  • CareSource OH Exchange — CareSource OH Exchange: $13,593.62
  • CareSource OH Medicare Advantage — All Plans: $12,357.84
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE $10,861 $5,430.50 $98.80 – $643.95
Shoulder arthroscopy: shaving of shoulder bone: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $159.60
  • Alliance Coal — Alliance Coal: $266
  • Anthem OH Medicare Advantage — HMO: $156.56
  • Anthem Pathway — Anthem Pathway: $152
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $643.95
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $643.95
  • Buckeye Commercial — Exchange Plan: $228
  • Buckeye OH Medicare Advantage — All Plans: $159.60
  • CareSource OH Exchange — CareSource OH Exchange: $167.20
  • CareSource OH Medicare Advantage — All Plans: $152
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE $6,497.50 $3,248.75 $98.80 – $643.95
Shoulder arthroscopy: shaving of shoulder bone: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $159.60
  • Alliance Coal — Alliance Coal: $266
  • Anthem OH Medicare Advantage — HMO: $156.56
  • Anthem Pathway — Anthem Pathway: $152
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $643.95
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $643.95
  • Buckeye Commercial — Exchange Plan: $228
  • Buckeye OH Medicare Advantage — All Plans: $159.60
  • CareSource OH Exchange — CareSource OH Exchange: $167.20
  • CareSource OH Medicare Advantage — All Plans: $152
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT_XS In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE $5,784.83 $2,892.42 $98.80 – $643.95
Shoulder arthroscopy: shaving of shoulder bone: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $159.60
  • Alliance Coal — Alliance Coal: $266
  • Anthem OH Medicare Advantage — HMO: $156.56
  • Anthem Pathway — Anthem Pathway: $152
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $643.95
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $643.95
  • Buckeye Commercial — Exchange Plan: $228
  • Buckeye OH Medicare Advantage — All Plans: $159.60
  • CareSource OH Exchange — CareSource OH Exchange: $167.20
  • CareSource OH Medicare Advantage — All Plans: $152
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $10,426 $5,213 $2,047.14 – $13,342.64
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3,306.92
  • Alliance Coal — Alliance Coal: $5,511.54
  • Anthem OH Medicare Advantage — HMO: $3,243.93
  • Anthem Pathway — Anthem Pathway: $3,149.45
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13,342.64
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13,342.64
  • Buckeye Commercial — Exchange Plan: $4,724.18
  • Buckeye OH Medicare Advantage — All Plans: $3,306.92
  • CareSource OH Exchange — CareSource OH Exchange: $3,464.40
  • CareSource OH Medicare Advantage — All Plans: $3,149.45
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_XS In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $7,652.67 $3,826.34 $2,047.14 – $13,342.64
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3,306.92
  • Alliance Coal — Alliance Coal: $5,511.54
  • Anthem OH Medicare Advantage — HMO: $3,243.93
  • Anthem Pathway — Anthem Pathway: $3,149.45
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13,342.64
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13,342.64
  • Buckeye Commercial — Exchange Plan: $4,724.18
  • Buckeye OH Medicare Advantage — All Plans: $3,306.92
  • CareSource OH Exchange — CareSource OH Exchange: $3,464.40
  • CareSource OH Medicare Advantage — All Plans: $3,149.45
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $10,923 $5,461.50 $2,047.14 – $13,342.64
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3,306.92
  • Alliance Coal — Alliance Coal: $5,511.54
  • Anthem OH Medicare Advantage — HMO: $3,243.93
  • Anthem Pathway — Anthem Pathway: $3,149.45
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13,342.64
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13,342.64
  • Buckeye Commercial — Exchange Plan: $4,724.18
  • Buckeye OH Medicare Advantage — All Plans: $3,306.92
  • CareSource OH Exchange — CareSource OH Exchange: $3,464.40
  • CareSource OH Medicare Advantage — All Plans: $3,149.45
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) $10,506 $5,253 $205.80 – $24,140.04
Removal of tonsils and adenoids (under age 12): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $694
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $5,983.02
  • Alliance Coal — Alliance Coal: $9,971.69
  • Anthem OH Medicare Advantage — HMO: $5,869.05
  • Anthem Pathway — Anthem Pathway: $5,698.11
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $24,140.04
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $24,140.04
  • Buckeye Commercial — Exchange Plan: $8,547.17
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) $12,955 $6,477.50 $3,703.77 – $24,140.04
Removal of tonsils and adenoids (under age 12): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $5,983.02
  • Alliance Coal — Alliance Coal: $9,971.69
  • Anthem OH Medicare Advantage — HMO: $5,869.05
  • Anthem Pathway — Anthem Pathway: $5,698.11
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $24,140.04
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $24,140.04
  • Buckeye Commercial — Exchange Plan: $8,547.17
  • Buckeye OH Medicare Advantage — All Plans: $5,983.02
  • CareSource OH Exchange — CareSource OH Exchange: $6,267.92
  • CareSource OH Medicare Advantage — All Plans: $5,698.11
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,588 $794 $105 – $3,698.51
Upper GI endoscopy (diagnostic): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $107
  • Aetna Better Health PA — CHIP: $125.22
  • Aetna Better Health WV — CHIP: $107
  • Aetna Medicare Advantage — All Plans: $916.66
  • Alliance Coal — Alliance Coal: $1,527.77
  • Anthem OH Medicare Advantage — HMO: $899.20
  • Anthem Pathway — Anthem Pathway: $873.01
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,698.51
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,698.51
  • Buckeye Commercial — Exchange Plan: $1,309.52
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XS In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $5,308 $2,654 $567.46 – $3,698.51
Upper GI endoscopy (diagnostic): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $916.66
  • Alliance Coal — Alliance Coal: $1,527.77
  • Anthem OH Medicare Advantage — HMO: $899.20
  • Anthem Pathway — Anthem Pathway: $873.01
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,698.51
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,698.51
  • Buckeye Commercial — Exchange Plan: $1,309.52
  • Buckeye OH Medicare Advantage — All Plans: $916.66
  • CareSource OH Exchange — CareSource OH Exchange: $960.31
  • CareSource OH Medicare Advantage — All Plans: $873.01
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,666 $833 $567.46 – $3,698.51
Upper GI endoscopy (diagnostic): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $916.66
  • Alliance Coal — Alliance Coal: $1,527.77
  • Anthem OH Medicare Advantage — HMO: $899.20
  • Anthem Pathway — Anthem Pathway: $873.01
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,698.51
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,698.51
  • Buckeye Commercial — Exchange Plan: $1,309.52
  • Buckeye OH Medicare Advantage — All Plans: $916.66
  • CareSource OH Exchange — CareSource OH Exchange: $960.31
  • CareSource OH Medicare Advantage — All Plans: $873.01
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE $2,863 $1,431.50 $148.58 – $3,698.51
Upper GI endoscopy with biopsy: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $148.58
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $916.66
  • Alliance Coal — Alliance Coal: $1,527.77
  • Anthem OH Medicare Advantage — HMO: $899.20
  • Anthem Pathway — Anthem Pathway: $873.01
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,698.51
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,698.51
  • Buckeye Commercial — Exchange Plan: $1,309.52
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $2,053 $1,026.50 $148.58 – $3,698.51
Upper GI endoscopy with biopsy: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $148.58
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $916.66
  • Alliance Coal — Alliance Coal: $1,527.77
  • Anthem OH Medicare Advantage — HMO: $899.20
  • Anthem Pathway — Anthem Pathway: $873.01
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,698.51
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,698.51
  • Buckeye Commercial — Exchange Plan: $1,309.52
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $3,913 $1,956.50 $567.46 – $3,698.51
Upper GI endoscopy with biopsy: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $916.66
  • Alliance Coal — Alliance Coal: $1,527.77
  • Anthem OH Medicare Advantage — HMO: $899.20
  • Anthem Pathway — Anthem Pathway: $873.01
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,698.51
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,698.51
  • Buckeye Commercial — Exchange Plan: $1,309.52
  • Buckeye OH Medicare Advantage — All Plans: $916.66
  • CareSource OH Exchange — CareSource OH Exchange: $960.31
  • CareSource OH Medicare Advantage — All Plans: $873.01
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $4,068 $2,034 $105 – $3,792.22
Colonoscopy (diagnostic): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $107
  • Aetna Better Health PA — CHIP: $180.50
  • Aetna Better Health WV — CHIP: $107
  • Aetna Medicare Advantage — All Plans: $939.89
  • Alliance Coal — Alliance Coal: $1,566.48
  • Anthem OH Medicare Advantage — HMO: $921.98
  • Anthem Pathway — Anthem Pathway: $895.13
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,792.22
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,792.22
  • Buckeye Commercial — Exchange Plan: $1,342.70
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_74 In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $2,608.67 $1,304.34 $581.83 – $3,792.22
Colonoscopy (diagnostic): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $939.89
  • Alliance Coal — Alliance Coal: $1,566.48
  • Anthem OH Medicare Advantage — HMO: $921.98
  • Anthem Pathway — Anthem Pathway: $895.13
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,792.22
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,792.22
  • Buckeye Commercial — Exchange Plan: $1,342.70
  • Buckeye OH Medicare Advantage — All Plans: $939.89
  • CareSource OH Exchange — CareSource OH Exchange: $984.64
  • CareSource OH Medicare Advantage — All Plans: $895.13
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_XU In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $2,344 $1,172 $581.83 – $3,792.22
Colonoscopy (diagnostic): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $939.89
  • Alliance Coal — Alliance Coal: $1,566.48
  • Anthem OH Medicare Advantage — HMO: $921.98
  • Anthem Pathway — Anthem Pathway: $895.13
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,792.22
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,792.22
  • Buckeye Commercial — Exchange Plan: $1,342.69
  • Buckeye OH Medicare Advantage — All Plans: $939.89
  • CareSource OH Exchange — CareSource OH Exchange: $984.64
  • CareSource OH Medicare Advantage — All Plans: $895.13
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY $3,249 $1,624.50 $205.80 – $4,879.73
Colonoscopy with biopsy: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $225.42
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $1,209.42
  • Alliance Coal — Alliance Coal: $2,015.70
  • Anthem OH Medicare Advantage — HMO: $1,186.38
  • Anthem Pathway — Anthem Pathway: $1,151.83
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4,879.73
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4,879.73
  • Buckeye Commercial — Exchange Plan: $1,727.74
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $4,688 $2,344 $205.80 – $4,879.73
Colonoscopy with biopsy: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $225.42
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $1,209.42
  • Alliance Coal — Alliance Coal: $2,015.70
  • Anthem OH Medicare Advantage — HMO: $1,186.38
  • Anthem Pathway — Anthem Pathway: $1,151.83
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4,879.73
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4,879.73
  • Buckeye Commercial — Exchange Plan: $1,727.74
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_KX_XU In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $891 $445.50 $748.69 – $4,879.73
Colonoscopy with biopsy: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $1,209.42
  • Alliance Coal — Alliance Coal: $2,015.70
  • Anthem OH Medicare Advantage — HMO: $1,186.38
  • Anthem Pathway — Anthem Pathway: $1,151.83
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4,879.73
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4,879.73
  • Buckeye Commercial — Exchange Plan: $1,727.74
  • Buckeye OH Medicare Advantage — All Plans: $1,209.42
  • CareSource OH Exchange — CareSource OH Exchange: $1,267.01
  • CareSource OH Medicare Advantage — All Plans: $1,151.83
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $4,468.67 $2,234.34 $205.80 – $4,879.73
Colonoscopy with removal of polyps (snare): 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $268.08
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $1,209.42
  • Alliance Coal — Alliance Coal: $2,015.70
  • Anthem OH Medicare Advantage — HMO: $1,186.38
  • Anthem Pathway — Anthem Pathway: $1,151.83
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4,879.73
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4,879.73
  • Buckeye Commercial — Exchange Plan: $1,727.74
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_KX In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $3,603 $1,801.50 $748.69 – $4,879.73
Colonoscopy with removal of polyps (snare): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $1,209.42
  • Alliance Coal — Alliance Coal: $2,015.70
  • Anthem OH Medicare Advantage — HMO: $1,186.38
  • Anthem Pathway — Anthem Pathway: $1,151.83
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4,879.73
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4,879.73
  • Buckeye Commercial — Exchange Plan: $1,727.74
  • Buckeye OH Medicare Advantage — All Plans: $1,209.42
  • CareSource OH Exchange — CareSource OH Exchange: $1,267.01
  • CareSource OH Medicare Advantage — All Plans: $1,151.83
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT_XU In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $3,041.50 $1,520.75 $748.69 – $4,879.73
Colonoscopy with removal of polyps (snare): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $1,209.42
  • Alliance Coal — Alliance Coal: $2,015.70
  • Anthem OH Medicare Advantage — HMO: $1,186.38
  • Anthem Pathway — Anthem Pathway: $1,151.83
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4,879.73
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4,879.73
  • Buckeye Commercial — Exchange Plan: $1,727.74
  • Buckeye OH Medicare Advantage — All Plans: $1,209.42
  • CareSource OH Exchange — CareSource OH Exchange: $1,267.01
  • CareSource OH Medicare Advantage — All Plans: $1,151.83
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $3,913 $1,956.50 $138.72 – $3,792.22
Screening colonoscopy (not high risk): 10 of 56 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $141.36
  • Aetna Better Health WV — CHIP: $141.36
  • Aetna Medicare Advantage — All Plans: $939.89
  • Alliance Coal — Alliance Coal: $1,566.48
  • Anthem OH Medicare Advantage — HMO: $921.98
  • Anthem Pathway — Anthem Pathway: $895.13
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,792.22
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,792.22
  • Buckeye Commercial — Exchange Plan: $1,342.70
  • Buckeye OH Medicare Advantage — All Plans: $939.89
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $939.50 $469.75 $581.83 – $3,792.22
Screening colonoscopy (not high risk): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $939.89
  • Alliance Coal — Alliance Coal: $1,566.48
  • Anthem OH Medicare Advantage — HMO: $921.98
  • Anthem Pathway — Anthem Pathway: $895.13
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,792.22
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,792.22
  • Buckeye Commercial — Exchange Plan: $1,342.70
  • Buckeye OH Medicare Advantage — All Plans: $939.89
  • CareSource OH Exchange — CareSource OH Exchange: $984.64
  • CareSource OH Medicare Advantage — All Plans: $895.13
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_PT In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $4,223 $2,111.50 $581.83 – $3,792.22
Screening colonoscopy (not high risk): 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $939.89
  • Alliance Coal — Alliance Coal: $1,566.48
  • Anthem OH Medicare Advantage — HMO: $921.98
  • Anthem Pathway — Anthem Pathway: $895.13
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,792.22
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,792.22
  • Buckeye Commercial — Exchange Plan: $1,342.70
  • Buckeye OH Medicare Advantage — All Plans: $939.89
  • CareSource OH Exchange — CareSource OH Exchange: $984.64
  • CareSource OH Medicare Advantage — All Plans: $895.13
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE $11,186 $5,593 $205.80 – $24,652.66
Gallbladder removal by laparoscope: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $776
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $6,110.07
  • Alliance Coal — Alliance Coal: $10,183.44
  • Anthem OH Medicare Advantage — HMO: $5,993.68
  • Anthem Pathway — Anthem Pathway: $5,819.11
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $24,652.66
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $24,652.66
  • Buckeye Commercial — Exchange Plan: $8,728.67
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE $22,533 $11,266.50 $3,782.42 – $24,652.66
Gallbladder removal by laparoscope: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $6,110.07
  • Alliance Coal — Alliance Coal: $10,183.44
  • Anthem OH Medicare Advantage — HMO: $5,993.68
  • Anthem Pathway — Anthem Pathway: $5,819.11
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $24,652.66
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $24,652.66
  • Buckeye Commercial — Exchange Plan: $8,728.67
  • Buckeye OH Medicare Advantage — All Plans: $6,110.07
  • CareSource OH Exchange — CareSource OH Exchange: $6,401.02
  • CareSource OH Medicare Advantage — All Plans: $5,819.11
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $17,039 $8,519.50 $63.50 – $14,600.25
Groin (inguinal) hernia repair, age 5 or older: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $63.50
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $3,618.61
  • Alliance Coal — Alliance Coal: $6,031.02
  • Anthem OH Medicare Advantage — HMO: $3,549.69
  • Anthem Pathway — Anthem Pathway: $3,446.30
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $14,600.25
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $14,600.25
  • Buckeye Commercial — Exchange Plan: $5,169.45
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $16,900 $8,450 $2,240.09 – $14,600.25
Groin (inguinal) hernia repair, age 5 or older: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3,618.61
  • Alliance Coal — Alliance Coal: $6,031.02
  • Anthem OH Medicare Advantage — HMO: $3,549.69
  • Anthem Pathway — Anthem Pathway: $3,446.30
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $14,600.25
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $14,600.25
  • Buckeye Commercial — Exchange Plan: $5,169.45
  • Buckeye OH Medicare Advantage — All Plans: $3,618.61
  • CareSource OH Exchange — CareSource OH Exchange: $3,790.93
  • CareSource OH Medicare Advantage — All Plans: $3,446.30
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $16,124 $8,062 $2,240.09 – $14,600.25
Groin (inguinal) hernia repair, age 5 or older: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $3,618.62
  • Alliance Coal — Alliance Coal: $6,031.02
  • Anthem OH Medicare Advantage — HMO: $3,549.69
  • Anthem Pathway — Anthem Pathway: $3,446.30
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $14,600.25
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $14,600.25
  • Buckeye Commercial — Exchange Plan: $5,169.45
  • Buckeye OH Medicare Advantage — All Plans: $3,618.62
  • CareSource OH Exchange — CareSource OH Exchange: $3,790.93
  • CareSource OH Medicare Advantage — All Plans: $3,446.30
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE GLAND $4,852 $2,426 $89.50 – $209.72
Prostate biopsy: 10 of 33 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $89.50
  • Aetna Better Health WV — CHIP: $209.72
  • Geisinger Pennsylvania — Mgd Medicaid: $107.40
  • Highmark Health Options — CHIP: $205.80
  • Highmark Health Options West VA — Mgd MCaid: $205.80
  • Pennsylvania Health & Wellness — Medicaid: $98.45
  • The Health Plan WV — CHIP: $209.72
  • The Health Plan WV — Mgd MCaid: $208.74
  • UHC Community PA CHIP — Unison Kids: $92.19
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE $6,058 $3,029 $205.80 – $13,200.47
Hysteroscopy with biopsy of the uterus lining: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $776
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $3,271.68
  • Alliance Coal — Alliance Coal: $5,452.81
  • Anthem OH Medicare Advantage — HMO: $3,209.37
  • Anthem Pathway — Anthem Pathway: $3,115.89
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13,200.47
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13,200.47
  • Buckeye Commercial — Exchange Plan: $4,673.84
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC $1,994 $997 $74.37 – $2,878.45
Spinal injection, lower back (epidural), with imaging guidance: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $75.79
  • Aetna Better Health PA — CHIP: $81.32
  • Aetna Better Health WV — CHIP: $75.79
  • Aetna Medicare Advantage — All Plans: $713.41
  • Alliance Coal — Alliance Coal: $1,189.02
  • Anthem OH Medicare Advantage — HMO: $699.82
  • Anthem Pathway — Anthem Pathway: $679.44
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,878.45
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,878.45
  • Buckeye Commercial — Exchange Plan: $1,019.16
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE $1,771 $885.50 $74.37 – $2,878.45
Spinal injection, lower back (epidural), with imaging guidance: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $75.79
  • Aetna Better Health PA — CHIP: $81.32
  • Aetna Better Health WV — CHIP: $75.79
  • Aetna Medicare Advantage — All Plans: $713.41
  • Alliance Coal — Alliance Coal: $1,189.02
  • Anthem OH Medicare Advantage — HMO: $699.82
  • Anthem Pathway — Anthem Pathway: $679.44
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,878.45
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,878.45
  • Buckeye Commercial — Exchange Plan: $1,019.16
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1 $3,626 $1,813 $95.04 – $3,606.74
Nerve root injection, lower back, with imaging guidance: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $95.04
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $893.92
  • Alliance Coal — Alliance Coal: $1,489.86
  • Anthem OH Medicare Advantage — HMO: $876.89
  • Anthem Pathway — Anthem Pathway: $851.35
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,606.74
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,606.74
  • Buckeye Commercial — Exchange Plan: $1,277.03
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL $7,252 $3,626 $830.06 – $5,410.10
Nerve root injection, lower back, with imaging guidance: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $1,340.87
  • Alliance Coal — Alliance Coal: $2,234.78
  • Anthem OH Medicare Advantage — HMO: $1,315.33
  • Anthem Pathway — Anthem Pathway: $1,277.02
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,410.10
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,410.10
  • Buckeye Commercial — Exchange Plan: $1,915.53
  • Buckeye OH Medicare Advantage — All Plans: $1,340.87
  • CareSource OH Exchange — CareSource OH Exchange: $1,404.72
  • CareSource OH Medicare Advantage — All Plans: $1,277.02
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_LT In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL $3,626 $1,813 $553.38 – $3,606.74
Nerve root injection, lower back, with imaging guidance: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $893.92
  • Alliance Coal — Alliance Coal: $1,489.86
  • Anthem OH Medicare Advantage — HMO: $876.89
  • Anthem Pathway — Anthem Pathway: $851.35
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,606.74
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,606.74
  • Buckeye Commercial — Exchange Plan: $1,277.03
  • Buckeye OH Medicare Advantage — All Plans: $893.92
  • CareSource OH Exchange — CareSource OH Exchange: $936.49
  • CareSource OH Medicare Advantage — All Plans: $851.35
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $8,112 $4,056 $205.80 – $7,962.88
Carpal tunnel release: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $300
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $1,973.57
  • Alliance Coal — Alliance Coal: $3,289.28
  • Anthem OH Medicare Advantage — HMO: $1,935.98
  • Anthem Pathway — Anthem Pathway: $1,879.59
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,962.88
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,962.88
  • Buckeye Commercial — Exchange Plan: $2,819.39
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 79_LT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $5,224 $2,612 $1,221.73 – $7,962.88
Carpal tunnel release: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $1,973.57
  • Alliance Coal — Alliance Coal: $3,289.28
  • Anthem OH Medicare Advantage — HMO: $1,935.98
  • Anthem Pathway — Anthem Pathway: $1,879.59
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,962.88
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,962.88
  • Buckeye Commercial — Exchange Plan: $2,819.38
  • Buckeye OH Medicare Advantage — All Plans: $1,973.57
  • CareSource OH Exchange — CareSource OH Exchange: $2,067.55
  • CareSource OH Medicare Advantage — All Plans: $1,879.59
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 79_RT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $5,780 $2,890 $1,221.73 – $7,962.88
Carpal tunnel release: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $1,973.57
  • Alliance Coal — Alliance Coal: $3,289.28
  • Anthem OH Medicare Advantage — HMO: $1,935.98
  • Anthem Pathway — Anthem Pathway: $1,879.59
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,962.88
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,962.88
  • Buckeye Commercial — Exchange Plan: $2,819.39
  • Buckeye OH Medicare Advantage — All Plans: $1,973.57
  • CareSource OH Exchange — CareSource OH Exchange: $2,067.55
  • CareSource OH Medicare Advantage — All Plans: $1,879.59
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY $1,489 $744.50 $205.80 – $2,242.80
Laser treatment of clouding after cataract surgery: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $216.51
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $555.87
  • Alliance Coal — Alliance Coal: $926.45
  • Anthem OH Medicare Advantage — HMO: $545.28
  • Anthem Pathway — Anthem Pathway: $529.40
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,242.80
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,242.80
  • Buckeye Commercial — Exchange Plan: $794.10
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER $1,385 $692.50 $205.80 – $2,242.80
Laser treatment of clouding after cataract surgery: 10 of 60 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $209.72
  • Aetna Better Health PA — CHIP: $216.51
  • Aetna Better Health WV — CHIP: $209.72
  • Aetna Medicare Advantage — All Plans: $555.87
  • Alliance Coal — Alliance Coal: $926.45
  • Anthem OH Medicare Advantage — HMO: $545.28
  • Anthem Pathway — Anthem Pathway: $529.40
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,242.80
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,242.80
  • Buckeye Commercial — Exchange Plan: $794.10
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER $1,385 $692.50 $344.11 – $2,242.80
Laser treatment of clouding after cataract surgery: 10 of 48 insurance plan rates
  • Aetna Medicare Advantage — All Plans: $555.87
  • Alliance Coal — Alliance Coal: $926.45
  • Anthem OH Medicare Advantage — HMO: $545.28
  • Anthem Pathway — Anthem Pathway: $529.40
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,242.80
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,242.80
  • Buckeye Commercial — Exchange Plan: $794.10
  • Buckeye OH Medicare Advantage — All Plans: $555.87
  • CareSource OH Exchange — CareSource OH Exchange: $582.34
  • CareSource OH Medicare Advantage — All Plans: $529.40

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC WITH CARD CATH WITH COMORBITY Not listed in the file Not listed in the file $850 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $148,352.26
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 56 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $50,053.99
  • Aetna Better Health PA — CHIP: $77,196.07
  • Aetna Better Health WV — CHIP: $50,053.99
  • Aetna Medicare Advantage — All Plans: $76,892.08
  • Alliance Coal — Alliance Coal: $12,172
  • Anthem OH Medicare Advantage — HMO: $75,427.47
  • Anthem Pathway — Anthem Pathway: $850 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $148,352.26
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $148,352.26
  • Buckeye Commercial — Exchange Plan: $109,845.82
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT COMORBITY Not listed in the file Not listed in the file $850 – $26,088.19
Hip or knee replacement (major joint of the leg), without major complications: 10 of 56 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $9,869.27
  • Aetna Better Health PA — CHIP: $15,220.95
  • Aetna Better Health WV — CHIP: $9,869.27
  • Aetna Medicare Advantage — All Plans: $15,768.40
  • Alliance Coal — Alliance Coal: $12,172
  • Anthem OH Medicare Advantage — HMO: $15,468.05
  • Anthem Pathway — Anthem Pathway: $850
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $26,088.19
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $26,088.19
  • Buckeye Commercial — Exchange Plan: $22,526.28
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT COMPLICATION/COMORBITY Not listed in the file Not listed in the file $850 – $33,572.86
Neck (cervical) spinal fusion, without complications: 10 of 56 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $12,490.98
  • Aetna Better Health PA — CHIP: $19,264.30
  • Aetna Better Health WV — CHIP: $12,490.98
  • Aetna Medicare Advantage — All Plans: $19,756.19
  • Alliance Coal — Alliance Coal: $12,172
  • Anthem OH Medicare Advantage — HMO: $19,379.88
  • Anthem Pathway — Anthem Pathway: $850
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $33,572.86
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $33,572.86
  • Buckeye Commercial — Exchange Plan: $28,223.13
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY WITHOUT COMPLICATION/COMORBITY Not listed in the file Not listed in the file $850 – $18,884.74
Uterus and ovary surgery (not for cancer), without complications: 10 of 56 insurance plan rates
  • Aetna — Better Health Mgd Medicaid: $6,348.08
  • Aetna Better Health PA — CHIP: $9,790.36
  • Aetna Better Health WV — CHIP: $6,348.08
  • Aetna Medicare Advantage — All Plans: $10,412.43
  • Alliance Coal — Alliance Coal: $12,172
  • Anthem OH Medicare Advantage — HMO: $10,214.10
  • Anthem Pathway — Anthem Pathway: $850
  • Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $18,884.74
  • Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $18,884.74
  • Buckeye Commercial — Exchange Plan: $14,874.90

Source: Wheeling Hospital, Inc’s standard charges file (wvumedicine.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on July 9, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address1 Medical Park, Wheeling, WV 26003
CountyOhio County
StateWest Virginia
Phone(304) 243‑3000
Emergency servicesYes
OwnershipVoluntary non-profit - Church
Medicare overall rating2 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number510050
Name in Medicare recordsWHEELING HOSPITAL, INC
Profile levelMedicare data + hospital website
Name on the hospital’s websiteWheeling Hospital (WVU Medicine)
Official websitewvumedicine.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Wheeling Hospital — wvumedicine.org
  2. Emergency Medicine | Wheeling Hospital — wvumedicine.org
  3. Patients and Visitors | Wheeling Hospital — wvumedicine.org
  4. Before Your Visit | Wheeling Hospital — wvumedicine.org
  5. Visitation Guidelines | Wheeling Hospital — wvumedicine.org
  6. WVU Medicine Wheeling Hospital Family Medicine Rural Scholars Program | Wheeling Hospital — wvumedicine.org
  7. Podiatric Medicine and Surgery Residency | Wheeling Hospital — wvumedicine.org
  8. Accreditation and Application | Wheeling Hospital — wvumedicine.org
  9. Accreditation and Application | Wheeling Hospital — wvumedicine.org
  10. Foot and Ankle Advanced Surgical Fellowship | Wheeling Hospital — wvumedicine.org