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Critical Access Hospital

Whidbeyhealth Medical Center

Coupeville, Washington · Island County · Emergency services listed

Summary

Whidbeyhealth Medical Center is a critical access hospital in Coupeville, Washington. Medicare data lists emergency services. CMS overall star rating: 2 of 5 stars. Its official website lists 30 services, specialties and programs. Medicare lists 343 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is a critical access hospital?

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

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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
30Services listed

Quick answers

Does Whidbeyhealth Medical Center have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Whidbeyhealth Medical Center. In a medical emergency, call 911.
Where is Whidbeyhealth Medical Center?
101 North Main Street, Coupeville, WA 98239, in Island County, Washington.
What is the phone number of Whidbeyhealth Medical Center?
(360) 678-5151, as listed by Medicare (CMS).
What is the Medicare star rating of Whidbeyhealth Medical Center?
2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4]

Treatments[4][6]

Procedures[4][6]

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

Emergency roomYes
Open 24/7Yes
Trauma designationLevel 4
Stroke designationLevel 3 Stroke Center

Visiting and practical information

Interpreters and languagesFree language assistance services are available; call to request[6]
Patient portalMyWhidbeyHealth

Recognition[4][8]

  • DNV accreditation

Doctors and clinicians (343)

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

Main specialties

Doctors with a page on this site (343)

And 319 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

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 licence 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 Whidbeyhealth Medical Center reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics) 4 of 5 stars
Overall rating of the hospital4 of 5 stars
Would recommend the hospital4 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well4 of 5 stars
Staff explained medicines4 of 5 stars
Information about recovery at home5 of 5 stars
Room and bathroom kept clean3 of 5 stars
Quiet at night4 of 5 stars
Rated the hospital 9 or 10 out of 1070%National average: 72%
Would definitely recommend the hospital71%National average: 71%
Nurses “always” communicated well81%National average: 80%
Doctors “always” communicated well84%National average: 80%
Staff “always” explained medicines before giving them67%National average: 62%
Were given information about recovery at home92%National average: 86%
Room and bathroom “always” clean70%National average: 74%
Area around the room “always” quiet at night62%National average: 60%
Completed surveys166Response rate: 22%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)Not reported to Medicare
Surgical site infections after colon surgeryNot reported to Medicare
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infectionsNot reported to Medicare
Clostridioides difficile (C. diff) intestinal infections1.144No different from the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 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 patientsToo few cases to report
Deaths within 30 days: heart failure patients14.7%
Deaths within 30 days: pneumonia patients21.8%
Deaths within 30 days: COPD patients11.6%
Deaths within 30 days: stroke patients15.9%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)Not reported to Medicare
Complications after hip or knee replacementNot reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 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)Not reported to Medicare
Readmitted within 30 days: heart attackToo few cases to report
Readmitted within 30 days: heart failure21.5%
Readmitted within 30 days: pneumonia16.7%
Readmitted within 30 days: COPD18.7%
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacementNot reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

Emergency room times and sepsis care

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

Average (median) time patients spent in the emergency room before leaving (OP-18b)Not reported to Medicare
Patients who left the emergency room before being seen (OP-22)Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 75 common services exactly as Whidbeyhealth Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean
Hospital charge
The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price
The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates
The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees
A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OFFICE O/P NEW LOW 30 MIN $275 $275 $275
New patient office visit (about 30–44 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: PF MAC OBS NEW LVL 3 $383 $383 $383
New patient office visit (about 30–44 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · modifier 25 In the file: ACUPUNCTURE DETAILED HX 99203 $160 $160 $160
New patient office visit (about 30–44 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OFFICE O/P NEW MOD 45 MIN $425 $425 $425
New patient office visit (about 45–59 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: PF MAC OBS NEW LVL 4 $571 $571 $571
New patient office visit (about 45–59 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OFFICE O/P NEW HI 60 MIN $550 $550 $550
New patient office visit (about 60–74 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: PF MAC OBS NEW LVL 5 $714 $714 $714
New patient office visit (about 60–74 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OFFICE O/P EST LOW 20 MIN $200 $200 $200
Established patient office visit (about 20–29 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of an established patient which requires a medically appropriate history $475 $475 $475
Established patient office visit (about 20–29 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: MAC VISIT LEVEL 3 $900 $900 $900
Established patient office visit (about 20–29 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OFFICE O/P EST MOD 30 MIN $300 $300 $300
Established patient office visit (about 30–39 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Office or other outpatient visit for the evaluation and management of an established patient which requires a medically appropriate history $700 $700 $700
Established patient office visit (about 30–39 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: MAC VISIT LEVEL 4 $1,400 $1,400 $1,400
Established patient office visit (about 30–39 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: OFF/OP CNSLTJ NEW/EST LOW 30 $285 $285 $285
Office consultation with a specialist (moderate): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: PF OFF/OP CONSULT NEW/EST LOW $285 $285 $285
Office consultation with a specialist (moderate): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: OFF/OP CNSLTJ NEW/EST MOD 40 $404 $404 $404
Office consultation with a specialist (moderate to high): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: PF OFF/OP CONSULT NEW/EST MOD $404 $404 $404
Office consultation with a specialist (moderate to high): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: PREV VISIT NEW AGE 18-39 $301 $301 $301
Preventive checkup, new patient, age 18–39: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: PF PREV VISIT NEW AGE 18-39 $301 $301 $301
Preventive checkup, new patient, age 18–39: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: WELL ADULT NEW 40-64 YRS $350 $350 $350
Preventive checkup, new patient, age 40–64: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: PF PREV VISIT NEW AGE 40-64 $350 $350 $350
Preventive checkup, new patient, age 40–64: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient which requires a medically appropriate history and/or examination $1,303 $1,303 $1,303
Emergency room visit (moderate): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: EMERGENCY DEPT VISIT LOW MDM $550 $550 $550
Emergency room visit (moderate): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: PF EMERG DEPT VISIT LOW MDM $550 $550 $550
Emergency room visit (moderate): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient which requires a medically appropriate history and/or examination $2,276 $2,276 $2,276
Emergency room visit (moderately high): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: EMERGENCY DEPT VISIT MOD MDM $750 $750 $750
Emergency room visit (moderately high): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: PF EMERG DEPT VISIT MOD MDM $271 $271 $271
Emergency room visit (moderately high): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient which requires a medically appropriate history and/or examination $3,447 $3,447 $3,447
Emergency room visit (high): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: EMERGENCY DEPT VISIT HI MDM $1,000 $1,000 $1,000
Emergency room visit (high): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: PF EMERGENCY DEPT VISIT HI MDM $1,000 $1,000 $1,000
Emergency room visit (high): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Basic metabolic panel (Calcium total) This panel must include the following: Calcium total (82310) Carbon dioxide (bicarbonate) (82374) Chlo $174 $174 $174
Basic metabolic panel (blood test): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin total (82247) Calcium total (82310) Carbon di $105 $105 $105
Comprehensive metabolic panel (blood test): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric panel This panel must include the following: Blood count complete (CBC) automated and automated differential WBC count (85025 or 8 $265 $265 $265
Obstetric blood test panel: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID SCREEN FASTING $125 $125 $125
Cholesterol panel (lipid panel): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID SCREEN FASTING UNKNOWN $167 $167 $167
Cholesterol panel (lipid panel): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium total (82310) Carbon dioxide (bicarbonate) (82374) Chlor $83 $83 $83
Kidney function panel: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin total (82247) Bilirubin direct (82248) Phosphatase a $74 $74 $74
Liver function panel: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis by dip stick or tablet reagent for bilirubin glucose hemoglobin ketones leukocytes nitrite pH protein specific gravity urobilinog $65 $65 $65
Urine test (automated, with microscope): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: URINALYSIS NONAUTO W/O SCOPE $8 $8 $8
Urine test (manual, without microscope): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: POC URINALYSIS NAUTO W/O SCOPE $36 $36 $36
Urine test (manual, without microscope): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis by dip stick or tablet reagent for bilirubin glucose hemoglobin ketones leukocytes nitrite pH protein specific gravity urobilinog $54 $54 $54
Urine test (manual, without microscope): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urinalysis by dip stick or tablet reagent for bilirubin glucose hemoglobin ketones leukocytes nitrite pH protein specific gravity urobilinog $64 $64 $64
Urine test (automated, without microscope): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PSA SCREENING $154 $154 $154
PSA (prostate specific antigen) blood test: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total $154 $154 $154
PSA (prostate specific antigen) blood test: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH) $129 $129 $129
Thyroid stimulating hormone (TSH) test: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC) automated (Hgb Hct RBC WBC and platelet count) and automated differential WBC count $61 $61 $61
Complete blood count (CBC) with differential: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC) automated (Hgb Hct RBC WBC and platelet count) $53 $53 $53
Complete blood count (CBC), automated: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HEMOGRAM (CBC NO DIFF) $53 $53 $53
Complete blood count (CBC), automated: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time; $20 $20 $20
Blood clotting time test (prothrombin time, PT): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: WHOLE BLOOD PROTIME $74 $74 $74
Blood clotting time test (prothrombin time, PT): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time $74 $74 $74
Blood clotting time test (prothrombin time, PT): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time partial (PTT); plasma or whole blood $122 $122 $122
Blood clotting test (partial thromboplastin time, PTT): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: THROMBOLPLASTIN TIME PARTL(PH) $122 $122 $122
Blood clotting test (partial thromboplastin time, PTT): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · modifier TC In the file: Computed tomography head or brain; without contrast material $2,018 $2,018 $2,018
CT scan of the head or brain, without contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · modifier 26 In the file: Computed tomography head or brain; without contrast material $106 $106 $106
CT scan of the head or brain, without contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · modifier TC In the file: Magnetic resonance (eg proton) imaging brain (including brain stem); without contrast material followed by contrast material(s) and further $4,911 $4,911 $4,911
MRI of the brain, before and after contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · modifier 26 In the file: Magnetic resonance (eg proton) imaging brain (including brain stem); without contrast material followed by contrast material(s) and further $269 $269 $269
MRI of the brain, before and after contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: X-RAY EXAM CHEST 2 VIEWS $260 $260 $260
Chest X-ray, 2 views: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination chest; 2 views $410 $410 $410
Chest X-ray, 2 views: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier 26 In the file: Radiologic examination chest; 2 views $29 $29 $29
Chest X-ray, 2 views: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XRAY SPINE LS MIN 4V $686 $686 $686
X-ray of the lower spine, at least 4 views: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination spine lumbosacral; minimum of 4 views $686 $686 $686
X-ray of the lower spine, at least 4 views: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier 26 In the file: Radiologic examination spine lumbosacral; minimum of 4 views $35 $35 $35
X-ray of the lower spine, at least 4 views: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · modifier TC In the file: Magnetic resonance (eg proton) imaging spinal canal and contents lumbar; without contrast material $3,123 $3,123 $3,123
MRI of the lower back (lumbar spine), without contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · modifier 26 In the file: Magnetic resonance (eg proton) imaging spinal canal and contents lumbar; without contrast material $184 $184 $184
MRI of the lower back (lumbar spine), without contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · modifier TC In the file: Computed tomography pelvis; with contrast material(s) $2,544 $2,544 $2,544
CT scan of the pelvis, with contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · modifier 26 In the file: Computed tomography pelvis; with contrast material(s) $144 $144 $144
CT scan of the pelvis, with contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier TC In the file: Magnetic resonance (eg proton) imaging any joint of lower extremity; without contrast material $2,690 $2,690 $2,690
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier LT In the file: Magnetic resonance (eg proton) imaging any joint of lower extremity; without contrast material $168 $168 $168
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier RT In the file: Magnetic resonance (eg proton) imaging any joint of lower extremity; without contrast material $168 $168 $168
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · modifier TC In the file: Computed tomography abdomen and pelvis; with contrast material(s) $5,548 $5,548 $5,548
CT scan of the abdomen and pelvis, with contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · modifier 26 In the file: Computed tomography abdomen and pelvis; with contrast material(s) $225 $225 $225
CT scan of the abdomen and pelvis, with contrast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound abdominal real time with image documentation; complete $903 $903 $903
Ultrasound of the abdomen, complete: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier 26 In the file: Ultrasound abdominal real time with image documentation; complete $102 $102 $102
Ultrasound of the abdomen, complete: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound pregnant uterus real time with image documentation fetal and maternal evaluation after first trimester (> or = 14 weeks 0 days) t $739 $739 $739
Pregnancy ultrasound (after the first trimester): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier 26 In the file: Ultrasound pregnant uterus real time with image documentation fetal and maternal evaluation after first trimester (> or = 14 weeks 0 days) t $124 $124 $124
Pregnancy ultrasound (after the first trimester): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound transvaginal $686 $686 $686
Transvaginal ultrasound: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier 26 In the file: Ultrasound transvaginal $87 $87 $87
Transvaginal ultrasound: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier LT In the file: Diagnostic mammography including computer-aided detection (CAD) when performed; unilateral $600 $600 $600
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier RT In the file: Diagnostic mammography including computer-aided detection (CAD) when performed; unilateral $600 $600 $600
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier 26 In the file: Diagnostic mammography including computer-aided detection (CAD) when performed; unilateral $102 $102 $102
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier TC In the file: Diagnostic mammography including computer-aided detection (CAD) when performed; bilateral $780 $780 $780
Diagnostic mammogram, both breasts: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier 26 In the file: Diagnostic mammography including computer-aided detection (CAD) when performed; bilateral $125 $125 $125
Diagnostic mammogram, both breasts: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier TC In the file: Screening mammography bilateral (2-view study of each breast) including computer-aided detection (CAD) when performed $946 $946 $946
Screening mammogram, both breasts: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier 52 In the file: Screening mammography bilateral (2-view study of each breast) including computer-aided detection (CAD) when performed $474 $474 $474
Screening mammogram, both breasts: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier 26 In the file: Screening mammography bilateral (2-view study of each breast) including computer-aided detection (CAD) when performed $97 $97 $97
Screening mammogram, both breasts: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: ELECTROCARDIOGRAM COMPLETE $220 $220 $220
Electrocardiogram (ECG/EKG) with reading: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysomnography; age 6 years or older sleep staging with 4 or more additional parameters of sleep attended by a technologist $5,809 $5,809 $5,809
Sleep study (overnight, in a sleep lab): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · modifier 26 In the file: Polysomnography; age 6 years or older sleep staging with 4 or more additional parameters of sleep attended by a technologist $1,400 $1,400 $1,400
Sleep study (overnight, in a sleep lab): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: Therapeutic procedure 1 or more areas each 15 minutes; therapeutic exercises to develop strength and endurance range of motion and flexibili $152 $152 $152
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO In the file: Therapeutic procedure 1 or more areas each 15 minutes; therapeutic exercises to develop strength and endurance range of motion and flexibili $152 $152 $152
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier 95 In the file: Therapeutic procedure 1 or more areas each 15 minutes; therapeutic exercises to develop strength and endurance range of motion and flexibili $152 $152 $152
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: Physical therapy evaluation: low complexity requiring these components: A history with no personal factors and/or comorbidities that impact $413 $413 $413
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier 95 In the file: Physical therapy evaluation: low complexity requiring these components: A history with no personal factors and/or comorbidities that impact $413 $413 $413
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: PT EVAL LOW COMPLEX 20 MIN $413 $413 $413
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: Physical therapy evaluation: moderate complexity requiring these components: A history of present problem with 1-2 personal factors and/or c $421 $421 $421
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier 95 In the file: Physical therapy evaluation: moderate complexity requiring these components: A history of present problem with 1-2 personal factors and/or c $421 $421 $421
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: PT EVAL MOD COMPLEX 30 MIN $421 $421 $421
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: Physical therapy evaluation: high complexity requiring these components: A history of present problem with 3 or more personal factors and/or $432 $432 $432
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: PT EVAL HIGH COMPLEX 45 MIN $432 $432 $432
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psytx pt&/family 30 minutes $263 $263 $263
Psychotherapy, 30 minutes: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psytx pt&/family 45 minutes $349 $349 $349
Psychotherapy, 45 minutes: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · modifier GT In the file: Psychotherapy 45 minutes with patient $490 $490 $490
Psychotherapy, 45 minutes: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psytx pt&/family 60 minutes $512 $512 $512
Psychotherapy, 60 minutes: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psytx w/o patient $321 $321 $321
Family psychotherapy, without the patient: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family psytx w/patient $334 $334 $334
Family psychotherapy, with the patient: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: GROUP PSYCHOTHERAPY $124 $124 $124
Group psychotherapy: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: REMOVAL OF BREAST LESION OPEN $1,500 $1,500 $1,500
Removal of breast growth (open surgery): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: TOTAL HIP ARTHROPLASTY $4,800 $4,800 $4,800
Total hip replacement: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: PF TOTAL HIP ARTHROPLASTY $4,800 $4,800 $4,800
Total hip replacement: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: TKA WWO PTLA RSRFCG $8,400 $8,400 $8,400
Total knee replacement: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: PF TKA WWO PTLA RSRFCG $8,400 $8,400 $8,400
Total knee replacement: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: ARTHRS SHD DCP SUB W/ACPLTY $5,200 $5,200 $5,200
Shoulder arthroscopy: shaving of shoulder bone: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: PF ARTHRS SHD DCP SUB W/ACPLTY $1,590 $1,590 $1,590
Shoulder arthroscopy: shaving of shoulder bone: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: ARTHRS KNE MNSCTMY MED/LAT $4,200 $4,200 $4,200
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: PF ARTHRS KNE MNSCTMY MED/LAT $4,200 $4,200 $4,200
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: EGD DIAGNOSTIC BRUSH WASH $1,800 $1,800 $1,800
Upper GI endoscopy (diagnostic): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: IPMD EGD DIAGNOSTIC BRUSH $134 $134 $134
Upper GI endoscopy (diagnostic): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: OPMD EGD DIAGNOSTIC BRUSH $134 $134 $134
Upper GI endoscopy (diagnostic): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: EGD BIOPSY SINGLE/MULTIPLE $2,200 $2,200 $2,200
Upper GI endoscopy with biopsy: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: IPMD EGD BIOPSY SINGLE/MULTI $151 $151 $151
Upper GI endoscopy with biopsy: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: OPMD EGD BIOPSY SINGLE/MULTI $151 $151 $151
Upper GI endoscopy with biopsy: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: DIAGNOSTIC COLONOSCOPY $2,400 $2,400 $2,400
Colonoscopy (diagnostic): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: IPMD COLONOSCOPY $101 $101 $101
Colonoscopy (diagnostic): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: OPMD COLONOSCOPY $101 $101 $101
Colonoscopy (diagnostic): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY AND BIOPSY $2,600 $2,600 $2,600
Colonoscopy with biopsy: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: IPMD COLONOSCOPY W/BX $219 $219 $219
Colonoscopy with biopsy: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: OPMD COLONOSCOPY W/BX $219 $219 $219
Colonoscopy with biopsy: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY W/LESION REMOVAL $3,000 $3,000 $3,000
Colonoscopy with removal of polyps (snare): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: IPMD COLO W/MASS RMVL SNR $277 $277 $277
Colonoscopy with removal of polyps (snare): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: OPMD COLO W/MASS RMVL SNR $277 $277 $277
Colonoscopy with removal of polyps (snare): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: COLON CA SCRN NOT HI RSK IND $1,184 $1,184 $1,184
Screening colonoscopy (not high risk): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: OPMD COLONOSCOPY LOW RISK $102 $102 $102
Screening colonoscopy (not high risk): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAP CHOLECYSTECTOMY $8,500 $8,500 $8,500
Gallbladder removal by laparoscope: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: IPMD LAPAROSCOPIC CHLCYSTCTMY $725 $725 $725
Gallbladder removal by laparoscope: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: OPMD LAPAROSCOPIC CHLCYSTCTMY $725 $725 $725
Gallbladder removal by laparoscope: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PRP I/HERN INIT REDUC >5 YR $1,600 $1,600 $1,600
Groin (inguinal) hernia repair, age 5 or older: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: PROSTATE NDLE BX ANY APPCH $1,800 $1,800 $1,800
Prostate biopsy: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: LAPS SURG PRST8ECT RPBIC RAD $2,864 $2,864 $2,864
Prostate removal by laparoscope (radical prostatectomy): 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY BIOPSY $2,200 $2,200 $2,200
Hysteroscopy with biopsy of the uterus lining: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: PF HYSTEROSCOPY BIOPSY $844 $844 $844
Hysteroscopy with biopsy of the uterus lining: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: NJX INTERLAMINAR LMBR/SAC $3,240 $3,240 $3,240
Spinal injection, lower back (epidural), with imaging guidance: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: NJX AA&/STRD TFRM EPI L/S 1 $4,600 $4,600 $4,600
Nerve root injection, lower back, with imaging guidance: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · modifier 50 In the file: BL NJX AA&/STRD TFRM EPI L/S 1 $9,200 $9,200 $9,200
Nerve root injection, lower back, with imaging guidance: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: CARPAL TUNNEL SURGERY $3,800 $3,800 $3,800
Carpal tunnel release: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: PF CARPAL TUNNEL SURGERY $3,800 $3,800 $3,800
Carpal tunnel release: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: VAG DELIVERY W/ANTE & POST $6,200 $6,200 $6,200
Vaginal delivery, with care before and after: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: PF VAG DELIVERY W/ANTE & POST $5,312 $5,312 $5,312
Vaginal delivery, with care before and after: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: CSEC DELIVERY W/ANTE & POST $11,500 $11,500 $11,500
Cesarean delivery (C-section), with care before and after: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: PF CSEC DELIVERY W/ANTE & POST $5,871 $5,871 $5,871
Cesarean delivery (C-section), with care before and after: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: VBAC DELIVERY $5,566 $5,566 $5,566
Vaginal delivery after a previous C-section, with care before and after: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: PF VBAC DELIVERY $5,566 $5,566 $5,566
Vaginal delivery after a previous C-section, with care before and after: 10 of 11 insurance plan rates
  • Aetna — Aetna: 89.3% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 31.5% (a percentage in the contract, not a dollar amount)
  • Ambetter — Ambetter: 43.2% (a percentage in the contract, not a dollar amount)
  • BCBS — Medicare Advantage: 29.4% (a percentage in the contract, not a dollar amount)
  • CHAMPVA — Champva/Health Net: 28% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount)
  • Humana — Medicare Advantage: 31.05% (a percentage in the contract, not a dollar amount)
  • Managed Medicare Plans — Managed Medicare Plans: 28% (a percentage in the contract, not a dollar amount)
  • Regence — Regence: 88% (a percentage in the contract, not a dollar amount)
  • Regence — Regence Medicare: 29.4% (a percentage in the contract, not a dollar amount)

Source: Whidbeyhealth Medical Center’s standard charges file (whidbeyhealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on October 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeCritical Access Hospital
Address101 North Main Street, Coupeville, WA 98239
CountyIsland County
StateWashington
Phone(360) 678‑5151
Emergency servicesYes
OwnershipGovernment - Hospital District or Authority
Medicare overall rating2 of 5 stars
CMS Certification Number501339
Name in Medicare recordsWHIDBEYHEALTH MEDICAL CENTER
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(360) 678‑7656[4]
Official websitewhidbeyhealth.org
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
  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. WhidbeyHealth Medical Center — whidbeyhealth.org
  2. Emergency Care — whidbeyhealth.org
  3. Patient Services — whidbeyhealth.org
  4. About Us - WhidbeyHealth — whidbeyhealth.org