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Acute Care Hospital

Winter Haven Hospital

Also listed as: BayCare Winter Haven Hospital

Winter Haven, Florida · Polk County · Emergency services listed

Winter Haven Hospital is an acute care hospital at 200 Ave F NE, Winter Haven, FL 33881. Phone: (863) 293-1121. It has an emergency department. Medicare overall rating: 3 of 5 stars (CMS, October 2026).

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

Summary

Winter Haven Hospital is an acute care hospital in Winter Haven, Florida. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 85 services, specialties and programs. Medicare lists 535 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

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

Call(863) 293‑1121 Directions Website Medicare profile
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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
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
535Doctors and clinicians
85Services listed

Quick answers

Does Winter Haven Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Winter Haven Hospital. In a medical emergency, call 911.
Where is Winter Haven Hospital?
200 Ave F NE, Winter Haven, FL 33881, in Polk County, Florida.
What is the phone number of Winter Haven Hospital?
(863) 293-1121, as listed by Medicare (CMS).
What is the Medicare star rating of Winter Haven Hospital?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Winter Haven Hospital for hospital-acquired conditions?
No. For fiscal year 2026, CMS lists no Medicare payment reduction for Winter Haven Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.1418; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4][7][8][12]

Conditions treated[7][9][10]

Treatments[7][8][9][11][13]

  • Cardiac CT and cardiac MRI
  • Echocardiogram
  • Electrocardiogram (EKG)
  • Stress test
  • Tilt table test
  • Cardiac catheterization
  • Percutaneous coronary intervention (PCI)
  • Renal denervation
  • Cardiac ablation
  • Cardioversion
  • Pacemaker implantation
  • Implantable cardioverter-defibrillator implantation
  • Transcatheter aortic valve replacement (TAVR)
  • Left atrial appendage occlusion
  • Coronary artery bypass grafting (CABG)
  • Heart valve repair and replacement
  • Chemotherapy infusion
  • Radiation therapy

Programs and centers[4][6][7][8][9][10][11][12]

  • Cassidy Cancer Center
  • Bostick Heart Center
  • Structural Heart and Minimally Invasive Valve Program
  • Cardiovascular intensive care unit
  • Heart failure clinic
  • Cardiac rehabilitation
  • Oncology nurse navigator
  • Total joint replacement program
  • Outpatient Rehabilitation Program
  • Joy Fuller Rehabilitation Center
  • Stroke support groups
  • Ambulatory Surgical and Diagnostic Center
  • Center for Psychiatry (inpatient)
  • Pediatric emergency center
  • Vertical Bed Area (ER)

Emergency care (hospital website)[4][6][10]

Emergency roomYes
Open 24/7Yes
Stroke designationAdvanced Primary Stroke Center (The Joint Commission)

Visiting and practical information

ParkingFree valet parking at the Emergency Department, Monday to Friday, 8am to 5pm[6]
Patient portalMy BayCare Patient Portal

Recognition[9][10][12][13]

  • Advanced Primary Stroke Center (The Joint Commission)
  • The Joint Commission accreditation
  • CARF-accredited outpatient rehabilitation program
  • Brain Injury program designation (Florida Brain and Spinal Cord Injury Program)

Doctors and clinicians (535)

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

Main specialties

Doctors with a page on this site (535)

And 511 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Winter Haven

Hospitals in Polk County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 3 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well2 of 5 stars
Patients got help quickly from staff3 of 5 stars
Staff explained medicines3 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean4 of 5 stars
Restfulness of Environment2 of 5 stars
Care Coordination3 of 5 stars
Symptoms After Stay3 of 5 stars
Rated the hospital 9 or 10 out of 1066%National average: 72%
Would definitely recommend the hospital66%National average: 71%
Nurses “always” communicated well77%National average: 80%
Doctors “always” communicated well73%National average: 80%
“Always” got help as soon as they wanted64%National average: 64%
Staff “always” explained medicines before giving them62%National average: 62%
Were given information about recovery at home84%National average: 86%
Room and bathroom “always” clean73%National average: 73%
Completed surveys2,338Response rate: 18%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.359No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.539No different from the national benchmark
Surgical site infections after colon surgery0.775No different from the national benchmark
MRSA bloodstream infections0.342Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.376Better than the national benchmark
Not reported to MedicareSurgical site infections after abdominal hysterectomy

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

Complications and deaths

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

Deaths within 30 days: heart attack patients12%
Deaths within 30 days: heart failure patients13.5%
Deaths within 30 days: pneumonia patients21.5%
Deaths within 30 days: COPD patients12.2%
Deaths within 30 days: stroke patients10.2%
Deaths within 30 days: coronary bypass surgery (CABG)1.8%
Serious complications (patient safety indicator PSI-90)1.27No different from the national rate
Too few cases to reportComplications after hip or knee replacement

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)18.1%
Readmitted within 30 days: heart attack14.9%
Readmitted within 30 days: heart failure19.8%
Readmitted within 30 days: pneumonia17.3%
Readmitted within 30 days: COPD23%
Readmitted within 30 days: coronary bypass surgery9.3%
Readmitted within 30 days: hip or knee replacement5.5%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)194 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)72%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026NoCMS lists no payment reduction for this hospital.
Total HAC Score-0.1418Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack1.1016More readmissions than expected
Heart failure1.0810More readmissions than expected
Pneumonia1.0945More readmissions than expected
COPD (chronic lung disease)1.0262More readmissions than expected
Coronary bypass surgery (CABG)0.9706Fewer readmissions than expected
No result publishedHip or knee replacement (not reported, or too few cases)

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score23.00 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)28.00 out of 100
Person and community engagement (patient survey)34.00 out of 100
Safety (infections and sepsis care)30.00 out of 100
Efficiency and cost reduction (Medicare spending)0.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio1.00Same as the national median hospital

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

ER wait times and Medicare ratings nearby

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

ER wait times in FloridaBest hospitals in Florida

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 82 common services exactly as Winter Haven Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Show the prices of 82 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB OP VISIT NEW DETAILED PROF $197 $118.20 $35.46 – $197
New patient office visit (about 30–44 minutes): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $95.35
  • Aetna — Commercial Other: $91.21
  • Aetna — Commercial PPO: $160.55
  • Ambetter — Commercial Select Core: $197
  • Ambetter — Commercial Value: $197
  • AvMed — Commercial: $96.53
  • AvMed — Commercial Other: $61.07
  • Blue Cross — Commercial HMO Health Options: $100.51
  • Blue Cross — Commercial HMO My Blue: $62.94
  • Blue Cross — Commercial HMO Simply Blue: $82.50
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB OP VISIT NEW DETAILED PROF $197 $118.20 $110.91 – $197
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $160.55
  • Ambetter — Commercial Select Core: $197
  • Ambetter — Commercial Value: $197
  • Cigna — Commercial PPO: $171.39
  • Evolutions — Commercial PPO Choice: $183.21
  • Evolutions — Commercial PPO International: $137.90
  • Evolutions — Commercial PPO Select Network: $167.45
  • First Health — Commercial PPO: $167.45
  • Molina — Commercial Other: $110.91
  • Multiplan — Commercial PPO: $157.60
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW LOW 30 MIN Not listed in the file Not listed in the file $89.98 – $95.17
New patient office visit (about 30–44 minutes): rates for 9 insurance plans
  • Aetna — Medicaid HMO: $92.58
  • Clear Health Alliance — Medicaid HMO: $87.39
  • Florida Community Care — Medicaid HMO: $95.17
  • Freedom Health — Medicaid HMO: $90.85
  • Humana — Medicaid HMO: $89.98
  • Molina Healthcare — Medicaid HMO: $90.85
  • Simply HealthCare — Medicaid HMO: $90.85
  • Sunshine Health — Medicaid HMO: $90.85
  • United Healthcare — Medicaid HMO: $88.25
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB OP VISIT NEW COMPREHEN W/MOD PROF $320 $192 $57.60 – $320
New patient office visit (about 45–59 minutes): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $154.88
  • Aetna — Commercial Other: $148.16
  • Aetna — Commercial PPO: $260.80
  • Ambetter — Commercial Select Core: $320
  • Ambetter — Commercial Value: $320
  • AvMed — Commercial: $156.80
  • AvMed — Commercial Other: $99.20
  • Blue Cross — Commercial HMO Health Options: $163.26
  • Blue Cross — Commercial HMO My Blue: $102.24
  • Blue Cross — Commercial HMO Simply Blue: $134.02
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB OP VISIT NEW COMPREHEN W/MOD PROF $320 $192 $180.16 – $320
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $260.80
  • Ambetter — Commercial Select Core: $320
  • Ambetter — Commercial Value: $320
  • Cigna — Commercial PPO: $278.40
  • Evolutions — Commercial PPO Choice: $297.60
  • Evolutions — Commercial PPO International: $224
  • Evolutions — Commercial PPO Select Network: $272
  • First Health — Commercial PPO: $272
  • Molina — Commercial Other: $180.16
  • Multiplan — Commercial PPO: $256
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW MOD 45 MIN Not listed in the file Not listed in the file $89.98 – $95.17
New patient office visit (about 45–59 minutes): rates for 9 insurance plans
  • Aetna — Medicaid HMO: $92.58
  • Clear Health Alliance — Medicaid HMO: $87.39
  • Florida Community Care — Medicaid HMO: $95.17
  • Freedom Health — Medicaid HMO: $90.85
  • Humana — Medicaid HMO: $89.98
  • Molina Healthcare — Medicaid HMO: $90.85
  • Simply HealthCare — Medicaid HMO: $90.85
  • Sunshine Health — Medicaid HMO: $90.85
  • United Healthcare — Medicaid HMO: $88.25
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB OP VISIT NEW COMPREHEN W/HIGH PROF $435 $261 $78.30 – $435
New patient office visit (about 60–74 minutes): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $210.54
  • Aetna — Commercial Other: $201.40
  • Aetna — Commercial PPO: $354.52
  • Ambetter — Commercial Select Core: $435
  • Ambetter — Commercial Value: $435
  • AvMed — Commercial: $213.15
  • AvMed — Commercial Other: $134.85
  • Blue Cross — Commercial HMO Health Options: $221.94
  • Blue Cross — Commercial HMO My Blue: $138.98
  • Blue Cross — Commercial HMO Simply Blue: $182.18
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB OP VISIT NEW COMPREHEN W/HIGH PROF $435 $261 $244.90 – $435
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $354.52
  • Ambetter — Commercial Select Core: $435
  • Ambetter — Commercial Value: $435
  • Cigna — Commercial PPO: $378.45
  • Evolutions — Commercial PPO Choice: $404.55
  • Evolutions — Commercial PPO International: $304.50
  • Evolutions — Commercial PPO Select Network: $369.75
  • First Health — Commercial PPO: $369.75
  • Molina — Commercial Other: $244.90
  • Multiplan — Commercial PPO: $348
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60 MIN Not listed in the file Not listed in the file $107.13 – $113.31
New patient office visit (about 60–74 minutes): rates for 9 insurance plans
  • Aetna — Medicaid HMO: $110.22
  • Clear Health Alliance — Medicaid HMO: $104.04
  • Florida Community Care — Medicaid HMO: $113.31
  • Freedom Health — Medicaid HMO: $108.16
  • Humana — Medicaid HMO: $107.13
  • Molina Healthcare — Medicaid HMO: $108.16
  • Simply HealthCare — Medicaid HMO: $108.16
  • Sunshine Health — Medicaid HMO: $108.16
  • United Healthcare — Medicaid HMO: $105.07
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB OP VISIT EST EXPAND PROB FOCUS PROF $157 $94.20 $28.26 – $157
Established patient office visit (about 20–29 minutes): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $75.99
  • Aetna — Commercial Other: $72.69
  • Aetna — Commercial PPO: $127.96
  • Ambetter — Commercial Select Core: $157
  • Ambetter — Commercial Value: $157
  • AvMed — Commercial: $76.93
  • AvMed — Commercial Other: $48.67
  • Blue Cross — Commercial HMO Health Options: $80.10
  • Blue Cross — Commercial HMO My Blue: $50.16
  • Blue Cross — Commercial HMO Simply Blue: $65.75
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB OP VISIT EST EXPAND PROB FOCUS PROF $157 $94.20 $88.39 – $157
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $127.96
  • Ambetter — Commercial Select Core: $157
  • Ambetter — Commercial Value: $157
  • Cigna — Commercial PPO: $136.59
  • Evolutions — Commercial PPO Choice: $146.01
  • Evolutions — Commercial PPO International: $109.90
  • Evolutions — Commercial PPO Select Network: $133.45
  • First Health — Commercial PPO: $133.45
  • Molina — Commercial Other: $88.39
  • Multiplan — Commercial PPO: $125.60
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN Not listed in the file Not listed in the file $107.13 – $113.31
Established patient office visit (about 20–29 minutes): rates for 9 insurance plans
  • Aetna — Medicaid HMO: $110.22
  • Clear Health Alliance — Medicaid HMO: $104.04
  • Florida Community Care — Medicaid HMO: $113.31
  • Freedom Health — Medicaid HMO: $108.16
  • Humana — Medicaid HMO: $107.13
  • Molina Healthcare — Medicaid HMO: $108.16
  • Simply HealthCare — Medicaid HMO: $108.16
  • Sunshine Health — Medicaid HMO: $108.16
  • United Healthcare — Medicaid HMO: $105.07
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB OP VISIT EST DETAILED PROF $231 $138.60 $41.58 – $231
Established patient office visit (about 30–39 minutes): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $111.80
  • Aetna — Commercial Other: $106.95
  • Aetna — Commercial PPO: $188.26
  • Ambetter — Commercial Select Core: $231
  • Ambetter — Commercial Value: $231
  • AvMed — Commercial: $113.19
  • AvMed — Commercial Other: $71.61
  • Blue Cross — Commercial HMO Health Options: $117.86
  • Blue Cross — Commercial HMO My Blue: $73.80
  • Blue Cross — Commercial HMO Simply Blue: $96.74
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB OP VISIT EST DETAILED PROF $231 $138.60 $130.05 – $231
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $188.26
  • Ambetter — Commercial Select Core: $231
  • Ambetter — Commercial Value: $231
  • Cigna — Commercial PPO: $200.97
  • Evolutions — Commercial PPO Choice: $214.83
  • Evolutions — Commercial PPO International: $161.70
  • Evolutions — Commercial PPO Select Network: $196.35
  • First Health — Commercial PPO: $196.35
  • Molina — Commercial Other: $130.05
  • Multiplan — Commercial PPO: $184.80
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN Not listed in the file Not listed in the file $158.97 – $168.14
Established patient office visit (about 30–39 minutes): rates for 9 insurance plans
  • Aetna — Medicaid HMO: $163.56
  • Clear Health Alliance — Medicaid HMO: $154.39
  • Florida Community Care — Medicaid HMO: $168.14
  • Freedom Health — Medicaid HMO: $160.50
  • Humana — Medicaid HMO: $158.97
  • Molina Healthcare — Medicaid HMO: $160.50
  • Simply HealthCare — Medicaid HMO: $160.50
  • Sunshine Health — Medicaid HMO: $160.50
  • United Healthcare — Medicaid HMO: $155.91
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB OP NON M PT CONSULT DETAILED PROF $157 $94.20 $28.26 – $157
Office consultation with a specialist (moderate): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $75.99
  • Aetna — Commercial Other: $72.69
  • Aetna — Commercial PPO: $127.96
  • Ambetter — Commercial Select Core: $157
  • Ambetter — Commercial Value: $157
  • AvMed — Commercial: $76.93
  • AvMed — Commercial Other: $48.67
  • Blue Cross — Commercial HMO Health Options: $80.10
  • Blue Cross — Commercial HMO My Blue: $50.16
  • Blue Cross — Commercial HMO Simply Blue: $65.75
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB OP NON M PT CONSULT DETAILED PROF $157 $94.20 $88.39 – $157
Office consultation with a specialist (moderate): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $127.96
  • Ambetter — Commercial Select Core: $157
  • Ambetter — Commercial Value: $157
  • Cigna — Commercial PPO: $136.59
  • Evolutions — Commercial PPO Choice: $146.01
  • Evolutions — Commercial PPO International: $109.90
  • Evolutions — Commercial PPO Select Network: $133.45
  • First Health — Commercial PPO: $133.45
  • Molina — Commercial Other: $88.39
  • Multiplan — Commercial PPO: $125.60
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30 Not listed in the file Not listed in the file $28.08 – $29.70
Office consultation with a specialist (moderate): rates for 9 insurance plans
  • Aetna — Medicaid HMO: $28.89
  • Clear Health Alliance — Medicaid HMO: $27.27
  • Florida Community Care — Medicaid HMO: $29.70
  • Freedom Health — Medicaid HMO: $28.35
  • Humana — Medicaid HMO: $28.08
  • Molina Healthcare — Medicaid HMO: $28.35
  • Simply HealthCare — Medicaid HMO: $28.35
  • Sunshine Health — Medicaid HMO: $28.35
  • United Healthcare — Medicaid HMO: $27.54
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NS LACTATION CONSULT $76 $45.60 $13.68 – $76
Office consultation with a specialist (moderate to high): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $36.78
  • Aetna — Commercial Other: $35.19
  • Aetna — Commercial PPO: $61.94
  • Ambetter — Commercial Select Core: $76
  • Ambetter — Commercial Value: $76
  • AvMed — Commercial: $37.24
  • AvMed — Commercial Other: $23.56
  • Blue Cross — Commercial HMO Health Options: $38.78
  • Blue Cross — Commercial HMO My Blue: $24.28
  • Blue Cross — Commercial HMO Simply Blue: $31.83
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB OP NON M PT CONSULT COMPRHNSIVE PROF $231 $138.60 $41.58 – $231
Office consultation with a specialist (moderate to high): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $111.80
  • Aetna — Commercial Other: $106.95
  • Aetna — Commercial PPO: $188.26
  • Ambetter — Commercial Select Core: $231
  • Ambetter — Commercial Value: $231
  • AvMed — Commercial: $113.19
  • AvMed — Commercial Other: $71.61
  • Blue Cross — Commercial HMO Health Options: $117.86
  • Blue Cross — Commercial HMO My Blue: $73.80
  • Blue Cross — Commercial HMO Simply Blue: $96.74
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NS LACTATION CONSULT $76 $45.60 $42.79 – $76
Office consultation with a specialist (moderate to high): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $61.94
  • Ambetter — Commercial Select Core: $76
  • Ambetter — Commercial Value: $76
  • Cigna — Commercial PPO: $66.12
  • Evolutions — Commercial PPO Choice: $70.68
  • Evolutions — Commercial PPO International: $53.20
  • Evolutions — Commercial PPO Select Network: $64.60
  • First Health — Commercial PPO: $64.60
  • Molina — Commercial Other: $42.79
  • Multiplan — Commercial PPO: $60.80
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 18-39 Not listed in the file Not listed in the file $88.35
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan
  • Humana Military — Commercial Other: $88.35
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 40-64 Not listed in the file Not listed in the file $106.85
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan
  • Humana Military — Commercial Other: $106.85
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 3 $2,776 $1,665.60 $499.68 – $2,776
Emergency room visit (moderate): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $1,343.58
  • Aetna — Commercial Other: $1,285.29
  • Aetna — Commercial PPO: $2,262.44
  • Ambetter — Commercial Select Core: $2,776
  • Ambetter — Commercial Value: $2,776
  • AvMed — Commercial: $1,360.24
  • AvMed — Commercial Other: $860.56
  • Blue Cross — Commercial HMO Health Options: $1,416.32
  • Blue Cross — Commercial HMO My Blue: $886.93
  • Blue Cross — Commercial HMO Simply Blue: $1,162.59
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB TRIAGE EXPAND PROB FOCUS W/MOD PROF $171 $102.60 $30.78 – $171
Emergency room visit (moderate): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $82.76
  • Aetna — Commercial Other: $79.17
  • Aetna — Commercial PPO: $139.36
  • Ambetter — Commercial Select Core: $171
  • Ambetter — Commercial Value: $171
  • AvMed — Commercial: $83.79
  • AvMed — Commercial Other: $53.01
  • Blue Cross — Commercial HMO Health Options: $87.24
  • Blue Cross — Commercial HMO My Blue: $54.63
  • Blue Cross — Commercial HMO Simply Blue: $71.61
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 3 $2,776 $1,665.60 $1,562.89 – $2,776
Emergency room visit (moderate): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $2,262.44
  • Ambetter — Commercial Select Core: $2,776
  • Ambetter — Commercial Value: $2,776
  • Cigna — Commercial PPO: $2,415.12
  • Evolutions — Commercial PPO Choice: $2,581.68
  • Evolutions — Commercial PPO International: $1,943.20
  • Evolutions — Commercial PPO Select Network: $2,359.60
  • First Health — Commercial PPO: $2,359.60
  • Molina — Commercial Other: $1,562.89
  • Multiplan — Commercial PPO: $2,220.80
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 4 $4,561 $2,736.60 $820.98 – $4,561
Emergency room visit (moderately high): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $2,207.52
  • Aetna — Commercial Other: $2,111.74
  • Aetna — Commercial PPO: $3,717.21
  • Ambetter — Commercial Select Core: $4,561
  • Ambetter — Commercial Value: $4,561
  • AvMed — Commercial: $2,234.89
  • AvMed — Commercial Other: $1,413.91
  • Blue Cross — Commercial HMO Health Options: $2,327.02
  • Blue Cross — Commercial HMO My Blue: $1,457.24
  • Blue Cross — Commercial HMO Simply Blue: $1,910.15
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB TRIAGE DETAILED PROF $292 $175.20 $52.56 – $292
Emergency room visit (moderately high): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $141.33
  • Aetna — Commercial Other: $135.20
  • Aetna — Commercial PPO: $237.98
  • Ambetter — Commercial Select Core: $292
  • Ambetter — Commercial Value: $292
  • AvMed — Commercial: $143.08
  • AvMed — Commercial Other: $90.52
  • Blue Cross — Commercial HMO Health Options: $148.98
  • Blue Cross — Commercial HMO My Blue: $93.29
  • Blue Cross — Commercial HMO Simply Blue: $122.29
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 4 $4,561 $2,736.60 $2,567.84 – $4,561
Emergency room visit (moderately high): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $3,717.21
  • Ambetter — Commercial Select Core: $4,561
  • Ambetter — Commercial Value: $4,561
  • Cigna — Commercial PPO: $3,968.07
  • Evolutions — Commercial PPO Choice: $4,241.73
  • Evolutions — Commercial PPO International: $3,192.70
  • Evolutions — Commercial PPO Select Network: $3,876.85
  • First Health — Commercial PPO: $3,876.85
  • Molina — Commercial Other: $2,567.84
  • Multiplan — Commercial PPO: $3,648.80
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 5 $6,610 $3,966 $1,189.80 – $6,610
Emergency room visit (high): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $3,199.24
  • Aetna — Commercial Other: $3,060.43
  • Aetna — Commercial PPO: $5,387.15
  • Ambetter — Commercial Select Core: $6,610
  • Ambetter — Commercial Value: $6,610
  • AvMed — Commercial: $3,238.90
  • AvMed — Commercial Other: $2,049.10
  • Blue Cross — Commercial HMO Health Options: $3,372.42
  • Blue Cross — Commercial HMO My Blue: $2,111.90
  • Blue Cross — Commercial HMO Simply Blue: $2,768.27
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB TRIAGE COMPREHENSIVE PROF $425 $255 $76.50 – $425
Emergency room visit (high): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $205.70
  • Aetna — Commercial Other: $196.78
  • Aetna — Commercial PPO: $346.38
  • Ambetter — Commercial Select Core: $425
  • Ambetter — Commercial Value: $425
  • AvMed — Commercial: $208.25
  • AvMed — Commercial Other: $131.75
  • Blue Cross — Commercial HMO Health Options: $216.84
  • Blue Cross — Commercial HMO My Blue: $135.79
  • Blue Cross — Commercial HMO Simply Blue: $177.99
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED VISIT LEVEL 5 $6,610 $3,966 $3,721.43 – $6,610
Emergency room visit (high): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $5,387.15
  • Ambetter — Commercial Select Core: $6,610
  • Ambetter — Commercial Value: $6,610
  • Cigna — Commercial PPO: $5,750.70
  • Evolutions — Commercial PPO Choice: $6,147.30
  • Evolutions — Commercial PPO International: $4,627
  • Evolutions — Commercial PPO Select Network: $5,618.50
  • First Health — Commercial PPO: $5,618.50
  • Molina — Commercial Other: $3,721.43
  • Multiplan — Commercial PPO: $5,288

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL $32 $19.20 $5.76 – $32
Basic metabolic panel (blood test): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $15.49
  • Aetna — Commercial Other: $14.82
  • Aetna — Commercial PPO: $26.08
  • Ambetter — Commercial Select Core: $32
  • Ambetter — Commercial Value: $32
  • AvMed — Commercial: $15.68
  • AvMed — Commercial Other: $9.92
  • Blue Cross — Commercial HMO Health Options: $16.33
  • Blue Cross — Commercial HMO My Blue: $10.22
  • Blue Cross — Commercial HMO Simply Blue: $13.40
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RT BASIC METABOLIC PANEL $257 $154.20 $46.26 – $257
Basic metabolic panel (blood test): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $124.39
  • Aetna — Commercial Other: $118.99
  • Aetna — Commercial PPO: $209.46
  • Ambetter — Commercial Select Core: $257
  • Ambetter — Commercial Value: $257
  • AvMed — Commercial: $125.93
  • AvMed — Commercial Other: $79.67
  • Blue Cross — Commercial HMO Health Options: $131.12
  • Blue Cross — Commercial HMO My Blue: $82.11
  • Blue Cross — Commercial HMO Simply Blue: $107.63
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL $32 $19.20 $18.02 – $32
Basic metabolic panel (blood test): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $26.08
  • Ambetter — Commercial Select Core: $32
  • Ambetter — Commercial Value: $32
  • Cigna — Commercial PPO: $27.84
  • Evolutions — Commercial PPO Choice: $29.76
  • Evolutions — Commercial PPO International: $22.40
  • Evolutions — Commercial PPO Select Network: $27.20
  • First Health — Commercial PPO: $27.20
  • Molina — Commercial Other: $18.02
  • Multiplan — Commercial PPO: $25.60
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PNL $45 $27 $8.10 – $45
Comprehensive metabolic panel (blood test): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $21.78
  • Aetna — Commercial Other: $20.84
  • Aetna — Commercial PPO: $36.67
  • Ambetter — Commercial Select Core: $45
  • Ambetter — Commercial Value: $45
  • AvMed — Commercial: $22.05
  • AvMed — Commercial Other: $13.95
  • Blue Cross — Commercial HMO Health Options: $22.96
  • Blue Cross — Commercial HMO My Blue: $14.38
  • Blue Cross — Commercial HMO Simply Blue: $18.85
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CMP 2ND HALF $31 $18.60 $5.58 – $31
Comprehensive metabolic panel (blood test): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $15
  • Aetna — Commercial Other: $14.35
  • Aetna — Commercial PPO: $25.26
  • Ambetter — Commercial Select Core: $31
  • Ambetter — Commercial Value: $31
  • AvMed — Commercial: $15.19
  • AvMed — Commercial Other: $9.61
  • Blue Cross — Commercial HMO Health Options: $15.82
  • Blue Cross — Commercial HMO My Blue: $9.90
  • Blue Cross — Commercial HMO Simply Blue: $12.98
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CMP 3rd $31 $18.60 $5.58 – $31
Comprehensive metabolic panel (blood test): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $15
  • Aetna — Commercial Other: $14.35
  • Aetna — Commercial PPO: $25.26
  • Ambetter — Commercial Select Core: $31
  • Ambetter — Commercial Value: $31
  • AvMed — Commercial: $15.19
  • AvMed — Commercial Other: $9.61
  • Blue Cross — Commercial HMO Health Options: $15.82
  • Blue Cross — Commercial HMO My Blue: $9.90
  • Blue Cross — Commercial HMO Simply Blue: $12.98
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB PANEL $241 $144.60 $43.38 – $241
Obstetric blood test panel: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $116.64
  • Aetna — Commercial Other: $111.58
  • Aetna — Commercial PPO: $196.42
  • Ambetter — Commercial Select Core: $241
  • Ambetter — Commercial Value: $241
  • AvMed — Commercial: $118.09
  • AvMed — Commercial Other: $74.71
  • Blue Cross — Commercial HMO Health Options: $122.96
  • Blue Cross — Commercial HMO My Blue: $77
  • Blue Cross — Commercial HMO Simply Blue: $100.93
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB PANEL $241 $144.60 $135.68 – $241
Obstetric blood test panel: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $196.42
  • Ambetter — Commercial Select Core: $241
  • Ambetter — Commercial Value: $241
  • Cigna — Commercial PPO: $209.67
  • Evolutions — Commercial PPO Choice: $224.13
  • Evolutions — Commercial PPO International: $168.70
  • Evolutions — Commercial PPO Select Network: $204.85
  • First Health — Commercial PPO: $204.85
  • Molina — Commercial Other: $135.68
  • Multiplan — Commercial PPO: $192.80
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel Not listed in the file Not listed in the file $47.81 – $121.92
Obstetric blood test panel: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $58.33
  • Aetna — Commercial Other: $54.03
  • Aetna — Commercial PPO: $58.33
  • Aetna — Medicare HMO: $54.98
  • Aetna — Medicare PPO: $47.81
  • Ambetter — Commercial Select Core: $107.57
  • Ambetter — Commercial Value: $121.92
  • BayCarePlus — Medicare HMO: $47.81
  • Blue Cross — Medicare HMO: $47.81
  • CarePlus — Medicare HMO: $53.36
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHOLESTEROL FRACTIONATION $58 $34.80 $10.44 – $58
Cholesterol panel (lipid panel): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $28.07
  • Aetna — Commercial Other: $26.85
  • Aetna — Commercial PPO: $47.27
  • Ambetter — Commercial Select Core: $58
  • Ambetter — Commercial Value: $58
  • AvMed — Commercial: $28.42
  • AvMed — Commercial Other: $17.98
  • Blue Cross — Commercial HMO Health Options: $29.59
  • Blue Cross — Commercial HMO My Blue: $18.53
  • Blue Cross — Commercial HMO Simply Blue: $24.29
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: QUEST LIPID W/REFLEX LDL $58 $34.80 $10.44 – $58
Cholesterol panel (lipid panel): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $28.07
  • Aetna — Commercial Other: $26.85
  • Aetna — Commercial PPO: $47.27
  • Ambetter — Commercial Select Core: $58
  • Ambetter — Commercial Value: $58
  • AvMed — Commercial: $28.42
  • AvMed — Commercial Other: $17.98
  • Blue Cross — Commercial HMO Health Options: $29.59
  • Blue Cross — Commercial HMO My Blue: $18.53
  • Blue Cross — Commercial HMO Simply Blue: $24.29
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NMR LIPOPROTEIN P1 $62 $37.20 $11.16 – $62
Cholesterol panel (lipid panel): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $30.01
  • Aetna — Commercial Other: $28.71
  • Aetna — Commercial PPO: $50.53
  • Ambetter — Commercial Select Core: $62
  • Ambetter — Commercial Value: $62
  • AvMed — Commercial: $30.38
  • AvMed — Commercial Other: $19.22
  • Blue Cross — Commercial HMO Health Options: $31.63
  • Blue Cross — Commercial HMO My Blue: $19.81
  • Blue Cross — Commercial HMO Simply Blue: $25.97
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION (COS) $43 $25.80 $7.74 – $43
Kidney function panel: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $20.81
  • Aetna — Commercial Other: $19.91
  • Aetna — Commercial PPO: $35.04
  • Ambetter — Commercial Select Core: $43
  • Ambetter — Commercial Value: $43
  • AvMed — Commercial: $21.07
  • AvMed — Commercial Other: $13.33
  • Blue Cross — Commercial HMO Health Options: $21.94
  • Blue Cross — Commercial HMO My Blue: $13.74
  • Blue Cross — Commercial HMO Simply Blue: $18.01
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION (COS) $43 $25.80 $24.21 – $43
Kidney function panel: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $35.04
  • Ambetter — Commercial Select Core: $43
  • Ambetter — Commercial Value: $43
  • Cigna — Commercial PPO: $37.41
  • Evolutions — Commercial PPO Choice: $39.99
  • Evolutions — Commercial PPO International: $30.10
  • Evolutions — Commercial PPO Select Network: $36.55
  • First Health — Commercial PPO: $36.55
  • Molina — Commercial Other: $24.21
  • Multiplan — Commercial PPO: $34.40
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel Not listed in the file Not listed in the file $7.87 – $22.13
Kidney function panel: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $10.59
  • Aetna — Commercial Other: $9.81
  • Aetna — Commercial PPO: $10.59
  • Aetna — Medicare HMO: $9.98
  • Aetna — Medicare PPO: $8.68
  • Ambetter — Commercial Select Core: $19.53
  • Ambetter — Commercial Value: $22.13
  • BayCarePlus — Medicare HMO: $8.68
  • Blue Cross — Medicare HMO: $8.68
  • CarePlus — Medicare HMO: $9.69
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION (COS) $41 $24.60 $7.38 – $41
Liver function panel: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $19.84
  • Aetna — Commercial Other: $18.98
  • Aetna — Commercial PPO: $33.42
  • Ambetter — Commercial Select Core: $41
  • Ambetter — Commercial Value: $41
  • AvMed — Commercial: $20.09
  • AvMed — Commercial Other: $12.71
  • Blue Cross — Commercial HMO Health Options: $20.92
  • Blue Cross — Commercial HMO My Blue: $13.10
  • Blue Cross — Commercial HMO Simply Blue: $17.17
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION PANEL $39 $23.40 $7.02 – $39
Liver function panel: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $18.88
  • Aetna — Commercial Other: $18.06
  • Aetna — Commercial PPO: $31.78
  • Ambetter — Commercial Select Core: $39
  • Ambetter — Commercial Value: $39
  • AvMed — Commercial: $19.11
  • AvMed — Commercial Other: $12.09
  • Blue Cross — Commercial HMO Health Options: $19.90
  • Blue Cross — Commercial HMO My Blue: $12.46
  • Blue Cross — Commercial HMO Simply Blue: $16.33
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION (COS) $41 $24.60 $23.08 – $41
Liver function panel: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $33.42
  • Ambetter — Commercial Select Core: $41
  • Ambetter — Commercial Value: $41
  • Cigna — Commercial PPO: $35.67
  • Evolutions — Commercial PPO Choice: $38.13
  • Evolutions — Commercial PPO International: $28.70
  • Evolutions — Commercial PPO Select Network: $34.85
  • First Health — Commercial PPO: $34.85
  • Molina — Commercial Other: $23.08
  • Multiplan — Commercial PPO: $32.80
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE MICROSCOPIC $30 $18 $5.40 – $30
Urine test (automated, with microscope): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $14.52
  • Aetna — Commercial Other: $13.89
  • Aetna — Commercial PPO: $24.45
  • Ambetter — Commercial Select Core: $30
  • Ambetter — Commercial Value: $30
  • AvMed — Commercial: $14.70
  • AvMed — Commercial Other: $9.30
  • Blue Cross — Commercial HMO Health Options: $15.31
  • Blue Cross — Commercial HMO My Blue: $9.59
  • Blue Cross — Commercial HMO Simply Blue: $12.56
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA W/ MICRO REF CULT $28 $16.80 $5.04 – $28
Urine test (automated, with microscope): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $13.55
  • Aetna — Commercial Other: $12.96
  • Aetna — Commercial PPO: $22.82
  • Ambetter — Commercial Select Core: $28
  • Ambetter — Commercial Value: $28
  • AvMed — Commercial: $13.72
  • AvMed — Commercial Other: $8.68
  • Blue Cross — Commercial HMO Health Options: $14.29
  • Blue Cross — Commercial HMO My Blue: $8.95
  • Blue Cross — Commercial HMO Simply Blue: $11.73
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS WITH MICROSCOPIC $30 $18 $5.40 – $30
Urine test (automated, with microscope): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $14.52
  • Aetna — Commercial Other: $13.89
  • Aetna — Commercial PPO: $24.45
  • Ambetter — Commercial Select Core: $30
  • Ambetter — Commercial Value: $30
  • AvMed — Commercial: $14.70
  • AvMed — Commercial Other: $9.30
  • Blue Cross — Commercial HMO Health Options: $15.31
  • Blue Cross — Commercial HMO My Blue: $9.59
  • Blue Cross — Commercial HMO Simply Blue: $12.56
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UR BILIRUBIN $32 $19.20 $5.76 – $32
Urine test (manual, without microscope): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $15.49
  • Aetna — Commercial Other: $14.82
  • Aetna — Commercial PPO: $26.08
  • Ambetter — Commercial Select Core: $32
  • Ambetter — Commercial Value: $32
  • AvMed — Commercial: $15.68
  • AvMed — Commercial Other: $9.92
  • Blue Cross — Commercial HMO Health Options: $16.33
  • Blue Cross — Commercial HMO My Blue: $10.22
  • Blue Cross — Commercial HMO Simply Blue: $13.40
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UR BILIRUBIN $32 $19.20 $18.02 – $32
Urine test (manual, without microscope): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $26.08
  • Ambetter — Commercial Select Core: $32
  • Ambetter — Commercial Value: $32
  • Cigna — Commercial PPO: $27.84
  • Evolutions — Commercial PPO Choice: $29.76
  • Evolutions — Commercial PPO International: $22.40
  • Evolutions — Commercial PPO Select Network: $27.20
  • First Health — Commercial PPO: $27.20
  • Molina — Commercial Other: $18.02
  • Multiplan — Commercial PPO: $25.60
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope Not listed in the file Not listed in the file $3.15 – $8.87
Urine test (manual, without microscope): 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $4.25
  • Aetna — Commercial Other: $3.93
  • Aetna — Commercial PPO: $4.25
  • Aetna — Medicare HMO: $4
  • Aetna — Medicare PPO: $3.48
  • Ambetter — Commercial Select Core: $7.83
  • Ambetter — Commercial Value: $8.87
  • BayCarePlus — Medicare HMO: $3.48
  • Blue Cross — Medicare HMO: $3.48
  • CarePlus — Medicare HMO: $3.88
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UF-100 $30 $18 $5.40 – $30
Urine test (automated, without microscope): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $14.52
  • Aetna — Commercial Other: $13.89
  • Aetna — Commercial PPO: $24.45
  • Ambetter — Commercial Select Core: $30
  • Ambetter — Commercial Value: $30
  • AvMed — Commercial: $14.70
  • AvMed — Commercial Other: $9.30
  • Blue Cross — Commercial HMO Health Options: $15.31
  • Blue Cross — Commercial HMO My Blue: $9.59
  • Blue Cross — Commercial HMO Simply Blue: $12.56
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS $30 $18 $5.40 – $30
Urine test (automated, without microscope): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $14.52
  • Aetna — Commercial Other: $13.89
  • Aetna — Commercial PPO: $24.45
  • Ambetter — Commercial Select Core: $30
  • Ambetter — Commercial Value: $30
  • AvMed — Commercial: $14.70
  • AvMed — Commercial Other: $9.30
  • Blue Cross — Commercial HMO Health Options: $15.31
  • Blue Cross — Commercial HMO My Blue: $9.59
  • Blue Cross — Commercial HMO Simply Blue: $12.56
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS WITH REFLEX CULTURE $30 $18 $5.40 – $30
Urine test (automated, without microscope): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $14.52
  • Aetna — Commercial Other: $13.89
  • Aetna — Commercial PPO: $24.45
  • Ambetter — Commercial Select Core: $30
  • Ambetter — Commercial Value: $30
  • AvMed — Commercial: $14.70
  • AvMed — Commercial Other: $9.30
  • Blue Cross — Commercial HMO Health Options: $15.31
  • Blue Cross — Commercial HMO My Blue: $9.59
  • Blue Cross — Commercial HMO Simply Blue: $12.56
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROSTATE SPECIFIC AG $64 $38.40 $11.52 – $64
PSA (prostate specific antigen) blood test: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $30.98
  • Aetna — Commercial Other: $29.63
  • Aetna — Commercial PPO: $52.16
  • Ambetter — Commercial Select Core: $64
  • Ambetter — Commercial Value: $64
  • AvMed — Commercial: $31.36
  • AvMed — Commercial Other: $19.84
  • Blue Cross — Commercial HMO Health Options: $32.65
  • Blue Cross — Commercial HMO My Blue: $20.45
  • Blue Cross — Commercial HMO Simply Blue: $26.80
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA POST PROSTECTOMY $40 $24 $7.20 – $40
PSA (prostate specific antigen) blood test: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $19.36
  • Aetna — Commercial Other: $18.52
  • Aetna — Commercial PPO: $32.60
  • Ambetter — Commercial Select Core: $40
  • Ambetter — Commercial Value: $40
  • AvMed — Commercial: $19.60
  • AvMed — Commercial Other: $12.40
  • Blue Cross — Commercial HMO Health Options: $20.41
  • Blue Cross — Commercial HMO My Blue: $12.78
  • Blue Cross — Commercial HMO Simply Blue: $16.75
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PROSTATE SPECIFIC AG $64 $38.40 $36.03 – $64
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $52.16
  • Ambetter — Commercial Select Core: $64
  • Ambetter — Commercial Value: $64
  • Cigna — Commercial PPO: $55.68
  • Evolutions — Commercial PPO Choice: $59.52
  • Evolutions — Commercial PPO International: $44.80
  • Evolutions — Commercial PPO Select Network: $54.40
  • First Health — Commercial PPO: $54.40
  • Molina — Commercial Other: $36.03
  • Multiplan — Commercial PPO: $51.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH 3RD GENERATION $62 $37.20 $11.16 – $62
Thyroid stimulating hormone (TSH) test: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $30.01
  • Aetna — Commercial Other: $28.71
  • Aetna — Commercial PPO: $50.53
  • Ambetter — Commercial Select Core: $62
  • Ambetter — Commercial Value: $62
  • AvMed — Commercial: $30.38
  • AvMed — Commercial Other: $19.22
  • Blue Cross — Commercial HMO Health Options: $31.63
  • Blue Cross — Commercial HMO My Blue: $19.81
  • Blue Cross — Commercial HMO Simply Blue: $25.97
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH SCREEN $62 $37.20 $11.16 – $62
Thyroid stimulating hormone (TSH) test: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $30.01
  • Aetna — Commercial Other: $28.71
  • Aetna — Commercial PPO: $50.53
  • Ambetter — Commercial Select Core: $62
  • Ambetter — Commercial Value: $62
  • AvMed — Commercial: $30.38
  • AvMed — Commercial Other: $19.22
  • Blue Cross — Commercial HMO Health Options: $31.63
  • Blue Cross — Commercial HMO My Blue: $19.81
  • Blue Cross — Commercial HMO Simply Blue: $25.97
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEWBORN COMP SCREEN P6 $33 $19.80 $5.94 – $33
Thyroid stimulating hormone (TSH) test: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $15.97
  • Aetna — Commercial Other: $15.28
  • Aetna — Commercial PPO: $26.90
  • Ambetter — Commercial Select Core: $33
  • Ambetter — Commercial Value: $33
  • AvMed — Commercial: $16.17
  • AvMed — Commercial Other: $10.23
  • Blue Cross — Commercial HMO Health Options: $16.84
  • Blue Cross — Commercial HMO My Blue: $10.54
  • Blue Cross — Commercial HMO Simply Blue: $13.82
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W/ DIFF $27 $16.20 $4.86 – $27
Complete blood count (CBC) with differential: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $13.07
  • Aetna — Commercial Other: $12.50
  • Aetna — Commercial PPO: $22
  • Ambetter — Commercial Select Core: $27
  • Ambetter — Commercial Value: $27
  • AvMed — Commercial: $13.23
  • AvMed — Commercial Other: $8.37
  • Blue Cross — Commercial HMO Health Options: $13.78
  • Blue Cross — Commercial HMO My Blue: $8.63
  • Blue Cross — Commercial HMO Simply Blue: $11.31
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC W/ DIFF $27 $16.20 $15.20 – $27
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $22
  • Ambetter — Commercial Select Core: $27
  • Ambetter — Commercial Value: $27
  • Cigna — Commercial PPO: $23.49
  • Evolutions — Commercial PPO Choice: $25.11
  • Evolutions — Commercial PPO International: $18.90
  • Evolutions — Commercial PPO Select Network: $22.95
  • First Health — Commercial PPO: $22.95
  • Molina — Commercial Other: $15.20
  • Multiplan — Commercial PPO: $21.60
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc Not listed in the file Not listed in the file $7.04 – $19.81
Complete blood count (CBC) with differential: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $9.48
  • Aetna — Commercial Other: $8.78
  • Aetna — Commercial PPO: $9.48
  • Aetna — Medicare HMO: $8.94
  • Aetna — Medicare PPO: $7.77
  • Ambetter — Commercial Select Core: $17.48
  • Ambetter — Commercial Value: $19.81
  • BayCarePlus — Medicare HMO: $7.77
  • Blue Cross — Medicare HMO: $7.77
  • CarePlus — Medicare HMO: $8.67
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W/OUT DIFF $23 $13.80 $4.14 – $23
Complete blood count (CBC), automated: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $11.13
  • Aetna — Commercial Other: $10.65
  • Aetna — Commercial PPO: $18.74
  • Ambetter — Commercial Select Core: $23
  • Ambetter — Commercial Value: $23
  • AvMed — Commercial: $11.27
  • AvMed — Commercial Other: $7.13
  • Blue Cross — Commercial HMO Health Options: $11.73
  • Blue Cross — Commercial HMO My Blue: $7.35
  • Blue Cross — Commercial HMO Simply Blue: $9.63
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC W/OUT DIFF $23 $13.80 $12.95 – $23
Complete blood count (CBC), automated: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $18.74
  • Ambetter — Commercial Select Core: $23
  • Ambetter — Commercial Value: $23
  • Cigna — Commercial PPO: $20.01
  • Evolutions — Commercial PPO Choice: $21.39
  • Evolutions — Commercial PPO International: $16.10
  • Evolutions — Commercial PPO Select Network: $19.55
  • First Health — Commercial PPO: $19.55
  • Molina — Commercial Other: $12.95
  • Multiplan — Commercial PPO: $18.40
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated Not listed in the file Not listed in the file $5.87 – $16.50
Complete blood count (CBC), automated: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $7.89
  • Aetna — Commercial Other: $7.31
  • Aetna — Commercial PPO: $7.89
  • Aetna — Medicare HMO: $7.44
  • Aetna — Medicare PPO: $6.47
  • Ambetter — Commercial Select Core: $14.56
  • Ambetter — Commercial Value: $16.50
  • BayCarePlus — Medicare HMO: $6.47
  • Blue Cross — Medicare HMO: $6.47
  • CarePlus — Medicare HMO: $7.22
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $23 $13.80 $4.14 – $23
Blood clotting time test (prothrombin time, PT): 10 of 39 insurance plan rates
  • Aetna — Commercial HMO: $11.13
  • Aetna — Commercial Other: $10.65
  • Aetna — Commercial PPO: $18.74
  • Aetna — Medicaid HMO: $2.39
  • Ambetter — Commercial Select Core: $23
  • Ambetter — Commercial Value: $23
  • AvMed — Commercial: $11.27
  • AvMed — Commercial Other: $7.13
  • Blue Cross — Commercial HMO Health Options: $11.73
  • Blue Cross — Commercial HMO My Blue: $7.35
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC PROTIME $22 $13.20 $3.96 – $22
Blood clotting time test (prothrombin time, PT): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $10.65
  • Aetna — Commercial Other: $10.19
  • Aetna — Commercial PPO: $17.93
  • Ambetter — Commercial Select Core: $22
  • Ambetter — Commercial Value: $22
  • AvMed — Commercial: $10.78
  • AvMed — Commercial Other: $6.82
  • Blue Cross — Commercial HMO Health Options: $11.22
  • Blue Cross — Commercial HMO My Blue: $7.03
  • Blue Cross — Commercial HMO Simply Blue: $9.21
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $23 $13.80 $12.95 – $23
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $18.74
  • Ambetter — Commercial Select Core: $23
  • Ambetter — Commercial Value: $23
  • Cigna — Commercial PPO: $20.01
  • Evolutions — Commercial PPO Choice: $21.39
  • Evolutions — Commercial PPO International: $16.10
  • Evolutions — Commercial PPO Select Network: $19.55
  • First Health — Commercial PPO: $19.55
  • Molina — Commercial Other: $12.95
  • Multiplan — Commercial PPO: $18.40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: APTT $28 $16.80 $5.04 – $28
Blood clotting test (partial thromboplastin time, PTT): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $13.55
  • Aetna — Commercial Other: $12.96
  • Aetna — Commercial PPO: $22.82
  • Ambetter — Commercial Select Core: $28
  • Ambetter — Commercial Value: $28
  • AvMed — Commercial: $13.72
  • AvMed — Commercial Other: $8.68
  • Blue Cross — Commercial HMO Health Options: $14.29
  • Blue Cross — Commercial HMO My Blue: $8.95
  • Blue Cross — Commercial HMO Simply Blue: $11.73
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: APTT $28 $16.80 $15.76 – $28
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $22.82
  • Ambetter — Commercial Select Core: $28
  • Ambetter — Commercial Value: $28
  • Cigna — Commercial PPO: $24.36
  • Evolutions — Commercial PPO Choice: $26.04
  • Evolutions — Commercial PPO International: $19.60
  • Evolutions — Commercial PPO Select Network: $23.80
  • First Health — Commercial PPO: $23.80
  • Molina — Commercial Other: $15.76
  • Multiplan — Commercial PPO: $22.40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time partial Not listed in the file Not listed in the file $5.45 – $15.33
Blood clotting test (partial thromboplastin time, PTT): 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $7.33
  • Aetna — Commercial Other: $6.79
  • Aetna — Commercial PPO: $7.33
  • Aetna — Medicare HMO: $6.91
  • Aetna — Medicare PPO: $6.01
  • Ambetter — Commercial Select Core: $13.52
  • Ambetter — Commercial Value: $15.33
  • BayCarePlus — Medicare HMO: $6.01
  • Blue Cross — Medicare HMO: $6.01
  • CarePlus — Medicare HMO: $6.71

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT BRAIN W/O $4,425 $2,655 $796.50 – $4,425
CT scan of the head or brain, without contrast: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $2,141.70
  • Aetna — Commercial Other: $2,048.78
  • Aetna — Commercial PPO: $3,606.37
  • Ambetter — Commercial Select Core: $4,425
  • Ambetter — Commercial Value: $4,425
  • AvMed — Commercial: $2,168.25
  • AvMed — Commercial Other: $1,371.75
  • Blue Cross — Commercial HMO Health Options: $2,257.63
  • Blue Cross — Commercial HMO My Blue: $1,413.79
  • Blue Cross — Commercial HMO Simply Blue: $1,853.19
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT BRAIN W/O $4,425 $2,655 $2,491.27 – $4,425
CT scan of the head or brain, without contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $3,606.37
  • Ambetter — Commercial Select Core: $4,425
  • Ambetter — Commercial Value: $4,425
  • Cigna — Commercial PPO: $3,849.75
  • Evolutions — Commercial PPO Choice: $4,115.25
  • Evolutions — Commercial PPO International: $3,097.50
  • Evolutions — Commercial PPO Select Network: $3,761.25
  • First Health — Commercial PPO: $3,761.25
  • Molina — Commercial Other: $2,491.27
  • Multiplan — Commercial PPO: $3,540
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye Not listed in the file Not listed in the file $86.25 – $272.20
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $170.63
  • Aetna — Commercial Other: $86.25
  • Aetna — Medicare HMO: $122.76
  • Aetna — Medicare PPO: $106.74
  • Ambetter — Commercial Select Core: $240.18
  • Ambetter — Commercial Value: $272.20
  • BayCarePlus — Medicare HMO: $106.74
  • Blue Cross — Medicare HMO: $106.74
  • CarePlus — Medicare HMO: $112.95
  • Cigna — Commercial HMO: $176.43
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN W/O W $7,258 $4,354.80 $1,306.44 – $7,258
MRI of the brain, before and after contrast: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $3,512.87
  • Aetna — Commercial Other: $3,360.45
  • Aetna — Commercial PPO: $5,915.27
  • Ambetter — Commercial Select Core: $7,258
  • Ambetter — Commercial Value: $7,258
  • AvMed — Commercial: $3,556.42
  • AvMed — Commercial Other: $2,249.98
  • Blue Cross — Commercial HMO Health Options: $3,703.03
  • Blue Cross — Commercial HMO My Blue: $2,318.93
  • Blue Cross — Commercial HMO Simply Blue: $3,039.65
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI BRAIN W/O W $7,258 $4,354.80 $4,086.25 – $7,258
MRI of the brain, before and after contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $5,915.27
  • Ambetter — Commercial Select Core: $7,258
  • Ambetter — Commercial Value: $7,258
  • Cigna — Commercial PPO: $6,314.46
  • Evolutions — Commercial PPO Choice: $6,749.94
  • Evolutions — Commercial PPO International: $5,080.60
  • Evolutions — Commercial PPO Select Network: $6,169.30
  • First Health — Commercial PPO: $6,169.30
  • Molina — Commercial Other: $4,086.25
  • Multiplan — Commercial PPO: $5,806.40
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye Not listed in the file Not listed in the file $272.19 – $914.13
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $538.47
  • Aetna — Commercial Other: $272.19
  • Aetna — Medicare HMO: $412.25
  • Aetna — Medicare PPO: $358.48
  • Ambetter — Commercial Select Core: $806.58
  • Ambetter — Commercial Value: $914.13
  • BayCarePlus — Medicare HMO: $358.48
  • Blue Cross — Medicare HMO: $358.48
  • CarePlus — Medicare HMO: $395.09
  • Cigna — Commercial HMO: $635.24
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX X-RAY EXAM CHEST 2 VIEWS $759 $455.40 $136.62 – $759
Chest X-ray, 2 views: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $367.36
  • Aetna — Commercial Other: $351.42
  • Aetna — Commercial PPO: $618.58
  • Ambetter — Commercial Select Core: $759
  • Ambetter — Commercial Value: $759
  • AvMed — Commercial: $371.91
  • AvMed — Commercial Other: $235.29
  • Blue Cross — Commercial HMO Health Options: $387.24
  • Blue Cross — Commercial HMO My Blue: $242.50
  • Blue Cross — Commercial HMO Simply Blue: $317.87
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DX X-RAY EXAM CHEST 2 VIEWS $759 $455.40 $427.32 – $759
Chest X-ray, 2 views: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $618.58
  • Ambetter — Commercial Select Core: $759
  • Ambetter — Commercial Value: $759
  • Cigna — Commercial PPO: $660.33
  • Evolutions — Commercial PPO Choice: $705.87
  • Evolutions — Commercial PPO International: $531.30
  • Evolutions — Commercial PPO Select Network: $645.15
  • First Health — Commercial PPO: $645.15
  • Molina — Commercial Other: $427.32
  • Multiplan — Commercial PPO: $607.20
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views Not listed in the file Not listed in the file $29.60 – $225.36
Chest X-ray, 2 views: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $58.56
  • Aetna — Commercial Other: $29.60
  • Aetna — Medicare HMO: $101.64
  • Aetna — Medicare PPO: $88.38
  • Ambetter — Commercial Select Core: $198.85
  • Ambetter — Commercial Value: $225.36
  • BayCarePlus — Medicare HMO: $88.38
  • Blue Cross — Medicare HMO: $88.38
  • CarePlus — Medicare HMO: $93.35
  • Cigna — Commercial HMO: $47.15
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX L SPINE 4 VIEW MIN $1,471 $882.60 $264.78 – $1,471
X-ray of the lower spine, at least 4 views: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $711.96
  • Aetna — Commercial Other: $681.07
  • Aetna — Commercial PPO: $1,198.86
  • Ambetter — Commercial Select Core: $1,471
  • Ambetter — Commercial Value: $1,471
  • AvMed — Commercial: $720.79
  • AvMed — Commercial Other: $456.01
  • Blue Cross — Commercial HMO Health Options: $750.50
  • Blue Cross — Commercial HMO My Blue: $469.98
  • Blue Cross — Commercial HMO Simply Blue: $616.05
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DX L SPINE 4 VIEW MIN $1,471 $882.60 $828.17 – $1,471
X-ray of the lower spine, at least 4 views: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $1,198.86
  • Ambetter — Commercial Select Core: $1,471
  • Ambetter — Commercial Value: $1,471
  • Cigna — Commercial PPO: $1,279.77
  • Evolutions — Commercial PPO Choice: $1,368.03
  • Evolutions — Commercial PPO International: $1,029.70
  • Evolutions — Commercial PPO Select Network: $1,250.35
  • First Health — Commercial PPO: $1,250.35
  • Molina — Commercial Other: $828.17
  • Multiplan — Commercial PPO: $1,176.80
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws Not listed in the file Not listed in the file $49.75 – $272.20
X-ray of the lower spine, at least 4 views: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $98.42
  • Aetna — Commercial Other: $49.75
  • Aetna — Medicare HMO: $122.76
  • Aetna — Medicare PPO: $106.74
  • Ambetter — Commercial Select Core: $240.18
  • Ambetter — Commercial Value: $272.20
  • BayCarePlus — Medicare HMO: $106.74
  • Blue Cross — Medicare HMO: $106.74
  • CarePlus — Medicare HMO: $112.95
  • Cigna — Commercial HMO: $79.47
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI L SPINE W/O $4,185 $2,511 $753.30 – $4,185
MRI of the lower back (lumbar spine), without contrast: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $2,025.54
  • Aetna — Commercial Other: $1,937.66
  • Aetna — Commercial PPO: $3,410.77
  • Ambetter — Commercial Select Core: $4,185
  • Ambetter — Commercial Value: $4,185
  • AvMed — Commercial: $2,050.65
  • AvMed — Commercial Other: $1,297.35
  • Blue Cross — Commercial HMO Health Options: $2,135.19
  • Blue Cross — Commercial HMO My Blue: $1,337.11
  • Blue Cross — Commercial HMO Simply Blue: $1,752.68
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI L SPINE W/O $4,185 $2,511 $2,356.15 – $4,185
MRI of the lower back (lumbar spine), without contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $3,410.77
  • Ambetter — Commercial Select Core: $4,185
  • Ambetter — Commercial Value: $4,185
  • Cigna — Commercial PPO: $3,640.95
  • Evolutions — Commercial PPO Choice: $3,892.05
  • Evolutions — Commercial PPO International: $2,929.50
  • Evolutions — Commercial PPO Select Network: $3,557.25
  • First Health — Commercial PPO: $3,557.25
  • Molina — Commercial Other: $2,356.15
  • Multiplan — Commercial PPO: $3,348
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye Not listed in the file Not listed in the file $156.98 – $618.71
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $310.54
  • Aetna — Commercial Other: $156.98
  • Aetna — Medicare HMO: $279.03
  • Aetna — Medicare PPO: $242.63
  • Ambetter — Commercial Select Core: $545.92
  • Ambetter — Commercial Value: $618.71
  • BayCarePlus — Medicare HMO: $242.63
  • Blue Cross — Medicare HMO: $242.63
  • CarePlus — Medicare HMO: $251.73
  • Cigna — Commercial HMO: $361.84
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W $7,870 $4,722 $1,416.60 – $7,870
CT scan of the pelvis, with contrast: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $3,809.08
  • Aetna — Commercial Other: $3,643.81
  • Aetna — Commercial PPO: $6,414.05
  • Ambetter — Commercial Select Core: $7,870
  • Ambetter — Commercial Value: $7,870
  • AvMed — Commercial: $3,856.30
  • AvMed — Commercial Other: $2,439.70
  • Blue Cross — Commercial HMO Health Options: $4,015.27
  • Blue Cross — Commercial HMO My Blue: $2,514.46
  • Blue Cross — Commercial HMO Simply Blue: $3,295.96
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS W $7,870 $4,722 $4,430.81 – $7,870
CT scan of the pelvis, with contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $6,414.05
  • Ambetter — Commercial Select Core: $7,870
  • Ambetter — Commercial Value: $7,870
  • Cigna — Commercial PPO: $6,846.90
  • Evolutions — Commercial PPO Choice: $7,319.10
  • Evolutions — Commercial PPO International: $5,509
  • Evolutions — Commercial PPO Select Network: $6,689.50
  • First Health — Commercial PPO: $6,689.50
  • Molina — Commercial Other: $4,430.81
  • Multiplan — Commercial PPO: $6,296
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye Not listed in the file Not listed in the file $178.69 – $455.66
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $438.38
  • Aetna — Commercial Other: $221.60
  • Aetna — Medicare HMO: $205.49
  • Aetna — Medicare PPO: $178.69
  • Ambetter — Commercial Select Core: $402.05
  • Ambetter — Commercial Value: $455.66
  • BayCarePlus — Medicare HMO: $178.69
  • Blue Cross — Medicare HMO: $178.69
  • CarePlus — Medicare HMO: $188.76
  • Cigna — Commercial HMO: $402.67
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LOW EXTREM ANY JNT WO $4,871 $2,922.60 $876.78 – $4,871
MRI of a leg joint (such as the knee), without contrast: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $2,357.56
  • Aetna — Commercial Other: $2,255.27
  • Aetna — Commercial PPO: $3,969.86
  • Ambetter — Commercial Select Core: $4,871
  • Ambetter — Commercial Value: $4,871
  • AvMed — Commercial: $2,386.79
  • AvMed — Commercial Other: $1,510.01
  • Blue Cross — Commercial HMO Health Options: $2,485.18
  • Blue Cross — Commercial HMO My Blue: $1,556.28
  • Blue Cross — Commercial HMO Simply Blue: $2,039.97
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI LOW EXTREM ANY JNT WO $4,871 $2,922.60 $2,742.37 – $4,871
MRI of a leg joint (such as the knee), without contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $3,969.86
  • Ambetter — Commercial Select Core: $4,871
  • Ambetter — Commercial Value: $4,871
  • Cigna — Commercial PPO: $4,237.77
  • Evolutions — Commercial PPO Choice: $4,530.03
  • Evolutions — Commercial PPO International: $3,409.70
  • Evolutions — Commercial PPO Select Network: $4,140.35
  • First Health — Commercial PPO: $4,140.35
  • Molina — Commercial Other: $2,742.37
  • Multiplan — Commercial PPO: $3,896.80
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye Not listed in the file Not listed in the file $180.30 – $618.71
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $356.67
  • Aetna — Commercial Other: $180.30
  • Aetna — Medicare HMO: $279.03
  • Aetna — Medicare PPO: $242.63
  • Ambetter — Commercial Select Core: $545.92
  • Ambetter — Commercial Value: $618.71
  • BayCarePlus — Medicare HMO: $242.63
  • Blue Cross — Medicare HMO: $242.63
  • CarePlus — Medicare HMO: $251.73
  • Cigna — Commercial HMO: $408.13
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABDOMEN PELVIS W CONTRAST $7,553 $4,531.80 $1,359.54 – $7,553
CT scan of the abdomen and pelvis, with contrast: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $3,655.65
  • Aetna — Commercial Other: $3,497.04
  • Aetna — Commercial PPO: $6,155.70
  • Ambetter — Commercial Select Core: $7,553
  • Ambetter — Commercial Value: $7,553
  • AvMed — Commercial: $3,700.97
  • AvMed — Commercial Other: $2,341.43
  • Blue Cross — Commercial HMO Health Options: $3,853.54
  • Blue Cross — Commercial HMO My Blue: $2,413.18
  • Blue Cross — Commercial HMO Simply Blue: $3,163.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT ABDOMEN PELVIS W CONTRAST $7,553 $4,531.80 $4,252.34 – $7,553
CT scan of the abdomen and pelvis, with contrast: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $6,155.70
  • Ambetter — Commercial Select Core: $7,553
  • Ambetter — Commercial Value: $7,553
  • Cigna — Commercial PPO: $6,571.11
  • Evolutions — Commercial PPO Choice: $7,024.29
  • Evolutions — Commercial PPO International: $5,287.10
  • Evolutions — Commercial PPO Select Network: $6,420.05
  • First Health — Commercial PPO: $6,420.05
  • Molina — Commercial Other: $4,252.34
  • Multiplan — Commercial PPO: $6,042.40
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelvis w/contrast Not listed in the file Not listed in the file $277.82 – $914.13
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $549.60
  • Aetna — Commercial Other: $277.82
  • Aetna — Medicare HMO: $412.25
  • Aetna — Medicare PPO: $358.48
  • Ambetter — Commercial Select Core: $806.58
  • Ambetter — Commercial Value: $914.13
  • BayCarePlus — Medicare HMO: $358.48
  • Blue Cross — Medicare HMO: $358.48
  • CarePlus — Medicare HMO: $395.09
  • Cigna — Commercial HMO: $529.41
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMEN COMPLETE $2,030 $1,218 $365.40 – $2,030
Ultrasound of the abdomen, complete: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $982.52
  • Aetna — Commercial Other: $939.89
  • Aetna — Commercial PPO: $1,654.45
  • Ambetter — Commercial Select Core: $2,030
  • Ambetter — Commercial Value: $2,030
  • AvMed — Commercial: $994.70
  • AvMed — Commercial Other: $629.30
  • Blue Cross — Commercial HMO Health Options: $1,035.71
  • Blue Cross — Commercial HMO My Blue: $648.58
  • Blue Cross — Commercial HMO Simply Blue: $850.16
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US ABDOMEN COMPLETE $2,030 $1,218 $1,142.89 – $2,030
Ultrasound of the abdomen, complete: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $1,654.45
  • Ambetter — Commercial Select Core: $2,030
  • Ambetter — Commercial Value: $2,030
  • Cigna — Commercial PPO: $1,766.10
  • Evolutions — Commercial PPO Choice: $1,887.90
  • Evolutions — Commercial PPO International: $1,421
  • Evolutions — Commercial PPO Select Network: $1,725.50
  • First Health — Commercial PPO: $1,725.50
  • Molina — Commercial Other: $1,142.89
  • Multiplan — Commercial PPO: $1,624
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete Not listed in the file Not listed in the file $97.81 – $272.20
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $193.50
  • Aetna — Commercial Other: $97.81
  • Aetna — Medicare HMO: $122.76
  • Aetna — Medicare PPO: $106.74
  • Ambetter — Commercial Select Core: $240.18
  • Ambetter — Commercial Value: $272.20
  • BayCarePlus — Medicare HMO: $106.74
  • Blue Cross — Medicare HMO: $106.74
  • CarePlus — Medicare HMO: $112.95
  • Cigna — Commercial HMO: $199.39
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US OB >14 WEEKS SINGLE FETUS $1,073 $643.80 $193.14 – $1,073
Pregnancy ultrasound (after the first trimester): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $519.33
  • Aetna — Commercial Other: $496.80
  • Aetna — Commercial PPO: $874.49
  • Ambetter — Commercial Select Core: $1,073
  • Ambetter — Commercial Value: $1,073
  • AvMed — Commercial: $525.77
  • AvMed — Commercial Other: $332.63
  • Blue Cross — Commercial HMO Health Options: $547.44
  • Blue Cross — Commercial HMO My Blue: $342.82
  • Blue Cross — Commercial HMO Simply Blue: $449.37
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US OB >14 WEEKS SINGLE FETUS $1,073 $643.80 $604.10 – $1,073
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $874.49
  • Ambetter — Commercial Select Core: $1,073
  • Ambetter — Commercial Value: $1,073
  • Cigna — Commercial PPO: $933.51
  • Evolutions — Commercial PPO Choice: $997.89
  • Evolutions — Commercial PPO International: $751.10
  • Evolutions — Commercial PPO Select Network: $912.05
  • First Health — Commercial PPO: $912.05
  • Molina — Commercial Other: $604.10
  • Multiplan — Commercial PPO: $858.40
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us > 14 wks sngl fetus Not listed in the file Not listed in the file $106.74 – $272.20
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $217.58
  • Aetna — Commercial Other: $109.99
  • Aetna — Medicare HMO: $122.76
  • Aetna — Medicare PPO: $106.74
  • Ambetter — Commercial Select Core: $240.18
  • Ambetter — Commercial Value: $272.20
  • BayCarePlus — Medicare HMO: $106.74
  • Blue Cross — Medicare HMO: $106.74
  • CarePlus — Medicare HMO: $112.95
  • Cigna — Commercial HMO: $223.21
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PELVIC TRANSVAGINAL NON-OB $1,256 $753.60 $226.08 – $1,256
Transvaginal ultrasound: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $607.90
  • Aetna — Commercial Other: $581.53
  • Aetna — Commercial PPO: $1,023.64
  • Ambetter — Commercial Select Core: $1,256
  • Ambetter — Commercial Value: $1,256
  • AvMed — Commercial: $615.44
  • AvMed — Commercial Other: $389.36
  • Blue Cross — Commercial HMO Health Options: $640.81
  • Blue Cross — Commercial HMO My Blue: $401.29
  • Blue Cross — Commercial HMO Simply Blue: $526.01
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US PELVIC TRANSVAGINAL NON-OB $1,256 $753.60 $707.13 – $1,256
Transvaginal ultrasound: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $1,023.64
  • Ambetter — Commercial Select Core: $1,256
  • Ambetter — Commercial Value: $1,256
  • Cigna — Commercial PPO: $1,092.72
  • Evolutions — Commercial PPO Choice: $1,168.08
  • Evolutions — Commercial PPO International: $879.20
  • Evolutions — Commercial PPO Select Network: $1,067.60
  • First Health — Commercial PPO: $1,067.60
  • Molina — Commercial Other: $707.13
  • Multiplan — Commercial PPO: $1,004.80
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob Not listed in the file Not listed in the file $106.74 – $272.20
Transvaginal ultrasound: 10 of 20 insurance plan rates
  • Aetna — Commercial HMO: $212.61
  • Aetna — Commercial Other: $107.47
  • Aetna — Medicare HMO: $122.76
  • Aetna — Medicare PPO: $106.74
  • Ambetter — Commercial Select Core: $240.18
  • Ambetter — Commercial Value: $272.20
  • BayCarePlus — Medicare HMO: $106.74
  • Blue Cross — Medicare HMO: $106.74
  • CarePlus — Medicare HMO: $112.95
  • Cigna — Commercial HMO: $212.14
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX DIAGNOSTIC MAMMO INCL CAD UNILATERAL $328 $196.80 $59.04 – $328
Diagnostic mammogram, one breast: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $158.75
  • Aetna — Commercial Other: $151.86
  • Aetna — Commercial PPO: $267.32
  • Ambetter — Commercial Select Core: $328
  • Ambetter — Commercial Value: $328
  • AvMed — Commercial: $160.72
  • AvMed — Commercial Other: $101.68
  • Blue Cross — Commercial HMO Health Options: $167.35
  • Blue Cross — Commercial HMO My Blue: $104.80
  • Blue Cross — Commercial HMO Simply Blue: $137.37
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: WM DIAGNOSTIC MAMMO INCL CAD UNILATERAL $328 $196.80 $59.04 – $328
Diagnostic mammogram, one breast: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $158.75
  • Aetna — Commercial Other: $151.86
  • Aetna — Commercial PPO: $267.32
  • Ambetter — Commercial Select Core: $328
  • Ambetter — Commercial Value: $328
  • AvMed — Commercial: $160.72
  • AvMed — Commercial Other: $101.68
  • Blue Cross — Commercial HMO Health Options: $167.35
  • Blue Cross — Commercial HMO My Blue: $104.80
  • Blue Cross — Commercial HMO Simply Blue: $137.37
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DX DIAGNOSTIC MAMMO INCL CAD UNILATERAL $328 $196.80 $184.66 – $328
Diagnostic mammogram, one breast: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $267.32
  • Ambetter — Commercial Select Core: $328
  • Ambetter — Commercial Value: $328
  • Cigna — Commercial PPO: $285.36
  • Evolutions — Commercial PPO Choice: $305.04
  • Evolutions — Commercial PPO International: $229.60
  • Evolutions — Commercial PPO Select Network: $278.80
  • First Health — Commercial PPO: $278.80
  • Molina — Commercial Other: $184.66
  • Multiplan — Commercial PPO: $262.40
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX DIAGNOSTIC MAMMO INCL CAD BILATERAL $492 $295.20 $88.56 – $492
Diagnostic mammogram, both breasts: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $238.13
  • Aetna — Commercial Other: $227.80
  • Aetna — Commercial PPO: $400.98
  • Ambetter — Commercial Select Core: $492
  • Ambetter — Commercial Value: $492
  • AvMed — Commercial: $241.08
  • AvMed — Commercial Other: $152.52
  • Blue Cross — Commercial HMO Health Options: $251.02
  • Blue Cross — Commercial HMO My Blue: $157.19
  • Blue Cross — Commercial HMO Simply Blue: $206.05
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: WM DIAGNOSTIC MAMMO INCL CAD BILATERAL $492 $295.20 $88.56 – $492
Diagnostic mammogram, both breasts: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $238.13
  • Aetna — Commercial Other: $227.80
  • Aetna — Commercial PPO: $400.98
  • Ambetter — Commercial Select Core: $492
  • Ambetter — Commercial Value: $492
  • AvMed — Commercial: $241.08
  • AvMed — Commercial Other: $152.52
  • Blue Cross — Commercial HMO Health Options: $251.02
  • Blue Cross — Commercial HMO My Blue: $157.19
  • Blue Cross — Commercial HMO Simply Blue: $206.05
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DX DIAGNOSTIC MAMMO INCL CAD BILATERAL $492 $295.20 $277 – $492
Diagnostic mammogram, both breasts: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $400.98
  • Ambetter — Commercial Select Core: $492
  • Ambetter — Commercial Value: $492
  • Cigna — Commercial PPO: $428.04
  • Evolutions — Commercial PPO Choice: $457.56
  • Evolutions — Commercial PPO International: $344.40
  • Evolutions — Commercial PPO Select Network: $418.20
  • First Health — Commercial PPO: $418.20
  • Molina — Commercial Other: $277
  • Multiplan — Commercial PPO: $393.60
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX SCREENING MAMMO BILATERAL INCL CAD $455 $273 $81.90 – $455
Screening mammogram, both breasts: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $220.22
  • Aetna — Commercial Other: $210.67
  • Aetna — Commercial PPO: $370.82
  • Ambetter — Commercial Select Core: $455
  • Ambetter — Commercial Value: $455
  • AvMed — Commercial: $222.95
  • AvMed — Commercial Other: $141.05
  • Blue Cross — Commercial HMO Health Options: $232.14
  • Blue Cross — Commercial HMO My Blue: $145.37
  • Blue Cross — Commercial HMO Simply Blue: $190.55
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: WM SCREENING MAMMO BILATERAL INCL CAD $455 $273 $81.90 – $455
Screening mammogram, both breasts: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $220.22
  • Aetna — Commercial Other: $210.67
  • Aetna — Commercial PPO: $370.82
  • Ambetter — Commercial Select Core: $455
  • Ambetter — Commercial Value: $455
  • AvMed — Commercial: $222.95
  • AvMed — Commercial Other: $141.05
  • Blue Cross — Commercial HMO Health Options: $232.14
  • Blue Cross — Commercial HMO My Blue: $145.37
  • Blue Cross — Commercial HMO Simply Blue: $190.55
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DX SCREENING MAMMO BILATERAL INCL CAD $455 $273 $256.16 – $455
Screening mammogram, both breasts: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $370.82
  • Ambetter — Commercial Select Core: $455
  • Ambetter — Commercial Value: $455
  • Cigna — Commercial PPO: $395.85
  • Evolutions — Commercial PPO Choice: $423.15
  • Evolutions — Commercial PPO International: $318.50
  • Evolutions — Commercial PPO Select Network: $386.75
  • First Health — Commercial PPO: $386.75
  • Molina — Commercial Other: $256.16
  • Multiplan — Commercial PPO: $364

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrocardiogram complete Not listed in the file Not listed in the file $13.34
Electrocardiogram (ECG/EKG) with reading: rates for 1 insurance plan
  • Humana Military — Commercial Other: $13.34
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IR LHC W OR WO LV $18,807 $11,284.20 $3,385.26 – $18,807
Left heart catheterization (diagnostic): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $9,102.59
  • Aetna — Commercial Other: $8,707.64
  • Aetna — Commercial PPO: $15,327.70
  • Ambetter — Commercial Select Core: $18,807
  • Ambetter — Commercial Value: $18,807
  • AvMed — Commercial: $9,215.43
  • AvMed — Commercial Other: $5,830.17
  • Blue Cross — Commercial HMO Health Options: $9,595.33
  • Blue Cross — Commercial HMO My Blue: $6,008.84
  • Blue Cross — Commercial HMO Simply Blue: $7,876.37
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CL LHC W OR WO LV $18,807 $11,284.20 $3,385.26 – $18,807
Left heart catheterization (diagnostic): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $9,102.59
  • Aetna — Commercial Other: $8,707.64
  • Aetna — Commercial PPO: $15,327.70
  • Ambetter — Commercial Select Core: $18,807
  • Ambetter — Commercial Value: $18,807
  • AvMed — Commercial: $9,215.43
  • AvMed — Commercial Other: $5,830.17
  • Blue Cross — Commercial HMO Health Options: $9,595.33
  • Blue Cross — Commercial HMO My Blue: $6,008.84
  • Blue Cross — Commercial HMO Simply Blue: $7,876.37
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: IR LHC W OR WO LV $18,807 $11,284.20 $10,588.34 – $18,807
Left heart catheterization (diagnostic): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $15,327.70
  • Ambetter — Commercial Select Core: $18,807
  • Ambetter — Commercial Value: $18,807
  • Cigna — Commercial PPO: $16,362.09
  • Evolutions — Commercial PPO Choice: $17,490.51
  • Evolutions — Commercial PPO International: $13,164.90
  • Evolutions — Commercial PPO Select Network: $15,985.95
  • First Health — Commercial PPO: $15,985.95
  • Molina — Commercial Other: $10,588.34
  • Multiplan — Commercial PPO: $15,045.60
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CL COMPREHENSIVE EP W/O INDUCT $12,175 $7,305 $2,191.50 – $12,175
Heart rhythm study (electrophysiology evaluation): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $5,892.70
  • Aetna — Commercial Other: $5,637.02
  • Aetna — Commercial PPO: $9,922.62
  • Ambetter — Commercial Select Core: $12,175
  • Ambetter — Commercial Value: $12,175
  • AvMed — Commercial: $5,965.75
  • AvMed — Commercial Other: $3,774.25
  • Blue Cross — Commercial HMO Health Options: $6,211.68
  • Blue Cross — Commercial HMO My Blue: $3,889.91
  • Blue Cross — Commercial HMO Simply Blue: $5,098.89
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CL COMPREHENSIVE EP W/O INDUCT $12,175 $7,305 $6,854.52 – $12,175
Heart rhythm study (electrophysiology evaluation): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $9,922.62
  • Ambetter — Commercial Select Core: $12,175
  • Ambetter — Commercial Value: $12,175
  • Cigna — Commercial PPO: $10,592.25
  • Evolutions — Commercial PPO Choice: $11,322.75
  • Evolutions — Commercial PPO International: $8,522.50
  • Evolutions — Commercial PPO Select Network: $10,348.75
  • First Health — Commercial PPO: $10,348.75
  • Molina — Commercial Other: $6,854.52
  • Multiplan — Commercial PPO: $9,740
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive ep evaluation Not listed in the file Not listed in the file $7,616.79 – $19,866
Heart rhythm study (electrophysiology evaluation): 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $8,759.30
  • Aetna — Medicare PPO: $7,616.79
  • Ambetter — Commercial Select Core: $17,137.77
  • Ambetter — Commercial Value: $19,422.81
  • BayCarePlus — Medicare HMO: $7,616.79
  • Blue Cross — Medicare HMO: $7,616.79
  • CarePlus — Medicare HMO: $7,672.31
  • Cigna — Medicare HMO: $8,759.30
  • Freedom — Medicare HMO: $8,249.79
  • Health First — Medicare HMO: $8,759.30
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CL TX ATRIAL FIB PULM VEIN ISO $51,158 $30,694.80 $9,208.44 – $51,158
Heart rhythm study with ablation for atrial fibrillation: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $24,760.47
  • Aetna — Commercial Other: $23,686.15
  • Aetna — Commercial PPO: $41,693.77
  • Ambetter — Commercial Select Core: $51,158
  • Ambetter — Commercial Value: $51,158
  • AvMed — Commercial: $25,067.42
  • AvMed — Commercial Other: $15,858.98
  • Blue Cross — Commercial HMO Health Options: $26,100.81
  • Blue Cross — Commercial HMO My Blue: $16,344.98
  • Blue Cross — Commercial HMO Simply Blue: $21,424.97
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CL TX ATRIAL FIB PULM VEIN ISO $51,158 $30,694.80 $28,801.95 – $51,158
Heart rhythm study with ablation for atrial fibrillation: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $41,693.77
  • Ambetter — Commercial Select Core: $51,158
  • Ambetter — Commercial Value: $51,158
  • Cigna — Commercial PPO: $44,507.46
  • Evolutions — Commercial PPO Choice: $47,576.94
  • Evolutions — Commercial PPO International: $35,810.60
  • Evolutions — Commercial PPO Select Network: $43,484.30
  • First Health — Commercial PPO: $43,484.30
  • Molina — Commercial Other: $28,801.95
  • Multiplan — Commercial PPO: $40,926.40
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Compre ep eval abltj atr fib Not listed in the file Not listed in the file $24,399.58 – $62,793.83
Heart rhythm study with ablation for atrial fibrillation: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $28,318.79
  • Aetna — Medicare PPO: $24,625.03
  • Ambetter — Commercial Select Core: $55,406.32
  • Ambetter — Commercial Value: $62,793.83
  • BayCarePlus — Medicare HMO: $24,625.03
  • Blue Cross — Medicare HMO: $24,625.03
  • CarePlus — Medicare HMO: $24,399.58
  • Cigna — Medicare HMO: $28,318.79
  • Freedom — Medicare HMO: $26,236.11
  • Health First — Medicare HMO: $28,318.79
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ND POLYSOMNOGRAM $7,528 $4,516.80 $1,355.04 – $7,528
Sleep study (overnight, in a sleep lab): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $3,643.55
  • Aetna — Commercial Other: $3,485.46
  • Aetna — Commercial PPO: $6,135.32
  • Ambetter — Commercial Select Core: $7,528
  • Ambetter — Commercial Value: $7,528
  • AvMed — Commercial: $3,688.72
  • AvMed — Commercial Other: $2,333.68
  • Blue Cross — Commercial HMO Health Options: $3,840.79
  • Blue Cross — Commercial HMO My Blue: $2,405.20
  • Blue Cross — Commercial HMO Simply Blue: $3,152.73
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ND POLYSOMNOGRAM - ADULT $1,179 $707.40 $212.22 – $1,179
Sleep study (overnight, in a sleep lab): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $570.64
  • Aetna — Commercial Other: $545.88
  • Aetna — Commercial PPO: $960.88
  • Ambetter — Commercial Select Core: $1,179
  • Ambetter — Commercial Value: $1,179
  • AvMed — Commercial: $577.71
  • AvMed — Commercial Other: $365.49
  • Blue Cross — Commercial HMO Health Options: $601.53
  • Blue Cross — Commercial HMO My Blue: $376.69
  • Blue Cross — Commercial HMO Simply Blue: $493.77
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ND POLYSOMNOGRAM $7,528 $4,516.80 $4,238.26 – $7,528
Sleep study (overnight, in a sleep lab): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $6,135.32
  • Ambetter — Commercial Select Core: $7,528
  • Ambetter — Commercial Value: $7,528
  • Cigna — Commercial PPO: $6,549.36
  • Evolutions — Commercial PPO Choice: $7,001.04
  • Evolutions — Commercial PPO International: $5,269.60
  • Evolutions — Commercial PPO Select Network: $6,398.80
  • First Health — Commercial PPO: $6,398.80
  • Molina — Commercial Other: $4,238.26
  • Multiplan — Commercial PPO: $6,022.40

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic exercises Not listed in the file Not listed in the file $21.57 – $55
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 16 insurance plan rates
  • Aetna — Medicare HMO: $24.81
  • Aetna — Medicare PPO: $21.57
  • Ambetter — Commercial Select Core: $48.53
  • Ambetter — Commercial Value: $55
  • BayCarePlus — Medicare HMO: $21.57
  • Blue Cross — Medicare HMO: $21.57
  • CarePlus — Medicare HMO: $31.93
  • Cigna — Medicare HMO: $24.81
  • Freedom — Medicare HMO: $34.33
  • Health First — Medicare HMO: $24.81
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT THER EXERCISES EA 15MIN $174 $104.40 $31.32 – $174
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $84.22
  • Aetna — Commercial Other: $80.56
  • Aetna — Commercial PPO: $141.81
  • Ambetter — Commercial Select Core: $174
  • Ambetter — Commercial Value: $174
  • AvMed — Commercial: $85.26
  • AvMed — Commercial Other: $53.94
  • Blue Cross — Commercial HMO Health Options: $88.77
  • Blue Cross — Commercial HMO My Blue: $55.59
  • Blue Cross — Commercial HMO Simply Blue: $72.87
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT THER EXERCISES EA 15MIN PED $174 $104.40 $31.32 – $174
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $84.22
  • Aetna — Commercial Other: $80.56
  • Aetna — Commercial PPO: $141.81
  • Ambetter — Commercial Select Core: $174
  • Ambetter — Commercial Value: $174
  • AvMed — Commercial: $85.26
  • AvMed — Commercial Other: $53.94
  • Blue Cross — Commercial HMO Health Options: $88.77
  • Blue Cross — Commercial HMO My Blue: $55.59
  • Blue Cross — Commercial HMO Simply Blue: $72.87
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min Not listed in the file Not listed in the file $73.76 – $188.09
Physical therapy evaluation (low complexity): 10 of 16 insurance plan rates
  • Aetna — Medicare HMO: $84.82
  • Aetna — Medicare PPO: $73.76
  • Ambetter — Commercial Select Core: $165.96
  • Ambetter — Commercial Value: $188.09
  • BayCarePlus — Medicare HMO: $73.76
  • Blue Cross — Medicare HMO: $73.76
  • CarePlus — Medicare HMO: $109.32
  • Cigna — Medicare HMO: $84.82
  • Freedom — Medicare HMO: $117.55
  • Health First — Medicare HMO: $84.82
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL-LOW COMPLEXITY $299 $179.40 $53.82 – $299
Physical therapy evaluation (low complexity): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $144.72
  • Aetna — Commercial Other: $138.44
  • Aetna — Commercial PPO: $243.68
  • Ambetter — Commercial Select Core: $299
  • Ambetter — Commercial Value: $299
  • AvMed — Commercial: $146.51
  • AvMed — Commercial Other: $92.69
  • Blue Cross — Commercial HMO Health Options: $152.55
  • Blue Cross — Commercial HMO My Blue: $95.53
  • Blue Cross — Commercial HMO Simply Blue: $125.22
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL-LOW COMPLEXITY $299 $179.40 $168.34 – $299
Physical therapy evaluation (low complexity): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $243.68
  • Ambetter — Commercial Select Core: $299
  • Ambetter — Commercial Value: $299
  • Cigna — Commercial PPO: $260.13
  • Evolutions — Commercial PPO Choice: $278.07
  • Evolutions — Commercial PPO International: $209.30
  • Evolutions — Commercial PPO Select Network: $254.15
  • First Health — Commercial PPO: $254.15
  • Molina — Commercial Other: $168.34
  • Multiplan — Commercial PPO: $239.20
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min Not listed in the file Not listed in the file $73.76 – $188.09
Physical therapy evaluation (moderate complexity): 10 of 16 insurance plan rates
  • Aetna — Medicare HMO: $84.82
  • Aetna — Medicare PPO: $73.76
  • Ambetter — Commercial Select Core: $165.96
  • Ambetter — Commercial Value: $188.09
  • BayCarePlus — Medicare HMO: $73.76
  • Blue Cross — Medicare HMO: $73.76
  • CarePlus — Medicare HMO: $109.32
  • Cigna — Medicare HMO: $84.82
  • Freedom — Medicare HMO: $117.55
  • Health First — Medicare HMO: $84.82
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL-MEDIUM COMPLEXITY $399 $239.40 $71.82 – $399
Physical therapy evaluation (moderate complexity): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $193.12
  • Aetna — Commercial Other: $184.74
  • Aetna — Commercial PPO: $325.18
  • Ambetter — Commercial Select Core: $399
  • Ambetter — Commercial Value: $399
  • AvMed — Commercial: $195.51
  • AvMed — Commercial Other: $123.69
  • Blue Cross — Commercial HMO Health Options: $203.57
  • Blue Cross — Commercial HMO My Blue: $127.48
  • Blue Cross — Commercial HMO Simply Blue: $167.10
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL-MEDIUM COMPLEXITY $399 $239.40 $224.64 – $399
Physical therapy evaluation (moderate complexity): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $325.18
  • Ambetter — Commercial Select Core: $399
  • Ambetter — Commercial Value: $399
  • Cigna — Commercial PPO: $347.13
  • Evolutions — Commercial PPO Choice: $371.07
  • Evolutions — Commercial PPO International: $279.30
  • Evolutions — Commercial PPO Select Network: $339.15
  • First Health — Commercial PPO: $339.15
  • Molina — Commercial Other: $224.64
  • Multiplan — Commercial PPO: $319.20
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min Not listed in the file Not listed in the file $73.76 – $188.09
Physical therapy evaluation (high complexity): 10 of 16 insurance plan rates
  • Aetna — Medicare HMO: $84.82
  • Aetna — Medicare PPO: $73.76
  • Ambetter — Commercial Select Core: $165.96
  • Ambetter — Commercial Value: $188.09
  • BayCarePlus — Medicare HMO: $73.76
  • Blue Cross — Medicare HMO: $73.76
  • CarePlus — Medicare HMO: $109.32
  • Cigna — Medicare HMO: $84.82
  • Freedom — Medicare HMO: $117.55
  • Health First — Medicare HMO: $84.82
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL-HIGH COMPLEXITY $499 $299.40 $89.82 – $499
Physical therapy evaluation (high complexity): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $241.52
  • Aetna — Commercial Other: $231.04
  • Aetna — Commercial PPO: $406.68
  • Ambetter — Commercial Select Core: $499
  • Ambetter — Commercial Value: $499
  • AvMed — Commercial: $244.51
  • AvMed — Commercial Other: $154.69
  • Blue Cross — Commercial HMO Health Options: $254.59
  • Blue Cross — Commercial HMO My Blue: $159.43
  • Blue Cross — Commercial HMO Simply Blue: $208.98
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL-HIGH COMPLEXITY $499 $299.40 $280.94 – $499
Physical therapy evaluation (high complexity): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $406.68
  • Ambetter — Commercial Select Core: $499
  • Ambetter — Commercial Value: $499
  • Cigna — Commercial PPO: $434.13
  • Evolutions — Commercial PPO Choice: $464.07
  • Evolutions — Commercial PPO International: $349.30
  • Evolutions — Commercial PPO Select Network: $424.15
  • First Health — Commercial PPO: $424.15
  • Molina — Commercial Other: $280.94
  • Multiplan — Commercial PPO: $399.20
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NP PSYTX PT AND/OR FAM 30 MIN PROF $168 $100.80 $30.24 – $168
Psychotherapy, 30 minutes: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $81.31
  • Aetna — Commercial Other: $77.78
  • Aetna — Commercial PPO: $136.92
  • Ambetter — Commercial Select Core: $168
  • Ambetter — Commercial Value: $168
  • AvMed — Commercial: $82.32
  • AvMed — Commercial Other: $52.08
  • Blue Cross — Commercial HMO Health Options: $85.71
  • Blue Cross — Commercial HMO My Blue: $53.68
  • Blue Cross — Commercial HMO Simply Blue: $70.36
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NP PSYTX PT AND/OR FAM 30 MIN PROF $168 $100.80 $94.58 – $168
Psychotherapy, 30 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $136.92
  • Ambetter — Commercial Select Core: $168
  • Ambetter — Commercial Value: $168
  • Cigna — Commercial PPO: $146.16
  • Evolutions — Commercial PPO Choice: $156.24
  • Evolutions — Commercial PPO International: $117.60
  • Evolutions — Commercial PPO Select Network: $142.80
  • First Health — Commercial PPO: $142.80
  • Molina — Commercial Other: $94.58
  • Multiplan — Commercial PPO: $134.40
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 30 minutes Not listed in the file Not listed in the file $161.28 – $411.27
Psychotherapy, 30 minutes: 10 of 16 insurance plan rates
  • Aetna — Medicare HMO: $185.47
  • Aetna — Medicare PPO: $161.28
  • Ambetter — Commercial Select Core: $362.88
  • Ambetter — Commercial Value: $411.27
  • BayCarePlus — Medicare HMO: $161.28
  • Blue Cross — Medicare HMO: $161.28
  • CarePlus — Medicare HMO: $163.80
  • Cigna — Medicare HMO: $185.47
  • Freedom — Medicare HMO: $176.13
  • Health First — Medicare HMO: $185.47
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NP PSYTX PT AND/OR FAM 45 MIN PROF $221 $132.60 $39.78 – $221
Psychotherapy, 45 minutes: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $106.96
  • Aetna — Commercial Other: $102.32
  • Aetna — Commercial PPO: $180.11
  • Ambetter — Commercial Select Core: $221
  • Ambetter — Commercial Value: $221
  • AvMed — Commercial: $108.29
  • AvMed — Commercial Other: $68.51
  • Blue Cross — Commercial HMO Health Options: $112.75
  • Blue Cross — Commercial HMO My Blue: $70.61
  • Blue Cross — Commercial HMO Simply Blue: $92.55
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NP PSYTX PT AND/OR FAM 45 MIN PROF $221 $132.60 $124.42 – $221
Psychotherapy, 45 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $180.11
  • Ambetter — Commercial Select Core: $221
  • Ambetter — Commercial Value: $221
  • Cigna — Commercial PPO: $192.27
  • Evolutions — Commercial PPO Choice: $205.53
  • Evolutions — Commercial PPO International: $154.70
  • Evolutions — Commercial PPO Select Network: $187.85
  • First Health — Commercial PPO: $187.85
  • Molina — Commercial Other: $124.42
  • Multiplan — Commercial PPO: $176.80
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 45 minutes Not listed in the file Not listed in the file $161.28 – $411.27
Psychotherapy, 45 minutes: 10 of 16 insurance plan rates
  • Aetna — Medicare HMO: $185.47
  • Aetna — Medicare PPO: $161.28
  • Ambetter — Commercial Select Core: $362.88
  • Ambetter — Commercial Value: $411.27
  • BayCarePlus — Medicare HMO: $161.28
  • Blue Cross — Medicare HMO: $161.28
  • CarePlus — Medicare HMO: $163.80
  • Cigna — Medicare HMO: $185.47
  • Freedom — Medicare HMO: $176.13
  • Health First — Medicare HMO: $185.47
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NP PSYTX PT AND/OR FAM 60 MIN PROF $328 $196.80 $59.04 – $328
Psychotherapy, 60 minutes: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $158.75
  • Aetna — Commercial Other: $151.86
  • Aetna — Commercial PPO: $267.32
  • Ambetter — Commercial Select Core: $328
  • Ambetter — Commercial Value: $328
  • AvMed — Commercial: $160.72
  • AvMed — Commercial Other: $101.68
  • Blue Cross — Commercial HMO Health Options: $167.35
  • Blue Cross — Commercial HMO My Blue: $104.80
  • Blue Cross — Commercial HMO Simply Blue: $137.37
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NP PSYTX PT AND/OR FAM 60 MIN PROF $328 $196.80 $184.66 – $328
Psychotherapy, 60 minutes: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $267.32
  • Ambetter — Commercial Select Core: $328
  • Ambetter — Commercial Value: $328
  • Cigna — Commercial PPO: $285.36
  • Evolutions — Commercial PPO Choice: $305.04
  • Evolutions — Commercial PPO International: $229.60
  • Evolutions — Commercial PPO Select Network: $278.80
  • First Health — Commercial PPO: $278.80
  • Molina — Commercial Other: $184.66
  • Multiplan — Commercial PPO: $262.40
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 60 minutes Not listed in the file Not listed in the file $161.28 – $411.27
Psychotherapy, 60 minutes: 10 of 16 insurance plan rates
  • Aetna — Medicare HMO: $185.47
  • Aetna — Medicare PPO: $161.28
  • Ambetter — Commercial Select Core: $362.88
  • Ambetter — Commercial Value: $411.27
  • BayCarePlus — Medicare HMO: $161.28
  • Blue Cross — Medicare HMO: $161.28
  • CarePlus — Medicare HMO: $163.80
  • Cigna — Medicare HMO: $185.47
  • Freedom — Medicare HMO: $176.13
  • Health First — Medicare HMO: $185.47
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NP FAM THERAPY W/O PT PROF $240 $144 $43.20 – $240
Family psychotherapy, without the patient: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $116.16
  • Aetna — Commercial Other: $111.12
  • Aetna — Commercial PPO: $195.60
  • Ambetter — Commercial Select Core: $240
  • Ambetter — Commercial Value: $240
  • AvMed — Commercial: $117.60
  • AvMed — Commercial Other: $74.40
  • Blue Cross — Commercial HMO Health Options: $122.45
  • Blue Cross — Commercial HMO My Blue: $76.68
  • Blue Cross — Commercial HMO Simply Blue: $100.51
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NP FAM THERAPY W/O PT PROF $240 $144 $135.12 – $240
Family psychotherapy, without the patient: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $195.60
  • Ambetter — Commercial Select Core: $240
  • Ambetter — Commercial Value: $240
  • Cigna — Commercial PPO: $208.80
  • Evolutions — Commercial PPO Choice: $223.20
  • Evolutions — Commercial PPO International: $168
  • Evolutions — Commercial PPO Select Network: $204
  • First Health — Commercial PPO: $204
  • Molina — Commercial Other: $135.12
  • Multiplan — Commercial PPO: $192
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/o pt 50 min Not listed in the file Not listed in the file $161.28 – $411.27
Family psychotherapy, without the patient: 10 of 16 insurance plan rates
  • Aetna — Medicare HMO: $185.47
  • Aetna — Medicare PPO: $161.28
  • Ambetter — Commercial Select Core: $362.88
  • Ambetter — Commercial Value: $411.27
  • BayCarePlus — Medicare HMO: $161.28
  • Blue Cross — Medicare HMO: $161.28
  • CarePlus — Medicare HMO: $163.80
  • Cigna — Medicare HMO: $185.47
  • Freedom — Medicare HMO: $176.13
  • Health First — Medicare HMO: $185.47
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NP FAM THERAPY W/ PT PROF $250 $150 $45 – $250
Family psychotherapy, with the patient: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $121
  • Aetna — Commercial Other: $115.75
  • Aetna — Commercial PPO: $203.75
  • Ambetter — Commercial Select Core: $250
  • Ambetter — Commercial Value: $250
  • AvMed — Commercial: $122.50
  • AvMed — Commercial Other: $77.50
  • Blue Cross — Commercial HMO Health Options: $127.55
  • Blue Cross — Commercial HMO My Blue: $79.88
  • Blue Cross — Commercial HMO Simply Blue: $104.70
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NP FAM THERAPY W/ PT PROF $250 $150 $140.75 – $250
Family psychotherapy, with the patient: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $203.75
  • Ambetter — Commercial Select Core: $250
  • Ambetter — Commercial Value: $250
  • Cigna — Commercial PPO: $217.50
  • Evolutions — Commercial PPO Choice: $232.50
  • Evolutions — Commercial PPO International: $175
  • Evolutions — Commercial PPO Select Network: $212.50
  • First Health — Commercial PPO: $212.50
  • Molina — Commercial Other: $140.75
  • Multiplan — Commercial PPO: $200
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/pt 50 min Not listed in the file Not listed in the file $161.28 – $411.27
Family psychotherapy, with the patient: 10 of 16 insurance plan rates
  • Aetna — Medicare HMO: $185.47
  • Aetna — Medicare PPO: $161.28
  • Ambetter — Commercial Select Core: $362.88
  • Ambetter — Commercial Value: $411.27
  • BayCarePlus — Medicare HMO: $161.28
  • Blue Cross — Medicare HMO: $161.28
  • CarePlus — Medicare HMO: $163.80
  • Cigna — Medicare HMO: $185.47
  • Freedom — Medicare HMO: $176.13
  • Health First — Medicare HMO: $185.47
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NP GROUP THERAPY PROF $59 $35.40 $10.62 – $59
Group psychotherapy: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $28.56
  • Aetna — Commercial Other: $27.32
  • Aetna — Commercial PPO: $48.08
  • Ambetter — Commercial Select Core: $59
  • Ambetter — Commercial Value: $59
  • AvMed — Commercial: $28.91
  • AvMed — Commercial Other: $18.29
  • Blue Cross — Commercial HMO Health Options: $30.10
  • Blue Cross — Commercial HMO My Blue: $18.85
  • Blue Cross — Commercial HMO Simply Blue: $24.71
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NP GROUP THERAPY PROF $59 $35.40 $33.22 – $59
Group psychotherapy: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $48.08
  • Ambetter — Commercial Select Core: $59
  • Ambetter — Commercial Value: $59
  • Cigna — Commercial PPO: $51.33
  • Evolutions — Commercial PPO Choice: $54.87
  • Evolutions — Commercial PPO International: $41.30
  • Evolutions — Commercial PPO Select Network: $50.15
  • First Health — Commercial PPO: $50.15
  • Molina — Commercial Other: $33.22
  • Multiplan — Commercial PPO: $47.20
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group psychotherapy Not listed in the file Not listed in the file $91.57 – $236.78
Group psychotherapy: 10 of 16 insurance plan rates
  • Aetna — Medicare HMO: $106.78
  • Aetna — Medicare PPO: $92.85
  • Ambetter — Commercial Select Core: $208.92
  • Ambetter — Commercial Value: $236.78
  • BayCarePlus — Medicare HMO: $92.85
  • Blue Cross — Medicare HMO: $92.85
  • CarePlus — Medicare HMO: $91.57
  • Cigna — Medicare HMO: $106.78
  • Freedom — Medicare HMO: $98.46
  • Health First — Medicare HMO: $106.78

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion Not listed in the file Not listed in the file $3,843.76 – $9,801.58
Removal of breast growth (open surgery): 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $4,420.32
  • Aetna — Medicare PPO: $3,843.76
  • Ambetter — Commercial Select Core: $8,648.45
  • Ambetter — Commercial Value: $9,801.58
  • BayCarePlus — Medicare HMO: $3,843.76
  • Blue Cross — Medicare HMO: $3,843.76
  • CarePlus — Medicare HMO: $3,915.92
  • Cigna — Medicare HMO: $4,420.32
  • Freedom — Medicare HMO: $4,210.67
  • Health First — Medicare HMO: $4,420.32
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty Not listed in the file Not listed in the file $12,915.46 – $32,934.41
Total hip replacement: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $14,852.77
  • Aetna — Medicare PPO: $12,915.46
  • Ambetter — Commercial Select Core: $29,059.78
  • Ambetter — Commercial Value: $32,934.41
  • BayCarePlus — Medicare HMO: $12,915.46
  • Blue Cross — Medicare HMO: $12,915.46
  • CarePlus — Medicare HMO: $13,520.87
  • Cigna — Medicare HMO: $14,852.77
  • Freedom — Medicare HMO: $14,538.57
  • Health First — Medicare HMO: $14,852.77
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty Not listed in the file Not listed in the file $12,915.46 – $32,934.41
Total knee replacement: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $14,852.77
  • Aetna — Medicare PPO: $12,915.46
  • Ambetter — Commercial Select Core: $29,059.78
  • Ambetter — Commercial Value: $32,934.41
  • BayCarePlus — Medicare HMO: $12,915.46
  • Blue Cross — Medicare HMO: $12,915.46
  • CarePlus — Medicare HMO: $13,520.87
  • Cigna — Medicare HMO: $14,852.77
  • Freedom — Medicare HMO: $14,538.57
  • Health First — Medicare HMO: $14,852.77
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $167.29 – $2,482
Shoulder arthroscopy: shaving of shoulder bone: rates for 2 insurance plans
  • Humana Military — Commercial Other: $167.29
  • United Healthcare — Commercial HMO: $2,482
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery Not listed in the file Not listed in the file $3,256.87 – $11,233
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $3,745.41
  • Aetna — Medicare PPO: $3,256.87
  • Ambetter — Commercial Select Core: $7,327.97
  • Ambetter — Commercial Value: $8,305.03
  • BayCarePlus — Medicare HMO: $3,256.87
  • Blue Cross — Medicare HMO: $3,256.87
  • CarePlus — Medicare HMO: $3,325.31
  • Cigna — Medicare HMO: $3,745.41
  • Freedom — Medicare HMO: $3,575.60
  • Health First — Medicare HMO: $3,745.41
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $5,938.02 – $15,141.95
Removal of tonsils and adenoids (under age 12): 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $6,828.72
  • Aetna — Medicare PPO: $5,938.02
  • Ambetter — Commercial Select Core: $13,360.54
  • Ambetter — Commercial Value: $15,141.95
  • BayCarePlus — Medicare HMO: $5,938.02
  • Blue Cross — Medicare HMO: $5,938.02
  • CarePlus — Medicare HMO: $6,016.23
  • Cigna — Medicare HMO: $6,828.72
  • Freedom — Medicare HMO: $6,469.07
  • Health First — Medicare HMO: $6,828.72
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED UGI DIAGNOSTIC $3,813 $2,287.80 $686.34 – $3,813
Upper GI endoscopy (diagnostic): 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $1,845.49
  • Aetna — Commercial Other: $1,765.42
  • Aetna — Commercial PPO: $3,107.60
  • Ambetter — Commercial Select Core: $3,813
  • Ambetter — Commercial Value: $3,813
  • AvMed — Commercial: $1,868.37
  • AvMed — Commercial Other: $1,182.03
  • Blue Cross — Commercial HMO Health Options: $1,945.39
  • Blue Cross — Commercial HMO My Blue: $1,218.25
  • Blue Cross — Commercial HMO Simply Blue: $1,596.88
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED UGI DIAGNOSTIC $3,813 $2,287.80 $2,146.72 – $3,813
Upper GI endoscopy (diagnostic): 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $3,107.60
  • Ambetter — Commercial Select Core: $3,813
  • Ambetter — Commercial Value: $3,813
  • Cigna — Commercial PPO: $3,317.31
  • Evolutions — Commercial PPO Choice: $3,546.09
  • Evolutions — Commercial PPO International: $2,669.10
  • Evolutions — Commercial PPO Select Network: $3,241.05
  • First Health — Commercial PPO: $3,241.05
  • Molina — Commercial Other: $2,146.72
  • Multiplan — Commercial PPO: $3,050.40
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash Not listed in the file Not listed in the file $931.26 – $10,645
Upper GI endoscopy (diagnostic): 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $1,082.27
  • Aetna — Medicare PPO: $941.10
  • Ambetter — Commercial Select Core: $2,117.48
  • Ambetter — Commercial Value: $2,399.81
  • BayCarePlus — Medicare HMO: $941.10
  • Blue Cross — Medicare HMO: $941.10
  • CarePlus — Medicare HMO: $931.26
  • Cigna — Medicare HMO: $1,082.27
  • Freedom — Medicare HMO: $1,001.36
  • Health First — Medicare HMO: $1,082.27
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple Not listed in the file Not listed in the file $931.26 – $10,645
Upper GI endoscopy with biopsy: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $1,082.27
  • Aetna — Medicare PPO: $941.10
  • Ambetter — Commercial Select Core: $2,117.48
  • Ambetter — Commercial Value: $2,399.81
  • BayCarePlus — Medicare HMO: $941.10
  • Blue Cross — Medicare HMO: $941.10
  • CarePlus — Medicare HMO: $931.26
  • Cigna — Medicare HMO: $1,082.27
  • Freedom — Medicare HMO: $1,001.36
  • Health First — Medicare HMO: $1,082.27
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy Not listed in the file Not listed in the file $915.15 – $2,333.64
Colonoscopy (diagnostic): 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $1,052.43
  • Aetna — Medicare PPO: $915.15
  • Ambetter — Commercial Select Core: $2,059.10
  • Ambetter — Commercial Value: $2,333.64
  • BayCarePlus — Medicare HMO: $915.15
  • Blue Cross — Medicare HMO: $915.15
  • CarePlus — Medicare HMO: $938.94
  • Cigna — Medicare HMO: $1,052.43
  • Freedom — Medicare HMO: $1,009.61
  • Health First — Medicare HMO: $1,052.43
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy Not listed in the file Not listed in the file $1,183.54 – $3,018.02
Colonoscopy with biopsy: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $1,361.07
  • Aetna — Medicare PPO: $1,183.54
  • Ambetter — Commercial Select Core: $2,662.96
  • Ambetter — Commercial Value: $3,018.02
  • BayCarePlus — Medicare HMO: $1,183.54
  • Blue Cross — Medicare HMO: $1,183.54
  • CarePlus — Medicare HMO: $1,212.33
  • Cigna — Medicare HMO: $1,361.07
  • Freedom — Medicare HMO: $1,303.58
  • Health First — Medicare HMO: $1,361.07
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal Not listed in the file Not listed in the file $1,183.54 – $3,018.02
Colonoscopy with removal of polyps (snare): 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $1,361.07
  • Aetna — Medicare PPO: $1,183.54
  • Ambetter — Commercial Select Core: $2,662.96
  • Ambetter — Commercial Value: $3,018.02
  • BayCarePlus — Medicare HMO: $1,183.54
  • Blue Cross — Medicare HMO: $1,183.54
  • CarePlus — Medicare HMO: $1,212.33
  • Cigna — Medicare HMO: $1,361.07
  • Freedom — Medicare HMO: $1,303.58
  • Health First — Medicare HMO: $1,361.07
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $1,183.54 – $5,611
Ultrasound of the lower bowel by endoscope: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $1,361.07
  • Aetna — Medicare PPO: $1,183.54
  • Ambetter — Commercial Select Core: $2,662.96
  • Ambetter — Commercial Value: $3,018.02
  • BayCarePlus — Medicare HMO: $1,183.54
  • Blue Cross — Medicare HMO: $1,183.54
  • CarePlus — Medicare HMO: $1,212.33
  • Cigna — Medicare HMO: $1,361.07
  • Freedom — Medicare HMO: $1,303.58
  • Health First — Medicare HMO: $1,361.07
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $915.15 – $2,333.64
Screening colonoscopy (not high risk): 10 of 17 insurance plan rates
  • Aetna — Medicare HMO: $1,052.43
  • Aetna — Medicare PPO: $915.15
  • Ambetter — Commercial Select Core: $2,059.10
  • Ambetter — Commercial Value: $2,333.64
  • BayCarePlus — Medicare HMO: $915.15
  • Blue Cross — Medicare HMO: $915.15
  • CarePlus — Medicare HMO: $938.94
  • Cigna — Medicare HMO: $1,052.43
  • Freedom — Medicare HMO: $1,009.61
  • Health First — Medicare HMO: $1,052.43
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $5,856.42 – $19,866
Gallbladder removal by laparoscope: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $6,734.88
  • Aetna — Medicare PPO: $5,856.42
  • Ambetter — Commercial Select Core: $13,176.94
  • Ambetter — Commercial Value: $14,933.86
  • BayCarePlus — Medicare HMO: $5,856.42
  • Blue Cross — Medicare HMO: $5,856.42
  • CarePlus — Medicare HMO: $5,927.69
  • Cigna — Medicare HMO: $6,734.88
  • Freedom — Medicare HMO: $6,373.86
  • Health First — Medicare HMO: $6,734.88
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED REPR INGUINAL HRNA>=5YR RED $14,161 $8,496.60 $2,548.98 – $14,161
Groin (inguinal) hernia repair, age 5 or older: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $6,853.92
  • Aetna — Commercial Other: $6,556.54
  • Aetna — Commercial PPO: $11,541.22
  • Ambetter — Commercial Select Core: $14,161
  • Ambetter — Commercial Value: $14,161
  • AvMed — Commercial: $6,938.89
  • AvMed — Commercial Other: $4,389.91
  • Blue Cross — Commercial HMO Health Options: $7,224.94
  • Blue Cross — Commercial HMO My Blue: $4,524.44
  • Blue Cross — Commercial HMO Simply Blue: $5,930.63
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ED REPR INGUINAL HRNA>=5YR RED $14,161 $8,496.60 $7,972.64 – $14,161
Groin (inguinal) hernia repair, age 5 or older: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $11,541.22
  • Ambetter — Commercial Select Core: $14,161
  • Ambetter — Commercial Value: $14,161
  • Cigna — Commercial PPO: $12,320.07
  • Evolutions — Commercial PPO Choice: $13,169.73
  • Evolutions — Commercial PPO International: $9,912.70
  • Evolutions — Commercial PPO Select Network: $12,036.85
  • First Health — Commercial PPO: $12,036.85
  • Molina — Commercial Other: $7,972.64
  • Multiplan — Commercial PPO: $11,328.80
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $3,542.40 – $11,233
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $4,073.76
  • Aetna — Medicare PPO: $3,542.40
  • Ambetter — Commercial Select Core: $7,970.40
  • Ambetter — Commercial Value: $9,033.12
  • BayCarePlus — Medicare HMO: $3,542.40
  • Blue Cross — Medicare HMO: $3,542.40
  • CarePlus — Medicare HMO: $3,554.22
  • Cigna — Medicare HMO: $4,073.76
  • Freedom — Medicare HMO: $3,821.75
  • Health First — Medicare HMO: $4,073.76
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT BX PROSTAT NDL/PUNCH SGL/MX $8,947 $5,368.20 $1,610.46 – $8,947
Prostate biopsy: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $4,330.35
  • Aetna — Commercial Other: $4,142.46
  • Aetna — Commercial PPO: $7,291.80
  • Ambetter — Commercial Select Core: $8,947
  • Ambetter — Commercial Value: $8,947
  • AvMed — Commercial: $4,384.03
  • AvMed — Commercial Other: $2,773.57
  • Blue Cross — Commercial HMO Health Options: $4,564.76
  • Blue Cross — Commercial HMO My Blue: $2,858.57
  • Blue Cross — Commercial HMO Simply Blue: $3,747
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US BX PROSTAT NDL/PUNCH SGL/MX $8,947 $5,368.20 $1,610.46 – $8,947
Prostate biopsy: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $4,330.35
  • Aetna — Commercial Other: $4,142.46
  • Aetna — Commercial PPO: $7,291.80
  • Ambetter — Commercial Select Core: $8,947
  • Ambetter — Commercial Value: $8,947
  • AvMed — Commercial: $4,384.03
  • AvMed — Commercial Other: $2,773.57
  • Blue Cross — Commercial HMO Health Options: $4,564.76
  • Blue Cross — Commercial HMO My Blue: $2,858.57
  • Blue Cross — Commercial HMO Simply Blue: $3,747
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT BX PROSTAT NDL/PUNCH SGL/MX $8,947 $5,368.20 $5,037.16 – $8,947
Prostate biopsy: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $7,291.80
  • Ambetter — Commercial Select Core: $8,947
  • Ambetter — Commercial Value: $8,947
  • Cigna — Commercial PPO: $7,783.89
  • Evolutions — Commercial PPO Choice: $8,320.71
  • Evolutions — Commercial PPO International: $6,262.90
  • Evolutions — Commercial PPO Select Network: $7,604.95
  • First Health — Commercial PPO: $7,604.95
  • Molina — Commercial Other: $5,037.16
  • Multiplan — Commercial PPO: $7,157.60
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $10,450.58 – $26,648.97
Prostate removal by laparoscope (radical prostatectomy): 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $12,018.16
  • Aetna — Medicare PPO: $10,450.58
  • Ambetter — Commercial Select Core: $23,513.79
  • Ambetter — Commercial Value: $26,648.97
  • BayCarePlus — Medicare HMO: $10,450.58
  • Blue Cross — Medicare HMO: $10,450.58
  • CarePlus — Medicare HMO: $10,575.07
  • Cigna — Medicare HMO: $12,018.16
  • Freedom — Medicare HMO: $11,371.04
  • Health First — Medicare HMO: $12,018.16
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB HYSTEROSCOPY BIOPSY W/WO D&C PROF $568 $340.80 $102.24 – $568
Hysteroscopy with biopsy of the uterus lining: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $274.91
  • Aetna — Commercial Other: $262.98
  • Aetna — Commercial PPO: $462.92
  • Ambetter — Commercial Select Core: $568
  • Ambetter — Commercial Value: $568
  • AvMed — Commercial: $278.32
  • AvMed — Commercial Other: $176.08
  • Blue Cross — Commercial HMO Health Options: $289.79
  • Blue Cross — Commercial HMO My Blue: $181.48
  • Blue Cross — Commercial HMO Simply Blue: $237.88
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB HYSTEROSCOPY BIOPSY W/WO D&C PROF $568 $340.80 $319.78 – $568
Hysteroscopy with biopsy of the uterus lining: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $462.92
  • Ambetter — Commercial Select Core: $568
  • Ambetter — Commercial Value: $568
  • Cigna — Commercial PPO: $494.16
  • Evolutions — Commercial PPO Choice: $528.24
  • Evolutions — Commercial PPO International: $397.60
  • Evolutions — Commercial PPO Select Network: $482.80
  • First Health — Commercial PPO: $482.80
  • Molina — Commercial Other: $319.78
  • Multiplan — Commercial PPO: $454.40
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy Not listed in the file Not listed in the file $3,191.54 – $11,671
Hysteroscopy with biopsy of the uterus lining: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $3,670.28
  • Aetna — Medicare PPO: $3,191.54
  • Ambetter — Commercial Select Core: $7,180.97
  • Ambetter — Commercial Value: $8,138.44
  • BayCarePlus — Medicare HMO: $3,191.54
  • Blue Cross — Commercial HMO Health Options: $10,331
  • Blue Cross — Commercial HMO My Blue: $6,469
  • Blue Cross — Commercial HMO Simply Blue: $8,481
  • Blue Cross — Commercial PPO Blue Select: $8,749
  • Blue Cross — Commercial PPO Network Blue: $10,881
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX INJ INTERLAMINAR LMBR/SAC W/ IMAGING $2,319 $1,391.40 $417.42 – $2,319
Spinal injection, lower back (epidural), with imaging guidance: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $1,122.40
  • Aetna — Commercial Other: $1,073.70
  • Aetna — Commercial PPO: $1,889.98
  • Ambetter — Commercial Select Core: $2,319
  • Ambetter — Commercial Value: $2,319
  • AvMed — Commercial: $1,136.31
  • AvMed — Commercial Other: $718.89
  • Blue Cross — Commercial HMO Health Options: $1,183.15
  • Blue Cross — Commercial HMO My Blue: $740.92
  • Blue Cross — Commercial HMO Simply Blue: $971.20
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IR INJ INTERLAMINAR LMBR/SAC W/ IMAGING $2,319 $1,391.40 $417.42 – $2,319
Spinal injection, lower back (epidural), with imaging guidance: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $1,122.40
  • Aetna — Commercial Other: $1,073.70
  • Aetna — Commercial PPO: $1,889.98
  • Ambetter — Commercial Select Core: $2,319
  • Ambetter — Commercial Value: $2,319
  • AvMed — Commercial: $1,136.31
  • AvMed — Commercial Other: $718.89
  • Blue Cross — Commercial HMO Health Options: $1,183.15
  • Blue Cross — Commercial HMO My Blue: $740.92
  • Blue Cross — Commercial HMO Simply Blue: $971.20
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT INJ INTERLAMINAR LMBR/SAC W/ IMAGING $2,319 $1,391.40 $417.42 – $2,319
Spinal injection, lower back (epidural), with imaging guidance: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $1,122.40
  • Aetna — Commercial Other: $1,073.70
  • Aetna — Commercial PPO: $1,889.98
  • Ambetter — Commercial Select Core: $2,319
  • Ambetter — Commercial Value: $2,319
  • AvMed — Commercial: $1,136.31
  • AvMed — Commercial Other: $718.89
  • Blue Cross — Commercial HMO Health Options: $1,183.15
  • Blue Cross — Commercial HMO My Blue: $740.92
  • Blue Cross — Commercial HMO Simply Blue: $971.20
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IR L/S ESI TRANSFORM INJ SNG LVL $2,311 $1,386.60 $415.98 – $2,311
Nerve root injection, lower back, with imaging guidance: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $1,118.52
  • Aetna — Commercial Other: $1,069.99
  • Aetna — Commercial PPO: $1,883.46
  • Ambetter — Commercial Select Core: $2,311
  • Ambetter — Commercial Value: $2,311
  • AvMed — Commercial: $1,132.39
  • AvMed — Commercial Other: $716.41
  • Blue Cross — Commercial HMO Health Options: $1,179.07
  • Blue Cross — Commercial HMO My Blue: $738.36
  • Blue Cross — Commercial HMO Simply Blue: $967.85
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT L/S ESI TRANSFORM INJ SNG LVL $2,311 $1,386.60 $415.98 – $2,311
Nerve root injection, lower back, with imaging guidance: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $1,118.52
  • Aetna — Commercial Other: $1,069.99
  • Aetna — Commercial PPO: $1,883.46
  • Ambetter — Commercial Select Core: $2,311
  • Ambetter — Commercial Value: $2,311
  • AvMed — Commercial: $1,132.39
  • AvMed — Commercial Other: $716.41
  • Blue Cross — Commercial HMO Health Options: $1,179.07
  • Blue Cross — Commercial HMO My Blue: $738.36
  • Blue Cross — Commercial HMO Simply Blue: $967.85
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: IR L/S ESI TRANSFORM INJ SNG LVL $2,311 $1,386.60 $1,301.09 – $2,311
Nerve root injection, lower back, with imaging guidance: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $1,883.46
  • Ambetter — Commercial Select Core: $2,311
  • Ambetter — Commercial Value: $2,311
  • Cigna — Commercial PPO: $2,010.57
  • Evolutions — Commercial PPO Choice: $2,149.23
  • Evolutions — Commercial PPO International: $1,617.70
  • Evolutions — Commercial PPO Select Network: $1,964.35
  • First Health — Commercial PPO: $1,964.35
  • Molina — Commercial Other: $1,301.09
  • Multiplan — Commercial PPO: $1,848.80
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $1,960.16 – $8,692
Carpal tunnel release: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $2,254.18
  • Aetna — Medicare PPO: $1,960.16
  • Ambetter — Commercial Select Core: $4,410.35
  • Ambetter — Commercial Value: $4,998.40
  • BayCarePlus — Medicare HMO: $1,960.16
  • Blue Cross — Commercial HMO Health Options: $7,661
  • Blue Cross — Commercial HMO My Blue: $4,796
  • Blue Cross — Commercial PPO Blue Select: $6,488
  • Blue Cross — Commercial PPO Network Blue: $8,071
  • Blue Cross — Commercial PPO PHS: $8,657
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery Not listed in the file Not listed in the file $550.68 – $3,546
Laser treatment of clouding after cataract surgery: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $633.28
  • Aetna — Medicare PPO: $550.68
  • Ambetter — Commercial Select Core: $1,239.02
  • Ambetter — Commercial Value: $1,404.23
  • BayCarePlus — Medicare HMO: $550.68
  • Blue Cross — Medicare HMO: $550.68
  • CarePlus — Medicare HMO: $597.16
  • Cigna — Medicare HMO: $633.28
  • Freedom — Medicare HMO: $642.10
  • Health First — Medicare HMO: $633.28
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $2,289.35 – $8,692
Cataract removal with lens implant: 10 of 23 insurance plan rates
  • Aetna — Medicare HMO: $2,632.75
  • Aetna — Medicare PPO: $2,289.35
  • Ambetter — Commercial Select Core: $5,151.04
  • Ambetter — Commercial Value: $5,837.84
  • BayCarePlus — Medicare HMO: $2,289.35
  • Blue Cross — Commercial HMO Health Options: $7,661
  • Blue Cross — Commercial HMO My Blue: $4,796
  • Blue Cross — Commercial PPO Blue Select: $6,488
  • Blue Cross — Commercial PPO Network Blue: $8,071
  • Blue Cross — Commercial PPO PHS: $8,657

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB ROUTINE CARE ANTE,VAG,PPCARE PROF $6,051 $3,630.60 $1,089.18 – $6,051
Vaginal delivery, with care before and after: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $2,928.68
  • Aetna — Commercial Other: $2,801.61
  • Aetna — Commercial PPO: $4,931.56
  • Ambetter — Commercial Select Core: $6,051
  • Ambetter — Commercial Value: $6,051
  • AvMed — Commercial: $2,964.99
  • AvMed — Commercial Other: $1,875.81
  • Blue Cross — Commercial HMO Health Options: $3,087.22
  • Blue Cross — Commercial HMO My Blue: $1,933.29
  • Blue Cross — Commercial HMO Simply Blue: $2,534.16
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB ROUTINE CARE ANTE,VAG,PPCARE PROF $6,051 $3,630.60 $3,406.71 – $6,051
Vaginal delivery, with care before and after: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $4,931.56
  • Ambetter — Commercial Select Core: $6,051
  • Ambetter — Commercial Value: $6,051
  • Cigna — Commercial PPO: $5,264.37
  • Evolutions — Commercial PPO Choice: $5,627.43
  • Evolutions — Commercial PPO International: $4,235.70
  • Evolutions — Commercial PPO Select Network: $5,143.35
  • First Health — Commercial PPO: $5,143.35
  • Molina — Commercial Other: $3,406.71
  • Multiplan — Commercial PPO: $4,840.80
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care Not listed in the file Not listed in the file $1,756 – $3,169
Vaginal delivery, with care before and after: rates for 6 insurance plans
  • Blue Cross — Commercial HMO Health Options: $2,803
  • Blue Cross — Commercial HMO My Blue: $1,756
  • Blue Cross — Commercial HMO Simply Blue: $2,300
  • Blue Cross — Commercial PPO Blue Select: $2,376
  • Blue Cross — Commercial PPO Network Blue: $2,952
  • Blue Cross — Commercial PPO PHS: $3,169
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB ANTE/CSECTION/PP CARE PROF $6,769 $4,061.40 $1,218.42 – $6,769
Cesarean delivery (C-section), with care before and after: 10 of 30 insurance plan rates
  • Aetna — Commercial HMO: $3,276.20
  • Aetna — Commercial Other: $3,134.05
  • Aetna — Commercial PPO: $5,516.74
  • Ambetter — Commercial Select Core: $6,769
  • Ambetter — Commercial Value: $6,769
  • AvMed — Commercial: $3,316.81
  • AvMed — Commercial Other: $2,098.39
  • Blue Cross — Commercial HMO Health Options: $3,453.54
  • Blue Cross — Commercial HMO My Blue: $2,162.70
  • Blue Cross — Commercial HMO Simply Blue: $2,834.86
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB ANTE/CSECTION/PP CARE PROF $6,769 $4,061.40 $3,810.95 – $6,769
Cesarean delivery (C-section), with care before and after: 10 of 12 insurance plan rates
  • Aetna — Commercial PPO: $5,516.74
  • Ambetter — Commercial Select Core: $6,769
  • Ambetter — Commercial Value: $6,769
  • Cigna — Commercial PPO: $5,889.03
  • Evolutions — Commercial PPO Choice: $6,295.17
  • Evolutions — Commercial PPO International: $4,738.30
  • Evolutions — Commercial PPO Select Network: $5,753.65
  • First Health — Commercial PPO: $5,753.65
  • Molina — Commercial Other: $3,810.95
  • Multiplan — Commercial PPO: $5,415.20
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $1,756 – $3,169
Cesarean delivery (C-section), with care before and after: rates for 7 insurance plans
  • Blue Cross — Commercial HMO Health Options: $2,803
  • Blue Cross — Commercial HMO My Blue: $1,756
  • Blue Cross — Commercial HMO Simply Blue: $2,300
  • Blue Cross — Commercial PPO Blue Select: $2,376
  • Blue Cross — Commercial PPO Network Blue: $2,952
  • Blue Cross — Commercial PPO PHS: $3,169
  • Humana Military — Commercial Other: $2,666.39
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery Not listed in the file Not listed in the file $1,756 – $3,169
Vaginal delivery after a previous C-section, with care before and after: rates for 7 insurance plans
  • Blue Cross — Commercial HMO Health Options: $2,803
  • Blue Cross — Commercial HMO My Blue: $1,756
  • Blue Cross — Commercial HMO Simply Blue: $2,300
  • Blue Cross — Commercial PPO Blue Select: $2,376
  • Blue Cross — Commercial PPO Network Blue: $2,952
  • Blue Cross — Commercial PPO PHS: $3,169
  • Humana Military — Commercial Other: $2,516.76

Source: Winter Haven Hospital’s standard charges file (baycare.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 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 typeAcute Care Hospital
Address200 Ave F NE, Winter Haven, FL 33881
CountyPolk County
StateFlorida
Phone(863) 293‑1121
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number100052
Name in Medicare recordsWINTER HAVEN HOSPITAL
Profile levelMedicare data + hospital website
Name on the hospital’s websiteBayCare Winter Haven Hospital
Official websitebaycare.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. BayCare Winter Haven Hospital Services — baycare.org
  2. Emergency Care in Winter Haven, Florida — baycare.org
  3. Cardiology and Vascular — baycare.org
  4. Cancer Care at Winter Haven Hospital — baycare.org
  5. Orthopedic Services in Winter Haven, Florida — baycare.org
  6. Neurosciences Services in Winter Haven, Florida — baycare.org
  7. Surgical Services in Winter Haven, Florida — baycare.org
  8. Behavioral Health Services in Winter Haven, Florida — baycare.org
  9. Rehabilitation Services in Winter Haven, Florida — baycare.org