Does FORT LOUDOUN MEDICAL CENTER publish its standard charges and chargemaster?

Yes. FORT LOUDOUN MEDICAL CENTER publishes a machine-readable file with 30,715 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does FORT LOUDOUN MEDICAL CENTER charge for procedures?

FORT LOUDOUN MEDICAL CENTER (Lenoir City, TN) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · TN · CCN 440110

FORT LOUDOUN MEDICAL CENTER

Lenoir City, TN, 37772-1965

30 bedsAcute Care Hospitals2

Compliance grade

100/100

Rates published

30,715

last crawl 2026-05-23

Procedures tracked

201

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All TN hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://mrfs.hyvehealthcare.com/CovenantHealth/621373691_fort-loudoun-medical-center_standardcharges.json · JSON

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychoses	MS-DRG	885	24	—	—	$45	$9,834.19	0.77×	$21,719
Psychiatric diagnostic evaluation	CPT	90791	24	$275	$88	$52.5	$154.05	0.87×	$247.5
Psychiatric eval with medical services	CPT	90792	24	$330	$105.6	$63	$154.05	0.89×	$270
Psychotherapy 30 minutes	CPT	90832	24	$205	$65.6	$28.77	$109.6	0.74×	$154.05
Psychotherapy 45 minutes	CPT	90834	24	$205	$65.6	$38.85	$142.8	0.89×	$183.6
Psychotherapy 60 minutes	CPT	90837	24	$220	$70.4	$44.1	$147	0.77×	$198
Crisis psychotherapy 60 minutes	CPT	90839	24	$220	$70.4	$42	$146.71	0.92×	$198
emergency
ED visit level 1	CPT	99281	24	$325	$104	$77.39	$116	0.83×	$916
ED visit level 2	CPT	99282	24	$586	$187.52	$142.55	$151.83	0.64×	$1,393
ED visit level 3	CPT	99283	24	$750	$240	$215	$265.47	0.66×	$2,047
ED visit level 4	CPT	99284	24	$1,000	$320	$386.06	$408.26	0.61×	$2,894
ED visit level 5	CPT	99285	24	$1,144	$366.08	$514.8	$587.82	0.56×	$3,207
Critical care, first hour	CPT	99291	24	$1,320	$422.4	$367.5	$807.87	0.75×	$3,947
imaging
CT head without contrast	CPT	70450	24	$1,245	$398.4	$52.56	$101.96	0.49×	$1,120.5
CT head with contrast	CPT	70460	24	$1,245	$398.4	$121.19	$170.68	0.73×	$1,120.5
CT head with and without contrast	CPT	70470	24	$1,927	$616.64	$123.57	$170.68	0.64×	$1,734.3
CT neck with contrast	CPT	70491	24	$1,125	$360	$123.57	$170.68	0.62×	$1,012.5
MRI brain without contrast	CPT	70551	24	$1,772	$567.04	$105.33	$231.76	0.57×	$1,594.8
MRI brain with contrast	CPT	70552	24	$2,023	$647.36	$198.87	$342.41	0.72×	$1,820.7
MRI brain with and without contrast	CPT	70553	24	$2,526	$808.32	$198.87	$342.41	0.58×	$2,273.4
Chest X-ray single view	CPT	71045	24	$162	$51.84	$17.69	$84.42	0.89×	$163.61
Chest X-ray 2 views	CPT	71046	24	$248	$79.36	$23.38	$84.42	0.86×	$223.2
Chest X-ray 3 views	CPT	71047	24	$265	$84.8	$28.97	$84.42	0.88×	$238.5
CT chest without contrast	CPT	71250	24	$1,590	$508.8	$52.56	$101.96	0.47×	$1,431
CT chest with contrast	CPT	71260	24	$1,868	$597.76	$123.57	$170.68	0.61×	$1,681.2
CT chest with and without contrast	CPT	71270	24	$2,383	$762.56	$123.57	$170.68	0.59×	$2,144.7
MRI chest without contrast	CPT	71550	24	$1,769	$566.08	$105.33	$231.76	0.54×	$1,592.1
MRI chest with contrast	CPT	71551	24	$1,777	$568.64	$306.29	$757.49	0.93×	$1,599.3
MRI chest with and without contrast	CPT	71552	24	$2,526	$808.32	$198.87	$344.75	0.57×	$2,273.4
Lumbosacral spine X-ray	CPT	72100	24	$251	$80.32	$28.65	$101.96	0.99×	$229.76
CT cervical spine without contrast	CPT	72125	24	$1,814	$580.48	$52.56	$101.96	0.51×	$1,632.6
CT thoracic spine without contrast	CPT	72128	24	$1,814	$580.48	$52.56	$101.96	0.51×	$1,632.6
CT lumbar spine without contrast	CPT	72131	24	$1,814	$580.48	$52.56	$101.96	0.50×	$1,632.6
MRI cervical spine without contrast	CPT	72141	24	$2,350	$752	$105.33	$231.76	0.58×	$2,115
MRI thoracic spine without contrast	CPT	72146	24	$2,350	$752	$105.33	$231.76	0.62×	$2,115
MRI lumbar spine without contrast	CPT	72148	24	$2,350	$752	$105.33	$231.76	0.62×	$2,115
MRI lumbar spine with and without contrast	CPT	72149	24	$2,350	$752	$198.87	$342.41	0.75×	$2,115
MRI cervical spine with and without contrast	CPT	72156	24	$2,890	$924.8	$198.87	$342.41	0.63×	$2,601
MRI lumbar spine with contrast	CPT	72158	24	$2,890	$924.8	$198.87	$342.41	0.63×	$2,601
CT pelvis without contrast	CPT	72192	24	$1,320	$422.4	$52.56	$101.96	0.51×	$1,188
CT pelvis with contrast	CPT	72193	24	$1,320	$422.4	$123.57	$170.68	0.61×	$1,188
Shoulder X-ray	CPT	73030	24	$437	$139.84	$23.38	$82.81	0.89×	$163.61
Humerus X-ray	CPT	73060	24	$437	$139.84	$24.59	$82.81	0.93×	$163.61
Hand X-ray 3 views	CPT	73130	24	$438	$140.16	$27.84	$82.81	0.89×	$163.61
MRI upper extremity joint without contrast	CPT	73221	24	$1,769	$566.08	$45	$231.76	0.56×	$987
MRI upper extremity joint with and without contrast	CPT	73223	24	$2,715	$868.8	$45	$342.41	0.56×	$987
Knee X-ray 1-2 views	CPT	73560	24	$308	$98.56	$27.03	$82.81	0.89×	$163.61
Ankle X-ray 3 views	CPT	73610	24	$437	$139.84	$27.84	$82.81	0.90×	$163.61
MRI lower extremity joint without contrast	CPT	73721	24	$1,551	$496.32	$45	$231.76	0.50×	$987
MRI lower extremity joint with and without contrast	CPT	73723	24	$2,715	$868.8	$45	$342.41	0.54×	$987
CT abdomen without contrast	CPT	74150	24	$1,320	$422.4	$52.56	$101.96	0.54×	$1,188
CT abdomen with contrast	CPT	74160	24	$1,320	$422.4	$123.57	$170.68	0.60×	$1,188
CT abdomen with and without contrast	CPT	74170	24	$1,979	$633.28	$123.57	$170.68	0.51×	$1,781.1
CT abdomen and pelvis without contrast	CPT	74176	24	$2,640	$844.8	$105.33	$231.76	0.64×	$2,376
CT abdomen and pelvis with contrast	CPT	74177	24	$2,640	$844.8	$123.57	$342.41	0.62×	$2,376
CT abdomen and pelvis with and without contrast	CPT	74178	24	$3,958	$1,266.56	$198.87	$342.41	0.60×	$3,562.2
MRI abdomen without contrast	CPT	74181	24	$1,777	$568.64	$105.33	$231.76	0.59×	$1,599.3
MRI abdomen with and without contrast	CPT	74183	24	$2,526	$808.32	$198.87	$342.41	0.60×	$2,273.4
Abdominal ultrasound complete	CPT	76700	24	$894	$286.08	$52.56	$101.96	0.68×	$804.6
Abdominal ultrasound limited	CPT	76705	24	$487	$155.84	$52.56	$101.96	0.70×	$438.3
Retroperitoneal ultrasound complete	CPT	76770	24	$290	$92.8	$52.56	$101.96	0.71×	$331
Obstetric ultrasound first trimester	CPT	76801	24	$662	$211.84	$52.56	$101.96	0.72×	$595.8
Obstetric ultrasound after first trimester	CPT	76805	24	$662	$211.84	$52.56	$101.96	0.67×	$595.8
Obstetric ultrasound with fetal anatomy	CPT	76811	24	$301	$96.32	$45	$227.34	0.96×	$477.73
Transvaginal ultrasound	CPT	76830	24	$279	$89.28	$52.56	$101.96	0.69×	$331
Pelvic ultrasound complete	CPT	76856	24	$364	$116.48	$52.56	$101.96	0.71×	$331
Scrotal ultrasound	CPT	76870	24	$345	$110.4	$52.56	$101.96	0.78×	$331
Diagnostic mammography unilateral	CPT	77065	17	$271	$86.72	$44.35	$89	0.60×	$261
Diagnostic mammography bilateral	CPT	77066	17	$348	$111.36	$56.73	$247.11	1.3×	$313.2
Screening mammography bilateral	CPT	77067	17	$234	$74.88	$46.86	$185.6	1.2×	$261
EKG complete	CPT	93000	17	—	—	$18.31	$65	2.7×	$234
EKG tracing only	CPT	93005	24	$157	$50.24	$8.81	$56.95	0.48×	$234
EKG interpretation only	CPT	93010	17	$38	$12.16	$3.68	$15.46	0.85×	$34.2
Transthoracic echocardiogram complete	CPT	93306	24	$1,249	$399.68	$140.09	$525.69	0.88×	$1,124.1
Transthoracic echocardiogram	CPT	93307	24	$785	$251.2	$100.29	$231.76	0.94×	$706.5
Stress echocardiogram	CPT	93350	24	$89.54	$28.65	$45	$480.86	0.95×	$619
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	24	—	—	$45	$12,192	0.79×	$24,907
COPD w MCC	MS-DRG	190	24	—	—	$45	$8,397.94	0.75×	$17,303
COPD w CC	MS-DRG	191	24	—	—	$45	$6,201.99	0.70×	$13,237
COPD w/o CC/MCC	MS-DRG	192	24	—	—	$45	$4,644.9	0.66×	$9,972.06
Simple pneumonia & pleurisy w CC	MS-DRG	194	24	—	—	$45	$5,886.99	0.69×	$12,635
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	24	—	—	$45	$4,418.28	0.66×	$9,594.56
AMI discharged alive w MCC	MS-DRG	280	24	—	—	$45	$12,379	0.79×	$25,291
AMI discharged alive w CC	MS-DRG	281	24	—	—	$45	$7,023.1	0.73×	$14,203
AMI discharged alive w/o CC/MCC	MS-DRG	282	24	—	—	$45	$5,549.52	0.71×	$13,339
Heart failure & shock w MCC	MS-DRG	291	24	—	—	$45	$9,754.62	0.76×	$20,104
Heart failure & shock w CC	MS-DRG	292	24	—	—	$45	$6,347.06	0.71×	$13,269
Heart failure & shock w/o CC/MCC	MS-DRG	293	24	—	—	$45	$4,138.29	0.67×	$8,454.37
Cardiac arrhythmia w MCC	MS-DRG	308	24	—	—	$45	$9,094.89	0.75×	$18,581
Cardiac arrhythmia w CC	MS-DRG	309	24	—	—	$45	$5,575.79	0.72×	$11,391
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	24	—	—	$45	$4,219.74	0.68×	$8,620.78
GI hemorrhage w CC	MS-DRG	378	24	—	—	$45	$6,972.8	0.70×	$15,191
GI hemorrhage w/o CC/MCC	MS-DRG	379	24	—	—	$45	$4,801.99	0.70×	$9,810.27
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	24	—	—	$45	$5,542.11	0.69×	$12,023
Fractures of femur w/o MCC	MS-DRG	533	24	—	—	$45	$11,671	0.77×	$23,902
Kidney/UTI w MCC	MS-DRG	689	24	—	—	$45	$8,299.16	0.71×	$18,032
Kidney/UTI w/o MCC	MS-DRG	690	24	—	—	$45	$5,696.63	0.69×	$12,366
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	24	—	—	$45	$13,960	0.75×	$30,232
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	24	—	—	$45	$7,295.46	0.70×	$15,886
Initial hospital care, low complexity	CPT	99221	18	$225	$72	$83.25	$160.15	1.7×	$4,949
Initial hospital care, moderate complexity	CPT	99222	18	$252	$80.64	$112.5	$214.2	1.3×	$4,949
Initial hospital care, high complexity	CPT	99223	18	$370	$118.4	$123.75	$296	1.3×	$4,949
Hospital discharge, <30 min	CPT	99238	18	$132	$42.24	$59.4	$2,000	23.3×	$4,949
Hospital discharge, >30 min	CPT	99239	18	$196	$62.72	$59.4	$156.8	1.3×	$4,949
lab
Basic metabolic panel (BMP)	CPT	80048	23	$131	$41.92	$1.01	$8.88	0.27×	$117.9
General health panel	CPT	80050	16	—	—	$21.92	$80	0.75×	$90
Electrolyte panel	CPT	80051	23	$65	$20.8	$3.15	$7.36	0.31×	$58.5
Comprehensive metabolic panel	CPT	80053	23	$234	$74.88	$1	$11.09	0.25×	$210.6
Lipid panel	CPT	80061	23	$135	$43.2	$1.07	$14.06	0.37×	$121.5
Renal function panel	CPT	80069	23	$70	$22.4	$3.91	$9.11	0.33×	$63
Hepatic function panel	CPT	80076	23	$120	$38.4	$1.03	$8.58	0.32×	$108
Urinalysis non-automated	CPT	81002	23	$26	$8.32	$1.57	$5.01	0.72×	$23.4
Urinalysis automated	CPT	81003	23	$23	$7.36	$1	$2.36	0.17×	$20.7
Glucose quantitative	CPT	82947	23	$38	$12.16	$1.77	$4.13	0.23×	$34.2
Hemoglobin A1c	CPT	83036	23	$98	$31.36	$1.21	$10.2	0.38×	$88.2
Thyroid stimulating hormone (TSH)	CPT	84443	23	$169	$54.08	$1	$17.64	0.37×	$152.1
Complete blood count with automated differential	CPT	85025	23	$90	$28.8	$1	$8.16	0.31×	$81
Complete blood count without differential	CPT	85027	23	$65	$20.8	$2.91	$6.79	0.31×	$58.5
Urine culture bacterial	CPT	87086	23	$81	$25.92	$3.63	$8.47	0.36×	$72.9
Urine culture identification	CPT	87088	23	$82	$26.24	$3.64	$8.49	0.38×	$73.8
Tissue exam by pathologist level IV	CPT	88305	24	$424	$135.68	$18.51	$51.23	0.50×	$381.6
maternity
Fetal non-stress test	CPT	59025	24	$302	$96.64	$84	$192.87	1.0×	$2,244
Routine obstetric care including vaginal delivery	CPT	59400	18	—	—	$40	$85	0.04×	$3,295
Vaginal delivery only	CPT	59409	24	$2,609	$834.88	$1,174.05	$2,990.39	1.4×	$4,055
Vaginal delivery with postpartum	CPT	59410	18	—	—	$45	$86.5	0.08×	$3,295
Routine obstetric care with C-section	CPT	59510	18	—	—	$40	$85	0.03×	$3,295
C-section delivery only	CPT	59514	18	—	—	$40	$85	0.09×	$3,295
C-section with postpartum	CPT	59515	18	—	—	$45	$86.5	0.07×	$3,295
office
Office visit, new patient, 15-29 min	CPT	99202	17	$225	$72	$34.65	$132	1.5×	$237
Office visit, new patient, 30-44 minutes	CPT	99203	17	$250	$80	$40.74	$150	1.2×	$237
Office visit, new patient, 45-59 min	CPT	99204	17	$282	$90.24	$57.75	$169.85	0.98×	$253.8
Office visit, new patient, 60-74 min	CPT	99205	17	$345	$110.4	$63	$190	0.86×	$310.5
Office visit, established patient, 5 min	CPT	99211	17	$182	$58.24	$16.38	$70.2	1.1×	$237
Office visit, established patient, 10-19 min	CPT	99212	17	$200	$64	$19.32	$86.18	1.1×	$237
Office visit, established patient, 20-29 minutes	CPT	99213	17	$225	$72	$22.68	$102.3	0.89×	$237
Office visit, established patient, 30-39 minutes	CPT	99214	17	$250	$80	$25.62	$125	0.82×	$237
Office visit, established patient, 40-54 min	CPT	99215	17	$276	$88.32	$32.34	$140.76	0.75×	$248.4
preventive
Upper GI endoscopy diagnostic	CPT	43235	24	—	—	$45	$898.91	0.98×	$2,610
Upper GI endoscopy with biopsy	CPT	43239	24	—	—	$45	$898.91	0.93×	$2,610
Sigmoidoscopy diagnostic	CPT	45330	24	—	—	$45	$874.13	1.0×	$2,244
Sigmoidoscopy with biopsy	CPT	45331	24	—	—	$45	$874.13	0.98×	$2,244
Colonoscopy diagnostic	CPT	45378	24	—	—	$45	$874.13	1.00×	$2,610
Colonoscopy with biopsy	CPT	45380	24	—	—	$45	$1,130.47	0.93×	$2,805
Colonoscopy with polyp removal	CPT	45385	24	—	—	$45	$1,130.47	0.94×	$2,805
surgery
Total shoulder arthroplasty	CPT	23472	24	—	—	$45	$14,052	3.4×	$17,632
PCI w drug-eluting stent w MCC	MS-DRG	246	1	—	—	$16,591	$16,591	0.60×	$16,591
PCI w drug-eluting stent w/o MCC	MS-DRG	247	1	—	—	$10,639	$10,639	0.58×	$10,639
Hip hemiarthroplasty	CPT	27125	18	—	—	$45	$2,281	1.8×	$11,500
Total hip replacement	CPT	27130	24	—	—	$45	$11,907	2.7×	$20,333
Total knee replacement	CPT	27447	24	—	—	$45	$11,907	2.9×	$20,970
Knee revision arthroplasty single component	CPT	27486	18	—	—	$45	$2,281	1.4×	$24,147
Knee revision arthroplasty all components	CPT	27487	18	—	—	$45	$2,281	1.1×	$24,147
Shoulder arthroscopy with decompression	CPT	29826	18	—	—	$45	$147	0.45×	$2,669
Shoulder arthroscopy with rotator cuff repair	CPT	29827	24	—	—	$45	$6,523.08	2.0×	$8,352
Knee arthroscopy with meniscectomy	CPT	29881	24	—	—	$45	$3,051.6	1.5×	$5,482
ACL reconstruction	CPT	29888	24	—	—	$45	$6,523.08	2.0×	$8,352
Major small/large bowel procedures w MCC	MS-DRG	329	24	—	—	$45	$33,917	0.79×	$70,752
Major small/large bowel procedures w CC	MS-DRG	330	24	—	—	$45	$17,827	0.77×	$36,420
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	24	—	—	$45	$12,396	0.75×	$25,439
CABG single arterial graft	CPT	33533	18	—	—	$45	$1,575	0.84×	$3,295
CABG 2 arterial grafts	CPT	33534	18	—	—	$45	$1,575	0.73×	$3,295
CABG 3 arterial grafts	CPT	33535	18	—	—	$45	$1,575	0.69×	$3,295
CABG 4+ arterial grafts	CPT	33536	18	—	—	$45	$1,575	0.64×	$3,295
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	24	—	—	$45	$12,508	0.76×	$25,553
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	24	—	—	$45	$9,826.76	0.73×	$20,302
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	24	—	—	$45	$23,882	0.74×	$54,383
Open appendectomy	CPT	44950	24	—	—	$45	$5,697.64	5.0×	$6,848
Laparoscopic appendectomy	CPT	44970	24	—	—	$45	$5,407.38	3.5×	$8,352
Spinal fusion (non-cervical) w MCC	MS-DRG	459	2	—	—	$44,628	$44,628	0.90×	$45,326
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	2	—	—	$24,119	$24,613	0.73×	$24,613
Major joint replacement w MCC	MS-DRG	469	24	—	—	$45	$24,652	0.83×	$50,364
Major joint replacement w/o MCC	MS-DRG	470	24	—	—	$45	$14,220	0.75×	$29,052
Laparoscopic cholecystectomy	CPT	47562	24	—	—	$45	$5,407.38	3.0×	$8,352
Lap cholecystectomy with cholangiography	CPT	47563	24	—	—	$45	$5,407.38	2.9×	$8,352
Hip & femur procedures except major joint w MCC	MS-DRG	480	24	—	—	$45	$22,181	0.79×	$45,315
Hip & femur procedures except major joint w CC	MS-DRG	481	24	—	—	$45	$15,649	0.77×	$31,970
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	24	—	—	$45	$11,965	0.75×	$24,443
Open umbilical hernia repair	CPT	49560	1	—	—	$2,826.21	$2,826.21	1.5×	$2,826.21
Umbilical hernia repair age 5+	CPT	49585	1	—	—	$2,826.21	$2,826.21	2.1×	$2,826.21
Lap inguinal hernia repair	CPT	49650	24	—	—	$45	$5,407.38	4.8×	$8,352
Lap incisional hernia repair	CPT	49652	1	—	—	$4,393.57	$4,393.57	1.6×	$4,393.57
Total abdominal hysterectomy	CPT	58150	18	—	—	$45	$1,851	1.9×	$6,848
Vaginal hysterectomy	CPT	58260	24	—	—	$45	$4,499.79	2.5×	$5,482
Lap-assisted vaginal hysterectomy	CPT	58550	24	—	—	$45	$5,407.38	3.7×	$8,352
Lap-assisted vaginal hysterectomy >250g	CPT	58552	24	—	—	$45	$8,561	3.8×	$9,982.02
Lap salpingo-oophorectomy	CPT	58661	24	—	—	$45	$5,407.38	2.7×	$8,352
OR procedure for obesity w MCC	MS-DRG	619	24	—	—	$45	$20,867	0.77×	$42,010
OR procedure for obesity w CC	MS-DRG	620	24	—	—	$45	$12,223	0.75×	$24,607
OR procedure for obesity w/o CC/MCC	MS-DRG	621	24	—	—	$45	$11,188	0.74×	$22,865
Complex cataract surgery	CPT	66982	24	—	—	$45	$2,186.71	0.99×	$5,120
Cataract surgery with lens implant	CPT	66984	24	—	—	$45	$2,186.71	1.0×	$5,120
Intravitreal injection	CPT	67028	24	—	—	$45	$318.01	0.93×	$2,244
Vitrectomy mechanical	CPT	67042	24	—	—	$45	$3,783.55	1.5×	$6,324
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	24	—	—	$45	$8,362.95	0.68×	$18,470
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	24	—	—	$45	$13,593	0.71×	$30,107
PCI single major coronary artery	CPT	92920	24	$5,696	$1,822.72	$45	$5,466.48	0.96×	$11,074
PCI with drug-eluting stent	CPT	92928	24	$8,652	$2,768.64	$45	$9,972.17	0.99×	$11,074
PCI bypass graft	CPT	92937	24	$8,652	$2,768.64	$1,941	$10,511	0.97×	$11,074
Left heart catheterization	CPT	93452	24	$3,986	$1,275.52	$1,793.7	$3,083.82	1.00×	$9,300
Coronary angiography with cath	CPT	93455	24	$5,634	$1,802.88	$1,941	$3,083.82	0.98×	$9,300
Coronary angiography with bypass cath	CPT	93458	24	$5,266	$1,685.12	$2,186	$3,083.82	0.99×	$9,300

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 24)

Payer	Codes covered	Median rate
Aetna	194	$396
ehn	194	$45
galaxy health network	194	$90
initial group	194	$88
medsave usa	194	$80
national provider network	194	$80
novanet	194	$75
UnitedHealthcare	194	$477.73
usa managed care organization	194	$70
beech street	194	$85
Blue Cross Blue Shield	194	$522
ccn managed care	194	$85
Cigna	194	$454
community services network	194	$65
correctional medical services	194	$60
direct care america	194	$80
wellpoint	186	$525.69
Ambetter	178	$987
farm bureau	162	$335.21
WellCare	160	$342.41
TRICARE	160	$326.1
Humana	160	$335.88
optum	160	$326.1
devoted health	160	$342.41

Related data on other Healthparse brands

Explore this hospital across cost reports, quality ratings, and non-profit filings.

HCRIS.io

Medicare cost reports, margins, utilization

Stetho.io

SNF, HHA, hospice, dialysis cost reports + ownership

990Health

IRS Form 990 financials, executive compensation

CareLens

CMS quality ratings, inspections, staffing