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Witham Health Services
Lebanon, IN · CMS ID: 150104
This hospital has pricing data for 43 procedures ranging from $36 to $5,235.
Procedures (43)
C-Section Delivery
59510Cash Price
(No Insurance)
$2,561
Gross Charge
$3,658
Medicare Rate
$2,419
Insurance Negotiated Rates
Blue Cross Blue Shield$6
Cataract Surgery
66984Cash Price
(No Insurance)
$103
Gross Charge
$147
Medicare Rate
$445
Insurance Negotiated Rates
Blue Cross Blue Shield$91
Chest X-Ray 1 View
71045Cash Price
(No Insurance)
$433
Gross Charge
$618
Medicare Rate
$24
Insurance Negotiated Rates
Blue Cross Blue Shield$62
Chest X-Ray 2 Views
71046Cash Price
(No Insurance)
$347
Gross Charge
$496
Medicare Rate
$31
Insurance Negotiated Rates
Blue Cross Blue Shield$53
Cash Price
(No Insurance)
$341
Gross Charge
$487
Medicare Rate
$356
Insurance Negotiated Rates
Blue Cross Blue Shield$302
Cash Price
(No Insurance)
$1,027
Gross Charge
$1,467
Medicare Rate
$450
Insurance Negotiated Rates
Blue Cross Blue Shield$866
Cash Price
(No Insurance)
$1,040
Gross Charge
$1,486
Medicare Rate
$471
Insurance Negotiated Rates
Blue Cross Blue Shield$921
Cash Price
(No Insurance)
$122
Gross Charge
$174
Insurance Negotiated Rates
Blue Cross Blue Shield$8
Cash Price
(No Insurance)
$66
Gross Charge
$95
Insurance Negotiated Rates
Blue Cross Blue Shield$11
Cash Price
(No Insurance)
$4,807
Gross Charge
$6,867
Medicare Rate
$280
Insurance Negotiated Rates
Blue Cross Blue Shield$162
Cash Price
(No Insurance)
$3,527
Gross Charge
$5,039
Medicare Rate
$172
Insurance Negotiated Rates
Blue Cross Blue Shield$90
CT Chest Low Dose
71271Cash Price
(No Insurance)
$236
Gross Charge
$337
Medicare Rate
$128
Insurance Negotiated Rates
Blue Cross Blue Shield$81
Cash Price
(No Insurance)
$2,287
Gross Charge
$3,267
Medicare Rate
$156
Insurance Negotiated Rates
Blue Cross Blue Shield$123
ER Visit Level 3
99283Cash Price
(No Insurance)
$127
Gross Charge
$182
Medicare Rate
$69
Insurance Negotiated Rates
Encore-All Plans$48
ER Visit Level 4
99284Cash Price
(No Insurance)
$212
Gross Charge
$302
Medicare Rate
$117
Insurance Negotiated Rates
Encore-All Plans$48
ER Visit Level 5
99285Cash Price
(No Insurance)
$258
Gross Charge
$369
Medicare Rate
$170
Insurance Negotiated Rates
Encore-All Plans$48
Cash Price
(No Insurance)
$107
Gross Charge
$152
Medicare Rate
$48
Insurance Negotiated Rates
Blue Cross Blue Shield$68
Hemoglobin A1C
83036Cash Price
(No Insurance)
$67
Gross Charge
$96
Insurance Negotiated Rates
Blue Cross Blue Shield$10
Hip Replacement
27130Cash Price
(No Insurance)
$1,343
Gross Charge
$1,918
Medicare Rate
$1,129
Insurance Negotiated Rates
Blue Cross Blue Shield$191
Knee Arthroscopy
29881Cash Price
(No Insurance)
$567
Gross Charge
$811
Medicare Rate
$495
Insurance Negotiated Rates
Blue Cross Blue Shield$81
Knee Replacement
27447Cash Price
(No Insurance)
$1,341
Gross Charge
$1,915
Medicare Rate
$1,127
Insurance Negotiated Rates
Blue Cross Blue Shield$191
Knee X-Ray
73560Cash Price
(No Insurance)
$269
Gross Charge
$384
Medicare Rate
$32
Insurance Negotiated Rates
Blue Cross Blue Shield$3
Cash Price
(No Insurance)
$404
Gross Charge
$578
Medicare Rate
$615
Insurance Negotiated Rates
Blue Cross Blue Shield$341
Lipid Panel
80061Cash Price
(No Insurance)
$83
Gross Charge
$118
Insurance Negotiated Rates
Blue Cross Blue Shield$13
Mammogram Diagnostic
77066Cash Price
(No Insurance)
$680
Gross Charge
$971
Medicare Rate
$146
Insurance Negotiated Rates
Blue Cross Blue Shield$84
Mammogram Screening
77067Cash Price
(No Insurance)
$362
Gross Charge
$517
Medicare Rate
$118
Insurance Negotiated Rates
Blue Cross Blue Shield$69
MRI Brain
70551Cash Price
(No Insurance)
$2,539
Gross Charge
$3,628
Medicare Rate
$183
Insurance Negotiated Rates
Blue Cross Blue Shield$119
Cash Price
(No Insurance)
$496
Gross Charge
$709
Medicare Rate
$296
Insurance Negotiated Rates
Blue Cross Blue Shield$119
MRI Cervical Spine
72141Cash Price
(No Insurance)
$2,617
Gross Charge
$3,739
Medicare Rate
$179
Insurance Negotiated Rates
Blue Cross Blue Shield$117
MRI Knee
73721Cash Price
(No Insurance)
$3,693
Gross Charge
$5,276
Medicare Rate
$191
Insurance Negotiated Rates
Blue Cross Blue Shield$129
MRI Lumbar Spine
72148Cash Price
(No Insurance)
$2,496
Gross Charge
$3,566
Medicare Rate
$180
Insurance Negotiated Rates
Blue Cross Blue Shield$117
MRI Shoulder
73221Cash Price
(No Insurance)
$5,235
Gross Charge
$7,478
Medicare Rate
$191
Insurance Negotiated Rates
Blue Cross Blue Shield$48
Office Visit Level 3
99213Cash Price
(No Insurance)
$80
Gross Charge
$114
Medicare Rate
$91
Insurance Negotiated Rates
Blue Cross Blue Shield$30
Office Visit Level 4
99214Cash Price
(No Insurance)
$226
Gross Charge
$323
Medicare Rate
$130
Insurance Negotiated Rates
Aetna$70
Shoulder X-Ray
73030Cash Price
(No Insurance)
$463
Gross Charge
$662
Medicare Rate
$33
Insurance Negotiated Rates
Blue Cross Blue Shield$15
TSH (Thyroid)
84443Cash Price
(No Insurance)
$36
Gross Charge
$51
Insurance Negotiated Rates
Blue Cross Blue Shield$17
Ultrasound Abdomen
76700Cash Price
(No Insurance)
$1,114
Gross Charge
$1,592
Medicare Rate
$107
Insurance Negotiated Rates
Blue Cross Blue Shield$1
Ultrasound Pelvis
76856Cash Price
(No Insurance)
$139
Gross Charge
$198
Medicare Rate
$98
Insurance Negotiated Rates
Blue Cross Blue Shield$24
Cash Price
(No Insurance)
$139
Gross Charge
$198
Medicare Rate
$109
Insurance Negotiated Rates
Blue Cross Blue Shield$64
Cash Price
(No Insurance)
$567
Gross Charge
$810
Medicare Rate
$301
Insurance Negotiated Rates
Blue Cross Blue Shield$502
Cash Price
(No Insurance)
$654
Gross Charge
$935
Medicare Rate
$390
Insurance Negotiated Rates
Blue Cross Blue Shield$579
Urinalysis
81001Cash Price
(No Insurance)
$4,760
Gross Charge
$6,800
Insurance Negotiated Rates
Blue Cross Blue Shield$3
Vaginal Delivery
59400Cash Price
(No Insurance)
$2,195
Gross Charge
$3,136
Medicare Rate
$2,163
Insurance Negotiated Rates
Blue Cross Blue Shield$13