Does Akron General Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Akron General Medical Center. In a medical emergency, call 911.

Where is Akron General Medical Center?

1 Akron General Avenue, Akron, OH 44307, in Summit County, Ohio.

What is the phone number of Akron General Medical Center?

(330) 344-6000, as listed by Medicare (CMS).

What is the Medicare star rating of Akron General Medical Center?

5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Akron General Medical Center — Akron, OH

Quick answers

Does Akron General Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Akron General Medical Center. In a medical emergency, call 911.
Where is Akron General Medical Center?: 1 Akron General Avenue, Akron, OH 44307, in Summit County, Ohio.
What is the phone number of Akron General Medical Center?: (330) 344-6000, as listed by Medicare (CMS).
What is the Medicare star rating of Akron General Medical Center?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[5]

Acute care surgery
Bariatric surgery
Cancer
Diabetes and endocrinology
Gastroenterology
Heart and vascular
Neurology
Ob/Gyn and women's health
Orthopaedics
Pain management
Plastic surgery
Psychiatry and behavioral services
Pulmonary medicine
Radiology
Rheumatology
Sports medicine
Urology

Programs and centers^[5]

Breast health center
Sleep center
Wound center
Valve center
Vein center
Maternity services

Emergency care (hospital website)^[5]

Emergency room	Yes

Doctors and clinicians (2,302)

2,302 doctors and other clinicians list Akron General Medical Center as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 2,278 more: the button below opens the full list.

Other emergency rooms nearby

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

Akron Children's Hospital1.7 mi · Akron, OH · Children's Hospital
Summa Western Reserve Hospital4.7 mi · Cuyahoga Falls, OH · Acute Care Hospital
Medina Hospital16 mi · Medina, OH · Acute Care Hospital
University Hospitals Portage Medical Center17 mi · Ravenna, OH · Acute Care Hospital
Mercy Medical Center19 mi · Canton, OH · Acute Care Hospital

Other hospitals nearby

Select Specialty Hospital-Akron2.0 mi · Akron, OH · Long-Term Acute Care Hospital
Summa Rehab Hospital2.6 mi · Akron, OH · Inpatient Rehabilitation Hospital
Crystal Clinic Orthopaedic Center7.3 mi · Fairlawn, OH · Acute Care Hospital
Assurance Health Hudson LLC13 mi · Hudson, OH · Psychiatric Hospital

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

The Merriman2.0 mi · Akron, OH · 2 of 5 stars
Ohio Living Rockynol2.3 mi · Akron, OH · 5 of 5 stars
Highland Square Nursing and Rehabilitation2.3 mi · Akron, OH · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Homestead Hospice of Ohio, LLC1.4 mi · Akron, OH · 4 of 5 stars
Summa Hospice3.7 mi · Akron, OH · 3 of 5 stars
Elara Caring4.4 mi · Akron, OH · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Akron Children's Hospital0.0 mi · Akron, OH
Everest Home Health LLC3.7 mi · Akron, OH
Friendly Home Care LLC3.7 mi · Akron, OH

All home health agencies in the state →

Dialysis facilities

FMC - Akron0.0 mi · Akron, OH · 2 of 5 stars
Childrens Hospital Medical Ctr - Akron1.7 mi · Akron, OH
DaVita White Ponds Dialysis1.9 mi · Akron, OH · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Digestive Health Center, Ltd1.9 mi · Akron, OH
Digestive Wellness Center, LLC5.5 mi · Norton, OH
The Center for Surgery6.1 mi · Cuyahoga Falls, OH

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

Equitas Health Akron Health Center1.3 mi · Akron, OH · Community health center
Community Support Services1.3 mi · Akron, OH · Community health center
Health and Wellness - Akron1.7 mi · Akron, OH · Community health center

Clinics and urgent care

Quickclinic, LLC1.9 mi · Akron, OH · Urgent care center
Preble County Urgent Care LLC4.4 mi · Akron, OH · Urgent care center
Summa Physicians LLC6.8 mi · Tallmadge, OH · Urgent care center

Pharmacies

Walgreen Co1.4 mi · Akron, OH · Pharmacy
Amc Ohio LLC1.5 mi · Akron, OH · Community/retail pharmacy
Planned Parenthood of Greater Ohio1.5 mi · Akron, OH · Clinic pharmacy

Assisted living nearby

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

Merriman Care Community2.5 mi · Akron, OH
Ohio Living Rockynol4.4 mi · Akron, OH
Barberton Pointe Senior Living5.5 mi · Barberton, OH
Pleasant Pointe Assisted Living5.5 mi · Barberton, OH

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	2 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	63%National average: 72%
Would definitely recommend the hospital	66%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	77%National average: 80%
Staff “always” explained medicines before giving them	58%National average: 62%
Were given information about recovery at home	86%National average: 86%
Room and bathroom “always” clean	61%National average: 74%
Area around the room “always” quiet at night	39%National average: 60%
Completed surveys	2,590Response rate: 20%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0.843No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.573No different from the national benchmark
Surgical site infections after colon surgery	1.479No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.106Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.307Better than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

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

Deaths within 30 days: heart attack patients	11.1%
Deaths within 30 days: heart failure patients	9.4%
Deaths within 30 days: pneumonia patients	10.7%
Deaths within 30 days: COPD patients	7.1%
Deaths within 30 days: stroke patients	9.4%
Deaths within 30 days: coronary bypass surgery (CABG)	2%
Serious complications (patient safety indicator PSI-90)	0.95No different from the national rate
Complications after hip or knee replacement	4.6%

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	12.4%
Readmitted within 30 days: heart failure	19.9%
Readmitted within 30 days: pneumonia	18.3%
Readmitted within 30 days: COPD	20.6%
Readmitted within 30 days: coronary bypass surgery	9.5%
Readmitted within 30 days: hip or knee replacement	5.9%

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

Emergency room times and sepsis care

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

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)	166 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	42%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Akron Best hospitals in Ohio

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Akron General Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

$ 85 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OD NEW ONLINE E&M LEVEL 3	$640	$416	$162.62 – $640
New patient office visit (about 30–44 minutes): 10 of 50 insurance plan rates Aetna — Acop: $147.69 Aetna — All Products First Health: $480 Aetna — Asa: $512 Aetna — Medicare Advantage: $70.77 Aetna — Qhp/Ifp: $640 AmeriHealth — Managed Medicaid: $46.44 Anthem — All Products Mid-Level Facility: $94.87 Anthem — All Products Mid-Level Non-Facility: $126.59 Anthem — All Products Physician: $169.57 Anthem — All Products Physician Facility: $169.57
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$640	$416	$162.62 – $640
New patient office visit (about 30–44 minutes): 10 of 50 insurance plan rates Aetna — Acop: $147.69 Aetna — All Products First Health: $480 Aetna — Asa: $512 Aetna — Medicare Advantage: $70.77 Aetna — Qhp/Ifp: $640 AmeriHealth — Managed Medicaid: $46.44 Anthem — All Products Mid-Level Facility: $94.87 Anthem — All Products Mid-Level Non-Facility: $126.59 Anthem — All Products Physician: $169.57 Anthem — All Products Physician Facility: $169.57
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NEW PATIENT VISIT LEVEL 3	$25	$16.25	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $237.50
New patient office visit (about 30–44 minutes): 10 of 50 insurance plan rates Aetna — Acop: $147.69 Aetna — All Products First Health: $18.75 Aetna — Asa: $20 Aetna — Medicare Advantage: $70.77 Aetna — Qhp/Ifp: $25 AmeriHealth — Managed Medicaid: $46.44 Anthem — All Products Mid-Level Facility: $94.87 Anthem — All Products Mid-Level Non-Facility: $126.59 Anthem — All Products Physician: $169.57 Anthem — All Products Physician Facility: $169.57
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OD NEW ONLINE E&M LEVEL 4	$1,040	$676	$264.26 – $1,040
New patient office visit (about 45–59 minutes): 10 of 50 insurance plan rates Aetna — Acop: $225.33 Aetna — All Products First Health: $780 Aetna — Asa: $832 Aetna — Medicare Advantage: $115.62 Aetna — Qhp/Ifp: $1,040 AmeriHealth — Managed Medicaid: $75.19 Anthem — All Products Mid-Level Facility: $152.41 Anthem — All Products Mid-Level Non-Facility: $188.44 Anthem — All Products Physician: $272.41 Anthem — All Products Physician Facility: $272.41
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$1,040	$676	$264.26 – $1,040
New patient office visit (about 45–59 minutes): 10 of 50 insurance plan rates Aetna — Acop: $225.33 Aetna — All Products First Health: $780 Aetna — Asa: $832 Aetna — Medicare Advantage: $115.62 Aetna — Qhp/Ifp: $1,040 AmeriHealth — Managed Medicaid: $75.19 Anthem — All Products Mid-Level Facility: $152.41 Anthem — All Products Mid-Level Non-Facility: $188.44 Anthem — All Products Physician: $272.41 Anthem — All Products Physician Facility: $272.41
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NEW PATIENT VISIT LEVEL 4	$25	$16.25	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $357.22
New patient office visit (about 45–59 minutes): 10 of 50 insurance plan rates Aetna — Acop: $225.33 Aetna — All Products First Health: $18.75 Aetna — Asa: $20 Aetna — Medicare Advantage: $115.62 Aetna — Qhp/Ifp: $25 AmeriHealth — Managed Medicaid: $75.19 Anthem — All Products Mid-Level Facility: $152.41 Anthem — All Products Mid-Level Non-Facility: $188.44 Anthem — All Products Physician: $272.41 Anthem — All Products Physician Facility: $272.41
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OD NEW ONLINE E&M LEVEL 5	$1,400	$910	$355.74 – $1,400
New patient office visit (about 60–74 minutes): 10 of 50 insurance plan rates Aetna — Acop: $283.75 Aetna — All Products First Health: $1,050 Aetna — Asa: $1,120 Aetna — Medicare Advantage: $158.48 Aetna — Qhp/Ifp: $1,400 AmeriHealth — Managed Medicaid: $102.03 Anthem — All Products Mid-Level Facility: $206.82 Anthem — All Products Mid-Level Non-Facility: $248.97 Anthem — All Products Physician: $369.66 Anthem — All Products Physician Facility: $369.66
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$1,400	$910	$355.74 – $1,400
New patient office visit (about 60–74 minutes): 10 of 50 insurance plan rates Aetna — Acop: $283.75 Aetna — All Products First Health: $1,050 Aetna — Asa: $1,120 Aetna — Medicare Advantage: $158.48 Aetna — Qhp/Ifp: $1,400 AmeriHealth — Managed Medicaid: $102.03 Anthem — All Products Mid-Level Facility: $206.82 Anthem — All Products Mid-Level Non-Facility: $248.97 Anthem — All Products Physician: $369.66 Anthem — All Products Physician Facility: $369.66
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NEW PATIENT VISIT LEVEL 5	$25	$16.25	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $471.66
New patient office visit (about 60–74 minutes): 10 of 50 insurance plan rates Aetna — Acop: $283.75 Aetna — All Products First Health: $18.75 Aetna — Asa: $20 Aetna — Medicare Advantage: $158.48 Aetna — Qhp/Ifp: $25 AmeriHealth — Managed Medicaid: $102.03 Anthem — All Products Mid-Level Facility: $206.82 Anthem — All Products Mid-Level Non-Facility: $248.97 Anthem — All Products Physician: $369.66 Anthem — All Products Physician Facility: $369.66
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OD EST ONLINE E&M LEVEL 3	$520	$338	$132.13 – $520
Established patient office visit (about 20–29 minutes): 10 of 50 insurance plan rates Aetna — Acop: $101.07 Aetna — All Products First Health: $390 Aetna — Asa: $416 Aetna — Medicare Advantage: $56.80 Aetna — Qhp/Ifp: $520 AmeriHealth — Managed Medicaid: $37.11 Anthem — All Products Mid-Level Facility: $75.39 Anthem — All Products Mid-Level Non-Facility: $101.69 Anthem — All Products Physician: $134.74 Anthem — All Products Physician Facility: $134.74
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$520	$338	$132.13 – $520
Established patient office visit (about 20–29 minutes): 10 of 50 insurance plan rates Aetna — Acop: $101.07 Aetna — All Products First Health: $390 Aetna — Asa: $416 Aetna — Medicare Advantage: $56.80 Aetna — Qhp/Ifp: $520 AmeriHealth — Managed Medicaid: $37.11 Anthem — All Products Mid-Level Facility: $75.39 Anthem — All Products Mid-Level Non-Facility: $101.69 Anthem — All Products Physician: $134.74 Anthem — All Products Physician Facility: $134.74
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EST PATIENT VISIT LEVEL 3	$25	$16.25	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $181.76
Established patient office visit (about 20–29 minutes): 10 of 50 insurance plan rates Aetna — Acop: $101.07 Aetna — All Products First Health: $18.75 Aetna — Asa: $20 Aetna — Medicare Advantage: $56.80 Aetna — Qhp/Ifp: $25 AmeriHealth — Managed Medicaid: $37.11 Anthem — All Products Mid-Level Facility: $75.39 Anthem — All Products Mid-Level Non-Facility: $101.69 Anthem — All Products Physician: $134.74 Anthem — All Products Physician Facility: $134.74
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OD EST ONLINE E&M LEVEL 4	$768	$499.20	$195.15 – $768
Established patient office visit (about 30–39 minutes): 10 of 50 insurance plan rates Aetna — Acop: $148.30 Aetna — All Products First Health: $576 Aetna — Asa: $614.40 Aetna — Medicare Advantage: $83.59 Aetna — Qhp/Ifp: $768 AmeriHealth — Managed Medicaid: $54.44 Anthem — All Products Mid-Level Facility: $111.30 Anthem — All Products Mid-Level Non-Facility: $144.09 Anthem — All Products Physician: $198.93 Anthem — All Products Physician Facility: $198.93
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$768	$499.20	$195.15 – $768
Established patient office visit (about 30–39 minutes): 10 of 50 insurance plan rates Aetna — Acop: $148.30 Aetna — All Products First Health: $576 Aetna — Asa: $614.40 Aetna — Medicare Advantage: $83.59 Aetna — Qhp/Ifp: $768 AmeriHealth — Managed Medicaid: $54.44 Anthem — All Products Mid-Level Facility: $111.30 Anthem — All Products Mid-Level Non-Facility: $144.09 Anthem — All Products Physician: $198.93 Anthem — All Products Physician Facility: $198.93
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EST PATIENT VISIT LEVEL 4	$25	$16.25	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $257.54
Established patient office visit (about 30–39 minutes): 10 of 50 insurance plan rates Aetna — Acop: $148.30 Aetna — All Products First Health: $18.75 Aetna — Asa: $20 Aetna — Medicare Advantage: $83.59 Aetna — Qhp/Ifp: $25 AmeriHealth — Managed Medicaid: $54.44 Anthem — All Products Mid-Level Facility: $111.30 Anthem — All Products Mid-Level Non-Facility: $144.09 Anthem — All Products Physician: $198.93 Anthem — All Products Physician Facility: $198.93
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$147	$95.55	$48.59 – $60
Office consultation with a specialist (moderate): 10 of 43 insurance plan rates AETNA — Acop: $48.59 AETNA — ALL PRODUCTS: $110.25 AETNA — Asa_Whirlpool_Peia: $56.71 AETNA — International: $60 AETNA — MEDICARE ADVANTAGE: $32.05 AETNA — Qhp/Ipf: $147 AMERIHEALTH — Managed Medicaid: $63.17 Amish Community Aid Plan — ALL PRODUCTS: $66.15 ANTHEM — HPN: $21.87 ANTHEM — Managed Medicaid: $60.30
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VV OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$720	$468	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $239.69
Office consultation with a specialist (moderate): 10 of 41 insurance plan rates Aetna — Acop: $167.99 Aetna — All Products First Health: $540 Aetna — Asa: $576 Aetna — Qhp/Ifp: $720 AmeriHealth — Managed Medicaid: $52.54 Anthem — All Products Mid-Level Facility: $101.34 Anthem — All Products Mid-Level Non-Facility: $128.37 Anthem — All Products Physician: $181.12 Anthem — All Products Physician Facility: $181.12 Anthem — All Products Physician Non-Facility: $229.43
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$720	$468	$182.95 – $720
Office consultation with a specialist (moderate): 10 of 41 insurance plan rates Aetna — Acop: $167.99 Aetna — All Products First Health: $540 Aetna — Asa: $576 Aetna — Qhp/Ifp: $720 AmeriHealth — Managed Medicaid: $52.54 Anthem — All Products Mid-Level Facility: $101.34 Anthem — All Products Mid-Level Non-Facility: $128.37 Anthem — All Products Physician: $181.12 Anthem — All Products Physician Facility: $181.12 Anthem — All Products Physician Non-Facility: $229.43
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VV OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$1,076	$699.40	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $342.95
Office consultation with a specialist (moderate to high): 10 of 41 insurance plan rates Aetna — Acop: $252.18 Aetna — All Products First Health: $807 Aetna — Asa: $860.80 Aetna — Qhp/Ifp: $1,076 AmeriHealth — Managed Medicaid: $83.94 Anthem — All Products Mid-Level Facility: $154.51 Anthem — All Products Mid-Level Non-Facility: $184.07 Anthem — All Products Physician: $276.16 Anthem — All Products Physician Facility: $276.16 Anthem — All Products Physician Non-Facility: $328.98
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$1,076	$699.40	$273.41 – $1,076
Office consultation with a specialist (moderate to high): 10 of 41 insurance plan rates Aetna — Acop: $252.18 Aetna — All Products First Health: $807 Aetna — Asa: $860.80 Aetna — Qhp/Ifp: $1,076 AmeriHealth — Managed Medicaid: $83.94 Anthem — All Products Mid-Level Facility: $154.51 Anthem — All Products Mid-Level Non-Facility: $184.07 Anthem — All Products Physician: $276.16 Anthem — All Products Physician Facility: $276.16 Anthem — All Products Physician Non-Facility: $328.98
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Off/op cnsltj new/est mod 40	Not listed in the file	Not listed in the file	$54.56 – $63.17
Office consultation with a specialist (moderate to high): rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $63.17 ANTHEM — Managed Medicaid: $60.30 Buckeye — Managed Medicaid: $57.43 CARESOURCE — Managed Medicaid: $57.43 MOLINA — Managed Medicaid: $60.30 OPTUM — Managed Medicaid Transplant: $54.56 UNITED — Managed Medicaid: $60.30 United BH — Managed Medicaid: $60.88
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$184	$119.60	$27.38 – $184
Preventive checkup, new patient, age 18–39: 10 of 43 insurance plan rates AETNA — Acop: $48.59 AETNA — ALL PRODUCTS: $138 AETNA — Asa_Whirlpool_Peia: $56.71 AETNA — International: $60 AETNA — MEDICARE ADVANTAGE: $40.11 AETNA — Qhp/Ipf: $184 AMERIHEALTH — Managed Medicaid: $63.17 Amish Community Aid Plan — ALL PRODUCTS: $82.80 ANTHEM — HPN: $27.38 ANTHEM — Managed Medicaid: $60.30
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: WELLNESS EXAM NEW 18-39 YRS	$768	$499.20	$195.15 – $768
Preventive checkup, new patient, age 18–39: 10 of 41 insurance plan rates Aetna — Acop: $180.64 Aetna — All Products First Health: $576 Aetna — Asa: $614.40 Aetna — Qhp/Ifp: $768 AmeriHealth — Managed Medicaid: $53.87 Anthem — All Products Mid-Level Facility: $107.58 Anthem — All Products Mid-Level Non-Facility: $145.42 Anthem — All Products Physician: $192.28 Anthem — All Products Physician Facility: $192.28 Anthem — All Products Physician Non-Facility: $259.91
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PREV VISIT NEW AGE 18-39	$25	$16.25	$6.35 – $25
Preventive checkup, new patient, age 18–39: 10 of 41 insurance plan rates Aetna — Acop: $180.64 Aetna — All Products First Health: $18.75 Aetna — Asa: $20 Aetna — Qhp/Ifp: $25 AmeriHealth — Managed Medicaid: $53.87 Anthem — All Products Mid-Level Facility: $107.58 Anthem — All Products Mid-Level Non-Facility: $145.42 Anthem — All Products Physician: $192.28 Anthem — All Products Physician Facility: $192.28 Anthem — All Products Physician Non-Facility: $259.91
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: WELLNESS EXAMS NEW 40-64 YRS	$932	$605.80	$236.82 – $932
Preventive checkup, new patient, age 40–64: 10 of 41 insurance plan rates Aetna — Acop: $210.25 Aetna — All Products First Health: $699 Aetna — Asa: $745.60 Aetna — Qhp/Ifp: $932 AmeriHealth — Managed Medicaid: $68.52 Anthem — All Products Mid-Level Facility: $130.37 Anthem — All Products Mid-Level Non-Facility: $167.87 Anthem — All Products Physician: $233.03 Anthem — All Products Physician Facility: $233.03 Anthem — All Products Physician Non-Facility: $300.04
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PREV VISIT NEW AGE 40-64	$25	$16.25	$6.35 – $25
Preventive checkup, new patient, age 40–64: 10 of 41 insurance plan rates Aetna — Acop: $210.25 Aetna — All Products First Health: $18.75 Aetna — Asa: $20 Aetna — Qhp/Ifp: $25 AmeriHealth — Managed Medicaid: $68.52 Anthem — All Products Mid-Level Facility: $130.37 Anthem — All Products Mid-Level Non-Facility: $167.87 Anthem — All Products Physician: $233.03 Anthem — All Products Physician Facility: $233.03 Anthem — All Products Physician Non-Facility: $300.04
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	$54.56 – $63.17
Preventive checkup, new patient, age 40–64: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $63.17 ANTHEM — Managed Medicaid: $60.30 Buckeye — Managed Medicaid: $57.43 CARESOURCE — Managed Medicaid: $57.43 MOLINA — Managed Medicaid: $60.30 OPTUM — Managed Medicaid Transplant: $54.56 UNITED — Managed Medicaid: $60.30 United BH — Managed Medicaid: $60.88
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT LOW MDM	$1,911	$1,242.15	$54.56 – $2,453
Emergency room visit (moderate): 10 of 57 insurance plan rates AETNA — Acop: $812 AETNA — ALL PRODUCTS: $1,433.25 AETNA — Asa_Whirlpool_Peia: $948 AETNA — International: $996 AETNA — MEDICARE ADVANTAGE: $258.26 AETNA — Qhp/Ipf: $1,337.70 AMERIHEALTH — Managed Medicaid: $63.17 Amish Community Aid Plan — ALL PRODUCTS: $859.95 ANTHEM — HPN: $125.40 ANTHEM — Managed Medicaid: $60.30
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY DEPARTMENT VISIT LOW MDM	$704	$457.60	$178.89 – $633.60
Emergency room visit (moderate): 10 of 47 insurance plan rates Aetna — All Products First Health: $528 Aetna — Asa: $563.20 Aetna — Medicare Advantage: $69.06 Aetna — Qhp/Ifp: $492.80 AmeriHealth — Managed Medicaid: $41.45 Anthem — All Products Mid-Level Facility: $97.30 Anthem — All Products Mid-Level Non-Facility: $97.30 Anthem — All Products Physician: $149.06 Anthem — All Products Physician Facility: $149.06 Anthem — All Products Physician Non-Facility: $149.06
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT LOW MDM	$1,911	$1,242.15	$540.43 – $1,719.90
Emergency room visit (moderate): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $955.50 ANTHEM — TRADITIONAL: $1,090.61 OSCAR — ALL PRODUCTS: $689.68
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT MODERATE MDM	$2,938	$1,909.70	$54.56 – $2,735
Emergency room visit (moderately high): 10 of 57 insurance plan rates AETNA — Acop: $1,145 AETNA — ALL PRODUCTS: $2,203.50 AETNA — Asa_Whirlpool_Peia: $1,336 AETNA — International: $1,403 AETNA — MEDICARE ADVANTAGE: $394.76 AETNA — Qhp/Ipf: $2,056.60 AMERIHEALTH — Managed Medicaid: $63.17 Amish Community Aid Plan — ALL PRODUCTS: $1,322.10 ANTHEM — HPN: $213.79 ANTHEM — Managed Medicaid: $60.30
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY DEPARTMENT VISIT MODERATE MDM	$1,206	$783.90	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $652.41
Emergency room visit (moderately high): 10 of 47 insurance plan rates Aetna — All Products First Health: $904.50 Aetna — Asa: $964.80 Aetna — Medicare Advantage: $117.61 Aetna — Qhp/Ifp: $844.20 AmeriHealth — Managed Medicaid: $69.20 Anthem — All Products Mid-Level Facility: $163.51 Anthem — All Products Mid-Level Non-Facility: $163.51 Anthem — All Products Physician: $250.49 Anthem — All Products Physician Facility: $250.49 Anthem — All Products Physician Non-Facility: $250.49
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT MODERATE MDM	$2,938	$1,909.70	$830.87 – $2,644.20
Emergency room visit (moderately high): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $1,469 ANTHEM — TRADITIONAL: $1,676.72 OSCAR — ALL PRODUCTS: $1,060.32
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT HIGH MDM	$4,230	$2,749.50	$54.56 – $2,753
Emergency room visit (high): 10 of 57 insurance plan rates AETNA — Acop: $1,145 AETNA — ALL PRODUCTS: $3,172.50 AETNA — Asa_Whirlpool_Peia: $1,336 AETNA — International: $1,403 AETNA — MEDICARE ADVANTAGE: $563.42 AETNA — Qhp/Ipf: $2,961 AMERIHEALTH — Managed Medicaid: $63.17 Amish Community Aid Plan — ALL PRODUCTS: $1,903.50 ANTHEM — HPN: $310.28 ANTHEM — Managed Medicaid: $60.30
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY DEPARTMENT VISIT HIGH MDM	$1,760	$1,144	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $946.14
Emergency room visit (high): 10 of 47 insurance plan rates Aetna — All Products First Health: $1,320 Aetna — Asa: $1,408 Aetna — Medicare Advantage: $170.43 Aetna — Qhp/Ifp: $1,232 AmeriHealth — Managed Medicaid: $103.65 Anthem — All Products Mid-Level Facility: $238.20 Anthem — All Products Mid-Level Non-Facility: $238.20 Anthem — All Products Physician: $364.92 Anthem — All Products Physician Facility: $364.92 Anthem — All Products Physician Non-Facility: $364.92
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT HIGH MDM	$4,230	$2,749.50	$1,196.24 – $3,807
Emergency room visit (high): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $2,115 ANTHEM — TRADITIONAL: $2,414.06 OSCAR — ALL PRODUCTS: $1,526.61

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$58	$37.70	$16.40 – $58
Basic metabolic panel (blood test): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $43.50 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $17.83 AETNA — MEDICARE ADVANTAGE: $8.46 AETNA — Qhp/Ipf: $58 AMERIHEALTH — Managed Medicaid: $18.07 Amish Community Aid Plan — ALL PRODUCTS: $26.10 ANTHEM — HPN: $29.47 ANTHEM — Managed Medicaid: $17.25
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$58	$37.70	$16.40 – $58
Basic metabolic panel (blood test): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $29 ANTHEM — TRADITIONAL: $33.10 OSCAR — ALL PRODUCTS: $20.93
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BASIC METABOLIC PNL TOTAL CA	Not listed in the file	Not listed in the file	$9.48
Basic metabolic panel (blood test): rates for 1 insurance plan CC EHP — ALL PRODUCTS: $9.48
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE META PANL	$73	$47.45	$20.64 – $73
Comprehensive metabolic panel (blood test): 10 of 56 insurance plan rates AETNA — Acop: $0.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $54.75 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $22.27 AETNA — MEDICARE ADVANTAGE: $10.56 AETNA — Qhp/Ipf: $73 AMERIHEALTH — Managed Medicaid: $18.07 Amish Community Aid Plan — ALL PRODUCTS: $32.85 ANTHEM — HPN: $36.78 ANTHEM — Managed Medicaid: $17.25
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COMPREHENSIVE METABOLIC PANEL	$73	$47.45	$18.55 – $73
Comprehensive metabolic panel (blood test): 10 of 31 insurance plan rates Aetna — Acop: $16.44 Aetna — All Products First Health: $54.75 Aetna — Asa: $58.40 Aetna — Qhp/Ifp: $73 Anthem — All Products Mid-Level Facility: $14.37 Anthem — All Products Mid-Level Non-Facility: $14.37 Anthem — All Products Physician: $25.58 Anthem — All Products Physician Facility: $25.58 Anthem — All Products Physician Non-Facility: $25.58 Aultcare — PPO/HMO: $36.06
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPRE META PANL	$73	$47.45	$20.64 – $73
Comprehensive metabolic panel (blood test): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $36.50 ANTHEM — TRADITIONAL: $41.66 OSCAR — ALL PRODUCTS: $26.35
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB PANEL	$330	$214.50	$0.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $381.89
Obstetric blood test panel: 10 of 56 insurance plan rates AETNA — Acop: $0.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $247.50 AETNA — Asa_Whirlpool_Peia: $1.11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $100.80 AETNA — MEDICARE ADVANTAGE: $47.81 AETNA — Qhp/Ipf: $330 AMERIHEALTH — Managed Medicaid: $18.07 Amish Community Aid Plan — ALL PRODUCTS: $148.50 ANTHEM — HPN: $166.53 ANTHEM — Managed Medicaid: $17.25
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$330	$214.50	$0.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $381.89
Obstetric blood test panel: 10 of 56 insurance plan rates AETNA — Acop: $0.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $247.50 AETNA — Asa_Whirlpool_Peia: $1.11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $100.80 AETNA — MEDICARE ADVANTAGE: $47.81 AETNA — Qhp/Ipf: $330 AMERIHEALTH — Managed Medicaid: $18.07 Amish Community Aid Plan — ALL PRODUCTS: $148.50 ANTHEM — HPN: $166.53 ANTHEM — Managed Medicaid: $17.25
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB PANEL	$330	$214.50	$93.32 – $330
Obstetric blood test panel: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $165 ANTHEM — TRADITIONAL: $188.33 OSCAR — ALL PRODUCTS: $119.10
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID-LIPO PANEL 1	$92	$59.80	$26.02 – $92
Cholesterol panel (lipid panel): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $69 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $28.23 AETNA — MEDICARE ADVANTAGE: $13.39 AETNA — Qhp/Ipf: $92 AMERIHEALTH — Managed Medicaid: $18.07 Amish Community Aid Plan — ALL PRODUCTS: $41.40 ANTHEM — HPN: $46.64 ANTHEM — Managed Medicaid: $17.25
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: %NMRLIP CHOLESTEROL	$92	$59.80	$26.02 – $92
Cholesterol panel (lipid panel): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $69 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $28.23 AETNA — MEDICARE ADVANTAGE: $13.39 AETNA — Qhp/Ipf: $92 AMERIHEALTH — Managed Medicaid: $18.07 Amish Community Aid Plan — ALL PRODUCTS: $41.40 ANTHEM — HPN: $46.64 ANTHEM — Managed Medicaid: $17.25
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *LIPID PANEL	$92	$59.80	$26.02 – $92
Cholesterol panel (lipid panel): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $69 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $28.23 AETNA — MEDICARE ADVANTAGE: $13.39 AETNA — Qhp/Ipf: $92 AMERIHEALTH — Managed Medicaid: $18.07 Amish Community Aid Plan — ALL PRODUCTS: $41.40 ANTHEM — HPN: $46.64 ANTHEM — Managed Medicaid: $17.25
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNC PANL	$60	$39	$16.97 – $60
Kidney function panel: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $45 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $18.30 AETNA — MEDICARE ADVANTAGE: $8.68 AETNA — Qhp/Ipf: $60 AMERIHEALTH — Managed Medicaid: $18.07 Amish Community Aid Plan — ALL PRODUCTS: $27 ANTHEM — HPN: $30.23 ANTHEM — Managed Medicaid: $17.25
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNC PANL	$60	$39	$16.97 – $60
Kidney function panel: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $30 ANTHEM — TRADITIONAL: $34.24 OSCAR — ALL PRODUCTS: $21.65
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: RENAL FUNCTION PANEL	Not listed in the file	Not listed in the file	$9.72
Kidney function panel: rates for 1 insurance plan CC EHP — ALL PRODUCTS: $9.72
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEP FUNC PANL	$56	$36.40	$15.84 – $56
Liver function panel: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $42 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $17.22 AETNA — MEDICARE ADVANTAGE: $8.17 AETNA — Qhp/Ipf: $56 AMERIHEALTH — Managed Medicaid: $18.07 Amish Community Aid Plan — ALL PRODUCTS: $25.20 ANTHEM — HPN: $28.46 ANTHEM — Managed Medicaid: $17.25
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: HEPATIC FUNCTION PNL	$56	$36.40	$14.23 – $56
Liver function panel: 10 of 31 insurance plan rates Aetna — Acop: $12.71 Aetna — All Products First Health: $42 Aetna — Asa: $44.80 Aetna — Qhp/Ifp: $56 Anthem — All Products Mid-Level Facility: $11.12 Anthem — All Products Mid-Level Non-Facility: $11.12 Anthem — All Products Physician: $19.79 Anthem — All Products Physician Facility: $19.79 Anthem — All Products Physician Non-Facility: $19.79 Aultcare — PPO/HMO: $27.66
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEP FUNC PANL	$56	$36.40	$15.84 – $56
Liver function panel: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $28 ANTHEM — TRADITIONAL: $31.96 OSCAR — ALL PRODUCTS: $20.21
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W SCPE	$22	$14.30	$6.22 – $22
Urine test (automated, with microscope): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $16.50 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $9.63 AETNA — MEDICARE ADVANTAGE: $3.17 AETNA — Qhp/Ipf: $22 AMERIHEALTH — Managed Medicaid: $5.86 Amish Community Aid Plan — ALL PRODUCTS: $9.90 ANTHEM — HPN: $11.04 ANTHEM — Managed Medicaid: $5.60
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS WITH MICRO (POINT OF CARE LAB)	$22	$14.30	$3.17 – $9.20
Urine test (automated, with microscope): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $16.50 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $9.63 AETNA — MEDICARE ADVANTAGE: $3.17 AETNA — Qhp/Ipf: $22 AMERIHEALTH — Managed Medicaid: $5.86 Amish Community Aid Plan — ALL PRODUCTS: $9.90 ANTHEM — HPN: $11.04 ANTHEM — Managed Medicaid: $5.60
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY	$22	$14.30	$5.59 – $22
Urine test (automated, with microscope): 10 of 31 insurance plan rates Aetna — Acop: $4.93 Aetna — All Products First Health: $16.50 Aetna — Asa: $17.60 Aetna — Qhp/Ifp: $22 Anthem — All Products Mid-Level Facility: $4.32 Anthem — All Products Mid-Level Non-Facility: $4.32 Anthem — All Products Physician: $7.69 Anthem — All Products Physician Facility: $7.69 Anthem — All Products Physician Non-Facility: $7.69 Aultcare — PPO/HMO: $10.87
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA NON-AUTO W/O MICRO (POINT OF CARE LAB)	$24	$15.60	$0.95 – $14.26
Urine test (manual, without microscope): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $18 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $10.58 AETNA — MEDICARE ADVANTAGE: $3.48 AETNA — Qhp/Ipf: $24 AMERIHEALTH — Managed Medicaid: $5.86 Amish Community Aid Plan — ALL PRODUCTS: $10.80 ANTHEM — HPN: $12.12 ANTHEM — Managed Medicaid: $5.60
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB)	$24	$15.60	$3.48 – $10.10
Urine test (manual, without microscope): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $18 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $10.58 AETNA — MEDICARE ADVANTAGE: $3.48 AETNA — Qhp/Ipf: $24 AMERIHEALTH — Managed Medicaid: $5.86 Amish Community Aid Plan — ALL PRODUCTS: $10.80 ANTHEM — HPN: $12.12 ANTHEM — Managed Medicaid: $5.60
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$24	$15.60	$6.10 – $24
Urine test (manual, without microscope): 10 of 31 insurance plan rates Aetna — Acop: $4.87 Aetna — All Products First Health: $18 Aetna — Asa: $19.20 Aetna — Qhp/Ifp: $24 Anthem — All Products Mid-Level Facility: $4.73 Anthem — All Products Mid-Level Non-Facility: $4.73 Anthem — All Products Physician: $8.43 Anthem — All Products Physician Facility: $8.43 Anthem — All Products Physician Non-Facility: $8.43 Aultcare — PPO/HMO: $11.86
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS (POINT OF CARE LAB)	$16	$10.40	$2.25 – $6.53
Urine test (automated, without microscope): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $12 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $6.83 AETNA — MEDICARE ADVANTAGE: $2.25 AETNA — Qhp/Ipf: $16 AMERIHEALTH — Managed Medicaid: $5.86 Amish Community Aid Plan — ALL PRODUCTS: $7.20 ANTHEM — HPN: $7.84 ANTHEM — Managed Medicaid: $5.60
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO WO SCPE (POINT OF CARE LAB)	$16	$10.40	$0.95 – $17.31
Urine test (automated, without microscope): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $12 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $6.83 AETNA — MEDICARE ADVANTAGE: $2.25 AETNA — Qhp/Ipf: $16 AMERIHEALTH — Managed Medicaid: $5.86 Amish Community Aid Plan — ALL PRODUCTS: $7.20 ANTHEM — HPN: $7.84 ANTHEM — Managed Medicaid: $5.60
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO WO SCPE	$16	$10.40	$4.52 – $16
Urine test (automated, without microscope): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $12 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $6.83 AETNA — MEDICARE ADVANTAGE: $2.25 AETNA — Qhp/Ipf: $16 AMERIHEALTH — Managed Medicaid: $5.86 Amish Community Aid Plan — ALL PRODUCTS: $7.20 ANTHEM — HPN: $7.84 ANTHEM — Managed Medicaid: $5.60
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA DIAGNOSTIC	$127	$82.55	$0.95 – $75.36
PSA (prostate specific antigen) blood test: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $95.25 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $38.77 AETNA — MEDICARE ADVANTAGE: $18.39 AETNA — Qhp/Ipf: $127 AMERIHEALTH — Managed Medicaid: $16.68 Amish Community Aid Plan — ALL PRODUCTS: $57.15 ANTHEM — HPN: $64.05 ANTHEM — Managed Medicaid: $15.92
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA SCREENING	$127	$82.55	$0.95 – $75.36
PSA (prostate specific antigen) blood test: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $95.25 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $38.77 AETNA — MEDICARE ADVANTAGE: $18.39 AETNA — Qhp/Ipf: $127 AMERIHEALTH — Managed Medicaid: $16.68 Amish Community Aid Plan — ALL PRODUCTS: $57.15 ANTHEM — HPN: $64.05 ANTHEM — Managed Medicaid: $15.92
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: %PHI PROST SPEC AG TOT	$127	$82.55	$0.95 – $75.36
PSA (prostate specific antigen) blood test: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $95.25 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $38.77 AETNA — MEDICARE ADVANTAGE: $18.39 AETNA — Qhp/Ipf: $127 AMERIHEALTH — Managed Medicaid: $16.68 Amish Community Aid Plan — ALL PRODUCTS: $57.15 ANTHEM — HPN: $64.05 ANTHEM — Managed Medicaid: $15.92
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH	$116	$75.40	$16.80 – $48.74
Thyroid stimulating hormone (TSH) test: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $87 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $35.42 AETNA — MEDICARE ADVANTAGE: $16.80 AETNA — Qhp/Ipf: $116 AMERIHEALTH — Managed Medicaid: $20.22 Amish Community Aid Plan — ALL PRODUCTS: $52.20 ANTHEM — HPN: $58.52 ANTHEM — Managed Medicaid: $19.30
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: %NEO TSH	$116	$75.40	$16.80 – $48.74
Thyroid stimulating hormone (TSH) test: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $87 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $35.42 AETNA — MEDICARE ADVANTAGE: $16.80 AETNA — Qhp/Ipf: $116 AMERIHEALTH — Managed Medicaid: $20.22 Amish Community Aid Plan — ALL PRODUCTS: $52.20 ANTHEM — HPN: $58.52 ANTHEM — Managed Medicaid: $19.30
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE (TSH)	$116	$75.40	$0.95 – $68.84
Thyroid stimulating hormone (TSH) test: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $87 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $35.42 AETNA — MEDICARE ADVANTAGE: $16.80 AETNA — Qhp/Ipf: $116 AMERIHEALTH — Managed Medicaid: $20.22 Amish Community Aid Plan — ALL PRODUCTS: $52.20 ANTHEM — HPN: $58.52 ANTHEM — Managed Medicaid: $19.30
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W/DIFF	$54	$35.10	$0.95 – $31.84
Complete blood count (CBC) with differential: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $40.50 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $23.61 AETNA — MEDICARE ADVANTAGE: $7.77 AETNA — Qhp/Ipf: $54 AMERIHEALTH — Managed Medicaid: $7.80 Amish Community Aid Plan — ALL PRODUCTS: $24.30 ANTHEM — HPN: $27.06 ANTHEM — Managed Medicaid: $7.44
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC AUTO W AUTO DIFF	$54	$35.10	$0.95 – $31.84
Complete blood count (CBC) with differential: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $40.50 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $23.61 AETNA — MEDICARE ADVANTAGE: $7.77 AETNA — Qhp/Ipf: $54 AMERIHEALTH — Managed Medicaid: $7.80 Amish Community Aid Plan — ALL PRODUCTS: $24.30 ANTHEM — HPN: $27.06 ANTHEM — Managed Medicaid: $7.44
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$54	$35.10	$13.72 – $54
Complete blood count (CBC) with differential: 10 of 31 insurance plan rates Aetna — Acop: $12.08 Aetna — All Products First Health: $40.50 Aetna — Asa: $43.20 Aetna — Qhp/Ifp: $54 Anthem — All Products Mid-Level Facility: $10.57 Anthem — All Products Mid-Level Non-Facility: $10.57 Anthem — All Products Physician: $18.83 Anthem — All Products Physician Facility: $18.83 Anthem — All Products Physician Non-Facility: $18.83 Aultcare — PPO/HMO: $26.68
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC AUTO WO DIFF	$45	$29.25	$0.95 – $26.51
Complete blood count (CBC), automated: 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $33.75 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $19.66 AETNA — MEDICARE ADVANTAGE: $6.47 AETNA — Qhp/Ipf: $45 AMERIHEALTH — Managed Medicaid: $7.80 Amish Community Aid Plan — ALL PRODUCTS: $20.25 ANTHEM — HPN: $22.54 ANTHEM — Managed Medicaid: $7.44
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: BLOOD COUNT COMPLETE AUTOMATED	$45	$29.25	$11.43 – $45
Complete blood count (CBC), automated: 10 of 31 insurance plan rates Aetna — Acop: $10.05 Aetna — All Products First Health: $33.75 Aetna — Asa: $36 Aetna — Qhp/Ifp: $45 Anthem — All Products Mid-Level Facility: $8.81 Anthem — All Products Mid-Level Non-Facility: $8.81 Anthem — All Products Physician: $15.67 Anthem — All Products Physician Facility: $15.67 Anthem — All Products Physician Non-Facility: $15.67 Aultcare — PPO/HMO: $22.23
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC AUTO WO DIFF	$45	$29.25	$12.73 – $45
Complete blood count (CBC), automated: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $22.50 ANTHEM — TRADITIONAL: $25.68 OSCAR — ALL PRODUCTS: $16.24
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME AND INR (POINT OF CARE LAB)	$30	$19.50	$0.95 – $17.58
Blood clotting time test (prothrombin time, PT): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $22.50 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $13.03 AETNA — MEDICARE ADVANTAGE: $4.29 AETNA — Qhp/Ipf: $30 AMERIHEALTH — Managed Medicaid: $8.92 Amish Community Aid Plan — ALL PRODUCTS: $13.50 ANTHEM — HPN: $14.94 ANTHEM — Managed Medicaid: $8.52
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLOTTING TEST	$30	$19.50	$8.48 – $30
Blood clotting time test (prothrombin time, PT): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $22.50 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $13.03 AETNA — MEDICARE ADVANTAGE: $4.29 AETNA — Qhp/Ipf: $30 AMERIHEALTH — Managed Medicaid: $8.92 Amish Community Aid Plan — ALL PRODUCTS: $13.50 ANTHEM — HPN: $14.94 ANTHEM — Managed Medicaid: $8.52
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLOTTING TEST (POINT OF CARE LAB)	$30	$19.50	$8.48 – $30
Blood clotting time test (prothrombin time, PT): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $22.50 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $13.03 AETNA — MEDICARE ADVANTAGE: $4.29 AETNA — Qhp/Ipf: $30 AMERIHEALTH — Managed Medicaid: $8.92 Amish Community Aid Plan — ALL PRODUCTS: $13.50 ANTHEM — HPN: $14.94 ANTHEM — Managed Medicaid: $8.52
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *PTT PLASMA/WHOLE BLOOD	$41	$26.65	$0.95 – $24.63
Blood clotting test (partial thromboplastin time, PTT): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $30.75 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $18.26 AETNA — MEDICARE ADVANTAGE: $6.01 AETNA — Qhp/Ipf: $41 AMERIHEALTH — Managed Medicaid: $8.92 Amish Community Aid Plan — ALL PRODUCTS: $18.45 ANTHEM — HPN: $20.93 ANTHEM — Managed Medicaid: $8.52
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL HEME - PTT PLASMA/WHOLE BLOOD	$41	$26.65	$0.95 – $24.63
Blood clotting test (partial thromboplastin time, PTT): 10 of 56 insurance plan rates AETNA — Acop: $0.95 AETNA — ALL PRODUCTS: $30.75 AETNA — Asa_Whirlpool_Peia: $1.11 AETNA — International: $18.26 AETNA — MEDICARE ADVANTAGE: $6.01 AETNA — Qhp/Ipf: $41 AMERIHEALTH — Managed Medicaid: $8.92 Amish Community Aid Plan — ALL PRODUCTS: $18.45 ANTHEM — HPN: $20.93 ANTHEM — Managed Medicaid: $8.52
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: *PTT PLASMA/WHOLE BLOOD	$41	$26.65	$11.59 – $41
Blood clotting test (partial thromboplastin time, PTT): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $20.50 ANTHEM — TRADITIONAL: $23.40 OSCAR — ALL PRODUCTS: $14.80

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O CONTRAST MATERIAL	$734	$477.10	$207.58 – $734
CT scan of the head or brain, without contrast: 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $550.50 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $462.01 AETNA — MEDICARE ADVANTAGE: $98.91 AETNA — Qhp/Ipf: $734 AMERIHEALTH — Managed Medicaid: $361.89 Amish Community Aid Plan — ALL PRODUCTS: $330.30 ANTHEM — HPN: $189.23 ANTHEM — Managed Medicaid: $345.44
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CT HEAD/BRAIN W/O CONTRAST MATERIAL	$1,108	$720.20	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $360.96
CT scan of the head or brain, without contrast: 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $831 Aetna — Asa: $886.40 Aetna — Medicare Advantage: $100.38 Aetna — Qhp/Ifp: $1,108 AmeriHealth — Managed Medicaid: $111.06 Anthem — All Products Mid-Level Facility: $142.12 Anthem — All Products Mid-Level Non-Facility: $142.12 Anthem — All Products Physician: $360.96 Anthem — All Products Physician Facility: $360.96
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O CONTRAST MATERIAL	$734	$477.10	$207.58 – $734
CT scan of the head or brain, without contrast: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $367 ANTHEM — TRADITIONAL: $418.89 OSCAR — ALL PRODUCTS: $264.90
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$2,464	$1,601.60	$306.46 – $977.84
MRI of the brain, before and after contrast: 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $1,848 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $1,562.73 AETNA — MEDICARE ADVANTAGE: $330.06 AETNA — Qhp/Ipf: $2,464 AMERIHEALTH — Managed Medicaid: $354.85 Amish Community Aid Plan — ALL PRODUCTS: $1,108.80 ANTHEM — HPN: $568.60 ANTHEM — Managed Medicaid: $338.72
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$3,360	$2,184	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,089.98
MRI of the brain, before and after contrast: 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $2,520 Aetna — Asa: $2,688 Aetna — Medicare Advantage: $297.86 Aetna — Qhp/Ifp: $3,360 AmeriHealth — Managed Medicaid: $351.72 Anthem — All Products Mid-Level Facility: $429.16 Anthem — All Products Mid-Level Non-Facility: $429.16 Anthem — All Products Physician: $1,089.98 Anthem — All Products Physician Facility: $1,089.98
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$2,464	$1,601.60	$696.82 – $2,464
MRI of the brain, before and after contrast: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $1,232 ANTHEM — TRADITIONAL: $1,406.20 OSCAR — ALL PRODUCTS: $889.26
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS	$608	$395.20	$171.94 – $608
Chest X-ray, 2 views: 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $456 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $205.96 AETNA — MEDICARE ADVANTAGE: $82.33 AETNA — Qhp/Ipf: $608 AMERIHEALTH — Managed Medicaid: $52.18 Amish Community Aid Plan — ALL PRODUCTS: $273.60 ANTHEM — HPN: $59.28 ANTHEM — Managed Medicaid: $49.81
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS	$705	$458.25	$179.14 – $705
Chest X-ray, 2 views: 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $528.75 Aetna — Asa: $564 Aetna — Medicare Advantage: $31.02 Aetna — Qhp/Ifp: $705 AmeriHealth — Managed Medicaid: $25.15 Anthem — All Products Mid-Level Facility: $43.49 Anthem — All Products Mid-Level Non-Facility: $43.49 Anthem — All Products Physician: $110.46 Anthem — All Products Physician Facility: $110.46
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS	$608	$395.20	$171.94 – $608
Chest X-ray, 2 views: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $304 ANTHEM — TRADITIONAL: $346.99 OSCAR — ALL PRODUCTS: $219.43
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$734	$477.10	$0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $551.66
X-ray of the lower spine, at least 4 views: 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $550.50 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $277.21 AETNA — MEDICARE ADVANTAGE: $98.91 AETNA — Qhp/Ipf: $734 AMERIHEALTH — Managed Medicaid: $52.18 Amish Community Aid Plan — ALL PRODUCTS: $330.30 ANTHEM — HPN: $93.15 ANTHEM — Managed Medicaid: $49.81
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$848	$551.20	$215.48 – $848
X-ray of the lower spine, at least 4 views: 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $636 Aetna — Asa: $678.40 Aetna — Medicare Advantage: $49.86 Aetna — Qhp/Ifp: $848 AmeriHealth — Managed Medicaid: $41.15 Anthem — All Products Mid-Level Facility: $65.94 Anthem — All Products Mid-Level Non-Facility: $65.94 Anthem — All Products Physician: $167.48 Anthem — All Products Physician Facility: $167.48
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$734	$477.10	$207.58 – $734
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $367 ANTHEM — TRADITIONAL: $418.89 OSCAR — ALL PRODUCTS: $264.90
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$1,668	$1,084.20	$0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,165.03
MRI of the lower back (lumbar spine), without contrast: 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $1,251 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $976.47 AETNA — MEDICARE ADVANTAGE: $225.74 AETNA — Qhp/Ipf: $1,668 AMERIHEALTH — Managed Medicaid: $234.81 Amish Community Aid Plan — ALL PRODUCTS: $750.60 ANTHEM — HPN: $339.46 ANTHEM — Managed Medicaid: $224.13
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$2,260	$1,469	$574.27 – $2,260
MRI of the lower back (lumbar spine), without contrast: 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $1,695 Aetna — Asa: $1,808 Aetna — Medicare Advantage: $180.44 Aetna — Qhp/Ifp: $2,260 AmeriHealth — Managed Medicaid: $207.20 Anthem — All Products Mid-Level Facility: $257.28 Anthem — All Products Mid-Level Non-Facility: $257.28 Anthem — All Products Physician: $653.45 Anthem — All Products Physician Facility: $653.45
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$1,668	$1,084.20	$471.71 – $1,668
MRI of the lower back (lumbar spine), without contrast: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $834 ANTHEM — TRADITIONAL: $951.93 OSCAR — ALL PRODUCTS: $601.98
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTRAST MATERIAL	$1,228	$798.20	$347.28 – $1,228
CT scan of the pelvis, with contrast: 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $921 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $758.04 AETNA — MEDICARE ADVANTAGE: $165.94 AETNA — Qhp/Ipf: $1,228 AMERIHEALTH — Managed Medicaid: $361.89 Amish Community Aid Plan — ALL PRODUCTS: $552.60 ANTHEM — HPN: $412.55 ANTHEM — Managed Medicaid: $345.44
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CT PELVIS W/CONTRAST MATERIAL	$1,738	$1,129.70	$441.63 – $1,738
CT scan of the pelvis, with contrast: 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $1,303.50 Aetna — Asa: $1,390.40 Aetna — Medicare Advantage: $210.76 Aetna — Qhp/Ifp: $1,738 AmeriHealth — Managed Medicaid: $210.01 Anthem — All Products Mid-Level Facility: $297.89 Anthem — All Products Mid-Level Non-Facility: $297.89 Anthem — All Products Physician: $756.59 Anthem — All Products Physician Facility: $756.59
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTRAST MATERIAL	$1,228	$798.20	$347.28 – $1,228
CT scan of the pelvis, with contrast: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $614 ANTHEM — TRADITIONAL: $700.82 OSCAR — ALL PRODUCTS: $443.19
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$1,668	$1,084.20	$0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $976.47
MRI of a leg joint (such as the knee), without contrast: 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $1,251 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $976.47 AETNA — MEDICARE ADVANTAGE: $225.74 AETNA — Qhp/Ipf: $1,668 AMERIHEALTH — Managed Medicaid: $234.81 Amish Community Aid Plan — ALL PRODUCTS: $750.60 ANTHEM — HPN: $364.54 ANTHEM — Managed Medicaid: $224.13
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$1,668	$1,084.20	$471.71 – $1,668
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $834 ANTHEM — TRADITIONAL: $951.93 OSCAR — ALL PRODUCTS: $601.98
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$594	$386.10	$150.94 – $594
MRI of a leg joint (such as the knee), without contrast: 10 of 42 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $445.50 Aetna — Asa: $475.20 Aetna — Medicare Advantage: $61.69 Aetna — Qhp/Ifp: $594 Anthem — All Products Mid-Level Facility: $86.68 Anthem — All Products Mid-Level Non-Facility: $86.68 Anthem — All Products Physician: $220.16 Anthem — All Products Physician Facility: $220.16 Anthem — All Products Physician Non-Facility: $220.16
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 MATERIAL	$2,464	$1,601.60	$696.82 – $2,464
CT scan of the abdomen and pelvis, with contrast: 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $1,848 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $1,562.73 AETNA — MEDICARE ADVANTAGE: $330.06 AETNA — Qhp/Ipf: $2,464 AMERIHEALTH — Managed Medicaid: $361.89 Amish Community Aid Plan — ALL PRODUCTS: $1,108.80 ANTHEM — HPN: $544.43 ANTHEM — Managed Medicaid: $345.44
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CT ABD & PELVIS W/CONTRAST	$3,265	$2,122.25	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,037.45
CT scan of the abdomen and pelvis, with contrast: 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $2,448.75 Aetna — Asa: $2,612 Aetna — Medicare Advantage: $281.10 Aetna — Qhp/Ifp: $3,265 AmeriHealth — Managed Medicaid: $203.62 Anthem — All Products Mid-Level Facility: $408.48 Anthem — All Products Mid-Level Non-Facility: $408.48 Anthem — All Products Physician: $1,037.45 Anthem — All Products Physician Facility: $1,037.45
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 MATERIAL	$2,464	$1,601.60	$696.82 – $2,464
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $1,232 ANTHEM — TRADITIONAL: $1,406.20 OSCAR — ALL PRODUCTS: $889.26
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$734	$477.10	$0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $551.66
Ultrasound of the abdomen, complete: 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $550.50 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $277.21 AETNA — MEDICARE ADVANTAGE: $98.91 AETNA — Qhp/Ipf: $734 AMERIHEALTH — Managed Medicaid: $138.11 Amish Community Aid Plan — ALL PRODUCTS: $330.30 ANTHEM — HPN: $202.59 ANTHEM — Managed Medicaid: $131.83
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$734	$477.10	$207.58 – $734
Ultrasound of the abdomen, complete: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $367 ANTHEM — TRADITIONAL: $418.89 OSCAR — ALL PRODUCTS: $264.90
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$356	$231.40	$90.46 – $356
Ultrasound of the abdomen, complete: 10 of 42 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $267 Aetna — Asa: $284.80 Aetna — Medicare Advantage: $36.76 Aetna — Qhp/Ifp: $356 Anthem — All Products Mid-Level Facility: $51.49 Anthem — All Products Mid-Level Non-Facility: $51.49 Anthem — All Products Physician: $130.78 Anthem — All Products Physician Facility: $130.78 Anthem — All Products Physician Non-Facility: $130.78
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$734	$477.10	$207.58 – $734
Pregnancy ultrasound (after the first trimester): 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $550.50 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $277.21 AETNA — MEDICARE ADVANTAGE: $98.91 AETNA — Qhp/Ipf: $734 AMERIHEALTH — Managed Medicaid: $107.44 Amish Community Aid Plan — ALL PRODUCTS: $330.30 ANTHEM — HPN: $235.02 ANTHEM — Managed Medicaid: $102.55
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$1,130	$734.50	$287.13 – $1,130
Pregnancy ultrasound (after the first trimester): 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $847.50 Aetna — Asa: $904 Aetna — Medicare Advantage: $127.79 Aetna — Qhp/Ifp: $1,130 AmeriHealth — Managed Medicaid: $109.58 Anthem — All Products Mid-Level Facility: $175.98 Anthem — All Products Mid-Level Non-Facility: $175.98 Anthem — All Products Physician: $446.93 Anthem — All Products Physician Facility: $446.93
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$734	$477.10	$207.58 – $734
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $367 ANTHEM — TRADITIONAL: $418.89 OSCAR — ALL PRODUCTS: $264.90
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAGINAL	$734	$477.10	$207.58 – $734
Transvaginal ultrasound: 10 of 57 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $550.50 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $277.21 AETNA — MEDICARE ADVANTAGE: $98.91 AETNA — Qhp/Ipf: $734 AMERIHEALTH — Managed Medicaid: $89.80 Amish Community Aid Plan — ALL PRODUCTS: $330.30 ANTHEM — HPN: $209.10 ANTHEM — Managed Medicaid: $85.72
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: US TRANSVAGINAL	$1,038	$674.70	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $393.47
Transvaginal ultrasound: 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $778.50 Aetna — Asa: $830.40 Aetna — Medicare Advantage: $110.03 Aetna — Qhp/Ifp: $1,038 AmeriHealth — Managed Medicaid: $78.65 Anthem — All Products Mid-Level Facility: $154.93 Anthem — All Products Mid-Level Non-Facility: $154.93 Anthem — All Products Physician: $393.47 Anthem — All Products Physician Facility: $393.47
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US TRANSVAGINAL	$734	$477.10	$207.58 – $734
Transvaginal ultrasound: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $367 ANTHEM — TRADITIONAL: $418.89 OSCAR — ALL PRODUCTS: $264.90
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$563	$365.95	$41.14 – $487.69
Diagnostic mammogram, one breast: 10 of 56 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $422.25 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $394.10 AETNA — MEDICARE ADVANTAGE: $168.11 AETNA — Qhp/Ipf: $563 AMERIHEALTH — Managed Medicaid: $47.64 Amish Community Aid Plan — ALL PRODUCTS: $253.35 ANTHEM — HPN: $222 ANTHEM — Managed Medicaid: $45.48
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$887	$576.55	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $410.71
Diagnostic mammogram, one breast: 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $665.25 Aetna — Asa: $709.60 Aetna — Medicare Advantage: $116.20 Aetna — Qhp/Ifp: $887 AmeriHealth — Managed Medicaid: $65.38 Anthem — All Products Mid-Level Facility: $161.71 Anthem — All Products Mid-Level Non-Facility: $161.71 Anthem — All Products Physician: $410.71 Anthem — All Products Physician Facility: $410.71
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$563	$365.95	$159.22 – $563
Diagnostic mammogram, one breast: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $281.50 ANTHEM — TRADITIONAL: $321.30 OSCAR — ALL PRODUCTS: $203.19
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$706	$458.90	$41.14 – $618.15
Diagnostic mammogram, both breasts: 10 of 56 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $529.50 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $494.20 AETNA — MEDICARE ADVANTAGE: $213.08 AETNA — Qhp/Ipf: $706 AMERIHEALTH — Managed Medicaid: $47.64 Amish Community Aid Plan — ALL PRODUCTS: $317.70 ANTHEM — HPN: $280.61 ANTHEM — Managed Medicaid: $45.48
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$706	$458.90	$199.66 – $706
Diagnostic mammogram, both breasts: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $353 ANTHEM — TRADITIONAL: $402.91 OSCAR — ALL PRODUCTS: $254.80
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier TC In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$706	$458.90	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $356.82
Diagnostic mammogram, both breasts: 10 of 43 insurance plan rates Aetna — Acop: $142.76 Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $529.50 Aetna — Asa: $564.80 Aetna — Medicare Advantage: $101.51 Aetna — Qhp/Ifp: $706 Anthem — All Products Mid-Level Facility: $140.50 Anthem — All Products Mid-Level Non-Facility: $140.50 Anthem — All Products Physician: $356.82 Anthem — All Products Physician Facility: $356.82
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$609	$395.85	$0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $489.29
Screening mammogram, both breasts: 10 of 56 insurance plan rates AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — ALL PRODUCTS: $456.75 AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) AETNA — International: $426.30 AETNA — MEDICARE ADVANTAGE: $172.34 AETNA — Qhp/Ipf: $609 AMERIHEALTH — Managed Medicaid: $47.64 Amish Community Aid Plan — ALL PRODUCTS: $274.05 ANTHEM — HPN: $228.13 ANTHEM — Managed Medicaid: $45.48
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$913	$593.45	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $419.83
Screening mammogram, both breasts: 10 of 48 insurance plan rates Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Aetna — All Products First Health: $684.75 Aetna — Asa: $730.40 Aetna — Medicare Advantage: $118.17 Aetna — Qhp/Ifp: $913 AmeriHealth — Managed Medicaid: $66.84 Anthem — All Products Mid-Level Facility: $165.30 Anthem — All Products Mid-Level Non-Facility: $165.30 Anthem — All Products Physician: $419.83 Anthem — All Products Physician Facility: $419.83
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$609	$395.85	$172.23 – $609
Screening mammogram, both breasts: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $304.50 ANTHEM — TRADITIONAL: $347.56 OSCAR — ALL PRODUCTS: $219.79

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$75	$48.75	$19.06 – $75
Electrocardiogram (ECG/EKG) with reading: 10 of 47 insurance plan rates Aetna — All Products First Health: $56.25 Aetna — Asa: $60 Aetna — Medicare Advantage: $14.66 Aetna — Qhp/Ifp: $75 AmeriHealth — Managed Medicaid: $15.29 Anthem — All Products Mid-Level Facility: $18.91 Anthem — All Products Mid-Level Non-Facility: $18.91 Anthem — All Products Physician: $48.03 Anthem — All Products Physician Facility: $48.03 Anthem — All Products Physician Non-Facility: $48.03
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$415	$269.75	$90.47 – $415
Electrocardiogram (ECG/EKG) with reading: 10 of 43 insurance plan rates AETNA — Acop: $249 AETNA — ALL PRODUCTS: $311.25 AETNA — Asa_Whirlpool_Peia: $311.25 AETNA — International: $300.88 AETNA — MEDICARE ADVANTAGE: $90.47 AETNA — Qhp/Ipf: $415 AMERIHEALTH — Managed Medicaid: $21.60 Amish Community Aid Plan — ALL PRODUCTS: $186.75 ANTHEM — HPN: $23.68 ANTHEM — Managed Medicaid: $20.62
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$415	$269.75	$90.47 – $415
Electrocardiogram (ECG/EKG) with reading: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $207.50 ANTHEM — TRADITIONAL: $236.84 OSCAR — ALL PRODUCTS: $149.77
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$18,494	$12,021.10	$5,230.10 – $18,494
Left heart catheterization (diagnostic): 10 of 57 insurance plan rates AETNA — Acop: $8,566 AETNA — ALL PRODUCTS: $13,870.50 AETNA — Asa_Whirlpool_Peia: $9,996 AETNA — International: $9,329 AETNA — MEDICARE ADVANTAGE: $3,067.12 AETNA — Qhp/Ipf: $18,494 AMERIHEALTH — Managed Medicaid: $1,790.26 Amish Community Aid Plan — ALL PRODUCTS: $8,322.30 ANTHEM — HPN: $1,508.20 ANTHEM — Managed Medicaid: $1,708.89
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$18,494	$12,021.10	$5,230.10 – $18,494
Left heart catheterization (diagnostic): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $9,247 ANTHEM — TRADITIONAL: $10,554.53 OSCAR — ALL PRODUCTS: $6,674.48
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$1,980	$1,287	$503.12 – $1,980
Left heart catheterization (diagnostic): 10 of 41 insurance plan rates Aetna — All Products First Health: $1,485 Aetna — Asa: $1,584 Aetna — Medicare Advantage: $227.61 Aetna — Qhp/Ifp: $1,980 Anthem — All Products Mid-Level Facility: $312.24 Anthem — All Products Mid-Level Non-Facility: $312.24 Anthem — All Products Physician: $793.04 Anthem — All Products Physician Facility: $793.04 Anthem — All Products Physician Non-Facility: $793.04 Anthem — Medicare Advantage: $227.61
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$43,632	$28,360.80	$12,339.13 – $43,632
Heart rhythm study (electrophysiology evaluation): 10 of 57 insurance plan rates AETNA — Acop: $26,179.20 AETNA — ALL PRODUCTS: $32,724 AETNA — Asa_Whirlpool_Peia: $8,885 AETNA — International: $9,329 AETNA — MEDICARE ADVANTAGE: $7,379.08 AETNA — Qhp/Ipf: $43,632 AMERIHEALTH — Managed Medicaid: $1,433.86 Amish Community Aid Plan — ALL PRODUCTS: $19,634.40 ANTHEM — HPN: $18,582.01 ANTHEM — Managed Medicaid: $1,368.69
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$46,632	$30,310.80	$11,849.19 – $46,632
Heart rhythm study (electrophysiology evaluation): 10 of 37 insurance plan rates Aetna — All Products First Health: $34,974 Aetna — Asa: $37,305.60 Aetna — Qhp/Ifp: $46,632 AmeriHealth — Managed Medicaid: $652.44 Anthem — All Products Mid-Level Facility: $999.09 Anthem — All Products Mid-Level Non-Facility: $999.09 Anthem — All Products Physician: $2,537.48 Anthem — All Products Physician Facility: $2,537.48 Anthem — All Products Physician Non-Facility: $2,537.48 Aultcare — PPO/HMO: $23,036.21
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$43,632	$28,360.80	$12,339.13 – $43,632
Heart rhythm study (electrophysiology evaluation): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $21,816 ANTHEM — TRADITIONAL: $24,900.78 OSCAR — ALL PRODUCTS: $15,746.79
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 PULM VEIN ISOLATION	$69,628	$45,258.20	$1,537.52 – $73,260.44
Heart rhythm study with ablation for atrial fibrillation: 10 of 57 insurance plan rates AETNA — Acop: $41,776.80 AETNA — ALL PRODUCTS: $52,221 AETNA — Asa_Whirlpool_Peia: $8,885 AETNA — International: $9,329 AETNA — MEDICARE ADVANTAGE: $24,728.43 AETNA — Qhp/Ipf: $69,628 AMERIHEALTH — Managed Medicaid: $11,141.72 Amish Community Aid Plan — ALL PRODUCTS: $31,332.60 ANTHEM — HPN: $1,537.52 ANTHEM — Managed Medicaid: $10,635.28
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$7,480	$4,862	$1,900.67 – $7,480
Heart rhythm study with ablation for atrial fibrillation: 10 of 47 insurance plan rates Aetna — All Products First Health: $5,610 Aetna — Asa: $5,984 Aetna — Medicare Advantage: $801.02 Aetna — Qhp/Ifp: $7,480 AmeriHealth — Managed Medicaid: $896.53 Anthem — All Products Mid-Level Facility: $1,272.93 Anthem — All Products Mid-Level Non-Facility: $1,272.93 Anthem — All Products Physician: $3,232.98 Anthem — All Products Physician Facility: $3,232.98 Anthem — All Products Physician Non-Facility: $3,232.98
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$69,628	$45,258.20	$19,690.80 – $69,628
Heart rhythm study with ablation for atrial fibrillation: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $34,814 ANTHEM — TRADITIONAL: $39,736.70 OSCAR — ALL PRODUCTS: $25,128.75
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$7,020	$4,563	$1,985.26 – $7,020
Sleep study (overnight, in a sleep lab): 10 of 49 insurance plan rates AETNA — Acop: $4,212 AETNA — ALL PRODUCTS: $5,265 AETNA — Asa_Whirlpool_Peia: $4,914 AETNA — International: $4,914 AETNA — MEDICARE ADVANTAGE: $812.43 AETNA — Qhp/Ipf: $7,020 Amish Community Aid Plan — ALL PRODUCTS: $3,159 ANTHEM — HPN: $1,132.46 ANTHEM — MEDICARE ADVANTAGE: $812.43 ANTHEM — PPO/HMO: $2,406.92
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$8,120	$5,278	$2,063.29 – $8,120
Sleep study (overnight, in a sleep lab): 10 of 47 insurance plan rates Aetna — All Products First Health: $6,090 Aetna — Asa: $6,496 Aetna — Medicare Advantage: $626.11 Aetna — Qhp/Ifp: $8,120 AmeriHealth — Managed Medicaid: $396.29 Anthem — All Products Mid-Level Facility: $774.90 Anthem — All Products Mid-Level Non-Facility: $774.90 Anthem — All Products Physician: $1,968.10 Anthem — All Products Physician Facility: $1,968.10 Anthem — All Products Physician Non-Facility: $1,968.10
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$7,020	$4,563	$1,985.26 – $7,020
Sleep study (overnight, in a sleep lab): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $3,510 ANTHEM — TRADITIONAL: $4,006.31 OSCAR — ALL PRODUCTS: $2,533.52

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERA EXER 1	$258	$167.70	$72.96 – $258
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 56 insurance plan rates AETNA — Acop: $85.66 AETNA — ALL PRODUCTS: $193.50 AETNA — Asa_Whirlpool_Peia: $100.10 AETNA — International: $105.01 AETNA — MEDICARE ADVANTAGE: $37.31 AETNA — Qhp/Ipf: $258 AMERIHEALTH — Managed Medicaid: $78.20 Amish Community Aid Plan — ALL PRODUCTS: $116.10 ANTHEM — HPN: $50.01 ANTHEM — Managed Medicaid: $74.64
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERA EXER 15MIN	$258	$167.70	$37.06 – $108.24
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 56 insurance plan rates AETNA — Acop: $85.66 AETNA — ALL PRODUCTS: $193.50 AETNA — Asa_Whirlpool_Peia: $100.10 AETNA — International: $105.01 AETNA — MEDICARE ADVANTAGE: $37.31 AETNA — Qhp/Ipf: $258 AMERIHEALTH — Managed Medicaid: $78.20 Amish Community Aid Plan — ALL PRODUCTS: $116.10 ANTHEM — HPN: $50.01 ANTHEM — Managed Medicaid: $74.64
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT THERAPEUT PROC/EXER, 15 MIN	$258	$167.70	$37.06 – $108.24
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 56 insurance plan rates AETNA — Acop: $85.66 AETNA — ALL PRODUCTS: $193.50 AETNA — Asa_Whirlpool_Peia: $100.10 AETNA — International: $105.01 AETNA — MEDICARE ADVANTAGE: $37.31 AETNA — Qhp/Ipf: $258 AMERIHEALTH — Managed Medicaid: $78.20 Amish Community Aid Plan — ALL PRODUCTS: $116.10 ANTHEM — HPN: $50.01 ANTHEM — Managed Medicaid: $74.64
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VV EVALUATION LOW COMPLEXITY (97161)	$605	$393.25	$171.09 – $605
Physical therapy evaluation (low complexity): 10 of 56 insurance plan rates AETNA — Acop: $200.86 AETNA — ALL PRODUCTS: $453.75 AETNA — Asa_Whirlpool_Peia: $234.74 AETNA — International: $246.24 AETNA — MEDICARE ADVANTAGE: $126.43 AETNA — Qhp/Ipf: $605 AMERIHEALTH — Managed Medicaid: $85.65 Amish Community Aid Plan — ALL PRODUCTS: $272.25 ANTHEM — HPN: $170.28 ANTHEM — Managed Medicaid: $81.75
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL - LOW	$605	$393.25	$171.09 – $605
Physical therapy evaluation (low complexity): 10 of 56 insurance plan rates AETNA — Acop: $200.86 AETNA — ALL PRODUCTS: $453.75 AETNA — Asa_Whirlpool_Peia: $234.74 AETNA — International: $246.24 AETNA — MEDICARE ADVANTAGE: $126.43 AETNA — Qhp/Ipf: $605 AMERIHEALTH — Managed Medicaid: $85.65 Amish Community Aid Plan — ALL PRODUCTS: $272.25 ANTHEM — HPN: $170.28 ANTHEM — Managed Medicaid: $81.75
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: VV EVALUATION LOW COMPLEXITY (97161)	$605	$393.25	$171.09 – $605
Physical therapy evaluation (low complexity): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $302.50 ANTHEM — TRADITIONAL: $345.27 OSCAR — ALL PRODUCTS: $218.34
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VV EVALUATION MODERATE COMPLEXITY (97162)	$605	$393.25	$171.09 – $605
Physical therapy evaluation (moderate complexity): 10 of 56 insurance plan rates AETNA — Acop: $200.86 AETNA — ALL PRODUCTS: $453.75 AETNA — Asa_Whirlpool_Peia: $234.74 AETNA — International: $246.24 AETNA — MEDICARE ADVANTAGE: $126.43 AETNA — Qhp/Ipf: $605 AMERIHEALTH — Managed Medicaid: $85.65 Amish Community Aid Plan — ALL PRODUCTS: $272.25 ANTHEM — HPN: $170.28 ANTHEM — Managed Medicaid: $81.75
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL - MOD	$605	$393.25	$171.09 – $605
Physical therapy evaluation (moderate complexity): 10 of 56 insurance plan rates AETNA — Acop: $200.86 AETNA — ALL PRODUCTS: $453.75 AETNA — Asa_Whirlpool_Peia: $234.74 AETNA — International: $246.24 AETNA — MEDICARE ADVANTAGE: $126.43 AETNA — Qhp/Ipf: $605 AMERIHEALTH — Managed Medicaid: $85.65 Amish Community Aid Plan — ALL PRODUCTS: $272.25 ANTHEM — HPN: $170.28 ANTHEM — Managed Medicaid: $81.75
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: VV EVALUATION MODERATE COMPLEXITY (97162)	$605	$393.25	$171.09 – $605
Physical therapy evaluation (moderate complexity): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $302.50 ANTHEM — TRADITIONAL: $345.27 OSCAR — ALL PRODUCTS: $218.34
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VV EVALUATION HIGH COMPLEXITY (97163)	$605	$393.25	$171.09 – $605
Physical therapy evaluation (high complexity): 10 of 56 insurance plan rates AETNA — Acop: $200.86 AETNA — ALL PRODUCTS: $453.75 AETNA — Asa_Whirlpool_Peia: $234.74 AETNA — International: $246.24 AETNA — MEDICARE ADVANTAGE: $126.43 AETNA — Qhp/Ipf: $605 AMERIHEALTH — Managed Medicaid: $85.65 Amish Community Aid Plan — ALL PRODUCTS: $272.25 ANTHEM — HPN: $170.28 ANTHEM — Managed Medicaid: $81.75
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL - HIGH	$605	$393.25	$171.09 – $605
Physical therapy evaluation (high complexity): 10 of 56 insurance plan rates AETNA — Acop: $200.86 AETNA — ALL PRODUCTS: $453.75 AETNA — Asa_Whirlpool_Peia: $234.74 AETNA — International: $246.24 AETNA — MEDICARE ADVANTAGE: $126.43 AETNA — Qhp/Ipf: $605 AMERIHEALTH — Managed Medicaid: $85.65 Amish Community Aid Plan — ALL PRODUCTS: $272.25 ANTHEM — HPN: $170.28 ANTHEM — Managed Medicaid: $81.75
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: VV EVALUATION HIGH COMPLEXITY (97163)	$605	$393.25	$171.09 – $605
Physical therapy evaluation (high complexity): rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $302.50 ANTHEM — TRADITIONAL: $345.27 OSCAR — ALL PRODUCTS: $218.34
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 30 MINUTES	$482	$313.30	$136.31 – $482
Psychotherapy, 30 minutes: 10 of 57 insurance plan rates AETNA — Acop: $289.20 AETNA — ALL PRODUCTS: $361.50 AETNA — Asa_Whirlpool_Peia: $337.40 AETNA — International: $337.40 AETNA — MEDICARE ADVANTAGE: $167.92 AETNA — Qhp/Ipf: $482 AMERIHEALTH — Managed Medicaid: $87.41 Amish Community Aid Plan — ALL PRODUCTS: $216.90 ANTHEM — HPN: $133.67 ANTHEM — Managed Medicaid: $83.43
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY 30 MINUTES PATIENT	$744	$483.60	$189.05 – $744
Psychotherapy, 30 minutes: 10 of 50 insurance plan rates Aetna — Acop: $94.42 Aetna — All Products First Health: $558 Aetna — Asa: $595.20 Aetna — Medicare Advantage: $69.44 Aetna — Qhp/Ifp: $744 AmeriHealth — Managed Medicaid: $39.14 Anthem — All Products Mid-Level Facility: $89.59 Anthem — All Products Mid-Level Non-Facility: $100.93 Anthem — All Products Physician: $227.52 Anthem — All Products Physician Facility: $227.52
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VIRTUAL VISIT PSYTX PT&/FAMILY 30 MINS	$744	$483.60	$189.05 – $744
Psychotherapy, 30 minutes: 10 of 50 insurance plan rates Aetna — Acop: $94.42 Aetna — All Products First Health: $558 Aetna — Asa: $595.20 Aetna — Medicare Advantage: $69.44 Aetna — Qhp/Ifp: $744 AmeriHealth — Managed Medicaid: $39.14 Anthem — All Products Mid-Level Facility: $89.59 Anthem — All Products Mid-Level Non-Facility: $100.93 Anthem — All Products Physician: $227.52 Anthem — All Products Physician Facility: $227.52
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 45 MINUTES	$482	$313.30	$136.31 – $482
Psychotherapy, 45 minutes: 10 of 57 insurance plan rates AETNA — Acop: $289.20 AETNA — ALL PRODUCTS: $361.50 AETNA — Asa_Whirlpool_Peia: $337.40 AETNA — International: $337.40 AETNA — MEDICARE ADVANTAGE: $167.92 AETNA — Qhp/Ipf: $482 AMERIHEALTH — Managed Medicaid: $109.35 Amish Community Aid Plan — ALL PRODUCTS: $216.90 ANTHEM — HPN: $176.33 ANTHEM — Managed Medicaid: $104.38
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY 45 MINUTES WITH PATIENT	$980	$637	$249.02 – $980
Psychotherapy, 45 minutes: 10 of 50 insurance plan rates Aetna — Acop: $125.75 Aetna — All Products First Health: $735 Aetna — Asa: $784 Aetna — Medicare Advantage: $91.82 Aetna — Qhp/Ifp: $980 AmeriHealth — Managed Medicaid: $54.37 Anthem — All Products Mid-Level Facility: $118.82 Anthem — All Products Mid-Level Non-Facility: $133.54 Anthem — All Products Physician: $301.77 Anthem — All Products Physician Facility: $301.77
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VIRTUAL VISIT PSYTX PT&/FAMILY 45 MINS	$980	$637	$249.02 – $980
Psychotherapy, 45 minutes: 10 of 50 insurance plan rates Aetna — Acop: $125.75 Aetna — All Products First Health: $735 Aetna — Asa: $784 Aetna — Medicare Advantage: $91.82 Aetna — Qhp/Ifp: $980 AmeriHealth — Managed Medicaid: $54.37 Anthem — All Products Mid-Level Facility: $118.82 Anthem — All Products Mid-Level Non-Facility: $133.54 Anthem — All Products Physician: $301.77 Anthem — All Products Physician Facility: $301.77
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 60 MINUTES	$482	$313.30	$136.31 – $482
Psychotherapy, 60 minutes: 10 of 57 insurance plan rates AETNA — Acop: $289.20 AETNA — ALL PRODUCTS: $361.50 AETNA — Asa_Whirlpool_Peia: $337.40 AETNA — International: $337.40 AETNA — MEDICARE ADVANTAGE: $167.92 AETNA — Qhp/Ipf: $482 AMERIHEALTH — Managed Medicaid: $109.35 Amish Community Aid Plan — ALL PRODUCTS: $216.90 ANTHEM — HPN: $260.96 ANTHEM — Managed Medicaid: $104.38
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY 60 MINUTES WITH PATIENT	$1,452	$943.80	$368.95 – $1,452
Psychotherapy, 60 minutes: 10 of 50 insurance plan rates Aetna — Acop: $188.86 Aetna — All Products First Health: $1,089 Aetna — Asa: $1,161.60 Aetna — Medicare Advantage: $135.22 Aetna — Qhp/Ifp: $1,452 AmeriHealth — Managed Medicaid: $83.35 Anthem — All Products Mid-Level Facility: $174.60 Anthem — All Products Mid-Level Non-Facility: $196.45 Anthem — All Products Physician: $443.44 Anthem — All Products Physician Facility: $443.44
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VIRTUAL VISIT PSYTX PT&/FAMILY 60 MINS	$1,452	$943.80	$368.95 – $1,452
Psychotherapy, 60 minutes: 10 of 50 insurance plan rates Aetna — Acop: $188.86 Aetna — All Products First Health: $1,089 Aetna — Asa: $1,161.60 Aetna — Medicare Advantage: $135.22 Aetna — Qhp/Ifp: $1,452 AmeriHealth — Managed Medicaid: $83.35 Anthem — All Products Mid-Level Facility: $174.60 Anthem — All Products Mid-Level Non-Facility: $196.45 Anthem — All Products Physician: $443.44 Anthem — All Products Physician Facility: $443.44
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX FAMILY W/O PT	$482	$313.30	$136.31 – $482
Family psychotherapy, without the patient: 10 of 57 insurance plan rates AETNA — Acop: $289.20 AETNA — ALL PRODUCTS: $361.50 AETNA — Asa_Whirlpool_Peia: $337.40 AETNA — International: $337.40 AETNA — MEDICARE ADVANTAGE: $167.92 AETNA — Qhp/Ipf: $482 AMERIHEALTH — Managed Medicaid: $145.96 Amish Community Aid Plan — ALL PRODUCTS: $216.90 ANTHEM — HPN: $190.25 ANTHEM — Managed Medicaid: $139.32
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$482	$313.30	$126.06 – $497.49
Family psychotherapy, without the patient: 10 of 57 insurance plan rates AETNA — Acop: $289.20 AETNA — ALL PRODUCTS: $361.50 AETNA — Asa_Whirlpool_Peia: $337.40 AETNA — International: $337.40 AETNA — MEDICARE ADVANTAGE: $167.92 AETNA — Qhp/Ipf: $482 AMERIHEALTH — Managed Medicaid: $145.96 Amish Community Aid Plan — ALL PRODUCTS: $216.90 ANTHEM — HPN: $190.25 ANTHEM — Managed Medicaid: $139.32
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$1,052	$683.80	$267.31 – $1,052
Family psychotherapy, without the patient: 10 of 50 insurance plan rates Aetna — Acop: $152.03 Aetna — All Products First Health: $789 Aetna — Asa: $841.60 Aetna — Medicare Advantage: $99.12 Aetna — Qhp/Ifp: $1,052 AmeriHealth — Managed Medicaid: $63.43 Anthem — All Products Mid-Level Facility: $128.37 Anthem — All Products Mid-Level Non-Facility: $128.79 Anthem — All Products Physician: $326.02 Anthem — All Products Physician Facility: $326.02
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$482	$313.30	$126.06 – $497.49
Family psychotherapy, with the patient: 10 of 57 insurance plan rates AETNA — Acop: $289.20 AETNA — ALL PRODUCTS: $361.50 AETNA — Asa_Whirlpool_Peia: $337.40 AETNA — International: $337.40 AETNA — MEDICARE ADVANTAGE: $167.92 AETNA — Qhp/Ipf: $482 AMERIHEALTH — Managed Medicaid: $145.96 Amish Community Aid Plan — ALL PRODUCTS: $216.90 ANTHEM — HPN: $198.40 ANTHEM — Managed Medicaid: $139.32
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$1,096	$712.40	$278.49 – $1,096
Family psychotherapy, with the patient: 10 of 50 insurance plan rates Aetna — Acop: $158 Aetna — All Products First Health: $822 Aetna — Asa: $876.80 Aetna — Medicare Advantage: $102.81 Aetna — Qhp/Ifp: $1,096 AmeriHealth — Managed Medicaid: $74.48 Anthem — All Products Mid-Level Facility: $133.82 Anthem — All Products Mid-Level Non-Facility: $134.23 Anthem — All Products Physician: $339.89 Anthem — All Products Physician Facility: $339.89
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VIRTUAL VISIT FAMILY PSYTX W/PATIENT	$1,096	$712.40	$278.49 – $1,096
Family psychotherapy, with the patient: 10 of 50 insurance plan rates Aetna — Acop: $158 Aetna — All Products First Health: $822 Aetna — Asa: $876.80 Aetna — Medicare Advantage: $102.81 Aetna — Qhp/Ifp: $1,096 AmeriHealth — Managed Medicaid: $74.48 Anthem — All Products Mid-Level Facility: $133.82 Anthem — All Products Mid-Level Non-Facility: $134.23 Anthem — All Products Physician: $339.89 Anthem — All Products Physician Facility: $339.89
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IOP HALF DAY RATE	$834	$542.10	$235.86 – $834
Group psychotherapy: 10 of 59 insurance plan rates AETNA — Acop: $500.40 AETNA — ALL PRODUCTS: $625.50 AETNA — Asa_Whirlpool_Peia: $583.80 AETNA — International: $583.80 AETNA — MEDICARE ADVANTAGE: $96.11 AETNA — Qhp/Ipf: $834 AMERIHEALTH — Managed Medicaid: $121.10 Amish Community Aid Plan — ALL PRODUCTS: $375.30 ANTHEM — HPN: $46.85 ANTHEM — Managed Medicaid: $115.59
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VIRTUAL VISIT IOP HALF DAY RATE	$834	$542.10	$235.86 – $834
Group psychotherapy: 10 of 59 insurance plan rates AETNA — Acop: $500.40 AETNA — ALL PRODUCTS: $625.50 AETNA — Asa_Whirlpool_Peia: $583.80 AETNA — International: $583.80 AETNA — MEDICARE ADVANTAGE: $96.11 AETNA — Qhp/Ipf: $834 AMERIHEALTH — Managed Medicaid: $121.10 Amish Community Aid Plan — ALL PRODUCTS: $375.30 ANTHEM — HPN: $46.85 ANTHEM — Managed Medicaid: $115.59
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CD IOP DAY	$834	$542.10	$235.86 – $834
Group psychotherapy: 10 of 59 insurance plan rates AETNA — Acop: $500.40 AETNA — ALL PRODUCTS: $625.50 AETNA — Asa_Whirlpool_Peia: $583.80 AETNA — International: $583.80 AETNA — MEDICARE ADVANTAGE: $96.11 AETNA — Qhp/Ipf: $834 AMERIHEALTH — Managed Medicaid: $121.10 Amish Community Aid Plan — ALL PRODUCTS: $375.30 ANTHEM — HPN: $46.85 ANTHEM — Managed Medicaid: $115.59

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$11,488	$7,467.20	$679.17 – $10,974.37
Removal of breast growth (open surgery): 10 of 57 insurance plan rates AETNA — Acop: $5,355 AETNA — ALL PRODUCTS: $8,616 AETNA — Asa_Whirlpool_Peia: $6,249 AETNA — International: $6,561 AETNA — MEDICARE ADVANTAGE: $3,704.30 AETNA — Qhp/Ipf: $11,488 AMERIHEALTH — Managed Medicaid: $948.33 Amish Community Aid Plan — ALL PRODUCTS: $5,169.60 ANTHEM — HPN: $679.17 ANTHEM — Managed Medicaid: $905.23
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$2,368	$1,539.20	$601.71 – $2,368
Removal of breast growth (open surgery): 10 of 50 insurance plan rates Aetna — Acop: $692.54 Aetna — All Products First Health: $1,776 Aetna — Asa: $1,894.40 Aetna — Medicare Advantage: $395.68 Aetna — Qhp/Ifp: $2,368 AmeriHealth — Managed Medicaid: $236.59 Anthem — All Products Mid-Level Facility: $561.27 Anthem — All Products Mid-Level Non-Facility: $690.34 Anthem — All Products Physician: $1,425.50 Anthem — All Products Physician Facility: $1,425.50
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: REMOVAL OF BREAST LESION	$657	$427.05	$166.94 – $657
Removal of breast growth (open surgery): 10 of 50 insurance plan rates Aetna — Acop: $692.54 Aetna — All Products First Health: $492.75 Aetna — Asa: $525.60 Aetna — Medicare Advantage: $395.68 Aetna — Qhp/Ifp: $657 AmeriHealth — Managed Medicaid: $236.59 Anthem — All Products Mid-Level Facility: $561.27 Anthem — All Products Mid-Level Non-Facility: $690.34 Anthem — All Products Physician: $1,425.50 Anthem — All Products Physician Facility: $1,425.50
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$8,624	$5,605.60	$2,191.36 – $8,624
Total hip replacement: 10 of 47 insurance plan rates Aetna — All Products First Health: $6,468 Aetna — Asa: $6,899.20 Aetna — Medicare Advantage: $1,134.94 Aetna — Qhp/Ifp: $8,624 AmeriHealth — Managed Medicaid: $1,269.74 Anthem — All Products Mid-Level Facility: $1,721.01 Anthem — All Products Mid-Level Non-Facility: $1,721.01 Anthem — All Products Physician: $4,371.02 Anthem — All Products Physician Facility: $4,371.02 Anthem — All Products Physician Non-Facility: $4,371.02
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	$6,256.68 – $35,984.87
Total hip replacement: 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $12,146.38 ANTHEM — HPN: $30,587.02 ANTHEM — MEDICARE ADVANTAGE: $12,146.38 ANTHEM — PPO/HMO: $35,984.87 CIGNA — MEDICARE ADVANTAGE: $12,510.77 HUMANA — Medicare Advantage HMO: $11,888.68 MMO — ALL PRODUCTS: $33,402.55 MMO — Medicare Advantage HMO & PPO: $11,888.68 OPTUM — All Products VA: $11,888.68 Perennial Health — HMO I-SNP and HMO C-SNP: $13,118.09
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	$6,256.68 – $35,984.87
Total hip replacement: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $7,244.58 ANTHEM — Managed Medicaid: $6,915.28 Buckeye — Managed Medicaid: $6,585.98 CARESOURCE — Managed Medicaid: $6,585.98 MOLINA — Managed Medicaid: $6,915.28 OPTUM — Managed Medicaid Transplant: $6,256.68 UNITED — Managed Medicaid: $6,915.28 United BH — Managed Medicaid: $6,981.14
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$7,840	$5,096	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $22,471.68
Total knee replacement: 10 of 47 insurance plan rates Aetna — All Products First Health: $5,880 Aetna — Asa: $6,272 Aetna — Medicare Advantage: $1,132.39 Aetna — Qhp/Ifp: $7,840 AmeriHealth — Managed Medicaid: $1,350.81 Anthem — All Products Mid-Level Facility: $1,719.26 Anthem — All Products Mid-Level Non-Facility: $1,719.26 Anthem — All Products Physician: $4,366.55 Anthem — All Products Physician Facility: $4,366.55 Anthem — All Products Physician Non-Facility: $4,366.55
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	$6,256.68 – $35,984.87
Total knee replacement: 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $12,146.38 ANTHEM — HPN: $30,587.02 ANTHEM — MEDICARE ADVANTAGE: $12,146.38 ANTHEM — PPO/HMO: $35,984.87 CIGNA — MEDICARE ADVANTAGE: $12,510.77 HUMANA — Medicare Advantage HMO: $11,888.68 MMO — ALL PRODUCTS: $33,402.55 MMO — Medicare Advantage HMO & PPO: $11,888.68 OPTUM — All Products VA: $11,888.68 Perennial Health — HMO I-SNP and HMO C-SNP: $13,118.09
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	$6,256.68 – $35,984.87
Total knee replacement: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $7,244.58 ANTHEM — Managed Medicaid: $6,915.28 Buckeye — Managed Medicaid: $6,585.98 CARESOURCE — Managed Medicaid: $6,585.98 MOLINA — Managed Medicaid: $6,915.28 OPTUM — Managed Medicaid Transplant: $6,256.68 UNITED — Managed Medicaid: $6,915.28 United BH — Managed Medicaid: $6,981.14
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$1,320	$858	$335.41 – $1,320
Shoulder arthroscopy: shaving of shoulder bone: 10 of 47 insurance plan rates Aetna — All Products First Health: $990 Aetna — Asa: $1,056 Aetna — Medicare Advantage: $145.87 Aetna — Qhp/Ifp: $1,320 AmeriHealth — Managed Medicaid: $177.29 Anthem — All Products Mid-Level Facility: $231.06 Anthem — All Products Mid-Level Non-Facility: $231.06 Anthem — All Products Physician: $586.83 Anthem — All Products Physician Facility: $586.83 Anthem — All Products Physician Non-Facility: $586.83
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	$1,453.77 – $1,683.31
Shoulder arthroscopy: shaving of shoulder bone: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $1,683.31 ANTHEM — Managed Medicaid: $1,606.79 Buckeye — Managed Medicaid: $1,530.28 CARESOURCE — Managed Medicaid: $1,530.28 MOLINA — Managed Medicaid: $1,606.79 OPTUM — Managed Medicaid Transplant: $1,453.77 UNITED — Managed Medicaid: $1,606.79 United BH — Managed Medicaid: $1,622.10
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$3,093	$2,010.45	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,526.53
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 47 insurance plan rates Aetna — All Products First Health: $2,319.75 Aetna — Asa: $2,474.40 Aetna — Medicare Advantage: $497.66 Aetna — Qhp/Ifp: $3,093 AmeriHealth — Managed Medicaid: $499.32 Anthem — All Products Mid-Level Facility: $724.56 Anthem — All Products Mid-Level Non-Facility: $724.56 Anthem — All Products Physician: $1,840.22 Anthem — All Products Physician Facility: $1,840.22 Anthem — All Products Physician Non-Facility: $1,840.22
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$1,453.77 – $9,170.92
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $3,095.56 ANTHEM — HPN: $7,795.25 ANTHEM — MEDICARE ADVANTAGE: $3,095.56 ANTHEM — PPO/HMO: $9,170.92 CIGNA — MEDICARE ADVANTAGE: $3,188.43 HUMANA — Medicare Advantage HMO: $2,997.95 MMO — ALL PRODUCTS: $8,512.80 MMO — Medicare Advantage HMO & PPO: $2,997.95 OPTUM — All Products VA: $2,997.95 Perennial Health — HMO I-SNP and HMO C-SNP: $3,343.21
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrs kne srg mnisectmy m/l	Not listed in the file	Not listed in the file	$1,453.77 – $9,170.92
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $1,683.31 ANTHEM — Managed Medicaid: $1,606.79 Buckeye — Managed Medicaid: $1,530.28 CARESOURCE — Managed Medicaid: $1,530.28 MOLINA — Managed Medicaid: $1,606.79 OPTUM — Managed Medicaid Transplant: $1,453.77 UNITED — Managed Medicaid: $1,606.79 United BH — Managed Medicaid: $1,622.10
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$1,688	$1,097.20	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $9,999.36
Removal of tonsils and adenoids (under age 12): 10 of 47 insurance plan rates Aetna — All Products First Health: $1,266 Aetna — Asa: $1,350.40 Aetna — Medicare Advantage: $253.24 Aetna — Qhp/Ifp: $1,688 AmeriHealth — Managed Medicaid: $214.31 Anthem — All Products Mid-Level Facility: $389.53 Anthem — All Products Mid-Level Non-Facility: $389.53 Anthem — All Products Physician: $989.32 Anthem — All Products Physician Facility: $989.32 Anthem — All Products Physician Non-Facility: $989.32
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	$1,138.70 – $16,592.38
Removal of tonsils and adenoids (under age 12): 10 of 18 insurance plan rates AETNA — MEDICARE ADVANTAGE: $5,600.62 ANTHEM — HPN: $14,103.47 ANTHEM — MEDICARE ADVANTAGE: $5,600.62 ANTHEM — PPO/HMO: $16,592.38 CIGNA — MEDICARE ADVANTAGE: $5,768.63 HUMANA — Medicare Advantage HMO: $5,465.95 MMO — ALL PRODUCTS: $14,415.98 MMO — Medicare Advantage HMO & PPO: $5,465.95 OPTUM — All Products VA: $5,465.95 Perennial Health — HMO I-SNP and HMO C-SNP: $6,048.66
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	$1,138.70 – $16,592.38
Removal of tonsils and adenoids (under age 12): rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $1,318.49 ANTHEM — Managed Medicaid: $1,258.56 Buckeye — Managed Medicaid: $1,198.63 CARESOURCE — Managed Medicaid: $1,198.63 MOLINA — Managed Medicaid: $1,258.56 OPTUM — Managed Medicaid Transplant: $1,138.70 UNITED — Managed Medicaid: $1,258.56 United BH — Managed Medicaid: $1,270.55
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$4,313	$2,803.45	$1,219.72 – $4,313
Upper GI endoscopy (diagnostic): 10 of 57 insurance plan rates AETNA — Acop: $2,451 AETNA — ALL PRODUCTS: $3,234.75 AETNA — Asa_Whirlpool_Peia: $2,860 AETNA — International: $3,004 AETNA — MEDICARE ADVANTAGE: $858.08 AETNA — Qhp/Ipf: $4,313 AMERIHEALTH — Managed Medicaid: $717.17 Amish Community Aid Plan — ALL PRODUCTS: $1,940.85 ANTHEM — HPN: $204.68 ANTHEM — Managed Medicaid: $684.57
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$836	$543.40	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,548.29
Upper GI endoscopy (diagnostic): 10 of 50 insurance plan rates Aetna — Acop: $362.08 Aetna — All Products First Health: $627 Aetna — Asa: $668.80 Aetna — Medicare Advantage: $108.16 Aetna — Qhp/Ifp: $836 AmeriHealth — Managed Medicaid: $136.66 Anthem — All Products Mid-Level Facility: $161.64 Anthem — All Products Mid-Level Non-Facility: $374.38 Anthem — All Products Physician: $410.55 Anthem — All Products Physician Facility: $410.55
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: UPPR GI ENDOSCOPY, DIAGNOSIS	$468	$304.20	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,548.29
Upper GI endoscopy (diagnostic): 10 of 50 insurance plan rates Aetna — Acop: $362.08 Aetna — All Products First Health: $351 Aetna — Asa: $374.40 Aetna — Medicare Advantage: $108.16 Aetna — Qhp/Ifp: $468 AmeriHealth — Managed Medicaid: $136.66 Anthem — All Products Mid-Level Facility: $161.64 Anthem — All Products Mid-Level Non-Facility: $374.38 Anthem — All Products Physician: $410.55 Anthem — All Products Physician Facility: $410.55
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$1,052	$683.80	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,548.29
Upper GI endoscopy with biopsy: 10 of 50 insurance plan rates Aetna — Acop: $482.89 Aetna — All Products First Health: $789 Aetna — Asa: $841.60 Aetna — Medicare Advantage: $121.06 Aetna — Qhp/Ifp: $1,052 AmeriHealth — Managed Medicaid: $153.79 Anthem — All Products Mid-Level Facility: $182.43 Anthem — All Products Mid-Level Non-Facility: $488.50 Anthem — All Products Physician: $463.30 Anthem — All Products Physician Facility: $463.30
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: UPPER GI ENDOSCOPY, BIOPSY	$508	$330.20	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,548.29
Upper GI endoscopy with biopsy: 10 of 50 insurance plan rates Aetna — Acop: $482.89 Aetna — All Products First Health: $381 Aetna — Asa: $406.40 Aetna — Medicare Advantage: $121.06 Aetna — Qhp/Ifp: $508 AmeriHealth — Managed Medicaid: $153.79 Anthem — All Products Mid-Level Facility: $182.43 Anthem — All Products Mid-Level Non-Facility: $488.50 Anthem — All Products Physician: $463.30 Anthem — All Products Physician Facility: $463.30
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	$619.37 – $4,831
Upper GI endoscopy with biopsy: 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $858.08 ANTHEM — HPN: $2,160.81 ANTHEM — MEDICARE ADVANTAGE: $858.08 ANTHEM — PPO/HMO: $2,542.14 CIGNA — MEDICARE ADVANTAGE: $883.82 HUMANA — Medicare Advantage HMO: $866.29 MMO — ALL PRODUCTS: $2,359.71 MMO — Medicare Advantage HMO & PPO: $866.29 OPTUM — All Products VA: $866.29 Perennial Health — HMO I-SNP and HMO C-SNP: $926.72
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$1,434	$932.10	$364.38 – $1,434
Colonoscopy (diagnostic): 10 of 50 insurance plan rates Aetna — Acop: $440.43 Aetna — All Products First Health: $1,075.50 Aetna — Asa: $1,147.20 Aetna — Medicare Advantage: $161.68 Aetna — Qhp/Ifp: $1,434 AmeriHealth — Managed Medicaid: $102.78 Anthem — All Products Mid-Level Facility: $244.03 Anthem — All Products Mid-Level Non-Facility: $444.58 Anthem — All Products Physician: $619.79 Anthem — All Products Physician Facility: $619.79
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY	$630	$409.50	$160.08 – $630
Colonoscopy (diagnostic): 10 of 50 insurance plan rates Aetna — Acop: $440.43 Aetna — All Products First Health: $472.50 Aetna — Asa: $504 Aetna — Medicare Advantage: $161.68 Aetna — Qhp/Ifp: $630 AmeriHealth — Managed Medicaid: $102.78 Anthem — All Products Mid-Level Facility: $244.03 Anthem — All Products Mid-Level Non-Facility: $444.58 Anthem — All Products Physician: $619.79 Anthem — All Products Physician Facility: $619.79
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	$706.64 – $4,831
Colonoscopy (diagnostic): 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $879.81 ANTHEM — HPN: $2,215.54 ANTHEM — MEDICARE ADVANTAGE: $879.81 ANTHEM — PPO/HMO: $2,606.53 CIGNA — MEDICARE ADVANTAGE: $906.21 HUMANA — Medicare Advantage HMO: $842.40 MMO — ALL PRODUCTS: $2,264.64 MMO — Medicare Advantage HMO & PPO: $842.40 OPTUM — All Products VA: $842.40 Perennial Health — HMO I-SNP and HMO C-SNP: $950.20
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$1,566	$1,017.90	$397.92 – $1,566
Colonoscopy with biopsy: 10 of 50 insurance plan rates Aetna — Acop: $562.48 Aetna — All Products First Health: $1,174.50 Aetna — Asa: $1,252.80 Aetna — Medicare Advantage: $174.52 Aetna — Qhp/Ifp: $1,566 AmeriHealth — Managed Medicaid: $223.07 Anthem — All Products Mid-Level Facility: $265.15 Anthem — All Products Mid-Level Non-Facility: $565.76 Anthem — All Products Physician: $673.42 Anthem — All Products Physician Facility: $673.42
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY AND BIOPSY	$706	$458.90	$179.39 – $706
Colonoscopy with biopsy: 10 of 50 insurance plan rates Aetna — Acop: $562.48 Aetna — All Products First Health: $529.50 Aetna — Asa: $564.80 Aetna — Medicare Advantage: $174.52 Aetna — Qhp/Ifp: $706 AmeriHealth — Managed Medicaid: $223.07 Anthem — All Products Mid-Level Facility: $265.15 Anthem — All Products Mid-Level Non-Facility: $565.76 Anthem — All Products Physician: $673.42 Anthem — All Products Physician Facility: $673.42
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	$706.64 – $4,831
Colonoscopy with biopsy: 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $1,132.12 ANTHEM — HPN: $2,850.89 ANTHEM — MEDICARE ADVANTAGE: $1,132.12 ANTHEM — PPO/HMO: $3,354 CIGNA — MEDICARE ADVANTAGE: $1,166.08 HUMANA — Medicare Advantage HMO: $1,089.45 MMO — ALL PRODUCTS: $2,914.06 MMO — Medicare Advantage HMO & PPO: $1,089.45 OPTUM — All Products VA: $1,089.45 Perennial Health — HMO I-SNP and HMO C-SNP: $1,222.68
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$2,011	$1,307.15	$511 – $2,011
Colonoscopy with removal of polyps (snare): 10 of 50 insurance plan rates Aetna — Acop: $594.64 Aetna — All Products First Health: $1,508.25 Aetna — Asa: $1,608.80 Aetna — Medicare Advantage: $219.68 Aetna — Qhp/Ifp: $2,011 AmeriHealth — Managed Medicaid: $283.60 Anthem — All Products Mid-Level Facility: $335.61 Anthem — All Products Mid-Level Non-Facility: $594.58 Anthem — All Products Physician: $852.36 Anthem — All Products Physician Facility: $852.36
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LESION REMOVAL COLONOSCOPY	$970	$630.50	$246.48 – $970
Colonoscopy with removal of polyps (snare): 10 of 50 insurance plan rates Aetna — Acop: $594.64 Aetna — All Products First Health: $727.50 Aetna — Asa: $776 Aetna — Medicare Advantage: $219.68 Aetna — Qhp/Ifp: $970 AmeriHealth — Managed Medicaid: $283.60 Anthem — All Products Mid-Level Facility: $335.61 Anthem — All Products Mid-Level Non-Facility: $594.58 Anthem — All Products Physician: $852.36 Anthem — All Products Physician Facility: $852.36
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	$706.64 – $4,831
Colonoscopy with removal of polyps (snare): 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $1,132.12 ANTHEM — HPN: $2,850.89 ANTHEM — MEDICARE ADVANTAGE: $1,132.12 ANTHEM — PPO/HMO: $3,354 CIGNA — MEDICARE ADVANTAGE: $1,166.08 HUMANA — Medicare Advantage HMO: $1,089.45 MMO — ALL PRODUCTS: $2,914.06 MMO — Medicare Advantage HMO & PPO: $1,089.45 OPTUM — All Products VA: $1,089.45 Perennial Health — HMO I-SNP and HMO C-SNP: $1,222.68
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$1,856	$1,206.40	$471.61 – $1,856
Ultrasound of the lower bowel by endoscope: 10 of 47 insurance plan rates Aetna — All Products First Health: $1,392 Aetna — Asa: $1,484.80 Aetna — Medicare Advantage: $222.24 Aetna — Qhp/Ifp: $1,856 AmeriHealth — Managed Medicaid: $229.80 Anthem — All Products Mid-Level Facility: $340.43 Anthem — All Products Mid-Level Non-Facility: $340.43 Anthem — All Products Physician: $864.63 Anthem — All Products Physician Facility: $864.63 Anthem — All Products Physician Non-Facility: $864.63
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	$706.64 – $3,354
Ultrasound of the lower bowel by endoscope: 10 of 18 insurance plan rates AETNA — MEDICARE ADVANTAGE: $1,132.12 ANTHEM — HPN: $2,850.89 ANTHEM — MEDICARE ADVANTAGE: $1,132.12 ANTHEM — PPO/HMO: $3,354 CIGNA — MEDICARE ADVANTAGE: $1,166.08 HUMANA — Medicare Advantage HMO: $1,089.45 MMO — ALL PRODUCTS: $3,113.32 MMO — Medicare Advantage HMO & PPO: $1,089.45 OPTUM — All Products VA: $1,089.45 Perennial Health — HMO I-SNP and HMO C-SNP: $1,222.68
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	$706.64 – $3,354
Ultrasound of the lower bowel by endoscope: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $818.21 ANTHEM — Managed Medicaid: $781.02 Buckeye — Managed Medicaid: $743.83 CARESOURCE — Managed Medicaid: $743.83 MOLINA — Managed Medicaid: $781.02 OPTUM — Managed Medicaid Transplant: $706.64 UNITED — Managed Medicaid: $781.02 United BH — Managed Medicaid: $788.46
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY SCRN NOT HIGH RISK	$1,434	$932.10	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,560.83
Screening colonoscopy (not high risk): 10 of 42 insurance plan rates Aetna — Acop: $440.43 Aetna — All Products First Health: $1,075.50 Aetna — Asa: $1,147.20 Aetna — Medicare Advantage: $162.02 Aetna — Qhp/Ifp: $1,434 Anthem — All Products Mid-Level Facility: $244.52 Anthem — All Products Mid-Level Non-Facility: $445.06 Anthem — All Products Physician: $621.03 Anthem — All Products Physician Facility: $621.03 Anthem — All Products Physician Non-Facility: $1,130.36
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY MCR SCREENING	$657	$427.05	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,560.83
Screening colonoscopy (not high risk): 10 of 42 insurance plan rates Aetna — Acop: $440.43 Aetna — All Products First Health: $492.75 Aetna — Asa: $525.60 Aetna — Medicare Advantage: $162.02 Aetna — Qhp/Ifp: $657 Anthem — All Products Mid-Level Facility: $244.52 Anthem — All Products Mid-Level Non-Facility: $445.06 Anthem — All Products Physician: $621.03 Anthem — All Products Physician Facility: $621.03 Anthem — All Products Physician Non-Facility: $1,130.36
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	$706.64 – $2,606.53
Screening colonoscopy (not high risk): 10 of 26 insurance plan rates AETNA — MEDICARE ADVANTAGE: $879.81 AMERIHEALTH — Managed Medicaid: $818.21 ANTHEM — HPN: $2,215.54 ANTHEM — Managed Medicaid: $781.02 ANTHEM — MEDICARE ADVANTAGE: $879.81 ANTHEM — PPO/HMO: $2,606.53 Buckeye — Managed Medicaid: $743.83 CARESOURCE — Managed Medicaid: $743.83 CIGNA — MEDICARE ADVANTAGE: $906.21 HUMANA — Medicare Advantage HMO: $842.40
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LAPAROSCOPY SURG CHOLECYSTECTOMY	$4,188	$2,722.20	$1,064.17 – $4,188
Gallbladder removal by laparoscope: 10 of 47 insurance plan rates Aetna — All Products First Health: $3,141 Aetna — Asa: $3,350.40 Aetna — Medicare Advantage: $618.18 Aetna — Qhp/Ifp: $4,188 AmeriHealth — Managed Medicaid: $567.25 Anthem — All Products Mid-Level Facility: $891.09 Anthem — All Products Mid-Level Non-Facility: $891.09 Anthem — All Products Physician: $2,263.18 Anthem — All Products Physician Facility: $2,263.18 Anthem — All Products Physician Non-Facility: $2,263.18
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	$1,406	$913.90	$357.26 – $1,406
Gallbladder removal by laparoscope: 10 of 47 insurance plan rates Aetna — All Products First Health: $1,054.50 Aetna — Asa: $1,124.80 Aetna — Medicare Advantage: $618.18 Aetna — Qhp/Ifp: $1,406 AmeriHealth — Managed Medicaid: $567.25 Anthem — All Products Mid-Level Facility: $891.09 Anthem — All Products Mid-Level Non-Facility: $891.09 Anthem — All Products Physician: $2,263.18 Anthem — All Products Physician Facility: $2,263.18 Anthem — All Products Physician Non-Facility: $2,263.18
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	$2,399.58 – $16,944.69
Gallbladder removal by laparoscope: 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $5,719.53 ANTHEM — HPN: $14,402.93 ANTHEM — MEDICARE ADVANTAGE: $5,719.53 ANTHEM — PPO/HMO: $16,944.69 CIGNA — MEDICARE ADVANTAGE: $5,891.12 HUMANA — Medicare Advantage HMO: $5,390.83 MMO — ALL PRODUCTS: $15,728.72 MMO — Medicare Advantage HMO & PPO: $5,390.83 OPTUM — All Products VA: $5,390.83 Perennial Health — HMO I-SNP and HMO C-SNP: $6,177.10
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$3,184	$2,069.60	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,906.43
Groin (inguinal) hernia repair, age 5 or older: 10 of 47 insurance plan rates Aetna — All Products First Health: $2,388 Aetna — Asa: $2,547.20 Aetna — Medicare Advantage: $495.34 Aetna — Qhp/Ifp: $3,184 AmeriHealth — Managed Medicaid: $345.06 Anthem — All Products Mid-Level Facility: $706.53 Anthem — All Products Mid-Level Non-Facility: $706.53 Anthem — All Products Physician: $1,794.42 Anthem — All Products Physician Facility: $1,794.42 Anthem — All Products Physician Non-Facility: $1,794.42
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: REPAIR INGUINAL HERNIA	$1,050	$682.50	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,906.43
Groin (inguinal) hernia repair, age 5 or older: 10 of 47 insurance plan rates Aetna — All Products First Health: $787.50 Aetna — Asa: $840 Aetna — Medicare Advantage: $495.34 Aetna — Qhp/Ifp: $1,050 AmeriHealth — Managed Medicaid: $345.06 Anthem — All Products Mid-Level Facility: $706.53 Anthem — All Products Mid-Level Non-Facility: $706.53 Anthem — All Products Physician: $1,794.42 Anthem — All Products Physician Facility: $1,794.42 Anthem — All Products Physician Non-Facility: $1,794.42
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	$1,934.06 – $10,035.32
Groin (inguinal) hernia repair, age 5 or older: 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $3,387.33 ANTHEM — HPN: $8,529.99 ANTHEM — MEDICARE ADVANTAGE: $3,387.33 ANTHEM — PPO/HMO: $10,035.32 CIGNA — MEDICARE ADVANTAGE: $3,488.95 HUMANA — Medicare Advantage HMO: $3,260.78 MMO — ALL PRODUCTS: $8,719 MMO — Medicare Advantage HMO & PPO: $3,260.78 OPTUM — All Products VA: $3,260.78 Perennial Health — HMO I-SNP and HMO C-SNP: $3,658.32
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate	Not listed in the file	Not listed in the file	$895.32 – $4,831
Prostate biopsy: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $1,036.68 ANTHEM — Managed Medicaid: $989.56 Buckeye — Managed Medicaid: $942.44 CARESOURCE — Managed Medicaid: $942.44 MOLINA — Managed Medicaid: $989.56 OPTUM — Managed Medicaid Transplant: $895.32 UNITED — Managed Medicaid: $989.56 United BH — Managed Medicaid: $998.99
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$895.32 – $4,831
Prostate biopsy: rates for 7 insurance plans HUMANA — Medicare Advantage HMO: $1,892.78 MMO — Medicare Advantage HMO & PPO: $1,892.78 OPTUM — All Products VA: $1,892.78 Perennial Health — MEDICARE ADVANTAGE: $2,044.20 The Health Plan — MEDICARE ADVANTAGE: $1,959.03 UNITED — ALL PRODUCTS: $4,831 UNITED — MEDICARE ADVANTAGE: $1,892.78
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT	$9,882	$6,423.30	$2,511.02 – $9,882
Prostate removal by laparoscope (radical prostatectomy): 10 of 47 insurance plan rates Aetna — All Products First Health: $7,411.50 Aetna — Asa: $7,905.60 Aetna — Medicare Advantage: $1,065.64 Aetna — Qhp/Ifp: $9,882 AmeriHealth — Managed Medicaid: $1,221.73 Anthem — All Products Mid-Level Facility: $1,588.88 Anthem — All Products Mid-Level Non-Facility: $1,588.88 Anthem — All Products Physician: $4,035.41 Anthem — All Products Physician Facility: $4,035.41 Anthem — All Products Physician Non-Facility: $4,035.41
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	$2,607.32 – $29,793.81
Prostate removal by laparoscope (radical prostatectomy): 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $10,056.64 ANTHEM — HPN: $25,324.64 ANTHEM — MEDICARE ADVANTAGE: $10,056.64 ANTHEM — PPO/HMO: $29,793.81 CIGNA — MEDICARE ADVANTAGE: $10,358.34 HUMANA — Medicare Advantage HMO: $9,619.76 MMO — ALL PRODUCTS: $27,655.77 MMO — Medicare Advantage HMO & PPO: $9,619.76 OPTUM — All Products VA: $9,619.76 Perennial Health — HMO I-SNP and HMO C-SNP: $10,861.17
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	$2,607.32 – $29,793.81
Prostate removal by laparoscope (radical prostatectomy): rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $3,019.01 ANTHEM — Managed Medicaid: $2,881.78 Buckeye — Managed Medicaid: $2,744.55 CARESOURCE — Managed Medicaid: $2,744.55 MOLINA — Managed Medicaid: $2,881.78 OPTUM — Managed Medicaid Transplant: $2,607.32 UNITED — Managed Medicaid: $2,881.78 United BH — Managed Medicaid: $2,909.22
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$1,835	$1,192.75	$466.27 – $1,835
Hysteroscopy with biopsy of the uterus lining: 10 of 50 insurance plan rates Aetna — Acop: $1,818.12 Aetna — All Products First Health: $1,376.25 Aetna — Asa: $1,468 Aetna — Medicare Advantage: $201.74 Aetna — Qhp/Ifp: $1,835 AmeriHealth — Managed Medicaid: $129.43 Anthem — All Products Mid-Level Facility: $311.41 Anthem — All Products Mid-Level Non-Facility: $1,724.50 Anthem — All Products Physician: $790.90 Anthem — All Products Physician Facility: $790.90
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	$1,352.51 – $9,073.17
Hysteroscopy with biopsy of the uterus lining: 10 of 19 insurance plan rates AETNA — MEDICARE ADVANTAGE: $3,062.57 ANTHEM — HPN: $7,712.16 ANTHEM — MEDICARE ADVANTAGE: $3,062.57 ANTHEM — PPO/HMO: $9,073.17 CIGNA — MEDICARE ADVANTAGE: $3,154.45 HUMANA — Medicare Advantage HMO: $2,937.82 MMO — ALL PRODUCTS: $8,422.07 MMO — Medicare Advantage HMO & PPO: $2,937.82 OPTUM — All Products VA: $2,937.82 Perennial Health — HMO I-SNP and HMO C-SNP: $3,307.58
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	$1,352.51 – $9,073.17
Hysteroscopy with biopsy of the uterus lining: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $1,566.06 ANTHEM — Managed Medicaid: $1,494.87 Buckeye — Managed Medicaid: $1,423.69 CARESOURCE — Managed Medicaid: $1,423.69 MOLINA — Managed Medicaid: $1,494.87 OPTUM — Managed Medicaid Transplant: $1,352.51 UNITED — Managed Medicaid: $1,494.87 United BH — Managed Medicaid: $1,509.11
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$4,778	$3,105.70	$1,351.22 – $4,778
Spinal injection, lower back (epidural), with imaging guidance: 10 of 57 insurance plan rates AETNA — Acop: $2,451 AETNA — ALL PRODUCTS: $3,583.50 AETNA — Asa_Whirlpool_Peia: $2,860 AETNA — International: $3,004 AETNA — MEDICARE ADVANTAGE: $667.82 AETNA — Qhp/Ipf: $4,778 AMERIHEALTH — Managed Medicaid: $519.78 Amish Community Aid Plan — ALL PRODUCTS: $2,150.10 ANTHEM — HPN: $169.43 ANTHEM — Managed Medicaid: $496.16
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$792	$514.80	$201.25 – $792
Spinal injection, lower back (epidural), with imaging guidance: 10 of 50 insurance plan rates Aetna — Acop: $337.20 Aetna — All Products First Health: $594 Aetna — Asa: $633.60 Aetna — Medicare Advantage: $87.51 Aetna — Qhp/Ifp: $792 AmeriHealth — Managed Medicaid: $88.96 Anthem — All Products Mid-Level Facility: $131.33 Anthem — All Products Mid-Level Non-Facility: $333.97 Anthem — All Products Physician: $333.53 Anthem — All Products Physician Facility: $333.53
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$4,778	$3,105.70	$1,351.22 – $4,778
Spinal injection, lower back (epidural), with imaging guidance: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $2,389 ANTHEM — TRADITIONAL: $2,726.80 OSCAR — ALL PRODUCTS: $1,724.38
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$6,143	$3,992.95	$1,737.24 – $6,143
Nerve root injection, lower back, with imaging guidance: 10 of 57 insurance plan rates AETNA — Acop: $2,451 AETNA — ALL PRODUCTS: $4,607.25 AETNA — Asa_Whirlpool_Peia: $2,860 AETNA — International: $3,004 AETNA — MEDICARE ADVANTAGE: $836.78 AETNA — Qhp/Ipf: $6,143 AMERIHEALTH — Managed Medicaid: $519.78 Amish Community Aid Plan — ALL PRODUCTS: $2,764.35 ANTHEM — HPN: $188.46 ANTHEM — Managed Medicaid: $496.16
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$836	$543.40	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,555.46
Nerve root injection, lower back, with imaging guidance: 10 of 50 insurance plan rates Aetna — Acop: $306.59 Aetna — All Products First Health: $627 Aetna — Asa: $668.80 Aetna — Medicare Advantage: $97.27 Aetna — Qhp/Ifp: $836 AmeriHealth — Managed Medicaid: $62.05 Anthem — All Products Mid-Level Facility: $146.45 Anthem — All Products Mid-Level Non-Facility: $318.40 Anthem — All Products Physician: $371.94 Anthem — All Products Physician Facility: $371.94
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$6,143	$3,992.95	$1,737.24 – $6,143
Nerve root injection, lower back, with imaging guidance: rates for 3 insurance plans Amish Community Aid Plan — ALL PRODUCTS: $3,071.50 ANTHEM — TRADITIONAL: $3,505.81 OSCAR — ALL PRODUCTS: $2,217.01
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$1,988	$1,292.20	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,297.28
Carpal tunnel release: 10 of 50 insurance plan rates Aetna — Acop: $601.27 Aetna — All Products First Health: $1,491 Aetna — Asa: $1,590.40 Aetna — Medicare Advantage: $405.62 Aetna — Qhp/Ifp: $1,988 AmeriHealth — Managed Medicaid: $289.34 Anthem — All Products Mid-Level Facility: $581.89 Anthem — All Products Mid-Level Non-Facility: $591.98 Anthem — All Products Physician: $1,477.88 Anthem — All Products Physician Facility: $1,477.88
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	$865.36 – $5,473.19
Carpal tunnel release: 10 of 18 insurance plan rates AETNA — MEDICARE ADVANTAGE: $1,847.43 ANTHEM — HPN: $4,652.19 ANTHEM — MEDICARE ADVANTAGE: $1,847.43 ANTHEM — PPO/HMO: $5,473.19 CIGNA — MEDICARE ADVANTAGE: $1,902.85 HUMANA — Medicare Advantage HMO: $1,804.32 MMO — ALL PRODUCTS: $5,080.43 MMO — Medicare Advantage HMO & PPO: $1,804.32 OPTUM — All Products VA: $1,804.32 Perennial Health — HMO I-SNP and HMO C-SNP: $1,995.22
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	$865.36 – $5,473.19
Carpal tunnel release: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $1,002 ANTHEM — Managed Medicaid: $956.46 Buckeye — Managed Medicaid: $910.91 CARESOURCE — Managed Medicaid: $910.91 MOLINA — Managed Medicaid: $956.46 OPTUM — Managed Medicaid Transplant: $865.36 UNITED — Managed Medicaid: $956.46 United BH — Managed Medicaid: $965.56
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	$252.71 – $1,541.56
Laser treatment of clouding after cataract surgery: 10 of 18 insurance plan rates AETNA — MEDICARE ADVANTAGE: $520.34 ANTHEM — HPN: $1,310.32 ANTHEM — MEDICARE ADVANTAGE: $520.34 ANTHEM — PPO/HMO: $1,541.56 CIGNA — MEDICARE ADVANTAGE: $535.95 HUMANA — Medicare Advantage HMO: $506.90 MMO — ALL PRODUCTS: $1,430.93 MMO — Medicare Advantage HMO & PPO: $506.90 OPTUM — All Products VA: $506.90 Perennial Health — HMO I-SNP and HMO C-SNP: $561.97
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	$252.71 – $1,541.56
Laser treatment of clouding after cataract surgery: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $292.61 ANTHEM — Managed Medicaid: $279.31 Buckeye — Managed Medicaid: $266.01 CARESOURCE — Managed Medicaid: $266.01 MOLINA — Managed Medicaid: $279.31 OPTUM — Managed Medicaid Transplant: $252.71 UNITED — Managed Medicaid: $279.31 United BH — Managed Medicaid: $281.97
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$3,234	$2,102.10	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,978.24
Cataract removal with lens implant: 10 of 47 insurance plan rates Aetna — All Products First Health: $2,425.50 Aetna — Asa: $2,587.20 Aetna — Medicare Advantage: $447.12 Aetna — Qhp/Ifp: $3,234 AmeriHealth — Managed Medicaid: $597.91 Anthem — All Products Mid-Level Facility: $705.93 Anthem — All Products Mid-Level Non-Facility: $705.93 Anthem — All Products Physician: $1,792.94 Anthem — All Products Physician Facility: $1,792.94 Anthem — All Products Physician Non-Facility: $1,792.94
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	$1,047.84 – $6,468.48
Cataract removal with lens implant: 10 of 18 insurance plan rates AETNA — MEDICARE ADVANTAGE: $2,183.38 ANTHEM — HPN: $5,498.19 ANTHEM — MEDICARE ADVANTAGE: $2,183.38 ANTHEM — PPO/HMO: $6,468.48 CIGNA — MEDICARE ADVANTAGE: $2,248.88 HUMANA — Medicare Advantage HMO: $2,107.35 MMO — ALL PRODUCTS: $6,004.29 MMO — Medicare Advantage HMO & PPO: $2,107.35 OPTUM — All Products VA: $2,107.35 Perennial Health — HMO I-SNP and HMO C-SNP: $2,358.05
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	$1,047.84 – $6,468.48
Cataract removal with lens implant: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $1,213.29 ANTHEM — Managed Medicaid: $1,158.14 Buckeye — Managed Medicaid: $1,102.99 CARESOURCE — Managed Medicaid: $1,102.99 MOLINA — Managed Medicaid: $1,158.14 OPTUM — Managed Medicaid Transplant: $1,047.84 UNITED — Managed Medicaid: $1,158.14 United BH — Managed Medicaid: $1,169.17

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$14,800	$9,620	$3,760.68 – $14,800
Vaginal delivery, with care before and after: 10 of 47 insurance plan rates Aetna — All Products First Health: $11,100 Aetna — Asa: $11,840 Aetna — Medicare Advantage: $2,173.57 Aetna — Qhp/Ifp: $14,800 AmeriHealth — Managed Medicaid: $2,868.80 Anthem — All Products Mid-Level Facility: $3,238.88 Anthem — All Products Mid-Level Non-Facility: $3,238.88 Anthem — All Products Physician: $8,226.07 Anthem — All Products Physician Facility: $8,226.07 Anthem — All Products Physician Non-Facility: $8,226.07
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	$1,825.19 – $2,113.38
Vaginal delivery, with care before and after: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $2,113.38 ANTHEM — Managed Medicaid: $2,017.31 Buckeye — Managed Medicaid: $1,921.25 CARESOURCE — Managed Medicaid: $1,921.25 MOLINA — Managed Medicaid: $2,017.31 OPTUM — Managed Medicaid Transplant: $1,825.19 UNITED — Managed Medicaid: $2,017.31 United BH — Managed Medicaid: $2,036.53
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$16,420	$10,673	$4,172.32 – $16,420
Cesarean delivery (C-section), with care before and after: 10 of 41 insurance plan rates Aetna — All Products First Health: $12,315 Aetna — Asa: $13,136 Aetna — Medicare Advantage: $2,430.76 Aetna — Qhp/Ifp: $16,420 Anthem — All Products Mid-Level Facility: $3,590.94 Anthem — All Products Mid-Level Non-Facility: $3,590.94 Anthem — All Products Physician: $9,120.23 Anthem — All Products Physician Facility: $9,120.23 Anthem — All Products Physician Non-Facility: $9,120.23 Anthem — Medicare Advantage: $2,430.76
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	$1,267.71 – $1,467.87
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $1,467.87 ANTHEM — Managed Medicaid: $1,401.15 Buckeye — Managed Medicaid: $1,334.43 CARESOURCE — Managed Medicaid: $1,334.43 MOLINA — Managed Medicaid: $1,401.15 OPTUM — Managed Medicaid Transplant: $1,267.71 UNITED — Managed Medicaid: $1,401.15 United BH — Managed Medicaid: $1,414.50
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$15,484	$10,064.60	$1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $8,636.13
Vaginal delivery after a previous C-section, with care before and after: 10 of 41 insurance plan rates Aetna — All Products First Health: $11,613 Aetna — Asa: $12,387.20 Aetna — Medicare Advantage: $2,291.27 Aetna — Qhp/Ifp: $15,484 Anthem — All Products Mid-Level Facility: $3,400.33 Anthem — All Products Mid-Level Non-Facility: $3,400.33 Anthem — All Products Physician: $8,636.13 Anthem — All Products Physician Facility: $8,636.13 Anthem — All Products Physician Non-Facility: $8,636.13 Anthem — Medicare Advantage: $2,291.27
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	$1,825.19 – $2,113.38
Vaginal delivery after a previous C-section, with care before and after: rates for 8 insurance plans AMERIHEALTH — Managed Medicaid: $2,113.38 ANTHEM — Managed Medicaid: $2,017.31 Buckeye — Managed Medicaid: $1,921.25 CARESOURCE — Managed Medicaid: $1,921.25 MOLINA — Managed Medicaid: $2,017.31 OPTUM — Managed Medicaid Transplant: $1,825.19 UNITED — Managed Medicaid: $2,017.31 United BH — Managed Medicaid: $2,036.53

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$12,109 – $283,600
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 37 insurance plan rates AETNA — Acop: $98,796.50 AETNA — Asa_Whirlpool_Peia: $111,093.48 AETNA — International: $121,062.15 AETNA — MEDICARE ADVANTAGE: $79,762.56 ANTHEM — HPN: $12,109 ANTHEM — MEDICARE ADVANTAGE: $79,762.56 ANTHEM — PPO/HMO: $14,246 CIGNA — MEDICARE ADVANTAGE: $82,155.44 HUMANA — Medicare Advantage HMO: $79,762.56 Medical Benefit Corp — Transplant SMCP: $283,600
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major joint replacement or reattachment of lower extremity w/o MCC	Not listed in the file	Not listed in the file	$12,374 – $60,600
Hip or knee replacement (major joint of the leg), without major complications: 10 of 21 insurance plan rates AETNA — Acop: $30,439 AETNA — Asa_Whirlpool_Peia: $35,522 AETNA — International: $37,297 ANTHEM — HPN: $12,374 ANTHEM — PPO/HMO: $14,557.11 Medical Benefit Corp — Transplant SMCP: $60,600 MMO — ALL PRODUCTS: $18,856 The Health Plan — HMO: $19,468.39 UNITED — ALL PRODUCTS: $22,852 AETNA — ALL PRODUCTS: 75% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$12,374 – $60,600
Hip or knee replacement (major joint of the leg), without major complications: 10 of 16 insurance plan rates AETNA — MEDICARE ADVANTAGE: $16,409.13 ANTHEM — MEDICARE ADVANTAGE: $16,409.13 CIGNA — MEDICARE ADVANTAGE: $16,901.40 HUMANA — Medicare Advantage HMO: $16,409.13 MMO — Medicare Advantage HMO & PPO: $16,409.13 OPTUM — All Products VA: $16,409.13 Perennial Health — HMO I-SNP and HMO C-SNP: $17,721.86 Perennial Health — MEDICARE ADVANTAGE: $17,721.86 PPHP — ALL PRODUCTS: $18,050.04 Summacare — MEDICARE ADVANTAGE: $16,409.13
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$12,109 – $83,000
Neck (cervical) spinal fusion, without complications: 10 of 37 insurance plan rates AETNA — Acop: $34,878 AETNA — Asa_Whirlpool_Peia: $40,702 AETNA — International: $42,736 AETNA — MEDICARE ADVANTAGE: $20,542.40 ANTHEM — HPN: $12,109 ANTHEM — MEDICARE ADVANTAGE: $20,542.40 ANTHEM — PPO/HMO: $14,246 CIGNA — MEDICARE ADVANTAGE: $21,158.67 HUMANA — Medicare Advantage HMO: $20,542.40 Medical Benefit Corp — Transplant SMCP: $83,000
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$10,399 – $20,692.39
Uterus and ovary surgery (not for cancer), without complications: 10 of 36 insurance plan rates AETNA — Acop: $10,576 AETNA — Asa_Whirlpool_Peia: $12,342 AETNA — International: $12,959 AETNA — MEDICARE ADVANTAGE: $10,857.77 ANTHEM — HPN: $10,399 ANTHEM — MEDICARE ADVANTAGE: $10,857.77 ANTHEM — PPO/HMO: $12,234 CIGNA — MEDICARE ADVANTAGE: $11,183.50 HUMANA — Medicare Advantage HMO: $10,857.77 MMO — ALL PRODUCTS: $18,605.54

Source: Akron General Medical Center’s standard charges file (clevelandclinic.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 15, 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 type	Acute Care Hospital
Address	1 Akron General Avenue, Akron, OH 44307
County	Summit County
State	Ohio
Phone	(330) 344‑6000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	5 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	360027
Name in Medicare records	AKRON GENERAL MEDICAL CENTER
Profile level	Medicare data + hospital website
Name on the hospital’s website	Cleveland Clinic Akron General
Official website	my.clevelandclinic.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

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

Akron General specialties — my.clevelandclinic.org

Akron General Medical Center

Summary

Profile from official sources

At a glance