Does Beebe Medical Center have an emergency room?

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

Where is Beebe Medical Center?

424 Savannah Rd, Lewes, DE 19958, in Sussex County, Delaware.

What is the phone number of Beebe Medical Center?

(302) 645-3300, as listed by Medicare (CMS).

What is the Medicare star rating of Beebe Medical Center?

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

Beebe Medical Center — Lewes, DE

Quick answers

Does Beebe Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Beebe Medical Center. In a medical emergency, call 911.
Where is Beebe Medical Center?: 424 Savannah Rd, Lewes, DE 19958, in Sussex County, Delaware.
What is the phone number of Beebe Medical Center?: (302) 645-3300, as listed by Medicare (CMS).
What is the Medicare star rating of Beebe Medical Center?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5][6]

Cardiac and vascular
Women's health
Surgery
Cancer
Orthopaedics
Emergency services
Diagnostic services
Critical care
Palliative care
Hospital medicine
Labor and delivery / maternity
Gynecologic surgery
Laboratory services
Imaging

Treatments^[5]

Robotic surgery
Pulmonary rehabilitation (outpatient)

Procedures^[5][6]

Interventional cardiology procedures
Labor and delivery
Gynecologic surgery
Hybrid operating room procedures

Programs and centers^[5][6][7]

Center for Robotic Surgery
Hybrid operating room
Interventional cardiology labs
Hospital Medicine program (primary care for inpatients)
Sexual Assault Nurse Examiner (S.A.N.E.) program
Domestic Violence Victim's Advocate program
Maternity and birthing center

Emergency care (hospital website)^[4]

Emergency room	Yes

Visiting and practical information

Visiting	Inpatients may have well visitors; photo ID and a daily badge are required. The ED allows one well guest at a time^[5][8]
Parking	Free on-site parking garage; free valet at the West Entrance Mon-Fri, 6:30 a.m.-5:30 p.m^[5]
Patient portal	MyChart

Recognition^[6][7]

Level III trauma center
Baby-Friendly designation (first hospital in Delaware)

Doctors and clinicians (1,162)

1,162 doctors and other clinicians list Beebe 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 1,138 more: the button below opens the full list.

Other emergency rooms nearby

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

Bayhealth Hospital, Sussex Campus17 mi · Milford, DE · Acute Care Hospital
Tidalhealth Nanticoke, Inc.26 mi · Seaford, DE · Acute Care Hospital
Cape Regional Medical Center Inc28 mi · Cape May Court House, NJ · Acute Care Hospital
Atlantic General Hospital30 mi · Berlin, MD · Acute Care Hospital
Bayhealth Medical Center, Kent Campus33 mi · Dover, DE · Acute Care Hospital

Other hospitals nearby

PAM Health Rehabilitation Hospital of Georgetown L…15 mi · Georgetown, DE · Inpatient Rehabilitation Hospital
Sun Behavioral Delaware LLC15 mi · Georgetown, DE · 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

Excelcare at Lewes LLC0.7 mi · Lewes, DE · 2 of 5 stars
The Moorings at Lewes1.2 mi · Lewes, DE · 5 of 5 stars
Cadia Rehabilitation Renaissance10 mi · Millsboro, DE · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Compassionate Care Hospice of the Delmar Peninsula17 mi · Milford, DE · 3 of 5 stars
Delaware Hospice, Inc Southern Division17 mi · Milford, DE · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Beebe Hospital Home Health15 mi · Millsboro, DE
Amedisys Home Health16 mi · Georgetown, DE
Aveanna Healthcare17 mi · Milford, DE

All home health agencies in the state →

Dialysis facilities

FKC Rehoboth5.8 mi · Rehoboth Beach, DE · 2 of 5 stars
FKC Millsboro15 mi · Millsboro, DE · 2 of 5 stars
FKC Mid Sussex County16 mi · Georgetown, DE · 2 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.

Lewes Surgery Center3.3 mi · Lewes, DE
Seaside Endoscopy Pavilion3.3 mi · Lewes, DE
Delaware Eye Surgery Center5.8 mi · Rehoboth Beach, DE

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

La Red Health Center Main Campus15 mi · Georgetown, DE · Community health center
LRHC Mobile Health Unit15 mi · Georgetown, DE · Community health center
Northern Sussex Community Health Center18 mi · Milford, DE · Community health center

Clinics and urgent care

Aspira Health3.3 mi · Lewes, DE · Urgent care center
Atracare Walk-In LLC3.3 mi · Lewes, DE · Urgent care center
CNS Occupational Medicine of Delaware16 mi · Georgetown, DE · Urgent care center

Pharmacies

Cape RX LLC3.3 mi · Lewes, DE · Community/retail pharmacy
Walgreen Co3.3 mi · Lewes, DE · Pharmacy
Giant of Maryland LLC5.8 mi · Rehoboth Beach, DE · Community/retail pharmacy

Assisted living nearby

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

The Lodge at Historic Lewes Senior Living3.3 mi · Lewes, DE
The Moorings at Lewes Assisted Living3.3 mi · Lewes, DE
Brandywine Assisted Living Seaside Pointe5.8 mi · Rehoboth Beach, DE
Peach Tree Health Group, LLC8.5 mi · Harbeson, DE

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 Beebe 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)	2 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	2 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	2 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	60%National average: 72%
Would definitely recommend the hospital	60%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	74%National average: 80%
Staff “always” explained medicines before giving them	57%National average: 62%
Were given information about recovery at home	86%National average: 86%
Room and bathroom “always” clean	58%National average: 74%
Area around the room “always” quiet at night	38%National average: 60%
Completed surveys	1,012Response rate: 27%

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)	0.248No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.442No different from the national benchmark
Surgical site infections after colon surgery	0.468No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.819No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.502Better 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	12.5%
Deaths within 30 days: heart failure patients	11%
Deaths within 30 days: pneumonia patients	14.9%
Deaths within 30 days: COPD patients	8.5%
Deaths within 30 days: stroke patients	11.2%
Deaths within 30 days: coronary bypass surgery (CABG)	2.1%
Serious complications (patient safety indicator PSI-90)	3.07Worse than the national rate
Complications after hip or knee replacement	Too few cases to report

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	15.8%
Readmitted within 30 days: heart failure	20%
Readmitted within 30 days: pneumonia	16.3%
Readmitted within 30 days: COPD	18.6%
Readmitted within 30 days: coronary bypass surgery	10.6%
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	174 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)	74%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 Delaware

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 69 common services exactly as Beebe 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 →

$ 2 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) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$470	$399.50	$185.49
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates Highmark BC — Highmark BC: $185.49 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$470	$399.50	Not listed in the file
New patient office visit (about 30–44 minutes): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 27 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$337.50	$286.88	Not listed in the file
New patient office visit (about 30–44 minutes): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$513.50	$436.48	$262.22
New patient office visit (about 45–59 minutes): 10 of 18 insurance plan rates Highmark BC — Highmark BC: $262.22 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$513.50	$436.48	Not listed in the file
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$579.75	$492.79	$333.09
New patient office visit (about 60–74 minutes): 10 of 17 insurance plan rates Highmark BC — Highmark BC: $333.09 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$579.75	$492.79	Not listed in the file
New patient office visit (about 60–74 minutes): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$369	$313.65	$102.09
Established patient office visit (about 20–29 minutes): 10 of 18 insurance plan rates Highmark BC — Highmark BC: $102.09 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$303.50	$257.98	Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 93 In the file: OFFICE O/P EST LOW 20 MIN	$181	$153.85	Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$419	$356.15	$159.45
Established patient office visit (about 30–39 minutes): 10 of 20 insurance plan rates Highmark BC — Highmark BC: $159.45 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$526	$447.10	Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 20 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Health Options — Health Options: 78.75% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 93 In the file: OFFICE O/P EST MOD 30 MIN	$257	$218.45	Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM	$1,057	$898.45	Not listed in the file
Emergency room visit (moderate): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$1,007	$855.95	Not listed in the file
Emergency room visit (moderate): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM	$1,057	$898.45	Not listed in the file
Emergency room visit (moderate): 10 of 14 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 66.9% (a percentage in the contract, not a dollar amount) Coventry Health HMO — Coventry Health HMO: 88% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) Non Contracted Insurance — Non Contracted Insurance: 52.34% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM	$1,579	$1,342.15	Not listed in the file
Emergency room visit (moderately high): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$1,504	$1,278.40	Not listed in the file
Emergency room visit (moderately high): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM	$1,579	$1,342.15	Not listed in the file
Emergency room visit (moderately high): 10 of 14 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 66.9% (a percentage in the contract, not a dollar amount) Coventry Health HMO — Coventry Health HMO: 88% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) Non Contracted Insurance — Non Contracted Insurance: 52.34% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$95	$80.75	Not listed in the file
Emergency room visit (high): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 36.4% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 41% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM	$2,391	$2,032.35	Not listed in the file
Emergency room visit (high): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Famotidine	$3,169.38	$2,693.97	Not listed in the file
Emergency room visit (high): 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)

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: METABOLIC PANEL TOTAL CA	$195	$165.75	$19.62 – $27.24
Basic metabolic panel (blood test): 10 of 18 insurance plan rates Cigna — Cigna: $24.89 Coventry Health HMO — Coventry Health HMO: $27.24 Coventry Healthcare PPO — Coventry Healthcare PPO: $27.24 Highmark BC — Highmark BC: $19.62 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$186	$158.10	$19.62 – $27.24
Basic metabolic panel (blood test): 10 of 18 insurance plan rates Cigna — Cigna: $24.89 Coventry Health HMO — Coventry Health HMO: $27.24 Coventry Healthcare PPO — Coventry Healthcare PPO: $27.24 Highmark BC — Highmark BC: $19.62 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: METABOLIC PANEL TOTAL CA	$195	$165.75	Not listed in the file
Basic metabolic panel (blood test): 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL	$207	$175.95	$24.50 – $34.01
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates Cigna — Cigna: $31.32 Coventry Health HMO — Coventry Health HMO: $34.01 Coventry Healthcare PPO — Coventry Healthcare PPO: $34.01 Highmark BC — Highmark BC: $24.50 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$197	$167.45	$24.50 – $34.01
Comprehensive metabolic panel (blood test): 10 of 18 insurance plan rates Cigna — Cigna: $31.32 Coventry Health HMO — Coventry Health HMO: $34.01 Coventry Healthcare PPO — Coventry Healthcare PPO: $34.01 Highmark BC — Highmark BC: $24.50 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: COMPREHEN METABOLIC PANEL	$207	$175.95	Not listed in the file
Comprehensive metabolic panel (blood test): 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$488	$414.80	$32.47 – $122.36
Obstetric blood test panel: 10 of 18 insurance plan rates Cigna — Cigna: $105.27 Coventry Health HMO — Coventry Health HMO: $122.36 Coventry Healthcare PPO — Coventry Healthcare PPO: $122.36 Highmark BC — Highmark BC: $32.47 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$194	$164.90	$31.06 – $64.29
Cholesterol panel (lipid panel): 10 of 18 insurance plan rates Cigna — Cigna: $64.29 Coventry Health HMO — Coventry Health HMO: $43.11 Coventry Healthcare PPO — Coventry Healthcare PPO: $43.11 Highmark BC — Highmark BC: $31.06 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$185	$157.25	$31.06 – $64.29
Cholesterol panel (lipid panel): 10 of 18 insurance plan rates Cigna — Cigna: $64.29 Coventry Health HMO — Coventry Health HMO: $43.11 Coventry Healthcare PPO — Coventry Healthcare PPO: $43.11 Highmark BC — Highmark BC: $31.06 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$185	$157.25	Not listed in the file
Cholesterol panel (lipid panel): 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$216	$183.60	$20.15 – $27.95
Kidney function panel: 10 of 18 insurance plan rates Cigna — Cigna: $25.71 Coventry Health HMO — Coventry Health HMO: $27.95 Coventry Healthcare PPO — Coventry Healthcare PPO: $27.95 Highmark BC — Highmark BC: $20.15 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL	$206	$175.10	$20.15 – $27.95
Kidney function panel: 10 of 18 insurance plan rates Cigna — Cigna: $25.71 Coventry Health HMO — Coventry Health HMO: $27.95 Coventry Healthcare PPO — Coventry Healthcare PPO: $27.95 Highmark BC — Highmark BC: $20.15 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: RENAL FUNCTION PANEL	$216	$183.60	Not listed in the file
Kidney function panel: 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$373	$317.05	$18.94 – $26.29
Liver function panel: 10 of 18 insurance plan rates Cigna — Cigna: $24.09 Coventry Health HMO — Coventry Health HMO: $26.29 Coventry Healthcare PPO — Coventry Healthcare PPO: $26.29 Highmark BC — Highmark BC: $18.94 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL	$355	$301.75	$18.94 – $26.29
Liver function panel: 10 of 18 insurance plan rates Cigna — Cigna: $24.09 Coventry Health HMO — Coventry Health HMO: $26.29 Coventry Healthcare PPO — Coventry Healthcare PPO: $26.29 Highmark BC — Highmark BC: $18.94 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: LIVER FUNCTION BLOOD TEST PANEL	$355	$301.75	Not listed in the file
Liver function panel: 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE	$7	$5.95	$7 – $7.33
Urine test (automated, with microscope): 10 of 18 insurance plan rates Cigna — Cigna: $7 Coventry Health HMO — Coventry Health HMO: $7 Coventry Healthcare PPO — Coventry Healthcare PPO: $7 Highmark BC — Highmark BC: $7.33 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$104	$88.40	$7.33 – $10.15
Urine test (automated, with microscope): 10 of 18 insurance plan rates Cigna — Cigna: $9.65 Coventry Health HMO — Coventry Health HMO: $10.15 Coventry Healthcare PPO — Coventry Healthcare PPO: $10.15 Highmark BC — Highmark BC: $7.33 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$104	$88.40	Not listed in the file
Urine test (automated, with microscope): 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE	$70	$59.50	$5.20 – $7.21
Urine test (automated, without microscope): 10 of 18 insurance plan rates Cigna — Cigna: $6.43 Coventry Health HMO — Coventry Health HMO: $7.21 Coventry Healthcare PPO — Coventry Healthcare PPO: $7.21 Highmark BC — Highmark BC: $5.20 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST	$67	$56.95	$5.20 – $7.21
Urine test (automated, without microscope): 10 of 18 insurance plan rates Cigna — Cigna: $6.43 Coventry Health HMO — Coventry Health HMO: $7.21 Coventry Healthcare PPO — Coventry Healthcare PPO: $7.21 Highmark BC — Highmark BC: $5.20 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: AUTOMATED URINALYSIS TEST	$67	$56.95	Not listed in the file
Urine test (automated, without microscope): 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL	$163	$138.55	$42.66 – $59.18
PSA (prostate specific antigen) blood test: 10 of 18 insurance plan rates Cigna — Cigna: $54.64 Coventry Health HMO — Coventry Health HMO: $59.18 Coventry Healthcare PPO — Coventry Healthcare PPO: $59.18 Highmark BC — Highmark BC: $42.66 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$155	$131.75	$42.66 – $59.18
PSA (prostate specific antigen) blood test: 10 of 18 insurance plan rates Cigna — Cigna: $54.64 Coventry Health HMO — Coventry Health HMO: $59.18 Coventry Healthcare PPO — Coventry Healthcare PPO: $59.18 Highmark BC — Highmark BC: $42.66 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: ASSAY OF PSA TOTAL	$163	$138.55	Not listed in the file
PSA (prostate specific antigen) blood test: 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE	$10.25	$8.71	$10.25 – $38.98
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates Cigna — Cigna: $10.25 Coventry Health HMO — Coventry Health HMO: $10.25 Coventry Healthcare PPO — Coventry Healthcare PPO: $10.25 Highmark BC — Highmark BC: $38.98 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$281	$238.85	$38.98 – $54.04
Thyroid stimulating hormone (TSH) test: 10 of 18 insurance plan rates Cigna — Cigna: $49.82 Coventry Health HMO — Coventry Health HMO: $54.04 Coventry Healthcare PPO — Coventry Healthcare PPO: $54.04 Highmark BC — Highmark BC: $38.98 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: ASSAY THYROID STIM HORMONE	$295	$250.75	Not listed in the file
Thyroid stimulating hormone (TSH) test: 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC	$186	$158.10	$18.04 – $25.02
Complete blood count (CBC) with differential: 10 of 18 insurance plan rates Cigna — Cigna: $23.32 Coventry Health HMO — Coventry Health HMO: $25.02 Coventry Healthcare PPO — Coventry Healthcare PPO: $25.02 Highmark BC — Highmark BC: $18.04 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$177	$150.45	$18.04 – $25.02
Complete blood count (CBC) with differential: 10 of 18 insurance plan rates Cigna — Cigna: $23.32 Coventry Health HMO — Coventry Health HMO: $25.02 Coventry Healthcare PPO — Coventry Healthcare PPO: $25.02 Highmark BC — Highmark BC: $18.04 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$177	$150.45	Not listed in the file
Complete blood count (CBC) with differential: 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED	$110	$93.50	$15.01 – $20.83
Complete blood count (CBC), automated: 10 of 18 insurance plan rates Cigna — Cigna: $19.28 Coventry Health HMO — Coventry Health HMO: $20.83 Coventry Healthcare PPO — Coventry Healthcare PPO: $20.83 Highmark BC — Highmark BC: $15.01 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$105	$89.25	$15.01 – $20.83
Complete blood count (CBC), automated: 10 of 18 insurance plan rates Cigna — Cigna: $19.28 Coventry Health HMO — Coventry Health HMO: $20.83 Coventry Healthcare PPO — Coventry Healthcare PPO: $20.83 Highmark BC — Highmark BC: $15.01 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER_XU In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$105	$89.25	Not listed in the file
Complete blood count (CBC), automated: 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$117	$99.45	$9.13 – $12.64
Blood clotting time test (prothrombin time, PT): 10 of 18 insurance plan rates Cigna — Cigna: $11.25 Coventry Health HMO — Coventry Health HMO: $12.64 Coventry Healthcare PPO — Coventry Healthcare PPO: $12.64 Highmark BC — Highmark BC: $9.13 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME	$111	$94.35	$9.13 – $12.64
Blood clotting time test (prothrombin time, PT): 10 of 18 insurance plan rates Cigna — Cigna: $11.25 Coventry Health HMO — Coventry Health HMO: $12.64 Coventry Healthcare PPO — Coventry Healthcare PPO: $12.64 Highmark BC — Highmark BC: $9.13 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: PROTHROMBIN TIME	$117	$99.45	Not listed in the file
Blood clotting time test (prothrombin time, PT): 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL	$101	$85.85	$13.92 – $19.31
Blood clotting test (partial thromboplastin time, PTT): 10 of 18 insurance plan rates Cigna — Cigna: $17.67 Coventry Health HMO — Coventry Health HMO: $19.31 Coventry Healthcare PPO — Coventry Healthcare PPO: $19.31 Highmark BC — Highmark BC: $13.92 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$96	$81.60	$13.92 – $19.31
Blood clotting test (partial thromboplastin time, PTT): 10 of 18 insurance plan rates Cigna — Cigna: $17.67 Coventry Health HMO — Coventry Health HMO: $19.31 Coventry Healthcare PPO — Coventry Healthcare PPO: $19.31 Highmark BC — Highmark BC: $13.92 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: THROMBOPLASTIN TIME PARTIAL	$101	$85.85	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT): 10 of 15 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount) List Bill — List Bill: 100% (a percentage in the contract, not a dollar amount)

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 DYE	$2,293	$1,949.05	$189.81 – $421.34
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna — Aetna: $421.34 Coventry Health HMO — Coventry Health HMO: $317.87 Coventry Healthcare PPO — Coventry Healthcare PPO: $317.87 Highmark BC — Highmark BC: $189.81 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$2,184	$1,856.40	$189.81 – $421.34
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna — Aetna: $421.34 Coventry Health HMO — Coventry Health HMO: $317.87 Coventry Healthcare PPO — Coventry Healthcare PPO: $317.87 Highmark BC — Highmark BC: $189.81 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_MA In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$2,184	$1,856.40	Not listed in the file
CT scan of the head or brain, without contrast: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	$5,678	$4,826.30	$649.34 – $1,997.27
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna — Aetna: $1,997.27 Coventry Health HMO — Coventry Health HMO: $1,675.05 Coventry Healthcare PPO — Coventry Healthcare PPO: $1,675.05 Highmark BC — Highmark BC: $649.34 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$5,408	$4,596.80	$649.34 – $1,997.27
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna — Aetna: $1,997.27 Coventry Health HMO — Coventry Health HMO: $1,675.05 Coventry Healthcare PPO — Coventry Healthcare PPO: $1,675.05 Highmark BC — Highmark BC: $649.34 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: MRI BRAIN STEM W/O & W/DYE	$5,678	$4,826.30	Not listed in the file
MRI of the brain, before and after contrast: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS	$140	$119	$45.07
Chest X-ray, 2 views: 10 of 19 insurance plan rates Highmark BC — Highmark BC: $45.07 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF CHEST; 2 VIEWS	$432	$367.20	$45.07
Chest X-ray, 2 views: 10 of 19 insurance plan rates Highmark BC — Highmark BC: $45.07 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: X-RAY OF CHEST; 2 VIEWS	$432	$367.20	Not listed in the file
Chest X-ray, 2 views: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	$546	$464.10	$61.94 – $96.12
X-ray of the lower spine, at least 4 views: 10 of 20 insurance plan rates Aetna — Aetna: $96.12 Coventry Health HMO — Coventry Health HMO: $61.94 Coventry Healthcare PPO — Coventry Healthcare PPO: $61.94 Highmark BC — Highmark BC: $78.68 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$520	$442	$61.94 – $96.12
X-ray of the lower spine, at least 4 views: 10 of 20 insurance plan rates Aetna — Aetna: $96.12 Coventry Health HMO — Coventry Health HMO: $61.94 Coventry Healthcare PPO — Coventry Healthcare PPO: $61.94 Highmark BC — Highmark BC: $78.68 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$520	$442	Not listed in the file
X-ray of the lower spine, at least 4 views: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	$3,409	$2,897.65	$393.05 – $1,029.38
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates Aetna — Aetna: $1,029.38 Coventry Health HMO — Coventry Health HMO: $836.70 Coventry Healthcare PPO — Coventry Healthcare PPO: $836.70 Highmark BC — Highmark BC: $393.05 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$3,247	$2,759.95	$393.05 – $1,029.38
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates Aetna — Aetna: $1,029.38 Coventry Health HMO — Coventry Health HMO: $836.70 Coventry Healthcare PPO — Coventry Healthcare PPO: $836.70 Highmark BC — Highmark BC: $393.05 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: MRI LUMBAR SPINE W/O DYE	$3,409	$2,897.65	Not listed in the file
MRI of the lower back (lumbar spine), without contrast: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE	$2,644	$2,247.40	$412.95 – $602.23
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates Aetna — Aetna: $602.23 Coventry Health HMO — Coventry Health HMO: $460.49 Coventry Healthcare PPO — Coventry Healthcare PPO: $460.49 Highmark BC — Highmark BC: $412.95 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF PELVIS WITH CONTRAST	$2,518	$2,140.30	$412.95 – $602.23
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates Aetna — Aetna: $602.23 Coventry Health HMO — Coventry Health HMO: $460.49 Coventry Healthcare PPO — Coventry Healthcare PPO: $460.49 Highmark BC — Highmark BC: $412.95 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: CT SCAN OF PELVIS WITH CONTRAST	$2,518	$2,140.30	Not listed in the file
CT scan of the pelvis, with contrast: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$3,113	$2,646.05	$433.70 – $886.75
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna — Aetna: $886.75 Coventry Health HMO — Coventry Health HMO: $742.87 Coventry Healthcare PPO — Coventry Healthcare PPO: $742.87 Highmark BC — Highmark BC: $433.70 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_PO In the file: MRI JNT OF LWR EXTRE W/O DYE	$3,269	$2,778.65	Not listed in the file
MRI of a leg joint (such as the knee), without contrast: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI JNT OF LWR EXTRE W/O DYE	$3,269	$2,778.65	Not listed in the file
MRI of a leg joint (such as the knee), without contrast: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST	$5,994	$5,094.90	$447.84 – $543.18
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Coventry Health HMO — Coventry Health HMO: $447.84 Coventry Healthcare PPO — Coventry Healthcare PPO: $447.84 Highmark BC — Highmark BC: $543.18 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$759	$645.15	$447.84 – $543.18
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Coventry Health HMO — Coventry Health HMO: $447.84 Coventry Healthcare PPO — Coventry Healthcare PPO: $447.84 Highmark BC — Highmark BC: $543.18 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: CT ABD & PELVIS W/CONTRAST	$5,994	$5,094.90	Not listed in the file
CT scan of the abdomen and pelvis, with contrast: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE	$1,390	$1,181.50	$132.98 – $235.45
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates Aetna — Aetna: $221.49 Coventry Health HMO — Coventry Health HMO: $132.98 Coventry Healthcare PPO — Coventry Healthcare PPO: $132.98 Highmark BC — Highmark BC: $235.45 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$1,324	$1,125.40	$132.98 – $235.45
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates Aetna — Aetna: $221.49 Coventry Health HMO — Coventry Health HMO: $132.98 Coventry Healthcare PPO — Coventry Healthcare PPO: $132.98 Highmark BC — Highmark BC: $235.45 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$1,324	$1,125.40	Not listed in the file
Ultrasound of the abdomen, complete: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >= 14 WKS SNGL FETUS	$1,087	$923.95	$141.92 – $251.30
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — Aetna: $251.30 Coventry Health HMO — Coventry Health HMO: $141.92 Coventry Healthcare PPO — Coventry Healthcare PPO: $141.92 Highmark BC — Highmark BC: $226.33 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$1,035	$879.75	$141.92 – $251.30
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — Aetna: $251.30 Coventry Health HMO — Coventry Health HMO: $141.92 Coventry Healthcare PPO — Coventry Healthcare PPO: $141.92 Highmark BC — Highmark BC: $226.33 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: OB US >= 14 WKS SNGL FETUS	$1,087	$923.95	Not listed in the file
Pregnancy ultrasound (after the first trimester): 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL US NON-OB	$984	$836.40	$103.46 – $214.71
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — Aetna: $180.43 Coventry Health HMO — Coventry Health HMO: $103.46 Coventry Healthcare PPO — Coventry Healthcare PPO: $103.46 Highmark BC — Highmark BC: $214.71 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$937	$796.45	$103.46 – $214.71
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — Aetna: $180.43 Coventry Health HMO — Coventry Health HMO: $103.46 Coventry Healthcare PPO — Coventry Healthcare PPO: $103.46 Highmark BC — Highmark BC: $214.71 Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$937	$796.45	Not listed in the file
Transvaginal ultrasound: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ_PO_RT In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$627	$532.95	Not listed in the file
Diagnostic mammogram, one breast: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_PO In the file: DX MAMMO INCL CAD UNI	$658	$559.30	Not listed in the file
Diagnostic mammogram, one breast: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_GG In the file: DX MAMMO INCL CAD UNI	$658	$559.30	Not listed in the file
Diagnostic mammogram, one breast: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI	$777	$660.45	$325.38
Diagnostic mammogram, both breasts: 10 of 19 insurance plan rates Highmark BC — Highmark BC: $325.38 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$740	$629	$325.38
Diagnostic mammogram, both breasts: 10 of 19 insurance plan rates Highmark BC — Highmark BC: $325.38 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GG_PO In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$740	$629	Not listed in the file
Diagnostic mammogram, both breasts: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY	$4,916.50	$4,179.03	$256.63
Screening mammogram, both breasts: 10 of 20 insurance plan rates Highmark BC — Highmark BC: $256.63 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD	$668	$567.80	$256.63
Screening mammogram, both breasts: 10 of 19 insurance plan rates Highmark BC — Highmark BC: $256.63 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: SCREENING MAMMOGRAPHY	$636	$540.60	Not listed in the file
Screening mammogram, both breasts: 10 of 18 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 36% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	$6,906	$5,870.10	Not listed in the file
Left heart catheterization (diagnostic): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INSERTION OF TUBE IN LEFT HEART CHAMBERS FOR DIAGNOSIS WITH REVIEW BY RADIOLOGIST	$7,516.75	$6,389.24	Not listed in the file
Left heart catheterization (diagnostic): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: LEFT HRT CATH W/VENTRCLGRPHY	$417	$354.45	Not listed in the file
Left heart catheterization (diagnostic): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION	$13,024	$11,070.40	Not listed in the file
Heart rhythm study (electrophysiology evaluation): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
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	$49,953	$42,460.05	Not listed in the file
Heart rhythm study with ablation for atrial fibrillation: 10 of 20 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Health Options — Health Options: 78.75% (a percentage in the contract, not a dollar amount)
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY CAUSING ATRIAL FIBRILLATION (UNCOORDINATED CONTRACTION	$47,574	$40,437.90	Not listed in the file
Heart rhythm study with ablation for atrial fibrillation: 10 of 20 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Health Options — Health Options: 78.75% (a percentage in the contract, not a dollar amount)
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: COMPRE EP EVAL ABLTJ ATR FIB	$1,407	$1,195.95	Not listed in the file
Heart rhythm study with ablation for atrial fibrillation: 10 of 20 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 33% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Health Options — Health Options: 78.75% (a percentage in the contract, not a dollar amount)

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: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$123	$104.55	Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THERAPEUTIC EXERCISES	$123	$104.55	Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_PO In the file: THERAPEUTIC EXERCISES	$123	$104.55	Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$280	$238	Not listed in the file
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_PN In the file: PT EVAL LOW COMPLEX 20 MIN	$294	$249.90	Not listed in the file
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_95 In the file: PT EVAL LOW COMPLEX 20 MIN	$294	$249.90	Not listed in the file
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$280	$238	Not listed in the file
Physical therapy evaluation (moderate complexity): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_95 In the file: PT EVAL MOD COMPLEX 30 MIN	$294	$249.90	Not listed in the file
Physical therapy evaluation (moderate complexity): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEX 30 MIN	$294	$249.90	Not listed in the file
Physical therapy evaluation (moderate complexity): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_PN In the file: PT EVAL HIGH COMPLEX 45 MIN	$294	$249.90	Not listed in the file
Physical therapy evaluation (high complexity): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_95 In the file: PT EVAL HIGH COMPLEX 45 MIN	$294	$249.90	Not listed in the file
Physical therapy evaluation (high complexity): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_ER In the file: PT EVAL HIGH COMPLEX 45 MIN	$294	$249.90	Not listed in the file
Physical therapy evaluation (high complexity): 10 of 17 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 67.92% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Delaware First Health — Delaware First Health: 79% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)

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 · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$7,494	$6,369.90	Not listed in the file
Removal of breast growth (open surgery): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$12,489	$10,615.65	Not listed in the file
Removal of breast growth (open surgery): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$17,018	$14,465.30	Not listed in the file
Total hip replacement: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$15,500	$13,175	Not listed in the file
Total hip replacement: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$17,984	$15,286.40	Not listed in the file
Total hip replacement: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$18,259.99	$15,520.99	Not listed in the file
Total knee replacement: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$18,894	$16,059.90	Not listed in the file
Total knee replacement: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$20,744	$17,632.40	Not listed in the file
Total knee replacement: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$2,886	$2,453.10	Not listed in the file
Shoulder arthroscopy: shaving of shoulder bone: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_PO In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$7,037.25	$5,981.66	Not listed in the file
Shoulder arthroscopy: shaving of shoulder bone: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_RT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$4,208	$3,576.80	Not listed in the file
Shoulder arthroscopy: shaving of shoulder bone: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_PO In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$2,363	$2,008.55	Not listed in the file
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$5,874	$4,992.90	Not listed in the file
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$9,114	$7,746.90	Not listed in the file
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$6,549	$5,566.65	Not listed in the file
Removal of tonsils and adenoids (under age 12): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$12,736	$10,825.60	Not listed in the file
Upper GI endoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_PO In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,036.67	$1,731.17	Not listed in the file
Upper GI endoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,460.67	$2,091.57	Not listed in the file
Upper GI endoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$3,819.33	$3,246.43	Not listed in the file
Upper GI endoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,737	$2,326.45	Not listed in the file
Upper GI endoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$3,026	$2,572.10	Not listed in the file
Upper GI endoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$4,997	$4,247.45	Not listed in the file
Colonoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_PO In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$3,903	$3,317.55	Not listed in the file
Colonoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,787.67	$1,519.52	Not listed in the file
Colonoscopy (diagnostic): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,599.33	$2,209.43	Not listed in the file
Colonoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_XS In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$3,803.33	$3,232.83	Not listed in the file
Colonoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$5,493	$4,669.05	Not listed in the file
Colonoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$1,503	$1,277.55	Not listed in the file
Colonoscopy with removal of polyps (snare): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ_PT In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$1,371.67	$1,165.92	Not listed in the file
Colonoscopy with removal of polyps (snare): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier KX In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$2,357	$2,003.45	Not listed in the file
Colonoscopy with removal of polyps (snare): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$1,637.25	$1,391.66	Not listed in the file
Screening colonoscopy (not high risk): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier KX In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$1,654.33	$1,406.18	Not listed in the file
Screening colonoscopy (not high risk): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier KX_PO In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$3,797	$3,227.45	Not listed in the file
Screening colonoscopy (not high risk): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$9,384	$7,976.40	Not listed in the file
Gallbladder removal by laparoscope: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 73 In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	Not listed in the file
Gallbladder removal by laparoscope: 10 of 16 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$3,623	$3,079.55	Not listed in the file
Groin (inguinal) hernia repair, age 5 or older: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$23,829	$20,254.65	Not listed in the file
Groin (inguinal) hernia repair, age 5 or older: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$8,844	$7,517.40	Not listed in the file
Groin (inguinal) hernia repair, age 5 or older: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE GLAND	$3,869	$3,288.65	Not listed in the file
Prostate biopsy: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BIOPSY OF PROSTATE GLAND	$3,443	$2,926.55	Not listed in the file
Prostate biopsy: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: BIOPSY OF PROSTATE GLAND	$3,714	$3,156.90	Not listed in the file
Prostate biopsy: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE	$14,479.49	$12,307.57	Not listed in the file
Prostate removal by laparoscope (radical prostatectomy): 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$5,739	$4,878.15	Not listed in the file
Hysteroscopy with biopsy of the uterus lining: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$9,114	$7,746.90	Not listed in the file
Hysteroscopy with biopsy of the uterus lining: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$1,910	$1,623.50	Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$1,578	$1,341.30	Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$2,491	$2,117.35	Not listed in the file
Nerve root injection, lower back, with imaging guidance: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_PO In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$2,076	$1,764.60	Not listed in the file
Nerve root injection, lower back, with imaging guidance: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,993	$1,694.05	Not listed in the file
Nerve root injection, lower back, with imaging guidance: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_PO In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$3,174	$2,697.90	Not listed in the file
Carpal tunnel release: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$3,978	$3,381.30	Not listed in the file
Carpal tunnel release: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_RT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$4,414	$3,751.90	Not listed in the file
Carpal tunnel release: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_RT In the file: REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER	$2,888	$2,454.80	Not listed in the file
Laser treatment of clouding after cataract surgery: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER	$3,032	$2,577.20	Not listed in the file
Laser treatment of clouding after cataract surgery: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER	$3,032	$2,577.20	Not listed in the file
Laser treatment of clouding after cataract surgery: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$4,387	$3,728.95	Not listed in the file
Cataract removal with lens implant: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_PO In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$4,143	$3,521.55	Not listed in the file
Cataract removal with lens implant: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_RT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$5,363	$4,558.55	Not listed in the file
Cataract removal with lens implant: 10 of 19 insurance plan rates Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Amerihealth Caritas — Amerihealth Caritas: 43.62% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 70.2% (a percentage in the contract, not a dollar amount) Connections CSP — Connections CSP: 80% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Highmark BC — Highmark BC: 89.15% (a percentage in the contract, not a dollar amount)

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	$198,115.46
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 15 insurance plan rates Highmark BC — Highmark BC: $198,115.46 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 66.9% (a percentage in the contract, not a dollar amount) Coventry Health HMO — Coventry Health HMO: 88% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (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 COMORBITY	Not listed in the file	Not listed in the file	$34,971.86
Hip or knee replacement (major joint of the leg), without major complications: 10 of 15 insurance plan rates Highmark BC — Highmark BC: $34,971.86 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 66.9% (a percentage in the contract, not a dollar amount) Coventry Health HMO — Coventry Health HMO: 88% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
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	$44,846.96
Neck (cervical) spinal fusion, without complications: 10 of 15 insurance plan rates Highmark BC — Highmark BC: $44,846.96 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 66.9% (a percentage in the contract, not a dollar amount) Coventry Health HMO — Coventry Health HMO: 88% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY WITHOUT COMPLICATION/COMORBITY	Not listed in the file	Not listed in the file	$25,096.77
Uterus and ovary surgery (not for cancer), without complications: 10 of 15 insurance plan rates Highmark BC — Highmark BC: $25,096.77 Aetna — Aetna: 90% (a percentage in the contract, not a dollar amount) Amerihealth — Amerihealth: 90% (a percentage in the contract, not a dollar amount) Beebe Aetna — Beebe Aetna: 60% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 95% (a percentage in the contract, not a dollar amount) Claimsbridge — Claimsbridge: 88% (a percentage in the contract, not a dollar amount) Commercial Generic — Commercial Generic: 66.9% (a percentage in the contract, not a dollar amount) Coventry Health HMO — Coventry Health HMO: 88% (a percentage in the contract, not a dollar amount) Coventry Healthcare PPO — Coventry Healthcare PPO: 90% (a percentage in the contract, not a dollar amount) Kaiser Permanente — Kaiser Permanente: 90% (a percentage in the contract, not a dollar amount)

Source: Beebe Medical Center’s standard charges file (apim.services.craneware.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 5, 2026; retrieved November 5, 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	424 Savannah Rd, Lewes, DE 19958
County	Sussex County
State	Delaware
Phone	(302) 645‑3300
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	080007
Name in Medicare records	BEEBE MEDICAL CENTER
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(302) 645‑3554^[4]
Name on the hospital’s website	Beebe Healthcare Margaret H. Rollins Lewes Campus
Official website	beebehealthcare.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 Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-11-02.

Beebe Healthcare Margaret H. Rollins Lewes Campus | Beebe Healthcare — beebehealthcare.org
Margaret H. Rollins Lewes Campus — beebehealthcare.org
Women's Health | Beebe Healthcare — beebehealthcare.org
Emergency Rooms in Lewes and Millville | Beebe Healthcare — beebehealthcare.org
Visitor Information | Beebe Healthcare — beebehealthcare.org

Beebe Medical Center

Summary

Profile from official sources

At a glance