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Acute Care Hospital

Brooks-Tlc Hospital System, Inc

Dunkirk, New York · Chautauqua County · Emergency services listed

Brooks-Tlc Hospital System, Inc is an acute care hospital at 529 Central Avenue, Dunkirk, NY 14048. Phone: (716) 366-1111. It has an emergency department. Medicare overall rating: 1 of 5 stars (CMS, October 2026).

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

Summary

Brooks-Tlc Hospital System, Inc is an acute care hospital in Dunkirk, New York. Medicare data lists emergency services. CMS overall star rating: 1 of 5 stars. Its official website lists 38 services, specialties and programs. Medicare lists 278 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

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

Call(716) 366‑1111 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
1 of 5 stars1 of 5 stars · Medicare rating
278Doctors and clinicians
38Services listed

Quick answers

Does Brooks-Tlc Hospital System, Inc have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Brooks-Tlc Hospital System, Inc. In a medical emergency, call 911.
Where is Brooks-Tlc Hospital System, Inc?
529 Central Avenue, Dunkirk, NY 14048, in Chautauqua County, New York.
What is the phone number of Brooks-Tlc Hospital System, Inc?
(716) 366-1111, as listed by Medicare (CMS).
What is the Medicare star rating of Brooks-Tlc Hospital System, Inc?
1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Brooks-Tlc Hospital System, Inc for hospital-acquired conditions?
Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Brooks-Tlc Hospital System, Inc under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 1.0268; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4][5][8][9][10][11][12]

Treatments[4][8]

  • Cardiac rehabilitation
  • Infusion
  • Physical therapy rehabilitation
  • Speech and language services
  • Blood transfusions
  • Platelet transfusions
  • Immunoglobulin transfusions

Procedures[6][8][9][14]

  • Arteriograms
  • Chest and liver biopsy
  • Bone scans
  • Challenge testing
  • MRI
  • CT scan
  • Ultrasound
  • Nuclear medicine
  • Mammography
  • DEXA bone density scan
  • Modified barium swallow study

Programs and centers[4][10][12]

  • Substance use disorder outpatient clinics
  • Fast Track minor injury and illness service in the Emergency Department
  • Blood bank and transfusion services

Emergency care (hospital website)[4][5][12]

Emergency roomYes
Open 24/7Yes

Recognition[6][14]

  • American College of Radiology (ACR) accreditation in MRI, CT, ultrasound, nuclear medicine and mammography

Doctors and clinicians (278)

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

Main specialties

Doctors with a page on this site (278)

And 254 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Dunkirk

Hospitals in Chautauqua County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Dialysis facilities

All dialysis facilities in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

What Brooks-Tlc Hospital System, Inc 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) 4 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well5 of 5 stars
Doctors communicated well4 of 5 stars
Patients got help quickly from staff5 of 5 stars
Staff explained medicines4 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean5 of 5 stars
Restfulness of Environment4 of 5 stars
Care Coordination4 of 5 stars
Symptoms After Stay4 of 5 stars
Rated the hospital 9 or 10 out of 1067%National average: 72%
Would definitely recommend the hospital63%National average: 71%
Nurses “always” communicated well88%National average: 80%
Doctors “always” communicated well81%National average: 80%
“Always” got help as soon as they wanted75%National average: 64%
Staff “always” explained medicines before giving them69%National average: 62%
Were given information about recovery at home92%National average: 86%
Room and bathroom “always” clean78%National average: 73%
Completed surveys200Response rate: 25%

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

Infections caught in the hospital

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

Clostridioides difficile (C. diff) intestinal infections3.984Worse than the national benchmark
Not reported to MedicareCentral line bloodstream infections (CLABSI); Catheter-associated urinary tract infections (CAUTI); Surgical site infections after colon surgery; Surgical site infections after abdominal hysterectomy; MRSA bloodstream infections

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

Complications and deaths

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

Deaths within 30 days: heart failure patients14.3%
Deaths within 30 days: pneumonia patients17.3%
Deaths within 30 days: COPD patients8.4%
Serious complications (patient safety indicator PSI-90)1.18No different from the national rate
Not reported to MedicareDeaths within 30 days: coronary bypass surgery (CABG)
Too few cases to reportDeaths within 30 days: heart attack patients; Deaths within 30 days: stroke patients; Complications after hip or knee replacement

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)16.5%
Readmitted within 30 days: heart failure21.4%
Readmitted within 30 days: pneumonia18.2%
Readmitted within 30 days: COPD19.7%
Not reported to MedicareReadmitted within 30 days: coronary bypass surgery
Too few cases to reportReadmitted within 30 days: heart attack; Readmitted within 30 days: hip or knee replacement

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)162 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)60%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score1.0268Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart failure1.0024More readmissions than expected
Pneumonia0.9788Fewer readmissions than expected
COPD (chronic lung disease)1.0069More readmissions than expected
No result publishedHeart attack; Hip or knee replacement; Coronary bypass surgery (CABG) (not reported, or too few cases)

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score24.00 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)0.00 out of 100
Person and community engagement (patient survey)46.00 out of 100
Safety (infections and sepsis care)0.00 out of 100
Efficiency and cost reduction (Medicare spending)50.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio0.98Below the national median hospital (1.00): Medicare spent less

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

ER wait times and Medicare ratings nearby

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

ER wait times in New YorkBest hospitals in New York

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 87 common services exactly as Brooks-Tlc Hospital System, Inc 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 →

$ 1 amount is marked with “!”: it is 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. It is shown exactly as listed; ask the hospital before relying on it.

Show the prices of 87 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $73.19 – $136.06
New patient office visit (about 30–44 minutes): rates for 7 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $110.42
  • Bcbs — Highmark Hmo/Pos: $136.06
  • Independent Health Association — All Commercial Plans: $99.74
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $76.72
  • Nova Azero Health Plan — All Commercial Plans: $99.74
  • Univera — All Commercial Plans: $84.45
  • Univera — Medicare Managed Care Plan: $73.19
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: Hbp Office Visit Lvl 3 New $326 $326 Not listed in the file
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: Hbp Office Visit Lvl 3 Est $326 $326 Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $118.03 – $207.61
New patient office visit (about 45–59 minutes): rates for 7 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $168.48
  • Bcbs — Highmark Hmo/Pos: $207.61
  • Independent Health Association — All Commercial Plans: $162.60
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $125.08
  • Nova Azero Health Plan — All Commercial Plans: $162.60
  • Univera — All Commercial Plans: $136.18
  • Univera — Medicare Managed Care Plan: $118.03
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: Office Visit New Level 4 $408 $408 Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: Office Visit New, Level 4 $408 $408 Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $160.23 – $261.13
New patient office visit (about 60–74 minutes): rates for 7 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $211.91
  • Bcbs — Highmark Hmo/Pos: $261.13
  • Independent Health Association — All Commercial Plans: $221.09
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $170.07
  • Nova Azero Health Plan — All Commercial Plans: $221.09
  • Univera — All Commercial Plans: $184.89
  • Univera — Medicare Managed Care Plan: $160.23
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: Office Visit New Level 5 $510 $510 Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: Office Visit New, Level 5 $510 $510 Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est Not listed in the file Not listed in the file $42.37 – $83.29
Established patient office visit (about 20–29 minutes): rates for 7 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $67.59
  • Bcbs — Highmark Hmo/Pos: $83.29
  • Independent Health Association — All Commercial Plans: $80.50
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $61.92
  • Nova Azero Health Plan — All Commercial Plans: $80.50
  • Univera — All Commercial Plans: $67.53
  • Univera — Medicare Managed Care Plan: $58.52
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Established Patient Level 3 $261 $261 Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Postpartum Visit $261 $261 Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est Not listed in the file Not listed in the file $86.48 – $122.71
Established patient office visit (about 30–39 minutes): rates for 7 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $99.58
  • Bcbs — Highmark Hmo/Pos: $122.71
  • Independent Health Association — All Commercial Plans: $118.48
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $91.14
  • Nova Azero Health Plan — All Commercial Plans: $118.48
  • Univera — All Commercial Plans: $99.79
  • Univera — Medicare Managed Care Plan: $86.48
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: Established Patient Level 4 $326 $326 Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: Office Visit Establ Level 4 $326 $326 Not listed in the file
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office consultation Not listed in the file Not listed in the file $113.16 – $151.77
Office consultation with a specialist (moderate): rates for 3 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $123.17
  • Bcbs — Highmark Hmo/Pos: $151.77
  • Univera — All Commercial Plans: $113.16
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: Office Consult New/Est Level 3 $103 $103 Not listed in the file
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office consultation Not listed in the file Not listed in the file $181.86 – $227.51
Office consultation with a specialist (moderate to high): rates for 3 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $184.63
  • Bcbs — Highmark Hmo/Pos: $227.51
  • Univera — All Commercial Plans: $181.86
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: Office Consult New/Est Level 4 $153 $153 Not listed in the file
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 18-39 Not listed in the file Not listed in the file $90.11 – $167.69
Preventive checkup, new patient, age 18–39: rates for 4 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $136.08
  • Bcbs — Highmark Hmo/Pos: $167.69
  • Univera — All Commercial Plans: $91.95
  • Univera — Medicare Managed Care Plan: $90.11
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: Prev Visit New Pt 18-39 Yrs $321 $321 Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 40-64 Not listed in the file Not listed in the file $109.28 – $194.78
Preventive checkup, new patient, age 40–64: rates for 4 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $158.07
  • Bcbs — Highmark Hmo/Pos: $194.78
  • Univera — All Commercial Plans: $111.51
  • Univera — Medicare Managed Care Plan: $109.28
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: Prev Visit New Pt 40-64 Yrs $388 $388 Not listed in the file
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit Not listed in the file Not listed in the file $68.61 – $456.61
Emergency room visit (moderate): rates for 10 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $68.61
  • Bcbs — Highmark Hmo/Pos: $84.54
  • Emblemhealth — All Commercial Plans: $442.98
  • Humana — Medicare Managed Care Plan: $340.75
  • Independent Health Association — All Commercial Plans: $341.78
  • Independent Health Association — Essential Other Commercial Plan: $177.94
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $456.61
  • Univera — All Commercial Plans: $70.04
  • Univera — Medicare Managed Care Plan: $68.64
  • Wellcare — Medicare Managed Care Plan: $350.98
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: Emergency Dept Visit Low Mdm $646 $646 Not listed in the file
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: Pro Fee Ucc Level Iii $181 $181 Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit Not listed in the file Not listed in the file $115.67 – $697.95
Emergency room visit (moderately high): rates for 10 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $120.66
  • Bcbs — Highmark Hmo/Pos: $148.68
  • Emblemhealth — All Commercial Plans: $677.12
  • Humana — Medicare Managed Care Plan: $520.86
  • Independent Health Association — All Commercial Plans: $522.42
  • Independent Health Association — Essential Other Commercial Plan: $271.99
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $697.95
  • Univera — All Commercial Plans: $118.03
  • Univera — Medicare Managed Care Plan: $115.67
  • Wellcare — Medicare Managed Care Plan: $536.49
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: Er Dept Visit Mod Mdm $953 $953 Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: Pro Fee Ucc Level Iv $343 $343 Not listed in the file
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit Not listed in the file Not listed in the file $168.16 – $996.15
Emergency room visit (high): rates for 10 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $177.62
  • Bcbs — Highmark Hmo/Pos: $218.87
  • Emblemhealth — All Commercial Plans: $966.41
  • Humana — Medicare Managed Care Plan: $743.39
  • Independent Health Association — All Commercial Plans: $745.62
  • Independent Health Association — Essential Other Commercial Plan: $388.20
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $996.15
  • Univera — All Commercial Plans: $171.60
  • Univera — Medicare Managed Care Plan: $168.16
  • Wellcare — Medicare Managed Care Plan: $765.69
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: Er Dept Visit Hi Mdm $1,465 $1,465 Not listed in the file
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: Pro Fee Ucc Level V $508 $508 Not listed in the file

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca Not listed in the file Not listed in the file $4.42 – $11.34
Basic metabolic panel (blood test): 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $4.66
  • Bcbs — Highmark Hmo/Pos: $5.74
  • Emblemhealth — All Commercial Plans: $11
  • Humana — Medicare Managed Care Plan: $8.46
  • Independent Health Association — All Commercial Plans: $8.71
  • Independent Health Association — Essential Other Commercial Plan: $7.41
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $8.71
  • Independent Health Association — State - Medisource Other Commercial Plan: $7.41
  • Nova Azero Health Plan — All Commercial Plans: $8.71
  • Unitedhealthcare — All Commercial Plans: $6.35
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: Chem 7 $58 $58 Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel Not listed in the file Not listed in the file $5.51 – $14.15
Comprehensive metabolic panel (blood test): 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $5.81
  • Bcbs — Highmark Hmo/Pos: $7.16
  • Emblemhealth — All Commercial Plans: $13.73
  • Humana — Medicare Managed Care Plan: $10.56
  • Independent Health Association — All Commercial Plans: $10.88
  • Independent Health Association — Essential Other Commercial Plan: $9.25
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $10.88
  • Independent Health Association — State - Medisource Other Commercial Plan: $9.25
  • Nova Azero Health Plan — All Commercial Plans: $10.88
  • Unitedhealthcare — All Commercial Plans: $7.92
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: Comp. Metabolic Profile $65 $65 Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: Comp Metabolic Profile $65 $65 Not listed in the file
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel Not listed in the file Not listed in the file $24.97 – $64.07
Obstetric blood test panel: 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $26.34
  • Bcbs — Highmark Hmo/Pos: $32.46
  • Emblemhealth — All Commercial Plans: $62.15
  • Humana — Medicare Managed Care Plan: $47.81
  • Independent Health Association — All Commercial Plans: $49.24
  • Independent Health Association — Essential Other Commercial Plan: $41.86
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $49.24
  • Independent Health Association — State - Medisource Other Commercial Plan: $41.86
  • Nova Azero Health Plan — All Commercial Plans: $49.24
  • Unitedhealthcare — All Commercial Plans: $35.86
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: Obstetric Profile $292 $292 Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel Not listed in the file Not listed in the file $6.99 – $17.94
Cholesterol panel (lipid panel): 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $7.37
  • Bcbs — Highmark Hmo/Pos: $9.08
  • Emblemhealth — All Commercial Plans: $17.41
  • Humana — Medicare Managed Care Plan: $13.39
  • Independent Health Association — All Commercial Plans: $13.79
  • Independent Health Association — Essential Other Commercial Plan: $11.72
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $13.79
  • Independent Health Association — State - Medisource Other Commercial Plan: $11.72
  • Nova Azero Health Plan — All Commercial Plans: $13.79
  • Unitedhealthcare — All Commercial Plans: $10.04
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Lipid Panel $74 $74 Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Chd Profile I $74 $74 Not listed in the file
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel Not listed in the file Not listed in the file $4.53 – $11.63
Kidney function panel: 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $4.77
  • Bcbs — Highmark Hmo/Pos: $5.88
  • Emblemhealth — All Commercial Plans: $11.28
  • Humana — Medicare Managed Care Plan: $8.68
  • Independent Health Association — All Commercial Plans: $8.94
  • Independent Health Association — Essential Other Commercial Plan: $7.60
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $8.94
  • Independent Health Association — State - Medisource Other Commercial Plan: $7.60
  • Nova Azero Health Plan — All Commercial Plans: $8.94
  • Unitedhealthcare — All Commercial Plans: $6.51
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: Renal Panel $64 $64 Not listed in the file
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel Not listed in the file Not listed in the file $4.27 – $10.95
Liver function panel: 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $4.50
  • Bcbs — Highmark Hmo/Pos: $5.55
  • Emblemhealth — All Commercial Plans: $10.62
  • Humana — Medicare Managed Care Plan: $8.17
  • Independent Health Association — All Commercial Plans: $8.42
  • Independent Health Association — Essential Other Commercial Plan: $7.15
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $8.42
  • Independent Health Association — State - Medisource Other Commercial Plan: $7.15
  • Nova Azero Health Plan — All Commercial Plans: $8.42
  • Unitedhealthcare — All Commercial Plans: $6.13
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: Hepatic Function $56 $56 Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope Not listed in the file Not listed in the file $1.66 – $4.25
Urine test (automated, with microscope): 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1.74
  • Bcbs — Highmark Hmo/Pos: $2.15
  • Emblemhealth — All Commercial Plans: $4.12
  • Humana — Medicare Managed Care Plan: $3.17
  • Independent Health Association — All Commercial Plans: $3.27
  • Independent Health Association — Essential Other Commercial Plan: $2.78
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $3.27
  • Independent Health Association — State - Medisource Other Commercial Plan: $2.78
  • Nova Azero Health Plan — All Commercial Plans: $3.27
  • Unitedhealthcare — All Commercial Plans: $2.38
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: U/A Automated /Microscopy $20 $20 Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope Not listed in the file Not listed in the file $1.82 – $4.66
Urine test (manual, without microscope): 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1.92
  • Bcbs — Highmark Hmo/Pos: $2.36
  • Emblemhealth — All Commercial Plans: $4.52
  • Humana — Medicare Managed Care Plan: $3.48
  • Independent Health Association — All Commercial Plans: $3.58
  • Independent Health Association — Essential Other Commercial Plan: $3.05
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $3.58
  • Independent Health Association — State - Medisource Other Commercial Plan: $3.05
  • Nova Azero Health Plan — All Commercial Plans: $3.58
  • Unitedhealthcare — All Commercial Plans: $2.61
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: Urinalysis Nonauto W/O Scope $17 $17 Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: Urinalysis Non-Auto. W/O Micro $17 $17 Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/o scope Not listed in the file Not listed in the file $1.17 – $3.02
Urine test (automated, without microscope): 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1.23
  • Bcbs — Highmark Hmo/Pos: $1.52
  • Emblemhealth — All Commercial Plans: $2.92
  • Humana — Medicare Managed Care Plan: $2.25
  • Independent Health Association — All Commercial Plans: $2.32
  • Independent Health Association — Essential Other Commercial Plan: $1.97
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $2.32
  • Independent Health Association — State - Medisource Other Commercial Plan: $1.97
  • Nova Azero Health Plan — All Commercial Plans: $2.32
  • Unitedhealthcare — All Commercial Plans: $1.69
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: U/A Automated $17 $17 Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay of psa total Not listed in the file Not listed in the file $9.60 – $24.64
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $10.13
  • Bcbs — Highmark Hmo/Pos: $12.48
  • Emblemhealth — All Commercial Plans: $23.91
  • Humana — Medicare Managed Care Plan: $18.39
  • Independent Health Association — All Commercial Plans: $18.94
  • Independent Health Association — Essential Other Commercial Plan: $16.10
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $18.94
  • Independent Health Association — State - Medisource Other Commercial Plan: $16.10
  • Nova Azero Health Plan — All Commercial Plans: $18.94
  • Unitedhealthcare — All Commercial Plans: $13.79
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Psa Total $75 $75 Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay thyroid stim hormone Not listed in the file Not listed in the file $8.77 – $22.51
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $9.25
  • Bcbs — Highmark Hmo/Pos: $11.40
  • Emblemhealth — All Commercial Plans: $21.84
  • Humana — Medicare Managed Care Plan: $16.80
  • Independent Health Association — All Commercial Plans: $17.30
  • Independent Health Association — Essential Other Commercial Plan: $14.71
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $17.30
  • Independent Health Association — State - Medisource Other Commercial Plan: $14.71
  • Nova Azero Health Plan — All Commercial Plans: $17.30
  • Unitedhealthcare — All Commercial Plans: $12.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Ultrasensitive Tsh $120 $120 Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc Not listed in the file Not listed in the file $4.06 – $10.41
Complete blood count (CBC) with differential: 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $4.28
  • Bcbs — Highmark Hmo/Pos: $5.28
  • Emblemhealth — All Commercial Plans: $10.10
  • Humana — Medicare Managed Care Plan: $7.77
  • Independent Health Association — All Commercial Plans: $8
  • Independent Health Association — Essential Other Commercial Plan: $6.80
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $8
  • Independent Health Association — State - Medisource Other Commercial Plan: $6.80
  • Nova Azero Health Plan — All Commercial Plans: $8
  • Unitedhealthcare — All Commercial Plans: $5.83
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Complete Blood Count $56 $56 Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Cbc/ Automated Diff $56 $56 Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated Not listed in the file Not listed in the file $3.38 – $8.67
Complete blood count (CBC), automated: 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $3.56
  • Bcbs — Highmark Hmo/Pos: $4.39
  • Emblemhealth — All Commercial Plans: $8.41
  • Humana — Medicare Managed Care Plan: $6.47
  • Independent Health Association — All Commercial Plans: $6.66
  • Independent Health Association — Essential Other Commercial Plan: $5.66
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $6.66
  • Independent Health Association — State - Medisource Other Commercial Plan: $5.66
  • Nova Azero Health Plan — All Commercial Plans: $6.66
  • Unitedhealthcare — All Commercial Plans: $4.85
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: Hemogram Cbc $56 $56 Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time Not listed in the file Not listed in the file $2.24 – $5.75
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $2.36
  • Bcbs — Highmark Hmo/Pos: $2.91
  • Emblemhealth — All Commercial Plans: $5.58
  • Humana — Medicare Managed Care Plan: $4.29
  • Independent Health Association — All Commercial Plans: $4.42
  • Independent Health Association — Essential Other Commercial Plan: $3.76
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $4.42
  • Independent Health Association — State - Medisource Other Commercial Plan: $3.76
  • Nova Azero Health Plan — All Commercial Plans: $4.42
  • Unitedhealthcare — All Commercial Plans: $3.22
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Protime $29 $29 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time partial Not listed in the file Not listed in the file $3.14 – $8.05
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $3.31
  • Bcbs — Highmark Hmo/Pos: $4.08
  • Emblemhealth — All Commercial Plans: $7.81
  • Humana — Medicare Managed Care Plan: $6.01
  • Independent Health Association — All Commercial Plans: $6.19
  • Independent Health Association — Essential Other Commercial Plan: $5.26
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $6.19
  • Independent Health Association — State - Medisource Other Commercial Plan: $5.26
  • Nova Azero Health Plan — All Commercial Plans: $6.19
  • Unitedhealthcare — All Commercial Plans: $4.51
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Aptt $44 $44 Not listed in the file

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye Not listed in the file Not listed in the file $52.19 – $175.20
CT scan of the head or brain, without contrast: 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $65.24
  • Bcbs — Highmark Hmo/Pos: $80.39
  • Emblemhealth — All Commercial Plans: $169.65
  • Humana — Medicare Managed Care Plan: $130.50
  • Independent Health Association — All Commercial Plans: $175.20
  • Independent Health Association — Essential Other Commercial Plan: $87.27
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $134.77
  • Independent Health Association — State - Medisource Other Commercial Plan: $87.27
  • Nova Azero Health Plan — All Commercial Plans: $175.20
  • Univera — All Commercial Plans: $80.82
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: Ct/Head, W-O $906 $906 Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye Not listed in the file Not listed in the file $196.15 – $588.41
MRI of the brain, before and after contrast: 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $245.19
  • Bcbs — Highmark Hmo/Pos: $302.14
  • Emblemhealth — All Commercial Plans: $566.14
  • Humana — Medicare Managed Care Plan: $435.49
  • Independent Health Association — All Commercial Plans: $588.41
  • Independent Health Association — Essential Other Commercial Plan: $293.07
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $452.62
  • Independent Health Association — State - Medisource Other Commercial Plan: $293.07
  • Nova Azero Health Plan — All Commercial Plans: $588.41
  • Univera — All Commercial Plans: $259.81
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: Mri-Brain With/Without $2,382 $2,382 Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee · modifier 59 In the file: Mri Iac W/Wo $2,382 $2,382 Not listed in the file
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views Not listed in the file Not listed in the file $13.89 – $145.57
Chest X-ray, 2 views: 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $17.36
  • Bcbs — Highmark Hmo/Pos: $21.39
  • Emblemhealth — All Commercial Plans: $141.22
  • Humana — Medicare Managed Care Plan: $108.63
  • Independent Health Association — All Commercial Plans: $145.07
  • Independent Health Association — Essential Other Commercial Plan: $72.26
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $111.59
  • Independent Health Association — State - Medisource Other Commercial Plan: $72.26
  • Nova Azero Health Plan — All Commercial Plans: $145.07
  • Univera — All Commercial Plans: $27.01
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: Chest 2 Views $186 $186 Not listed in the file
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee · modifier FY In the file: Chest 2 Views Cr $186 $186 Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws Not listed in the file Not listed in the file $23.52 – $175.20
X-ray of the lower spine, at least 4 views: 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $29.39
  • Bcbs — Highmark Hmo/Pos: $36.22
  • Emblemhealth — All Commercial Plans: $169.65
  • Humana — Medicare Managed Care Plan: $130.50
  • Independent Health Association — All Commercial Plans: $175.20
  • Independent Health Association — Essential Other Commercial Plan: $87.27
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $134.77
  • Independent Health Association — State - Medisource Other Commercial Plan: $87.27
  • Nova Azero Health Plan — All Commercial Plans: $175.20
  • Univera — All Commercial Plans: $45.21
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: Lumbar Complete $400 $400 Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee · modifier FY In the file: Lumbar Complete Cr $400 $400 Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye Not listed in the file Not listed in the file $112 – $399.11
MRI of the lower back (lumbar spine), without contrast: 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $139.99
  • Bcbs — Highmark Hmo/Pos: $172.50
  • Emblemhealth — All Commercial Plans: $387.20
  • Humana — Medicare Managed Care Plan: $297.84
  • Independent Health Association — All Commercial Plans: $398.25
  • Independent Health Association — Essential Other Commercial Plan: $198.36
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $306.35
  • Independent Health Association — State - Medisource Other Commercial Plan: $198.36
  • Nova Azero Health Plan — All Commercial Plans: $398.25
  • Univera — All Commercial Plans: $149.26
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: Mri Lumbar Spine Without $1,599 $1,599 Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye Not listed in the file Not listed in the file $114.34 – $293.39
CT scan of the pelvis, with contrast: 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $150.30
  • Bcbs — Highmark Hmo/Pos: $185.21
  • Emblemhealth — All Commercial Plans: $284.64
  • Humana — Medicare Managed Care Plan: $218.95
  • Independent Health Association — All Commercial Plans: $293.31
  • Independent Health Association — Essential Other Commercial Plan: $146.09
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $225.62
  • Independent Health Association — State - Medisource Other Commercial Plan: $146.09
  • Nova Azero Health Plan — All Commercial Plans: $293.31
  • Univera — All Commercial Plans: $205.78
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: Ct Pelvis W $862 $862 Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye Not listed in the file Not listed in the file $126.07 – $399.11
MRI of a leg joint (such as the knee), without contrast: 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $157.59
  • Bcbs — Highmark Hmo/Pos: $194.19
  • Emblemhealth — All Commercial Plans: $387.20
  • Humana — Medicare Managed Care Plan: $297.84
  • Independent Health Association — All Commercial Plans: $398.25
  • Independent Health Association — Essential Other Commercial Plan: $198.36
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $306.35
  • Independent Health Association — State - Medisource Other Commercial Plan: $198.36
  • Nova Azero Health Plan — All Commercial Plans: $398.25
  • Univera — All Commercial Plans: $169.78
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee · modifier LT In the file: Mri Any Joint Lower Ext, Lt $1,599 $1,599 Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee · modifier RT In the file: Mri Any Joint Lower Ext, Rt $1,599 $1,599 Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelv w/contrast Not listed in the file Not listed in the file $167.88 – $588.41
CT scan of the abdomen and pelvis, with contrast: 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $209.85
  • Bcbs — Highmark Hmo/Pos: $258.59
  • Emblemhealth — All Commercial Plans: $566.14
  • Humana — Medicare Managed Care Plan: $435.49
  • Independent Health Association — All Commercial Plans: $588.41
  • Independent Health Association — Essential Other Commercial Plan: $293.07
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $452.62
  • Independent Health Association — State - Medisource Other Commercial Plan: $293.07
  • Nova Azero Health Plan — All Commercial Plans: $588.41
  • Univera — All Commercial Plans: $268.50
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: Ct Scan Abd & Pelvis W/Con $2,043 $2,043 Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete Not listed in the file Not listed in the file $59.05 – $175.20
Ultrasound of the abdomen, complete: 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $73.82
  • Bcbs — Highmark Hmo/Pos: $90.96
  • Emblemhealth — All Commercial Plans: $169.65
  • Humana — Medicare Managed Care Plan: $130.50
  • Independent Health Association — All Commercial Plans: $175.20
  • Independent Health Association — Essential Other Commercial Plan: $87.27
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $134.77
  • Independent Health Association — State - Medisource Other Commercial Plan: $87.27
  • Nova Azero Health Plan — All Commercial Plans: $175.20
  • Univera — All Commercial Plans: $91.66
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: Us Exam, Addom, Complete $770 $770 Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: Us Exam, Abdom Complete $770 $770 Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us >/= 14 wks sngl fetus Not listed in the file Not listed in the file $65.94 – $175.20
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $82.41
  • Bcbs — Highmark Hmo/Pos: $101.55
  • Emblemhealth — All Commercial Plans: $169.65
  • Humana — Medicare Managed Care Plan: $130.50
  • Independent Health Association — All Commercial Plans: $175.20
  • Independent Health Association — Essential Other Commercial Plan: $87.27
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $134.77
  • Independent Health Association — State - Medisource Other Commercial Plan: $87.27
  • Nova Azero Health Plan — All Commercial Plans: $175.20
  • Univera — All Commercial Plans: $103.19
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: Pregnancy Comp > 14Wks $437 $437 Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: Us Port Preg Comp $437 $437 Not listed in the file
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob Not listed in the file Not listed in the file $63.10 – $175.20
Transvaginal ultrasound: 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $78.88
  • Bcbs — Highmark Hmo/Pos: $97.20
  • Emblemhealth — All Commercial Plans: $169.65
  • Humana — Medicare Managed Care Plan: $130.50
  • Independent Health Association — All Commercial Plans: $175.20
  • Independent Health Association — Essential Other Commercial Plan: $87.27
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $134.77
  • Independent Health Association — State - Medisource Other Commercial Plan: $87.27
  • Nova Azero Health Plan — All Commercial Plans: $175.20
  • Univera — All Commercial Plans: $101.34
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: Ultrasound Echo Transvaginal $364 $364 Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni Not listed in the file Not listed in the file $52.18 – $109.49
Diagnostic mammogram, one breast: rates for 9 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $88.85
  • Bcbs — Highmark Hmo/Pos: $109.49
  • Independent Health Association — All Commercial Plans: $104.77
  • Independent Health Association — Essential Other Commercial Plan: $52.18
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $80.59
  • Independent Health Association — State - Medisource Other Commercial Plan: $52.18
  • Nova Azero Health Plan — All Commercial Plans: $104.77
  • Univera — All Commercial Plans: $92.90
  • Univera — Medicare Managed Care Plan: $88.67
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Dx mammo incl cad uni Not listed in the file Not listed in the file $42.71 – $109.59
Diagnostic mammogram, one breast: rates for 6 insurance plans
  • Emblemhealth — All Commercial Plans: $106.31
  • Humana — Medicare Managed Care Plan: $81.78
  • Independent Health Association — All Commercial Plans: $82.03
  • Independent Health Association — Essential Other Commercial Plan: $42.71
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $109.59
  • Wellcare — Medicare Managed Care Plan: $84.23
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee · modifier LT In the file: Diag Mammo Unilat W/Cad Lt $274 $274 Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi Not listed in the file Not listed in the file $66.49 – $140.15
Diagnostic mammogram, both breasts: rates for 9 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $113.74
  • Bcbs — Highmark Hmo/Pos: $140.15
  • Independent Health Association — All Commercial Plans: $133.50
  • Independent Health Association — Essential Other Commercial Plan: $66.49
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $102.69
  • Independent Health Association — State - Medisource Other Commercial Plan: $66.49
  • Nova Azero Health Plan — All Commercial Plans: $133.50
  • Univera — All Commercial Plans: $118.45
  • Univera — Medicare Managed Care Plan: $113.06
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: Diag Mammo Bilat W/Cad $358 $358 Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: Diag Mammo Bilat Bmh 4 Exp $358 $358 Not listed in the file
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad Not listed in the file Not listed in the file $55.01 – $115.78
Screening mammogram, both breasts: rates for 9 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $93.96
  • Bcbs — Highmark Hmo/Pos: $115.78
  • Independent Health Association — All Commercial Plans: $110.45
  • Independent Health Association — Essential Other Commercial Plan: $55.01
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $84.96
  • Independent Health Association — State - Medisource Other Commercial Plan: $55.01
  • Nova Azero Health Plan — All Commercial Plans: $110.45
  • Univera — All Commercial Plans: $98.22
  • Univera — Medicare Managed Care Plan: $93.76
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: Screening Mammo Bilat W/Cad $290 $290 Not listed in the file
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: Screening Mammo Bilat Bmh 4 Ex $290 $290 Not listed in the file

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrocardiogram complete Not listed in the file Not listed in the file $14.55 – $107.72
Electrocardiogram (ECG/EKG) with reading: rates for 9 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $16.02
  • Bcbs — Highmark Hmo/Pos: $19.74
  • Independent Health Association — All Commercial Plans: $107.72
  • Independent Health Association — Essential Other Commercial Plan: $53.66
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $82.87
  • Independent Health Association — State - Medisource Other Commercial Plan: $53.66
  • Nova Azero Health Plan — All Commercial Plans: $107.72
  • Univera — All Commercial Plans: $14.55
  • Univera — Medicare Managed Care Plan: $16.11
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Hospital (facility) fee In the file: Electrocardiogram, Complete $78 $78 Not listed in the file
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Hospital (facility) fee · modifier PO In the file: Ekg 12 Leads With Interp & Rep $78 $78 Not listed in the file
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left hrt cath w/ventrclgrphy Not listed in the file Not listed in the file $590.52 – $10,914
Left heart catheterization (diagnostic): 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $738.16
  • Bcbs — Highmark Hmo/Pos: $909.59
  • Emblemhealth — All Commercial Plans: $5,260.91
  • Humana — Medicare Managed Care Plan: $4,046.85
  • Independent Health Association — All Commercial Plans: $4,058.99
  • Independent Health Association — Essential Other Commercial Plan: $2,113.27
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $5,422.78
  • Unitedhealthcare — All Commercial Plans: $10,914
  • Univera — All Commercial Plans: $941.69
  • Univera — Medicare Managed Care Plan: $746.86
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: Left Hrt Cath W Ventrclgrphy $7,442 $7,442 Not listed in the file
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrophysiology evaluation Not listed in the file Not listed in the file $280.54 – $13,046.50
Heart rhythm study (electrophysiology evaluation): 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $350.67
  • Bcbs — Highmark Hmo/Pos: $432.11
  • Emblemhealth — All Commercial Plans: $12,657.05
  • Humana — Medicare Managed Care Plan: $9,736.19
  • Independent Health Association — All Commercial Plans: $9,765.40
  • Independent Health Association — Essential Other Commercial Plan: $5,084.24
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $13,046.50
  • Unitedhealthcare — All Commercial Plans: $10,914
  • Univera — All Commercial Plans: $638.55
  • Univera — Medicare Managed Care Plan: $604.94
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tx atrial fib pulm vein isol Not listed in the file Not listed in the file $1,181.57 – $43,720.81
Heart rhythm study with ablation for atrial fibrillation: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $3,327.46
  • Bcbs — Highmark Hmo/Pos: $3,767.24
  • Emblemhealth — All Commercial Plans: $42,415.71
  • Humana — Medicare Managed Care Plan: $32,627.47
  • Independent Health Association — All Commercial Plans: $32,725.35
  • Independent Health Association — Essential Other Commercial Plan: $17,038.06
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $43,720.81
  • Unitedhealthcare — All Commercial Plans: $10,914
  • Univera — All Commercial Plans: $1,718.31
  • Univera — Medicare Managed Care Plan: $1,627.87
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param Not listed in the file Not listed in the file $357.10 – $1,676.24
Sleep study (overnight, in a sleep lab): 10 of 12 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $446.38
  • Bcbs — Highmark Hmo/Pos: $550.05
  • Emblemhealth — All Commercial Plans: $1,393.54
  • Humana — Medicare Managed Care Plan: $1,071.95
  • Independent Health Association — All Commercial Plans: $1,676.24
  • Independent Health Association — Essential Other Commercial Plan: $834.89
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $1,289.41
  • Independent Health Association — State - Medisource Other Commercial Plan: $834.89
  • Nova Azero Health Plan — All Commercial Plans: $1,676.24
  • Univera — All Commercial Plans: $567.11
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: Sleep Staging 4 Or More Param. $2,688 $2,688 Not listed in the file

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic exercises Not listed in the file Not listed in the file $14.76 – $49.60
Physical therapy: therapeutic exercise (each 15 minutes): rates for 10 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $40.25
  • Bcbs — Highmark Hmo/Pos: $49.60
  • Emblemhealth — All Commercial Plans: $36.75
  • Humana — Medicare Managed Care Plan: $28.27
  • Independent Health Association — All Commercial Plans: $28.35
  • Independent Health Association — Essential Other Commercial Plan: $14.76
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $37.88
  • Univera — All Commercial Plans: $32.46
  • Univera — Medicare Managed Care Plan: $29.25
  • Wellcare — Medicare Managed Care Plan: $29.12
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee · modifier GO In the file: Kinetic Activities $96 $96 Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee · modifier 97 In the file: Therapeutic Exercise $96 $96 Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min Not listed in the file Not listed in the file $49.85 – $127.92
Physical therapy evaluation (low complexity): rates for 10 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $71.28
  • Bcbs — Highmark Hmo/Pos: $87.83
  • Emblemhealth — All Commercial Plans: $124.10
  • Humana — Medicare Managed Care Plan: $95.46
  • Independent Health Association — All Commercial Plans: $95.75
  • Independent Health Association — Essential Other Commercial Plan: $49.85
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $127.92
  • Univera — All Commercial Plans: $110.64
  • Univera — Medicare Managed Care Plan: $99.70
  • Wellcare — Medicare Managed Care Plan: $98.32
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee · modifier 97 In the file: Pt Eval Low Complex 20 Min $236 $236 Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee · modifier 97 In the file: A/V Pt Eval Low Complex 20 Min $236 $236 Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min Not listed in the file Not listed in the file $49.85 – $127.92
Physical therapy evaluation (moderate complexity): rates for 10 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $71.28
  • Bcbs — Highmark Hmo/Pos: $87.83
  • Emblemhealth — All Commercial Plans: $124.10
  • Humana — Medicare Managed Care Plan: $95.46
  • Independent Health Association — All Commercial Plans: $95.75
  • Independent Health Association — Essential Other Commercial Plan: $49.85
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $127.92
  • Univera — All Commercial Plans: $110.64
  • Univera — Medicare Managed Care Plan: $99.70
  • Wellcare — Medicare Managed Care Plan: $98.32
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee · modifier 97 In the file: Pt Eval Mod Complex 30 Min $261 $261 Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee · modifier 97 In the file: A/V Pt Eval Mod Complex 30 Min $261 $261 Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min Not listed in the file Not listed in the file $49.85 – $127.92
Physical therapy evaluation (high complexity): rates for 10 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $71.28
  • Bcbs — Highmark Hmo/Pos: $87.83
  • Emblemhealth — All Commercial Plans: $124.10
  • Humana — Medicare Managed Care Plan: $95.46
  • Independent Health Association — All Commercial Plans: $95.75
  • Independent Health Association — Essential Other Commercial Plan: $49.85
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $127.92
  • Univera — All Commercial Plans: $110.64
  • Univera — Medicare Managed Care Plan: $99.70
  • Wellcare — Medicare Managed Care Plan: $98.32
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee · modifier 97 In the file: Pt Eval High Complex 45 Min $286 $286 Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee · modifier 97 In the file: A/V Pt Eval High Complex 45 Mi $286 $286 Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 30 minutes Not listed in the file Not listed in the file $65.38 – $296.90
Psychotherapy, 30 minutes: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $65.38
  • Bcbs — Highmark Hmo/Pos: $80.56
  • Emblemhealth — All Commercial Plans: $288.03
  • Humana — Medicare Managed Care Plan: $221.56
  • Independent Health Association — All Commercial Plans: $264.72
  • Independent Health Association — Essential Other Commercial Plan: $115.70
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $203.63
  • Nova Azero Health Plan — All Commercial Plans: $264.72
  • Univera — All Commercial Plans: $82.14
  • Univera — Medicare Managed Care Plan: $70.44
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: Iop Individ Psychother 30Min $277 $277 Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: Op Ind/Famil Psychother 30 Min $277 $277 Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 45 minutes Not listed in the file Not listed in the file $86.90 – $296.90
Psychotherapy, 45 minutes: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $86.90
  • Bcbs — Highmark Hmo/Pos: $107.08
  • Emblemhealth — All Commercial Plans: $288.03
  • Humana — Medicare Managed Care Plan: $221.56
  • Independent Health Association — All Commercial Plans: $264.72
  • Independent Health Association — Essential Other Commercial Plan: $115.70
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $203.63
  • Nova Azero Health Plan — All Commercial Plans: $264.72
  • Univera — All Commercial Plans: $108.87
  • Univera — Medicare Managed Care Plan: $93.37
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: Iop Ind/Famil Psychother 45Min $367 $367 Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: Op Ind/Famil Psychother 45 Min $367 $367 Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 60 minutes Not listed in the file Not listed in the file $115.70 – $296.90
Psychotherapy, 60 minutes: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $130.66
  • Bcbs — Highmark Hmo/Pos: $161
  • Emblemhealth — All Commercial Plans: $288.03
  • Humana — Medicare Managed Care Plan: $221.56
  • Independent Health Association — All Commercial Plans: $264.72
  • Independent Health Association — Essential Other Commercial Plan: $115.70
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $203.63
  • Nova Azero Health Plan — All Commercial Plans: $264.72
  • Univera — All Commercial Plans: $160.06
  • Univera — Medicare Managed Care Plan: $137.27
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: Op Ind/Fam Psychotherapy 60Min $367 $367 Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee · modifier 95 In the file: Thav Psychotherapy 75-80 Min $367 $367 Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/o pt 50 min Not listed in the file Not listed in the file $88.50 – $296.90
Family psychotherapy, without the patient: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $88.50
  • Bcbs — Highmark Hmo/Pos: $109.05
  • Emblemhealth — All Commercial Plans: $288.03
  • Humana — Medicare Managed Care Plan: $221.56
  • Independent Health Association — All Commercial Plans: $264.72
  • Independent Health Association — Essential Other Commercial Plan: $115.70
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $203.63
  • Nova Azero Health Plan — All Commercial Plans: $264.72
  • Univera — All Commercial Plans: $117.57
  • Univera — Medicare Managed Care Plan: $100.83
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: Family Therapy W/O Patient $156 $156 Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/pt 50 min Not listed in the file Not listed in the file $91.65 – $296.90
Family psychotherapy, with the patient: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $91.65
  • Bcbs — Highmark Hmo/Pos: $112.93
  • Emblemhealth — All Commercial Plans: $288.03
  • Humana — Medicare Managed Care Plan: $221.56
  • Independent Health Association — All Commercial Plans: $264.72
  • Independent Health Association — Essential Other Commercial Plan: $115.70
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $203.63
  • Nova Azero Health Plan — All Commercial Plans: $264.72
  • Univera — All Commercial Plans: $122.61
  • Univera — Medicare Managed Care Plan: $105.15
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: Family Therapy With Patient $181 $181 Not listed in the file
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group psychotherapy Not listed in the file Not listed in the file $24.54 – $169.93
Group psychotherapy: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $24.54
  • Bcbs — Highmark Hmo/Pos: $30.24
  • Emblemhealth — All Commercial Plans: $164.86
  • Humana — Medicare Managed Care Plan: $126.81
  • Independent Health Association — All Commercial Plans: $152.41
  • Independent Health Association — Essential Other Commercial Plan: $66.22
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $117.24
  • Nova Azero Health Plan — All Commercial Plans: $152.41
  • Univera — All Commercial Plans: $28.85
  • Univera — Medicare Managed Care Plan: $24.74
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: Iop Group Therapy $37 $37 Not listed in the file
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee · modifier 95 In the file: Thav Iop Group Therapy $37 $37 Not listed in the file

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion Not listed in the file Not listed in the file $41.02 – $6,549.35
Removal of breast growth (open surgery): 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $2,000.79
  • Bcbs — Highmark Hmo/Pos: $2,263.76
  • Emblemhealth — All Commercial Plans: $6,353.85
  • Humana — Medicare Managed Care Plan: $4,887.57
  • Independent Health Association — All Commercial Plans: $4,902.24
  • Independent Health Association — Essential Other Commercial Plan: $2,552.29
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $6,549.35
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $4,045
  • Univera — Medicare Managed Care Plan: $1,634
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: Excis Of Breast Lesion 1 Or > $4,293 $4,293 Not listed in the file
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: Excision Of Cyst, One Or More $4,293 $4,293 Not listed in the file
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty Not listed in the file Not listed in the file $136.66 – $21,475.27
Total hip replacement: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $3,327.46
  • Bcbs — Highmark Hmo/Pos: $3,767.24
  • Emblemhealth — All Commercial Plans: $20,834.22
  • Humana — Medicare Managed Care Plan: $16,026.32
  • Independent Health Association — All Commercial Plans: $16,074.40
  • Independent Health Association — Essential Other Commercial Plan: $8,368.94
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $21,475.27
  • Unitedhealthcare — All Commercial Plans: $10,914
  • Univera — All Commercial Plans: $475
  • Univera — Medicare Managed Care Plan: $402
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty Not listed in the file Not listed in the file $136.52 – $21,475.27
Total knee replacement: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $2,598.53
  • Bcbs — Highmark Hmo/Pos: $3,212.12
  • Emblemhealth — All Commercial Plans: $20,834.22
  • Humana — Medicare Managed Care Plan: $16,026.32
  • Independent Health Association — All Commercial Plans: $16,074.40
  • Independent Health Association — Essential Other Commercial Plan: $8,368.94
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $21,475.27
  • Unitedhealthcare — All Commercial Plans: $10,914
  • Univera — All Commercial Plans: $475
  • Univera — Medicare Managed Care Plan: $402
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Shoulder arthroscopy/surgery Not listed in the file Not listed in the file $182.16 – $4,045
Shoulder arthroscopy: shaving of shoulder bone: rates for 5 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $2,000.79
  • Bcbs — Highmark Hmo/Pos: $2,263.76
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $4,045
  • Univera — Medicare Managed Care Plan: $1,634
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery Not listed in the file Not listed in the file $58.14 – $10,914
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $2,211.26
  • Bcbs — Highmark Hmo/Pos: $2,776.17
  • Emblemhealth — All Commercial Plans: $5,309.70
  • Humana — Medicare Managed Care Plan: $4,084.39
  • Independent Health Association — All Commercial Plans: $4,096.64
  • Independent Health Association — Essential Other Commercial Plan: $2,132.87
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $5,473.08
  • Unitedhealthcare — All Commercial Plans: $10,914
  • Univera — All Commercial Plans: $4,166
  • Univera — Medicare Managed Care Plan: $2,072
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $26.96 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $9,902.10
Removal of tonsils and adenoids (under age 12): 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $2,000.79
  • Bcbs — Highmark Hmo/Pos: $2,263.76
  • Emblemhealth — All Commercial Plans: $9,606.52
  • Humana — Medicare Managed Care Plan: $7,389.63
  • Independent Health Association — All Commercial Plans: $7,411.80
  • Independent Health Association — Essential Other Commercial Plan: $3,858.86
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $9,902.10
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $4,045
  • Univera — Medicare Managed Care Plan: $1,634
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash Not listed in the file Not listed in the file $123.57 – $3,423
Upper GI endoscopy (diagnostic): 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,114.60
  • Bcbs — Highmark Hmo/Pos: $1,219.06
  • Emblemhealth — All Commercial Plans: $1,471.83
  • Humana — Medicare Managed Care Plan: $1,132.18
  • Independent Health Association — All Commercial Plans: $1,135.57
  • Independent Health Association — Essential Other Commercial Plan: $591.22
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $1,517.11
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $877
  • Univera — Medicare Managed Care Plan: $1,029
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple Not listed in the file Not listed in the file $139.44 – $3,423
Upper GI endoscopy with biopsy: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,576.70
  • Bcbs — Highmark Hmo/Pos: $1,726.23
  • Emblemhealth — All Commercial Plans: $1,471.83
  • Humana — Medicare Managed Care Plan: $1,132.18
  • Independent Health Association — All Commercial Plans: $1,135.57
  • Independent Health Association — Essential Other Commercial Plan: $591.22
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $1,517.11
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $1,181
  • Univera — Medicare Managed Care Plan: $1,380
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy Not listed in the file Not listed in the file $101.87 – $3,423
Colonoscopy (diagnostic): 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,576.70
  • Bcbs — Highmark Hmo/Pos: $1,726.23
  • Emblemhealth — All Commercial Plans: $1,509.11
  • Humana — Medicare Managed Care Plan: $1,160.85
  • Independent Health Association — All Commercial Plans: $1,164.33
  • Independent Health Association — Essential Other Commercial Plan: $606.20
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $1,555.54
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $1,181
  • Univera — Medicare Managed Care Plan: $1,380
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy Not listed in the file Not listed in the file $221.58 – $3,423
Colonoscopy with biopsy: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,576.70
  • Bcbs — Highmark Hmo/Pos: $1,726.23
  • Emblemhealth — All Commercial Plans: $1,941.87
  • Humana — Medicare Managed Care Plan: $1,493.75
  • Independent Health Association — All Commercial Plans: $1,498.23
  • Independent Health Association — Essential Other Commercial Plan: $780.04
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $2,001.62
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $1,181
  • Univera — Medicare Managed Care Plan: $1,380
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal Not listed in the file Not listed in the file $280.44 – $3,423
Colonoscopy with removal of polyps (snare): 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,576.70
  • Bcbs — Highmark Hmo/Pos: $1,726.23
  • Emblemhealth — All Commercial Plans: $1,941.87
  • Humana — Medicare Managed Care Plan: $1,493.75
  • Independent Health Association — All Commercial Plans: $1,498.23
  • Independent Health Association — Essential Other Commercial Plan: $780.04
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $2,001.62
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $1,181
  • Univera — Medicare Managed Care Plan: $1,380
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $284.73 – $3,423
Ultrasound of the lower bowel by endoscope: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,576.70
  • Bcbs — Highmark Hmo/Pos: $1,726.23
  • Emblemhealth — All Commercial Plans: $1,941.87
  • Humana — Medicare Managed Care Plan: $1,493.75
  • Independent Health Association — All Commercial Plans: $1,498.23
  • Independent Health Association — Essential Other Commercial Plan: $780.04
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $2,001.62
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $1,181
  • Univera — Medicare Managed Care Plan: $1,380
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $79.95 – $3,423
Screening colonoscopy (not high risk): 10 of 13 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,576.70
  • Bcbs — Highmark Hmo/Pos: $1,726.23
  • Emblemhealth — All Commercial Plans: $1,509.11
  • Humana — Medicare Managed Care Plan: $1,160.85
  • Independent Health Association — All Commercial Plans: $1,502.12
  • Independent Health Association — Essential Other Commercial Plan: $748.17
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $1,155.48
  • Independent Health Association — State - Medisource Other Commercial Plan: $748.17
  • Nova Azero Health Plan — All Commercial Plans: $1,502.12
  • Unitedhealthcare — All Commercial Plans: $3,423
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $60.13 – $10,914
Gallbladder removal by laparoscope: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $2,598.53
  • Bcbs — Highmark Hmo/Pos: $3,212.12
  • Emblemhealth — All Commercial Plans: $9,810.49
  • Humana — Medicare Managed Care Plan: $7,546.53
  • Independent Health Association — All Commercial Plans: $7,569.17
  • Independent Health Association — Essential Other Commercial Plan: $3,940.80
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $10,112.36
  • Unitedhealthcare — All Commercial Plans: $10,914
  • Univera — All Commercial Plans: $4,045
  • Univera — Medicare Managed Care Plan: $1,634
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $47.79 – $10,914
Groin (inguinal) hernia repair, age 5 or older: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $2,211.26
  • Bcbs — Highmark Hmo/Pos: $2,776.17
  • Emblemhealth — All Commercial Plans: $5,810.16
  • Humana — Medicare Managed Care Plan: $4,469.36
  • Independent Health Association — All Commercial Plans: $4,482.76
  • Independent Health Association — Essential Other Commercial Plan: $2,333.90
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $5,988.94
  • Unitedhealthcare — All Commercial Plans: $10,914
  • Univera — All Commercial Plans: $4,166
  • Univera — Medicare Managed Care Plan: $2,072
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate Not listed in the file Not listed in the file $130.40 – $3,423
Prostate biopsy: rates for 5 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,576.70
  • Bcbs — Highmark Hmo/Pos: $1,726.23
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $1,181
  • Univera — Medicare Managed Care Plan: $1,380
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: Biopsy Of Prostate $1,988 $1,988 Not listed in the file
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: Prostate Biopsy $1,988 $1,988 Not listed in the file
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparo radical prostatectomy Not listed in the file Not listed in the file $98.64 – $17,780.53
Prostate removal by laparoscope (radical prostatectomy): 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $3,327.46
  • Bcbs — Highmark Hmo/Pos: $3,767.24
  • Emblemhealth — All Commercial Plans: $17,249.77
  • Humana — Medicare Managed Care Plan: $13,269.05
  • Independent Health Association — All Commercial Plans: $13,308.86
  • Independent Health Association — Essential Other Commercial Plan: $6,929.10
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $17,780.53
  • Unitedhealthcare — All Commercial Plans: $10,914
  • Univera — All Commercial Plans: $475
  • Univera — Medicare Managed Care Plan: $402
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy Not listed in the file Not listed in the file $216.27 – $5,414.74
Hysteroscopy with biopsy of the uterus lining: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $2,000.79
  • Bcbs — Highmark Hmo/Pos: $2,263.76
  • Emblemhealth — All Commercial Plans: $5,253.11
  • Humana — Medicare Managed Care Plan: $4,040.85
  • Independent Health Association — All Commercial Plans: $4,052.97
  • Independent Health Association — Essential Other Commercial Plan: $2,110.13
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $5,414.74
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $4,045
  • Univera — Medicare Managed Care Plan: $1,634
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac Not listed in the file Not listed in the file $97.68 – $3,423
Spinal injection, lower back (epidural), with imaging guidance: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,114.60
  • Bcbs — Highmark Hmo/Pos: $1,219.06
  • Emblemhealth — All Commercial Plans: $1,145.48
  • Humana — Medicare Managed Care Plan: $881.14
  • Independent Health Association — All Commercial Plans: $883.78
  • Independent Health Association — Essential Other Commercial Plan: $460.13
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $1,180.73
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $877
  • Univera — Medicare Managed Care Plan: $1,029
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: Inj Interlaminar Lmb/Sac W/Img $1,510 $1,510 Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj foramen epidural l/s Not listed in the file Not listed in the file $109.35 – $3,423
Nerve root injection, lower back, with imaging guidance: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,114.60
  • Bcbs — Highmark Hmo/Pos: $1,219.06
  • Emblemhealth — All Commercial Plans: $1,435.30
  • Humana — Medicare Managed Care Plan: $1,104.07
  • Independent Health Association — All Commercial Plans: $1,107.39
  • Independent Health Association — Essential Other Commercial Plan: $576.55
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $1,479.46
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $877
  • Univera — Medicare Managed Care Plan: $1,029
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: Njx Aa&/Strd Tfrm Epi L/S 1 $2,714 $2,714 Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee · modifier 50 In the file: Njx Aa&/Str Tfrm Epi Ls1 Bilat $4,071 $4,071 Not listed in the file
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $47.87 – $3,423
Carpal tunnel release: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,576.70
  • Bcbs — Highmark Hmo/Pos: $1,726.23
  • Emblemhealth — All Commercial Plans: $3,168.82
  • Humana — Medicare Managed Care Plan: $2,437.56
  • Independent Health Association — All Commercial Plans: $2,444.87
  • Independent Health Association — Essential Other Commercial Plan: $1,272.89
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $3,266.32
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $1,181
  • Univera — Medicare Managed Care Plan: $1,380
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery Not listed in the file Not listed in the file $31.53 – $3,423
Laser treatment of clouding after cataract surgery: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,576.70
  • Bcbs — Highmark Hmo/Pos: $1,726.23
  • Emblemhealth — All Commercial Plans: $892.52
  • Humana — Medicare Managed Care Plan: $686.55
  • Independent Health Association — All Commercial Plans: $688.61
  • Independent Health Association — Essential Other Commercial Plan: $358.52
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $919.98
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $1,181
  • Univera — Medicare Managed Care Plan: $1,380
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: Yag Laser $1,255 $1,255 Not listed in the file
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: Laser Eye Surgery, Yag $1,255 $1,255 Not listed in the file
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cataract surg w/iol 1 stage Not listed in the file Not listed in the file $55.01 – $3,860.30
Cataract removal with lens implant: 10 of 11 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $3,279.38
  • Bcbs — Highmark Hmo/Pos: $3,551.89
  • Emblemhealth — All Commercial Plans: $3,745.07
  • Humana — Medicare Managed Care Plan: $2,880.82
  • Independent Health Association — All Commercial Plans: $2,889.46
  • Independent Health Association — Essential Other Commercial Plan: $1,504.36
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $3,860.30
  • Unitedhealthcare — All Commercial Plans: $3,423
  • Univera — All Commercial Plans: $2,839
  • Univera — Medicare Managed Care Plan: $3,063

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care Not listed in the file Not listed in the file $402 – $2,608.62
Vaginal delivery, with care before and after: rates for 4 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,995.59
  • Bcbs — Highmark Hmo/Pos: $2,459.06
  • Univera — All Commercial Plans: $475
  • Univera — Medicare Managed Care Plan: $402
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $402 – $2,877.21
Cesarean delivery (C-section), with care before and after: rates for 4 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,995.59
  • Bcbs — Highmark Hmo/Pos: $2,459.06
  • Univera — All Commercial Plans: $475
  • Univera — Medicare Managed Care Plan: $402
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery Not listed in the file Not listed in the file $402 – $2,723.20
Vaginal delivery after a previous C-section, with care before and after: rates for 4 insurance plans
  • Bcbs — Bcwyn Medicare Managed Care Plan: $1,995.59
  • Bcbs — Highmark Hmo/Pos: $2,459.06
  • Univera — All Commercial Plans: $475
  • Univera — Medicare Managed Care Plan: $402

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance 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 $89,890.17 – $152,813.29
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 16 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $89,890.17
  • Emblemhealth — All Commercial Plans: $118,207.46
  • Humana — Medicare Managed Care Plan: $89,890.17
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $105,246.30
  • Mvp Health — Medicare Managed Care Plan: $89,890.17
  • Nalc — All Commercial Plans: $89,890.17
  • Seneca Nation-Lion John Hc — All Commercial Plans: $89,890.17
  • Total Senior Care — Medicare Managed Care Plan: $89,890.17
  • Unitedhealthcare — All Commercial Plans: $118,400.76
  • Unitedhealthcare — Medicare Managed Care Plan: $89,890.17
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal Fusion Except Cervical Without Mcc Not listed in the file Not listed in the file Not listed in the file
Spinal fusion (not neck), without major complications: rates for 1 insurance plan
  • Magnacare — Brighton All Commercial Plans: 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 Mcc Not listed in the file Not listed in the file $18,189.55 – $30,922.24
Hip or knee replacement (major joint of the leg), without major complications: 10 of 16 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $18,189.55
  • Emblemhealth — All Commercial Plans: $23,095.43
  • Humana — Medicare Managed Care Plan: $18,189.55
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $20,563.07
  • Mvp Health — Medicare Managed Care Plan: $18,189.55
  • Nalc — All Commercial Plans: $18,189.55
  • Seneca Nation-Lion John Hc — All Commercial Plans: $18,189.55
  • Total Senior Care — Medicare Managed Care Plan: $18,189.55
  • Unitedhealthcare — All Commercial Plans: $23,133.20
  • Unitedhealthcare — Medicare Managed Care Plan: $18,189.55
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 $22,867.40 – $38,874.58
Neck (cervical) spinal fusion, without complications: 10 of 16 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $22,867.40
  • Emblemhealth — All Commercial Plans: $28,995.76
  • Humana — Medicare Managed Care Plan: $22,867.40
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $25,816.45
  • Mvp Health — Medicare Managed Care Plan: $22,867.40
  • Nalc — All Commercial Plans: $22,867.40
  • Seneca Nation-Lion John Hc — All Commercial Plans: $22,867.40
  • Total Senior Care — Medicare Managed Care Plan: $22,867.40
  • Unitedhealthcare — All Commercial Plans: $29,043.18
  • Unitedhealthcare — Medicare Managed Care Plan: $22,867.40
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc Not listed in the file Not listed in the file $11,906.76 – $20,241.49
Uterus and ovary surgery (not for cancer), without complications: 10 of 16 insurance plan rates
  • Bcbs — Bcwyn Medicare Managed Care Plan: $11,906.76
  • Emblemhealth — All Commercial Plans: $14,681.62
  • Humana — Medicare Managed Care Plan: $11,906.76
  • Independent Health Association — Passport Ppo Medicare Managed Care Plan: $13,071.81
  • Mvp Health — Medicare Managed Care Plan: $11,906.76
  • Nalc — All Commercial Plans: $11,906.76
  • Seneca Nation-Lion John Hc — All Commercial Plans: $11,906.76
  • Total Senior Care — Medicare Managed Care Plan: $11,906.76
  • Unitedhealthcare — All Commercial Plans: $14,705.62
  • Unitedhealthcare — Medicare Managed Care Plan: $11,906.76

Source: Brooks-Tlc Hospital System, Inc’s standard charges file (hospitalpricedisclosure.com, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital typeAcute Care Hospital
Address529 Central Avenue, Dunkirk, NY 14048
CountyChautauqua County
StateNew York
Phone(716) 366‑1111
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating1 of 5 stars
CMS Certification Number330229
Name in Medicare recordsBROOKS-TLC HOSPITAL SYSTEM, INC
Profile levelMedicare data + hospital website
Name on the hospital’s websiteBrooks-TLC Hospital System, Inc
Official websitebrookshospital.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Brooks-TLC Hospital System, Inc — brookshospital.org
  2. Home - Brooks-TLC Hospital System, Inc — brookshospital.org
  3. What to Expect from the Radiology & Imaging Department at Brooks-TLC Hospital - Brooks-TLC Hospital System, Inc — brookshospital.org
  4. Surgical Services - Brooks-TLC Hospital System, Inc — brookshospital.org
  5. Speech / Language Services - Brooks-TLC Hospital System, Inc — brookshospital.org
  6. Laboratory Services - Brooks-TLC Hospital System, Inc — brookshospital.org
  7. Medical Services - Brooks-TLC Hospital System, Inc — brookshospital.org
  8. Emergency Care - Brooks-TLC Hospital System, Inc — brookshospital.org
  9. Radiology / Diagnostic Imaging - Brooks-TLC Hospital System, Inc — brookshospital.org