Does Canton-Potsdam Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Canton-Potsdam Hospital. In a medical emergency, call 911.

Where is Canton-Potsdam Hospital?

50 Leroy Street, Potsdam, NY 13676, in St. Lawrence County, New York.

What is the phone number of Canton-Potsdam Hospital?

(315) 265-3300, as listed by Medicare (CMS).

What is the Medicare star rating of Canton-Potsdam Hospital?

2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Does Medicare reduce its payments to Canton-Potsdam Hospital for hospital-acquired conditions?

Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Canton-Potsdam Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.8263; 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).

Canton-Potsdam Hospital — Phone, Address & ER

Quick answers

Does Canton-Potsdam Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Canton-Potsdam Hospital. In a medical emergency, call 911.
Where is Canton-Potsdam Hospital?: 50 Leroy Street, Potsdam, NY 13676, in St. Lawrence County, New York.
What is the phone number of Canton-Potsdam Hospital?: (315) 265-3300, as listed by Medicare (CMS).
What is the Medicare star rating of Canton-Potsdam Hospital?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Canton-Potsdam Hospital for hospital-acquired conditions?: Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Canton-Potsdam Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.8263; 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]

Conditions treated^[6]

Traumatic brain injury
Burns
Gunshot wounds
Stab wounds
Car and motorcycle crash injuries

Treatments^[4]

Infusion

Programs and centers^[4]

Stroke Center
Center for Cancer Care
Canton-Potsdam Maternity
Addiction Recovery Services inpatient rehabilitation
Imaging center

Emergency care (hospital website)^[4][6]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level III
Stroke designation	DNV-certified Primary Stroke Center

Visiting and practical information

Visiting	Visiting hours 9 a.m.-8 p.m^[4]
Parking	Free parking^[4]
Patient portal	RRH MyCare

Recognition^[4][6]

Level III Trauma Center
DNV Primary Stroke Center
DNV Certified Primary Stroke Center

Doctors and clinicians (415)

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

Main specialties

And 391 more: the button below opens the full list.

Other emergency rooms nearby

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

SLHS Massena, Inc18 mi · Massena, NY · Critical Access Hospital
Carthage Area Hospital, Inc25 mi · Ogdensburg, NY · Critical Access Hospital
Gouverneur Hospital34 mi · Gouverneur, NY · Critical Access Hospital
Clifton-Fine Hospital36 mi · Star Lake, NY · Rural Emergency Hospital
The University of Vermont Health Network-Alice Hy36 mi · Malone, NY · Critical Access Hospital

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

Other hospitals near Potsdam

St Lawrence Psychiatric Center23 mi · Ogdensburg, NY · Psychiatric Hospital
Claxton-Hepburn Medical Center25 mi · Ogdensburg, NY · Psychiatric Hospital

Hospitals in St. Lawrence 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

United Helpers Canton Nursing Home9.9 mi · Canton, NY · 3 of 5 stars
Massena Rehabilitation & Nursing Center18 mi · Massena, NY · 1 of 5 stars
North Country Nursing & Rehabilitation Center20 mi · Massena, NY · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice and Palliative Care of St Lawrence Valley3.8 mi · Potsdam, NY · 5 of 5 stars

All hospice providers in the state →

Home health agencies

Health Services of Northern New York Inc Chha3.8 mi · Potsdam, NY · 2.5 of 5 stars
Northern Lights Home Health Care10 mi · Ogdensberg, NY · 3.5 of 5 stars

All home health agencies in the state →

Dialysis facilities

Massena Dialysis Center19 mi · Massena, NY · 2 of 5 stars

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

Community Health Center of the North Country11 mi · Canton, NY · Community health center

Clinics and urgent care

Carthage Area Hospital Inc10 mi · Canton, NY · Rural health clinic
Carthage Area Hospital Inc11 mi · Madrid, NY · Rural health clinic
Carthage Area Hospital Inc16 mi · Waddington, NY · Rural health clinic

Pharmacies

KPH Healthcare Services, Inc.3.8 mi · Potsdam, NY · Community/retail pharmacy
KPH Healthcare Services, Inc.3.8 mi · Potsdam, NY · Community/retail pharmacy
Wal-Mart Stores East LP3.8 mi · Potsdam, NY · Community/retail pharmacy

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 Canton-Potsdam Hospital 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 hospital	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Patients got help quickly from staff	4 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	5 of 5 stars
Restfulness of Environment	3 of 5 stars
Care Coordination	3 of 5 stars
Symptoms After Stay	4 of 5 stars
Rated the hospital 9 or 10 out of 10	68%National average: 72%
Would definitely recommend the hospital	69%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	78%National average: 80%
“Always” got help as soon as they wanted	66%National average: 64%
Staff “always” explained medicines before giving them	62%National average: 62%
Were given information about recovery at home	88%National average: 86%
Room and bathroom “always” clean	78%National average: 73%
Completed surveys	569Response rate: 23%

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.

Central line bloodstream infections (CLABSI)	2.907No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	1.744No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.51No different from the national benchmark
Not reported to Medicare	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 attack patients	11.2%
Deaths within 30 days: heart failure patients	11.9%
Deaths within 30 days: pneumonia patients	20%
Deaths within 30 days: COPD patients	11%
Deaths within 30 days: stroke patients	13.1%
Serious complications (patient safety indicator PSI-90)	1.28No different from the national rate
Complications after hip or knee replacement	4.5%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG)

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)	17.9%
Readmitted within 30 days: heart attack	14.2%
Readmitted within 30 days: heart failure	21.1%
Readmitted within 30 days: pneumonia	19.7%
Readmitted within 30 days: COPD	21.1%
Readmitted within 30 days: hip or knee replacement	5.3%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery

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)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	152 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	68%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 Canton-Potsdam Hospital, 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 2026	YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score	0.8263Lower 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 attack	1.0519More readmissions than expected
Heart failure	1.0760More readmissions than expected
Pneumonia	0.9941Fewer readmissions than expected
COPD (chronic lung disease)	0.9717Fewer readmissions than expected
No result published	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 Score	30.75 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)	17.50 out of 100
Person and community engagement (patient survey)	48.00 out of 100
Safety (infections and sepsis care)	27.50 out of 100
Efficiency and cost reduction (Medicare spending)	30.00 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, ratio	0.96Below 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 York Best hospitals in New York

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Canton-Potsdam Hospital 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 →

Show the prices of 86 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new	Not listed in the file	Not listed in the file	$62.33 – $142.01
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $69.26 CDPHP — MEDICARE ADVANTAGE: $69.26 CHAMPUS-TRICARE — COMMERCIAL: $62.33 CIGNA — CIGNA BEHAVIORAL HEALTH: $142.01 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $70.65 HUMANA — MEDICARE ADVANTAGE: $72.72 MVP - CIGNA — ESSENTIAL 1&2: $142.01 MVP - CIGNA — INDIVIDUAL EXCHANGE: $142.01 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $69.26 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $69.26
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE_OUTPATIENT NEW LOW MDM 30 MINUTES	$353.36	$229.68	Not listed in the file
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN E_M NEW PATIENT LEVEL 3	$178.62	$116.10	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	$102.08 – $216.28
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $113.42 CDPHP — MEDICARE ADVANTAGE: $113.42 CHAMPUS-TRICARE — COMMERCIAL: $102.08 CIGNA — CIGNA BEHAVIORAL HEALTH: $216.28 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $115.69 HUMANA — MEDICARE ADVANTAGE: $119.09 MVP - CIGNA — ESSENTIAL 1&2: $216.28 MVP - CIGNA — INDIVIDUAL EXCHANGE: $216.28 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $113.42 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $113.42
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE_OUTPATIENT NEW MODERATE MDM 45 MINUTES	$461.28	$299.83	Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OMH E_M NEW PATIENT LEVEL 4	$32.73	$21.27	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	$139.66 – $272.05
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $155.18 CDPHP — MEDICARE ADVANTAGE: $155.18 CHAMPUS-TRICARE — COMMERCIAL: $139.66 CIGNA — CIGNA BEHAVIORAL HEALTH: $272.05 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $158.28 HUMANA — MEDICARE ADVANTAGE: $162.94 MVP - CIGNA — ESSENTIAL 1&2: $272.05 MVP - CIGNA — INDIVIDUAL EXCHANGE: $272.05 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $155.18 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $155.18
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE_OUTPATIENT NEW HIGH MDM 60 MINUTES	$442.17	$287.41	Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OMH E_M NEW PATIENT LEVEL 5	$195.49	$127.07	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	$50.41 – $101
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $56.01 CDPHP — MEDICARE ADVANTAGE: $56.01 CHAMPUS-TRICARE — COMMERCIAL: $50.41 CIGNA — CIGNA BEHAVIORAL HEALTH: $101 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $57.13 HUMANA — MEDICARE ADVANTAGE: $58.81 MVP - CIGNA — ESSENTIAL 1&2: $101 MVP - CIGNA — INDIVIDUAL EXCHANGE: $101 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $56.01 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $56.01
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE_OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$231.59	$150.53	Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN E_M EST PATIENT LEVEL 3	$113.47	$73.76	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	$74.10 – $149
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $82.33 CDPHP — MEDICARE ADVANTAGE: $82.33 CHAMPUS-TRICARE — COMMERCIAL: $74.10 CIGNA — CIGNA BEHAVIORAL HEALTH: $149 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $83.98 HUMANA — MEDICARE ADVANTAGE: $86.45 MVP - CIGNA — ESSENTIAL 1&2: $149 MVP - CIGNA — INDIVIDUAL EXCHANGE: $149 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $82.33 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $82.33
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE_OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$284.66	$185.03	Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OMH E_M EST PATIENT LEVEL 4	$240.17	$156.11	Not listed in the file
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE_ 40 MIN FACE_TO_FACE	$249.28	$162.03	Not listed in the file
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE TO HIGH_ 60 MIN FACE_TO_FACE	$466.42	$303.17	Not listed in the file
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 18 THROUGH 39 YEARS	$197.82	$128.58	Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 40 THROUGH 64 YEARS	$241.89	$157.23	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	$60.32 – $70.37
Emergency room visit (moderate): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $67.02 CDPHP — MEDICARE ADVANTAGE: $67.02 CHAMPUS-TRICARE — COMMERCIAL: $60.32 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $68.36 HUMANA — MEDICARE ADVANTAGE: $70.37 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $67.02 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $67.02 WELLCARE — MEDICARE ADVANTAGE: $68.36 WELLCARE — MEDICARE ADVANTAGE DUAL: $68.36
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EMERGENCY DEPT E_M VISIT_LEVEL III	$655.31	$425.95	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	$102.62 – $119.72
Emergency room visit (moderately high): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $114.02 CDPHP — MEDICARE ADVANTAGE: $114.02 CHAMPUS-TRICARE — COMMERCIAL: $102.62 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $116.30 HUMANA — MEDICARE ADVANTAGE: $119.72 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $114.02 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $114.02 WELLCARE — MEDICARE ADVANTAGE: $116.30 WELLCARE — MEDICARE ADVANTAGE DUAL: $116.30
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EMERGENCY DEPT E_M VISIT_LEVEL IV	$1,210.40	$786.76	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	$148.95 – $173.78
Emergency room visit (high): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $165.50 CDPHP — MEDICARE ADVANTAGE: $165.50 CHAMPUS-TRICARE — COMMERCIAL: $148.95 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $168.81 HUMANA — MEDICARE ADVANTAGE: $173.78 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $165.50 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $165.50 WELLCARE — MEDICARE ADVANTAGE: $168.81 WELLCARE — MEDICARE ADVANTAGE DUAL: $168.81
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EMERGENCY DEPT E_M VISIT_LEVEL V	$1,692.26	$1,099.97	Not listed in the file

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca	Not listed in the file	Not listed in the file	$7.32 – $80.13
Basic metabolic panel (blood test): 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $8.46 CDPHP — MEDICAID: $7.32 CDPHP — MEDICARE ADVANTAGE: $8.46 CHAMPUS-TRICARE — COMMERCIAL: $7.61 EXCELLUS — COMMERCIAL: $8.46 FIDELIS CARE NEW YORK — MEDICAID: $7.32 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $8.46 HUMANA — MEDICARE ADVANTAGE: $8.46 MVP - CIGNA — COMMERCIAL: $80.13 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $8.46
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL _8_	$183.10	$119.02	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	$9.50 – $100.02
Comprehensive metabolic panel (blood test): 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $10.56 CDPHP — MEDICAID: $10.10 CDPHP — MEDICARE ADVANTAGE: $10.56 CHAMPUS-TRICARE — COMMERCIAL: $9.50 EXCELLUS — COMMERCIAL: $10.56 FIDELIS CARE NEW YORK — MEDICAID: $10.10 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $10.56 HUMANA — MEDICARE ADVANTAGE: $10.56 MVP - CIGNA — COMMERCIAL: $100.02 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COMPREHENSIVE METABOLIC PANEL _14_	$298.68	$194.14	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	$43.03 – $452.83
Obstetric blood test panel: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $47.81 CDPHP — MEDICARE ADVANTAGE: $47.81 CHAMPUS-TRICARE — COMMERCIAL: $43.03 EXCELLUS — COMMERCIAL: $47.81 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $47.81 HUMANA — MEDICARE ADVANTAGE: $47.81 MVP - CIGNA — COMMERCIAL: $452.83 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $47.81 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $47.81 WELLCARE — MEDICARE ADVANTAGE: $47.81
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OBSTETRIC PANEL	$270.60	$175.89	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	$6.10 – $126.82
Cholesterol panel (lipid panel): 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $13.39 CDPHP — MEDICAID: $6.10 CDPHP — MEDICARE ADVANTAGE: $13.39 CHAMPUS-TRICARE — COMMERCIAL: $12.05 EXCELLUS — COMMERCIAL: $13.39 FIDELIS CARE NEW YORK — MEDICAID: $6.10 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $13.39 HUMANA — MEDICARE ADVANTAGE: $13.39 MVP - CIGNA — COMMERCIAL: $126.82 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LIPID PROFILE	$246.58	$160.28	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	$7.81 – $82.21
Kidney function panel: 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $8.68 CDPHP — MEDICAID: $8.68 CDPHP — MEDICARE ADVANTAGE: $8.68 CHAMPUS-TRICARE — COMMERCIAL: $7.81 EXCELLUS — COMMERCIAL: $8.68 FIDELIS CARE NEW YORK — MEDICAID: $8.68 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $8.68 HUMANA — MEDICARE ADVANTAGE: $8.68 MVP - CIGNA — COMMERCIAL: $82.21 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $8.68
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL	$250.56	$162.86	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	$7.32 – $77.38
Liver function panel: 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $8.17 CDPHP — MEDICAID: $7.32 CDPHP — MEDICARE ADVANTAGE: $8.17 CHAMPUS-TRICARE — COMMERCIAL: $7.35 EXCELLUS — COMMERCIAL: $8.17 FIDELIS CARE NEW YORK — MEDICAID: $7.32 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $8.17 HUMANA — MEDICARE ADVANTAGE: $8.17 MVP - CIGNA — COMMERCIAL: $77.38 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $8.17
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL _7_	$198.46	$129	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	$2.85 – $30.02
Urine test (automated, with microscope): 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $3.17 CDPHP — MEDICARE ADVANTAGE: $3.17 CHAMPUS-TRICARE — COMMERCIAL: $2.85 EXCELLUS — COMMERCIAL: $3.17 FIDELIS CARE NEW YORK — MEDICAID: $3.17 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $3.17 HUMANA — MEDICARE ADVANTAGE: $3.17 MVP - CIGNA — COMMERCIAL: $30.02 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $3.17 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $3.17
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINALYSIS _ ROUTINE	$118.98	$77.34	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	$2.02 – $32.96
Urine test (manual, without microscope): 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $3.48 CDPHP — MEDICARE ADVANTAGE: $3.48 CHAMPUS-TRICARE — COMMERCIAL: $3.13 EXCELLUS — COMMERCIAL: $3.48 FIDELIS CARE NEW YORK — MEDICAID: $2.02 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $3.48 HUMANA — MEDICARE ADVANTAGE: $3.48 MVP - CIGNA — COMMERCIAL: $32.96 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $3.48 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $3.48
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINE DIPSTICK_ NON_AUTOMATED	$33.40	$21.71	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	$2.02 – $21.31
Urine test (automated, without microscope): 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $2.25 CDPHP — MEDICARE ADVANTAGE: $2.25 CHAMPUS-TRICARE — COMMERCIAL: $2.02 EXCELLUS — COMMERCIAL: $2.25 FIDELIS CARE NEW YORK — MEDICAID: $2.02 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $2.25 HUMANA — MEDICARE ADVANTAGE: $2.25 MVP - CIGNA — COMMERCIAL: $21.31 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $2.25 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $2.25
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINALYSIS WO MICROSCOPY	$62.84	$40.85	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	$16.55 – $174.18
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $18.39 CDPHP — MEDICAID: $18.39 CDPHP — MEDICARE ADVANTAGE: $18.39 CHAMPUS-TRICARE — COMMERCIAL: $16.55 EXCELLUS — COMMERCIAL: $18.39 FIDELIS CARE NEW YORK — MEDICAID: $18.39 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $18.39 HUMANA — MEDICARE ADVANTAGE: $18.39 MVP - CIGNA — COMMERCIAL: $174.18 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSA_ TOTAL	$106.28	$69.08	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	$9.09 – $159.12
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $16.80 CDPHP — MEDICAID: $9.09 CDPHP — MEDICARE ADVANTAGE: $16.80 CHAMPUS-TRICARE — COMMERCIAL: $15.12 EXCELLUS — COMMERCIAL: $16.80 FIDELIS CARE NEW YORK — MEDICAID: $9.09 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $16.80 HUMANA — MEDICARE ADVANTAGE: $16.80 MVP - CIGNA — COMMERCIAL: $159.12 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE _TSH_	$276.65	$179.82	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	$3.20 – $73.59
Complete blood count (CBC) with differential: 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $7.77 CDPHP — MEDICAID: $3.20 CDPHP — MEDICARE ADVANTAGE: $7.77 CHAMPUS-TRICARE — COMMERCIAL: $6.99 EXCELLUS — COMMERCIAL: $7.77 FIDELIS CARE NEW YORK — MEDICAID: $3.20 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $7.77 HUMANA — MEDICARE ADVANTAGE: $7.77 MVP - CIGNA — COMMERCIAL: $73.59 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CBC WITH AUTO DIFFERENTIAL	$143.65	$93.37	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	$3.20 – $61.28
Complete blood count (CBC), automated: 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $6.47 CDPHP — MEDICAID: $3.20 CDPHP — MEDICARE ADVANTAGE: $6.47 CHAMPUS-TRICARE — COMMERCIAL: $5.82 EXCELLUS — COMMERCIAL: $6.47 FIDELIS CARE NEW YORK — MEDICAID: $3.20 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $6.47 HUMANA — MEDICARE ADVANTAGE: $6.47 MVP - CIGNA — COMMERCIAL: $61.28 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CBC _HEMOGRAM _ PLT_	$78.90	$51.28	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	$3.86 – $40.63
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $4.29 CDPHP — MEDICAID: $3.95 CDPHP — MEDICARE ADVANTAGE: $4.29 CHAMPUS-TRICARE — COMMERCIAL: $3.86 EXCELLUS — COMMERCIAL: $4.29 FIDELIS CARE NEW YORK — MEDICAID: $3.95 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $4.29 HUMANA — MEDICARE ADVANTAGE: $4.29 MVP - CIGNA — COMMERCIAL: $40.63 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$86.86	$56.46	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	$5.41 – $56.92
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates AETNA — MEDICARE ADVANTAGE: $6.01 CDPHP — MEDICAID: $6.01 CDPHP — MEDICARE ADVANTAGE: $6.01 CHAMPUS-TRICARE — COMMERCIAL: $5.41 EXCELLUS — COMMERCIAL: $6.01 FIDELIS CARE NEW YORK — MEDICAID: $6.01 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $6.01 HUMANA — MEDICARE ADVANTAGE: $6.01 MVP - CIGNA — COMMERCIAL: $56.92 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC APTT	$106.28	$69.08	Not listed in the file

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye	Not listed in the file	Not listed in the file	$57.33 – $126.02
CT scan of the head or brain, without contrast: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $63.70 CDPHP — MEDICAID: $121.20 CDPHP — MEDICARE ADVANTAGE: $63.70 CHAMPUS-TRICARE — COMMERCIAL: $57.33 FIDELIS CARE NEW YORK — MEDICAID: $126.02 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $64.97 HUMANA — MEDICARE ADVANTAGE: $66.89 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $63.70 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $63.70 WELLCARE — MEDICARE ADVANTAGE: $64.97
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT HEAD_BRAIN WO CONTRAST	$1,868.87	$1,214.77	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	$180.84 – $509.74
MRI of the brain, before and after contrast: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $200.93 CDPHP — MEDICAID: $505 CDPHP — MEDICARE ADVANTAGE: $200.93 CHAMPUS-TRICARE — COMMERCIAL: $180.84 FIDELIS CARE NEW YORK — MEDICAID: $509.74 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $204.95 HUMANA — MEDICARE ADVANTAGE: $210.98 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $200.93 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $200.93 WELLCARE — MEDICARE ADVANTAGE: $204.95
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI BRAIN WO _ W CONTRAST	$5,664.34	$3,681.82	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	$15.15 – $22.90
Chest X-ray, 2 views: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $21.81 CDPHP — MEDICAID: $15.15 CDPHP — MEDICARE ADVANTAGE: $21.81 CHAMPUS-TRICARE — COMMERCIAL: $19.63 FIDELIS CARE NEW YORK — MEDICAID: $15.15 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $22.25 HUMANA — MEDICARE ADVANTAGE: $22.90 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $21.81 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $21.81 WELLCARE — MEDICARE ADVANTAGE: $22.25
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC XR CHEST 2 VIEWS	$485.77	$315.75	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	$30.30 – $40.56
X-ray of the lower spine, at least 4 views: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $38.63 CDPHP — MEDICAID: $30.30 CDPHP — MEDICARE ADVANTAGE: $38.63 CHAMPUS-TRICARE — COMMERCIAL: $34.77 FIDELIS CARE NEW YORK — MEDICAID: $35.63 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $39.40 HUMANA — MEDICARE ADVANTAGE: $40.56 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $38.63 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $38.63 WELLCARE — MEDICARE ADVANTAGE: $39.40
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$823.20	$535.08	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	$105.23 – $505
MRI of the lower back (lumbar spine), without contrast: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $116.92 CDPHP — MEDICAID: $505 CDPHP — MEDICARE ADVANTAGE: $116.92 CHAMPUS-TRICARE — COMMERCIAL: $105.23 FIDELIS CARE NEW YORK — MEDICAID: $331.29 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $119.26 HUMANA — MEDICARE ADVANTAGE: $122.77 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $116.92 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $116.92 WELLCARE — MEDICARE ADVANTAGE: $119.26
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR WO CONTRAST	$3,435.75	$2,233.24	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	$147.21 – $188.83
CT scan of the pelvis, with contrast: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $163.57 CDPHP — MEDICAID: $171.70 CDPHP — MEDICARE ADVANTAGE: $163.57 CHAMPUS-TRICARE — COMMERCIAL: $147.21 FIDELIS CARE NEW YORK — MEDICAID: $188.83 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $166.84 HUMANA — MEDICARE ADVANTAGE: $171.75 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $163.57 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $163.57 WELLCARE — MEDICARE ADVANTAGE: $166.84
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT PELVIS W CONTRAST	$2,293.19	$1,490.57	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	$120.93 – $505
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $134.37 CDPHP — MEDICAID: $505 CDPHP — MEDICARE ADVANTAGE: $134.37 CHAMPUS-TRICARE — COMMERCIAL: $120.93 FIDELIS CARE NEW YORK — MEDICAID: $326.75 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $137.06 HUMANA — MEDICARE ADVANTAGE: $141.09 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $134.37 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $134.37 WELLCARE — MEDICARE ADVANTAGE: $137.06
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI LOWER EXTREMITY ANY JOINT WO CONTRAST	$3,278.28	$2,130.88	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	$109.01 – $215.72
CT scan of the abdomen and pelvis, with contrast: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $205.45 CDPHP — MEDICAID: $109.01 CDPHP — MEDICARE ADVANTAGE: $205.45 CHAMPUS-TRICARE — COMMERCIAL: $184.90 FIDELIS CARE NEW YORK — MEDICAID: $204 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $209.56 HUMANA — MEDICARE ADVANTAGE: $215.72 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $205.45 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $205.45 WELLCARE — MEDICARE ADVANTAGE: $209.56
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COMPUTED TOMOGRAPHY_ ABD _ PELVIS_ W CONTRAST	$4,419.75	$2,872.84	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	$60.60 – $105.69
Ultrasound of the abdomen, complete: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $72.82 CDPHP — MEDICAID: $60.60 CDPHP — MEDICARE ADVANTAGE: $72.82 CHAMPUS-TRICARE — COMMERCIAL: $65.54 FIDELIS CARE NEW YORK — MEDICAID: $105.69 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $74.28 HUMANA — MEDICARE ADVANTAGE: $76.46 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $72.82 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $72.82 WELLCARE — MEDICARE ADVANTAGE: $74.28
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US ECHOGRAPHY_ ABDOMINAL_ COMPLETE	$1,061.74	$690.13	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	$55.55 – $151.16
Pregnancy ultrasound (after the first trimester): 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $84.24 CDPHP — MEDICAID: $55.55 CDPHP — MEDICARE ADVANTAGE: $84.24 CHAMPUS-TRICARE — COMMERCIAL: $75.82 FIDELIS CARE NEW YORK — MEDICAID: $151.16 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $85.92 HUMANA — MEDICARE ADVANTAGE: $88.45 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $84.24 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $84.24 WELLCARE — MEDICARE ADVANTAGE: $85.92
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US PREGNANT UTERUS_ AFTER 1ST TRIMESTER_ SINGLE OR 1ST GESTATION	$479.95	$311.97	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	$60.60 – $84.79
Transvaginal ultrasound: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $80.75 CDPHP — MEDICAID: $60.60 CDPHP — MEDICARE ADVANTAGE: $80.75 CHAMPUS-TRICARE — COMMERCIAL: $72.68 FIDELIS CARE NEW YORK — MEDICAID: $80.05 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $82.36 HUMANA — MEDICARE ADVANTAGE: $84.79 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $80.75 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $80.75 WELLCARE — MEDICARE ADVANTAGE: $82.36
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US ECHOGRAPHY_TRANSVAGINAL	$936.77	$608.90	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	$73.60 – $330.53
Diagnostic mammogram, one breast: 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $81.78 CDPHP — MEDICAID: $97.97 CDPHP — MEDICARE ADVANTAGE: $81.78 CHAMPUS-TRICARE — COMMERCIAL: $73.60 EXCELLUS — COMMERCIAL: $330.53 FIDELIS CARE NEW YORK — MEDICAID: $103.01 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $83.42 HUMANA — MEDICARE ADVANTAGE: $85.87 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $81.78 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $81.78
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD UNI	$658.14	$427.79	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	$94.37 – $423.81
Diagnostic mammogram, both breasts: 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $104.86 CDPHP — MEDICAID: $97.97 CDPHP — MEDICARE ADVANTAGE: $104.86 CHAMPUS-TRICARE — COMMERCIAL: $94.37 EXCELLUS — COMMERCIAL: $423.81 FIDELIS CARE NEW YORK — MEDICAID: $125.96 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $106.96 HUMANA — MEDICARE ADVANTAGE: $110.10 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $104.86 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $104.86
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD BI	$823.20	$535.08	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	$77.89 – $349.77
Screening mammogram, both breasts: 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $86.54 CDPHP — MEDICAID: $97.97 CDPHP — MEDICARE ADVANTAGE: $86.54 CHAMPUS-TRICARE — COMMERCIAL: $77.89 EXCELLUS — COMMERCIAL: $349.77 FIDELIS CARE NEW YORK — MEDICAID: $103.39 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $88.27 HUMANA — MEDICARE ADVANTAGE: $90.87 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $86.54 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $86.54
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC SCR MAMMO BI INCL CAD	$711.60	$462.54	Not listed in the file

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrocardiogram complete	Not listed in the file	Not listed in the file	$13.25 – $15.46
Electrocardiogram (ECG/EKG) with reading: 10 of 11 insurance plan rates AETNA — MEDICARE ADVANTAGE: $14.72 CDPHP — MEDICAID: $15.15 CDPHP — MEDICARE ADVANTAGE: $14.72 CHAMPUS-TRICARE — COMMERCIAL: $13.25 FIDELIS CARE NEW YORK — MEDICAID: $15.15 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $15.01 HUMANA — MEDICARE ADVANTAGE: $15.46 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $14.72 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $14.72 WELLCARE — MEDICARE ADVANTAGE: $15.01
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ELECTROCARDIOGRAM COMPLETE	$96.04	$62.43	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	$551.08 – $642.93
Left heart catheterization (diagnostic): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $612.31 CDPHP — MEDICARE ADVANTAGE: $612.31 CHAMPUS-TRICARE — COMMERCIAL: $551.08 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $624.56 HUMANA — MEDICARE ADVANTAGE: $642.93 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $612.31 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $612.31 WELLCARE — MEDICARE ADVANTAGE: $624.56 WELLCARE — MEDICARE ADVANTAGE DUAL: $624.56
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	$685.56 – $799.82
Heart rhythm study with ablation for atrial fibrillation: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $761.73 CDPHP — MEDICARE ADVANTAGE: $761.73 CHAMPUS-TRICARE — COMMERCIAL: $685.56 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $776.96 HUMANA — MEDICARE ADVANTAGE: $799.82 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $761.73 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $761.73 WELLCARE — MEDICARE ADVANTAGE: $776.96 WELLCARE — MEDICARE ADVANTAGE DUAL: $776.96
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	$472.66 – $551.44
Sleep study (overnight, in a sleep lab): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $525.18 CDPHP — MEDICARE ADVANTAGE: $525.18 CHAMPUS-TRICARE — COMMERCIAL: $472.66 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $535.68 HUMANA — MEDICARE ADVANTAGE: $551.44 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $525.18 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $525.18 WELLCARE — MEDICARE ADVANTAGE: $535.68 WELLCARE — MEDICARE ADVANTAGE DUAL: $535.68
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POLYSOMNOGRAPHY_ AGE 6 OR OLDER_ SLEEP STAGING W 4_MORE PARAMETERS_ TECH ATTENDED	$5,044.01	$3,278.61	Not listed in the file

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic exercises	Not listed in the file	Not listed in the file	$25.44 – $77.64
Physical therapy: therapeutic exercise (each 15 minutes): rates for 10 insurance plans AETNA — MEDICARE ADVANTAGE: $28.42 CDPHP — MEDICARE ADVANTAGE: $28.27 CHAMPUS-TRICARE — COMMERCIAL: $25.44 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $28.84 HUMANA — MEDICARE ADVANTAGE: $29.68 MVP - CIGNA — COMMERCIAL: $77.64 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $28.27 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $28.27 WELLCARE — MEDICARE ADVANTAGE: $28.84 WELLCARE — MEDICARE ADVANTAGE DUAL: $28.84
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS	$152.04	$98.83	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	$85.91 – $216.76
Physical therapy evaluation (low complexity): rates for 10 insurance plans AETNA — MEDICARE ADVANTAGE: $95.94 CDPHP — MEDICARE ADVANTAGE: $95.46 CHAMPUS-TRICARE — COMMERCIAL: $85.91 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $97.37 HUMANA — MEDICARE ADVANTAGE: $100.23 MVP - CIGNA — COMMERCIAL: $216.76 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $95.46 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $95.46 WELLCARE — MEDICARE ADVANTAGE: $97.37 WELLCARE — MEDICARE ADVANTAGE DUAL: $97.37
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEX	$197.82	$128.58	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	$85.91 – $216.76
Physical therapy evaluation (moderate complexity): rates for 10 insurance plans AETNA — MEDICARE ADVANTAGE: $95.94 CDPHP — MEDICARE ADVANTAGE: $95.46 CHAMPUS-TRICARE — COMMERCIAL: $85.91 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $97.37 HUMANA — MEDICARE ADVANTAGE: $100.23 MVP - CIGNA — COMMERCIAL: $216.76 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $95.46 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $95.46 WELLCARE — MEDICARE ADVANTAGE: $97.37 WELLCARE — MEDICARE ADVANTAGE DUAL: $97.37
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEX	$224.53	$145.94	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	$85.91 – $216.76
Physical therapy evaluation (high complexity): rates for 10 insurance plans AETNA — MEDICARE ADVANTAGE: $95.94 CDPHP — MEDICARE ADVANTAGE: $95.46 CHAMPUS-TRICARE — COMMERCIAL: $85.91 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $97.37 HUMANA — MEDICARE ADVANTAGE: $100.23 MVP - CIGNA — COMMERCIAL: $216.76 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $95.46 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $95.46 WELLCARE — MEDICARE ADVANTAGE: $97.37 WELLCARE — MEDICARE ADVANTAGE DUAL: $97.37
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEX	$251.27	$163.33	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	$34 – $72.62
Psychotherapy, 30 minutes: 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $69.16 CDPHP — MEDICARE ADVANTAGE: $69.16 CHAMPUS-TRICARE — COMMERCIAL: $62.24 CIGNA — CIGNA BEHAVIORAL HEALTH: $34 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $70.54 HUMANA — MEDICARE ADVANTAGE: $72.62 MVP - CIGNA — ESSENTIAL 1&2: $34 MVP - CIGNA — INDIVIDUAL EXCHANGE: $34 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $69.16 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $69.16
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCHOTHERAPY 30 MINUTES WITH PATIENT AND_OR FAMILY MEMBER	$328.23	$213.35	Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ UP TO 44 MINS	$328.23	$213.35	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	$73 – $95.94
Psychotherapy, 45 minutes: 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $91.37 CDPHP — MEDICARE ADVANTAGE: $91.37 CHAMPUS-TRICARE — COMMERCIAL: $82.23 CIGNA — CIGNA BEHAVIORAL HEALTH: $73 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $93.20 HUMANA — MEDICARE ADVANTAGE: $95.94 MVP - CIGNA — ESSENTIAL 1&2: $73 MVP - CIGNA — INDIVIDUAL EXCHANGE: $73 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $91.37 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $91.37
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCHOTHERAPY 45 MINUTES W PATIENT AND_OR FAMILY MEMBER	$295.86	$192.31	Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN PSYCHOTHERAPY 45MINS	$307.69	$200	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	$80 – $141.39
Psychotherapy, 60 minutes: 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $134.66 CDPHP — MEDICARE ADVANTAGE: $134.66 CHAMPUS-TRICARE — COMMERCIAL: $121.19 CIGNA — CIGNA BEHAVIORAL HEALTH: $80 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $137.35 HUMANA — MEDICARE ADVANTAGE: $141.39 MVP - CIGNA — ESSENTIAL 1&2: $80 MVP - CIGNA — INDIVIDUAL EXCHANGE: $80 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $134.66 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $134.66
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCHOTHERAPY 60 MINUTES W PATIENT	$547.86	$356.11	Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OMH PSYCHOTHERAPY_ 60 MINS_ W PATIENT AND_OR FAMILY MEMBER	$307.69	$200	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 – $103.50
Family psychotherapy, without the patient: 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $98.57 CDPHP — MEDICARE ADVANTAGE: $98.57 CHAMPUS-TRICARE — COMMERCIAL: $88.71 CIGNA — CIGNA BEHAVIORAL HEALTH: $88 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $100.54 HUMANA — MEDICARE ADVANTAGE: $103.50 MVP - CIGNA — ESSENTIAL 1&2: $88 MVP - CIGNA — INDIVIDUAL EXCHANGE: $88 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $98.57 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $98.57
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ WO PATIENT PRESENT	$328.23	$213.35	Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OASAS_ FAMILY PSYCHOTHERAPY WO PATIENT PRESENT	$328.23	$213.35	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	$92 – $107.46
Family psychotherapy, with the patient: 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $102.34 CDPHP — MEDICARE ADVANTAGE: $102.34 CHAMPUS-TRICARE — COMMERCIAL: $92.11 CIGNA — CIGNA BEHAVIORAL HEALTH: $92 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $104.39 HUMANA — MEDICARE ADVANTAGE: $107.46 MVP - CIGNA — ESSENTIAL 1&2: $92 MVP - CIGNA — INDIVIDUAL EXCHANGE: $92 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $102.34 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $102.34
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT	$438.03	$284.72	Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OMH FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT	$438.03	$284.72	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	$21.78 – $30
Group psychotherapy: 10 of 12 insurance plan rates AETNA — MEDICARE ADVANTAGE: $24.20 CDPHP — MEDICARE ADVANTAGE: $24.20 CHAMPUS-TRICARE — COMMERCIAL: $21.78 CIGNA — CIGNA BEHAVIORAL HEALTH: $30 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $24.68 HUMANA — MEDICARE ADVANTAGE: $25.41 MVP - CIGNA — ESSENTIAL 1&2: $30 MVP - CIGNA — INDIVIDUAL EXCHANGE: $30 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $24.20 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $24.20
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC GROUP PSYCHOTHERAPY _OTHER THAN OF A MULTIPLE_FAMILY GROUP_	$322.19	$209.42	Not listed in the file
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OMH GROUP PSYCHOTHERAPY_ OTHER THAN OF A MULTI_FAMILY GROUP	$170.14	$110.59	Not listed in the file

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$346.60 – $404.37
Removal of breast growth (open surgery): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $385.11 CDPHP — MEDICARE ADVANTAGE: $385.11 CHAMPUS-TRICARE — COMMERCIAL: $346.60 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $392.81 HUMANA — MEDICARE ADVANTAGE: $404.37 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $385.11 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $385.11 WELLCARE — MEDICARE ADVANTAGE: $392.81 WELLCARE — MEDICARE ADVANTAGE DUAL: $392.81
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	$992.18 – $1,157.54
Total hip replacement: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $1,102.42 CDPHP — MEDICARE ADVANTAGE: $1,102.42 CHAMPUS-TRICARE — COMMERCIAL: $992.18 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $1,124.47 HUMANA — MEDICARE ADVANTAGE: $1,157.54 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $1,102.42 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $1,102.42 WELLCARE — MEDICARE ADVANTAGE: $1,124.47 WELLCARE — MEDICARE ADVANTAGE DUAL: $1,124.47
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	$990.12 – $1,155.14
Total knee replacement: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $1,100.13 CDPHP — MEDICARE ADVANTAGE: $1,100.13 CHAMPUS-TRICARE — COMMERCIAL: $990.12 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $1,122.13 HUMANA — MEDICARE ADVANTAGE: $1,155.14 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $1,100.13 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $1,100.13 WELLCARE — MEDICARE ADVANTAGE: $1,122.13 WELLCARE — MEDICARE ADVANTAGE DUAL: $1,122.13
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	$126.32 – $147.38
Shoulder arthroscopy: shaving of shoulder bone: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $140.36 CDPHP — MEDICARE ADVANTAGE: $140.36 CHAMPUS-TRICARE — COMMERCIAL: $126.32 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $143.17 HUMANA — MEDICARE ADVANTAGE: $147.38 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $140.36 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $140.36 WELLCARE — MEDICARE ADVANTAGE: $143.17 WELLCARE — MEDICARE ADVANTAGE DUAL: $143.17
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	$440.83 – $514.30
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $489.81 CDPHP — MEDICARE ADVANTAGE: $489.81 CHAMPUS-TRICARE — COMMERCIAL: $440.83 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $499.61 HUMANA — MEDICARE ADVANTAGE: $514.30 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $489.81 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $489.81 WELLCARE — MEDICARE ADVANTAGE: $499.61 WELLCARE — MEDICARE ADVANTAGE DUAL: $499.61
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	$224.83 – $262.30
Removal of tonsils and adenoids (under age 12): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $249.81 CDPHP — MEDICARE ADVANTAGE: $249.81 CHAMPUS-TRICARE — COMMERCIAL: $224.83 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $254.81 HUMANA — MEDICARE ADVANTAGE: $262.30 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $249.81 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $249.81 WELLCARE — MEDICARE ADVANTAGE: $254.81 WELLCARE — MEDICARE ADVANTAGE DUAL: $254.81
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	$95.81 – $111.78
Upper GI endoscopy (diagnostic): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $106.46 CDPHP — MEDICARE ADVANTAGE: $106.46 CHAMPUS-TRICARE — COMMERCIAL: $95.81 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $108.59 HUMANA — MEDICARE ADVANTAGE: $111.78 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $106.46 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $106.46 WELLCARE — MEDICARE ADVANTAGE: $108.59 WELLCARE — MEDICARE ADVANTAGE DUAL: $108.59
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	$107.16 – $125.02
Upper GI endoscopy with biopsy: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $119.07 CDPHP — MEDICARE ADVANTAGE: $119.07 CHAMPUS-TRICARE — COMMERCIAL: $107.16 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $121.45 HUMANA — MEDICARE ADVANTAGE: $125.02 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $119.07 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $119.07 WELLCARE — MEDICARE ADVANTAGE: $121.45 WELLCARE — MEDICARE ADVANTAGE DUAL: $121.45
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	$142.52 – $166.28
Colonoscopy (diagnostic): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $158.36 CDPHP — MEDICARE ADVANTAGE: $158.36 CHAMPUS-TRICARE — COMMERCIAL: $142.52 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $161.53 HUMANA — MEDICARE ADVANTAGE: $166.28 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $158.36 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $158.36 WELLCARE — MEDICARE ADVANTAGE: $161.53 WELLCARE — MEDICARE ADVANTAGE DUAL: $161.53
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	$154.03 – $179.70
Colonoscopy with biopsy: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $171.14 CDPHP — MEDICARE ADVANTAGE: $171.14 CHAMPUS-TRICARE — COMMERCIAL: $154.03 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $174.56 HUMANA — MEDICARE ADVANTAGE: $179.70 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $171.14 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $171.14 WELLCARE — MEDICARE ADVANTAGE: $174.56 WELLCARE — MEDICARE ADVANTAGE DUAL: $174.56
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	$193.97 – $226.30
Colonoscopy with removal of polyps (snare): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $215.52 CDPHP — MEDICARE ADVANTAGE: $215.52 CHAMPUS-TRICARE — COMMERCIAL: $193.97 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $219.83 HUMANA — MEDICARE ADVANTAGE: $226.30 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $215.52 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $215.52 WELLCARE — MEDICARE ADVANTAGE: $219.83 WELLCARE — MEDICARE ADVANTAGE DUAL: $219.83
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	$196.49 – $229.24
Ultrasound of the lower bowel by endoscope: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $218.32 CDPHP — MEDICARE ADVANTAGE: $218.32 CHAMPUS-TRICARE — COMMERCIAL: $196.49 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $222.69 HUMANA — MEDICARE ADVANTAGE: $229.24 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $218.32 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $218.32 WELLCARE — MEDICARE ADVANTAGE: $222.69 WELLCARE — MEDICARE ADVANTAGE DUAL: $222.69
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	$142.74 – $166.53
Screening colonoscopy (not high risk): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $158.60 CDPHP — MEDICARE ADVANTAGE: $158.60 CHAMPUS-TRICARE — COMMERCIAL: $142.74 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $161.77 HUMANA — MEDICARE ADVANTAGE: $166.53 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $158.60 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $158.60 WELLCARE — MEDICARE ADVANTAGE: $161.77 WELLCARE — MEDICARE ADVANTAGE DUAL: $161.77
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COLORECTAL CANCER SCREENING COLONOSCOPY NOT HIGH RISK PT	$1,637.01	$1,064.06	Not listed in the file
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	$535.83 – $625.14
Gallbladder removal by laparoscope: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $595.37 CDPHP — MEDICARE ADVANTAGE: $595.37 CHAMPUS-TRICARE — COMMERCIAL: $535.83 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $607.28 HUMANA — MEDICARE ADVANTAGE: $625.14 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $595.37 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $595.37 WELLCARE — MEDICARE ADVANTAGE: $607.28 WELLCARE — MEDICARE ADVANTAGE DUAL: $607.28
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	$430.80 – $502.60
Groin (inguinal) hernia repair, age 5 or older: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $478.67 CDPHP — MEDICARE ADVANTAGE: $478.67 CHAMPUS-TRICARE — COMMERCIAL: $430.80 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $488.24 HUMANA — MEDICARE ADVANTAGE: $502.60 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $478.67 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $478.67 WELLCARE — MEDICARE ADVANTAGE: $488.24 WELLCARE — MEDICARE ADVANTAGE DUAL: $488.24
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BIOPSY PROSTATE_ NEEDLE OR PUNCH SINGLE OR MULTIPLE ANY APPROACH	$7,139.75	$4,640.84	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	$936.89 – $1,093.04
Prostate removal by laparoscope (radical prostatectomy): rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $1,040.99 CDPHP — MEDICARE ADVANTAGE: $1,040.99 CHAMPUS-TRICARE — COMMERCIAL: $936.89 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $1,061.81 HUMANA — MEDICARE ADVANTAGE: $1,093.04 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $1,040.99 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $1,040.99 WELLCARE — MEDICARE ADVANTAGE: $1,061.81 WELLCARE — MEDICARE ADVANTAGE DUAL: $1,061.81
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	$175.54 – $204.80
Hysteroscopy with biopsy of the uterus lining: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $195.05 CDPHP — MEDICARE ADVANTAGE: $195.05 CHAMPUS-TRICARE — COMMERCIAL: $175.54 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $198.95 HUMANA — MEDICARE ADVANTAGE: $204.80 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $195.05 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $195.05 WELLCARE — MEDICARE ADVANTAGE: $198.95 WELLCARE — MEDICARE ADVANTAGE DUAL: $198.95
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee In the file: HC HYSTEROSCOPY_ SURGICAL_ W BIOPSY ENDOMETRIUM __OR POLYPECTOMY	$9,655.69	$6,276.20	Not listed in the file
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	$77.63 – $90.57
Spinal injection, lower back (epidural), with imaging guidance: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $86.26 CDPHP — MEDICARE ADVANTAGE: $86.26 CHAMPUS-TRICARE — COMMERCIAL: $77.63 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $87.99 HUMANA — MEDICARE ADVANTAGE: $90.57 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $86.26 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $86.26 WELLCARE — MEDICARE ADVANTAGE: $87.99 WELLCARE — MEDICARE ADVANTAGE DUAL: $87.99
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INJECTION EPIDURAL_SUBARACHNOID LUMBAR_SACRAL WITH IMAGING	$2,480.19	$1,612.12	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	$86.62 – $101.06
Nerve root injection, lower back, with imaging guidance: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $96.25 CDPHP — MEDICARE ADVANTAGE: $96.25 CHAMPUS-TRICARE — COMMERCIAL: $86.62 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $98.18 HUMANA — MEDICARE ADVANTAGE: $101.06 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $96.25 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $96.25 WELLCARE — MEDICARE ADVANTAGE: $98.18 WELLCARE — MEDICARE ADVANTAGE DUAL: $98.18
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INJ ANESTH__STEROID_TRANSFORAMINAL EPIDURAL_IMAGE GUIDE_FLUOR_CT__LUMBAR_SACARAL_SINGLE LVL	$3,721.82	$2,419.18	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	$361.76 – $422.06
Carpal tunnel release: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $401.96 CDPHP — MEDICARE ADVANTAGE: $401.96 CHAMPUS-TRICARE — COMMERCIAL: $361.76 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $410 HUMANA — MEDICARE ADVANTAGE: $422.06 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $401.96 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $401.96 WELLCARE — MEDICARE ADVANTAGE: $410 WELLCARE — MEDICARE ADVANTAGE DUAL: $410
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	$238.46 – $278.21
Laser treatment of clouding after cataract surgery: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $264.96 CDPHP — MEDICARE ADVANTAGE: $264.96 CHAMPUS-TRICARE — COMMERCIAL: $238.46 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $270.26 HUMANA — MEDICARE ADVANTAGE: $278.21 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $264.96 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $264.96 WELLCARE — MEDICARE ADVANTAGE: $270.26 WELLCARE — MEDICARE ADVANTAGE DUAL: $270.26
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DISCISSION SECONDARY MEMBRANOUS CATARACT_ LASER SURGERY	$2,373.49	$1,542.77	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	$402.29 – $469.34
Cataract removal with lens implant: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $446.99 CDPHP — MEDICARE ADVANTAGE: $446.99 CHAMPUS-TRICARE — COMMERCIAL: $402.29 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $455.93 HUMANA — MEDICARE ADVANTAGE: $469.34 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $446.99 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $446.99 WELLCARE — MEDICARE ADVANTAGE: $455.93 WELLCARE — MEDICARE ADVANTAGE DUAL: $455.93
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EXTRACAPSULAR CATARACT EXTRACTION W IOL_1ST SAGE_ MANUAL OR MECHANICAL_ W_O ECP	$2,317.90	$1,506.64	Not listed in the file

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care	Not listed in the file	Not listed in the file	$1,870.73 – $2,182.52
Vaginal delivery, with care before and after: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $2,078.59 CDPHP — MEDICARE ADVANTAGE: $2,078.59 CHAMPUS-TRICARE — COMMERCIAL: $1,870.73 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $2,120.16 HUMANA — MEDICARE ADVANTAGE: $2,182.52 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $2,078.59 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $2,078.59 WELLCARE — MEDICARE ADVANTAGE: $2,120.16 WELLCARE — MEDICARE ADVANTAGE DUAL: $2,120.16
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	$2,079.87 – $2,426.52
Cesarean delivery (C-section), with care before and after: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $2,310.97 CDPHP — MEDICARE ADVANTAGE: $2,310.97 CHAMPUS-TRICARE — COMMERCIAL: $2,079.87 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $2,357.19 HUMANA — MEDICARE ADVANTAGE: $2,426.52 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $2,310.97 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $2,310.97 WELLCARE — MEDICARE ADVANTAGE: $2,357.19 WELLCARE — MEDICARE ADVANTAGE DUAL: $2,357.19
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery	Not listed in the file	Not listed in the file	$1,958.58 – $2,285.01
Vaginal delivery after a previous C-section, with care before and after: rates for 9 insurance plans AETNA — MEDICARE ADVANTAGE: $2,176.20 CDPHP — MEDICARE ADVANTAGE: $2,176.20 CHAMPUS-TRICARE — COMMERCIAL: $1,958.58 FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $2,219.72 HUMANA — MEDICARE ADVANTAGE: $2,285.01 UNITED HEALTHCARE — MEDICARE ADVANTAGE: $2,176.20 UNITED HEALTHCARE — MEDICARE ADVANTAGE DUAL: $2,176.20 WELLCARE — MEDICARE ADVANTAGE: $2,219.72 WELLCARE — MEDICARE ADVANTAGE DUAL: $2,219.72

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc	Not listed in the file	Not listed in the file	$44,629.13 – $117,012.07
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 5 insurance plans AETNA — COMMERCIAL: $58,207.66 CDPHP — COMMERCIAL: $115,896.83 EMBLEM HEALTH — COMMERCIAL: $44,629.13 UNITED HEALTHCARE — COMMERCIAL: $117,012.07 ST REGIS MOHAWK — COMMERCIAL: 90% (a percentage in the contract, not a dollar amount)
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 ST REGIS MOHAWK — COMMERCIAL: 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	$8,799.64 – $23,071.57
Hip or knee replacement (major joint of the leg), without major complications: rates for 5 insurance plans AETNA — COMMERCIAL: $11,476.96 CDPHP — COMMERCIAL: $22,851.68 EMBLEM HEALTH — COMMERCIAL: $8,799.64 UNITED HEALTHCARE — COMMERCIAL: $23,071.57 ST REGIS MOHAWK — COMMERCIAL: 90% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cervical Spinal Fusion Without Cc/Mcc	Not listed in the file	Not listed in the file	$11,137.21 – $29,200.39
Neck (cervical) spinal fusion, without complications: rates for 5 insurance plans AETNA — COMMERCIAL: $14,525.74 CDPHP — COMMERCIAL: $28,922.08 EMBLEM HEALTH — COMMERCIAL: $11,137.21 UNITED HEALTHCARE — COMMERCIAL: $29,200.39 ST REGIS MOHAWK — COMMERCIAL: 90% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc	Not listed in the file	Not listed in the file	$5,660.07 – $14,840.01
Uterus and ovary surgery (not for cancer), without complications: rates for 5 insurance plans AETNA — COMMERCIAL: $7,382.16 CDPHP — COMMERCIAL: $14,698.57 EMBLEM HEALTH — COMMERCIAL: $5,660.07 UNITED HEALTHCARE — COMMERCIAL: $14,840.01 ST REGIS MOHAWK — COMMERCIAL: 90% (a percentage in the contract, not a dollar amount)

Source: Canton-Potsdam Hospital’s standard charges file (msc.rochesterregional.org, CSV, 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 type	Acute Care Hospital
Address	50 Leroy Street, Potsdam, NY 13676
County	St. Lawrence County
State	New York
Phone	(315) 265‑3300
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	330197
Name in Medicare records	CANTON-POTSDAM HOSPITAL
Profile level	Medicare data + hospital website
Official website	rochesterregional.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Canton-Potsdam Hospital - Rochester Regional Health — rochesterregional.org
Emergency Department - Potsdam | Rochester Regional Health — rochesterregional.org

Canton-Potsdam Hospital

Summary

Profile from official sources

At a glance