Does Capital Health Medical Center - Hopewell have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Capital Health Medical Center - Hopewell. In a medical emergency, call 911.

Where is Capital Health Medical Center - Hopewell?

One Capital Way, Pennington, NJ 08534, in Mercer County, New Jersey.

What is the phone number of Capital Health Medical Center - Hopewell?

(609) 303-4000, as listed by Medicare (CMS).

What is the Medicare star rating of Capital Health Medical Center - Hopewell?

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

Capital Health Medical Center - Hopewell

Quick answers

Does Capital Health Medical Center - Hopewell have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Capital Health Medical Center - Hopewell. In a medical emergency, call 911.
Where is Capital Health Medical Center - Hopewell?: One Capital Way, Pennington, NJ 08534, in Mercer County, New Jersey.
What is the phone number of Capital Health Medical Center - Hopewell?: (609) 303-4000, as listed by Medicare (CMS).
What is the Medicare star rating of Capital Health Medical Center - Hopewell?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Conditions treated^[4]

Treatments^[4]

CyberKnife radiosurgery
Cardiac rehabilitation
Physical therapy
Occupational therapy
Speech pathology
Wound management
Vein treatments
Hand therapy
Pelvic floor rehabilitation
Lymphedema management (upper extremity)
Stroke/neurological rehabilitation
Orthopedic rehabilitation
Diabetes education
Nutrition services
Lactation services

Procedures^[4]

Bariatric surgery
Hip replacement surgery
Knee replacement surgery
Shoulder and elbow surgery
Robotic-assisted surgery (daVinci)
Breast surgery
Therapeutic endoscopy (GI)
MRI

Programs and centers^[4]

Cancer Center
Capital Institute for Neurosciences
Center for Digestive Health
Heart & Vascular Institute
Metabolic & Weight Loss Center
Josephine Plumeri Birthing Center
Level III Neonatal Intensive Care
Concussion Program
Breast Center
Chest Pain Center
Comprehensive stroke program and center

Emergency care (hospital website)^[4]

Emergency room	Yes

Visiting and practical information

Patient portal	Capital Health Patient Portals

Recognition^[4]

LEED Gold certification (U.S. Green Building Council, 2012)

Doctors and clinicians (896)

896 doctors and other clinicians list Capital Health Medical Center - Hopewell 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 872 more: the button below opens the full list.

Other emergency rooms nearby

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

Capital Health Regional Medical Center6.8 mi · Trenton, NJ · Acute Care Hospital
University Medical Center of Princeton at Plainsboro8.8 mi · Plainsboro, NJ · Acute Care Hospital
Robert Wood Johnson University Hospital at Hamilton10.0 mi · Hamilton, NJ · Acute Care Hospital
St Mary Medical Center12 mi · Langhorne, PA · Acute Care Hospital
Hunterdon Medical Center14 mi · Flemington, NJ · Acute Care Hospital

Other hospitals nearby

Lawrence Rehabilitation Hospital4.2 mi · Lawrenceville, NJ · Inpatient Rehabilitation Hospital
Hackensack Meridian Health Carrier Clinic11 mi · Belle Mead, NJ · Psychiatric Hospital
St Mary Rehabilitation Hospital11 mi · Langhorne, PA · Inpatient Rehabilitation Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Lawrence Rehab & Hcc/The Meadows at Lawrence4.1 mi · Lawrenceville, NJ · 1 of 5 stars
Lawrence Rehabilitation Hospital4.2 mi · Lawrenceville, NJ · 2 of 5 stars
Preferred Care at Mercer4.6 mi · Ewing, NJ · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Greenwood House Hospice Services Inc5.0 mi · Lawrence Township, NJ
Penn Medicine Hospice Princeton Health7.6 mi · Princeton, NJ · 3 of 5 stars
Chandler Hall Health Services Inc9.0 mi · Newtown, PA · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Penn Medicine Home Health Princeton Health7.6 mi · Princeton, NJ
First Home Health Care, Inc.7.7 mi · Yardley, PA
Always a Step Beyond9.0 mi · Newtown, PA

All home health agencies in the state →

Dialysis facilities

FKC Harney's Corner5.0 mi · Lawrenceville, NJ · 2 of 5 stars
H. Fuld Capital Health5.4 mi · Trenton, NJ · 1 of 5 stars
FMC Ewing5.5 mi · Ewing, NJ · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Mercer County Surgery Center5.0 mi · Lawrenceville, NJ
Princeton Endoscopy Center LLC7.6 mi · Princeton, NJ
Princeton Eye Group, PA7.6 mi · Princeton, NJ

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Henry J. Austin Health Center-Bellevue7.0 mi · Trenton, NJ · Community health center
Henry J. Austin Health Center-Warren7.3 mi · Trenton, NJ · Community health center
Henry J Austin Health Center - Mobile Health Unit7.5 mi · Trenton, NJ · Community health center

Clinics and urgent care

Premier Brain and Spine LLC5.4 mi · Ewing, NJ · Urgent care center
Central Jersey Urgent Care7.5 mi · Skillman, NJ · Urgent care center
Tower Health Urgent Care, LLC9.0 mi · Newtown, PA · Urgent care center

Pharmacies

Capital Health Community Pharmacy, LLC0.0 mi · Pennington, NJ · Community/retail pharmacy
Capital Health System0.0 mi · Pennington, NJ · Pharmacy
New Jersey CVS Pharmacy LLC0.0 mi · Pennington, NJ · Pharmacy

Assisted living nearby

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

Arden Courts (Yardley)7.7 mi · Yardley, PA
Artis Senior Living of Yardley7.7 mi · Yardley, PA
Sunrise Senior Living of Lower Makefield7.7 mi · Yardley, PA
The Heritage of Green Hills Care Center7.7 mi · Reading, PA

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	2 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	62%National average: 72%
Would definitely recommend the hospital	66%National average: 71%
Nurses “always” communicated well	71%National average: 80%
Doctors “always” communicated well	70%National average: 80%
Staff “always” explained medicines before giving them	52%National average: 62%
Were given information about recovery at home	84%National average: 86%
Room and bathroom “always” clean	64%National average: 74%
Area around the room “always” quiet at night	48%National average: 60%
Completed surveys	1,608Response rate: 17%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.353No different from the national benchmark
Surgical site infections after colon surgery	0.337No different from the national benchmark
Surgical site infections after abdominal hysterectomy	0No different from the national benchmark
MRSA bloodstream infections	1.626No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.231Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	13.6%
Deaths within 30 days: heart failure patients	12.4%
Deaths within 30 days: pneumonia patients	16.2%
Deaths within 30 days: COPD patients	7.6%
Deaths within 30 days: stroke patients	10.6%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.12No different from the national rate
Complications after hip or knee replacement	4.1%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.1%
Readmitted within 30 days: heart failure	22.8%
Readmitted within 30 days: pneumonia	19.3%
Readmitted within 30 days: COPD	22%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	6.7%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	209 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	76%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in New Jersey Best hospitals in New Jersey

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 80 common services exactly as Capital Health Medical Center - Hopewell 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 →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW VISIT LEVEL THREE	$2,717	$2,717	$42.70 – $2,309.45
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $964.54 Aetna Better Health — Managed Medicaid: $146.72 Cigna — Local Plus: $234.75 Cigna — Managed Care/PPO: $698 Cigna — Shared Administration: $2,037.75 Clover — Medicare Advantage: $125.64 Fidelis Managed Medicaid — Managed Medicaid: $116.02 Horizon Blue Cross — Indemnity: $324.95 Horizon Blue Cross — Managed Care: $301.04 Horizon Blue Cross — Omnia: $270.88
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW VST LEVL THREE/W PROC	$1,671	$1,671	$42.70 – $1,420.35
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $593.21 Aetna Better Health — Managed Medicaid: $90.23 Cigna — Local Plus: $144.37 Cigna — Managed Care/PPO: $429.28 Cigna — Shared Administration: $1,253.25 Clover — Medicare Advantage: $125.64 Fidelis Managed Medicaid — Managed Medicaid: $71.35 Horizon Blue Cross — Indemnity: $199.85 Horizon Blue Cross — Managed Care: $185.15 Horizon Blue Cross — Omnia: $166.60
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW VISIT LEVEL 3/RESID	$2,566	$2,566	$42.70 – $2,181.10
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $910.93 Aetna Better Health — Managed Medicaid: $138.56 Cigna — Local Plus: $221.70 Cigna — Managed Care/PPO: $659.21 Cigna — Shared Administration: $1,924.50 Clover — Medicare Advantage: $125.64 Fidelis Managed Medicaid — Managed Medicaid: $109.57 Horizon Blue Cross — Indemnity: $306.89 Horizon Blue Cross — Managed Care: $284.31 Horizon Blue Cross — Omnia: $255.83
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW VISIT LEVEL FOUR	$3,168	$3,168	$60 – $2,692.80
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $1,124.64 Aetna Better Health — Managed Medicaid: $171.07 Cigna — Local Plus: $273.72 Cigna — Managed Care/PPO: $813.86 Cigna — Shared Administration: $2,376 Clover — Medicare Advantage: $189.20 Fidelis Managed Medicaid — Managed Medicaid: $135.27 Horizon Blue Cross — Indemnity: $378.89 Horizon Blue Cross — Managed Care: $351.01 Horizon Blue Cross — Omnia: $315.85
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW VST LEVL FOUR/ W PROC	$2,433	$2,433	$60 – $2,068.05
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $863.72 Aetna Better Health — Managed Medicaid: $131.38 Cigna — Local Plus: $210.21 Cigna — Managed Care/PPO: $625.04 Cigna — Shared Administration: $1,824.75 Clover — Medicare Advantage: $189.20 Fidelis Managed Medicaid — Managed Medicaid: $103.89 Horizon Blue Cross — Indemnity: $290.99 Horizon Blue Cross — Managed Care: $269.58 Horizon Blue Cross — Omnia: $242.57
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW VISIT LEVEL 4/RESID	$3,000	$3,000	$60 – $2,550
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $1,065 Aetna Better Health — Managed Medicaid: $162 Cigna — Local Plus: $259.20 Cigna — Managed Care/PPO: $770.70 Cigna — Shared Administration: $2,250 Clover — Medicare Advantage: $189.20 Fidelis Managed Medicaid — Managed Medicaid: $128.10 Horizon Blue Cross — Indemnity: $358.80 Horizon Blue Cross — Managed Care: $332.40 Horizon Blue Cross — Omnia: $299.10
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW VISIT LEVEL FIVE	$2,811	$2,811	$60 – $2,389.35
New patient office visit (about 60–74 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $997.91 Aetna Better Health — Managed Medicaid: $151.79 Cigna — Local Plus: $242.87 Cigna — Managed Care/PPO: $722.15 Cigna — Shared Administration: $2,108.25 Clover — Medicare Advantage: $252.58 Fidelis Managed Medicaid — Managed Medicaid: $120.03 Horizon Blue Cross — Indemnity: $336.20 Horizon Blue Cross — Managed Care: $311.46 Horizon Blue Cross — Omnia: $280.26
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW VST LEVL FIVE/ W PROC	$2,266	$2,266	$60 – $1,926.10
New patient office visit (about 60–74 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $804.43 Aetna Better Health — Managed Medicaid: $122.36 Cigna — Local Plus: $195.78 Cigna — Managed Care/PPO: $582.14 Cigna — Shared Administration: $1,699.50 Clover — Medicare Advantage: $252.58 Fidelis Managed Medicaid — Managed Medicaid: $96.76 Horizon Blue Cross — Indemnity: $271.01 Horizon Blue Cross — Managed Care: $251.07 Horizon Blue Cross — Omnia: $225.92
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW VISIT LEVEL 5/RESID	$2,006	$2,006	$60 – $1,705.10
New patient office visit (about 60–74 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $712.13 Aetna Better Health — Managed Medicaid: $108.32 Cigna — Local Plus: $173.32 Cigna — Managed Care/PPO: $515.34 Cigna — Shared Administration: $1,504.50 Clover — Medicare Advantage: $252.58 Fidelis Managed Medicaid — Managed Medicaid: $85.66 Horizon Blue Cross — Indemnity: $239.92 Horizon Blue Cross — Managed Care: $222.26 Horizon Blue Cross — Omnia: $200
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: P.D.CLINIC-NO LINE CHANGE	$6,084	$6,084	$23.74 – $5,171.40
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $2,159.82 Aetna Better Health — Managed Medicaid: $328.54 Cigna — Local Plus: $525.66 Cigna — Managed Care/PPO: $1,562.98 Cigna — Shared Administration: $4,563 Clover — Medicare Advantage: $101.71 Fidelis Managed Medicaid — Managed Medicaid: $259.79 Horizon Blue Cross — Indemnity: $727.65 Horizon Blue Cross — Managed Care: $674.11 Horizon Blue Cross — Omnia: $606.57
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: P.D. CLINIC - LINE CHG	$6,840	$6,840	$23.74 – $5,814
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $2,428.20 Aetna Better Health — Managed Medicaid: $369.36 Cigna — Local Plus: $590.98 Cigna — Managed Care/PPO: $1,757.20 Cigna — Shared Administration: $5,130 Clover — Medicare Advantage: $101.71 Fidelis Managed Medicaid — Managed Medicaid: $292.07 Horizon Blue Cross — Indemnity: $818.06 Horizon Blue Cross — Managed Care: $757.87 Horizon Blue Cross — Omnia: $681.95
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PD CLINIC-LINE CHG -CCPD	$6,840	$6,840	$23.74 – $5,814
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $2,428.20 Aetna Better Health — Managed Medicaid: $369.36 Cigna — Local Plus: $590.98 Cigna — Managed Care/PPO: $1,757.20 Cigna — Shared Administration: $5,130 Clover — Medicare Advantage: $101.71 Fidelis Managed Medicaid — Managed Medicaid: $292.07 Horizon Blue Cross — Indemnity: $818.06 Horizon Blue Cross — Managed Care: $757.87 Horizon Blue Cross — Omnia: $681.95
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTAB VISIT LEVEL FOUR	$2,352	$2,352	$36.51 – $1,999.20
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $834.96 Aetna Better Health — Managed Medicaid: $127.01 Cigna — Local Plus: $203.21 Cigna — Managed Care/PPO: $604.23 Cigna — Shared Administration: $1,764 Clover — Medicare Advantage: $144.77 Fidelis Managed Medicaid — Managed Medicaid: $100.43 Horizon Blue Cross — Indemnity: $281.30 Horizon Blue Cross — Managed Care: $260.60 Horizon Blue Cross — Omnia: $234.49
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EST VST LEVL FOUR/ W PROC	$2,614	$2,614	$36.51 – $2,221.90
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $927.97 Aetna Better Health — Managed Medicaid: $141.16 Cigna — Local Plus: $225.85 Cigna — Managed Care/PPO: $671.54 Cigna — Shared Administration: $1,960.50 Clover — Medicare Advantage: $144.77 Fidelis Managed Medicaid — Managed Medicaid: $111.62 Horizon Blue Cross — Indemnity: $312.63 Horizon Blue Cross — Managed Care: $289.63 Horizon Blue Cross — Omnia: $260.62
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTAB VISIT LEVEL 4/RESID	$2,079	$2,079	$36.51 – $1,767.15
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates Aetna — Commercial: $738.05 Aetna Better Health — Managed Medicaid: $112.27 Cigna — Local Plus: $179.63 Cigna — Managed Care/PPO: $534.10 Cigna — Shared Administration: $1,559.25 Clover — Medicare Advantage: $144.77 Fidelis Managed Medicaid — Managed Medicaid: $88.77 Horizon Blue Cross — Indemnity: $248.65 Horizon Blue Cross — Managed Care: $230.35 Horizon Blue Cross — Omnia: $207.28
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CONSULT INTERMEDIATE-HBO	$4,093	$4,093	$64.70 – $3,479.05
Office consultation with a specialist (moderate): 10 of 17 insurance plan rates Aetna — Commercial: $1,453.02 Aetna Better Health — Managed Medicaid: $221.02 Cigna — Local Plus: $353.64 Cigna — Managed Care/PPO: $1,051.49 Cigna — Shared Administration: $3,069.75 Clover — Medicare Advantage: $119.81 Fidelis Managed Medicaid — Managed Medicaid: $174.77 Horizon Blue Cross — Indemnity: $489.52 Horizon Blue Cross — Managed Care: $453.50 Horizon Blue Cross — Omnia: $408.07
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CONSULT INTERMEDIATE-HBO	$4,093	$4,093	$3,069.75 – $3,479.05
Office consultation with a specialist (moderate): rates for 2 insurance plans Cigna — Shared Administration: $3,069.75 MultiPlan — Commercial: $3,479.05
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CONSULT EXTENDED-HBO	$7,075	$7,075	$91.10 – $6,013.75
Office consultation with a specialist (moderate to high): 10 of 17 insurance plan rates Aetna — Commercial: $2,511.63 Aetna Better Health — Managed Medicaid: $382.05 Cigna — Local Plus: $611.28 Cigna — Managed Care/PPO: $1,817.57 Cigna — Shared Administration: $5,306.25 Clover — Medicare Advantage: $171.16 Fidelis Managed Medicaid — Managed Medicaid: $302.10 Horizon Blue Cross — Indemnity: $846.17 Horizon Blue Cross — Managed Care: $783.91 Horizon Blue Cross — Omnia: $705.38
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CONSULT EXTENDED-HBO	$7,075	$7,075	$5,306.25 – $6,013.75
Office consultation with a specialist (moderate to high): rates for 2 insurance plans Cigna — Shared Administration: $5,306.25 MultiPlan — Commercial: $6,013.75
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL 3	$10,451	$10,451	$307.12 – $8,883.35
Emergency room visit (moderate): 10 of 21 insurance plan rates Aetna — Commercial: $3,091 Aetna Better Health — Managed Medicaid: $564.35 Cigna — Local Plus: $720 Cigna — Managed Care/PPO: $1,200 Cigna — Shared Administration: $7,838.25 Clover — Medicare Advantage: $307.12 Fidelis — Commercial: $484.18 Fidelis Managed Medicaid — Managed Medicaid: $446.26 Fidelis Medicare Advantage — Medicare Advantage: $311.69 Horizon Blue Cross — Indemnity: $1,641
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: P LEVEL 3	$10,451	$10,451	$307.12 – $8,883.35
Emergency room visit (moderate): 10 of 21 insurance plan rates Aetna — Commercial: $3,091 Aetna Better Health — Managed Medicaid: $564.35 Cigna — Local Plus: $720 Cigna — Managed Care/PPO: $1,200 Cigna — Shared Administration: $7,838.25 Clover — Medicare Advantage: $307.12 Fidelis — Commercial: $484.18 Fidelis Managed Medicaid — Managed Medicaid: $446.26 Fidelis Medicare Advantage — Medicare Advantage: $311.69 Horizon Blue Cross — Indemnity: $1,641
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LEVEL 3	$10,451	$10,451	$7,838.25 – $8,883.35
Emergency room visit (moderate): rates for 2 insurance plans Cigna — Shared Administration: $7,838.25 MultiPlan — Commercial: $8,883.35
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL 4	$13,078	$13,078	$469.45 – $11,116.30
Emergency room visit (moderately high): 10 of 21 insurance plan rates Aetna — Commercial: $3,091 Aetna Better Health — Managed Medicaid: $706.21 Cigna — Local Plus: $720 Cigna — Managed Care/PPO: $1,200 Cigna — Shared Administration: $9,808.50 Clover — Medicare Advantage: $469.45 Fidelis — Commercial: $744.59 Fidelis Managed Medicaid — Managed Medicaid: $558.43 Fidelis Medicare Advantage — Medicare Advantage: $479.33 Horizon Blue Cross — Indemnity: $1,641
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: P LEVEL 4	$13,078	$13,078	$469.45 – $11,116.30
Emergency room visit (moderately high): 10 of 21 insurance plan rates Aetna — Commercial: $3,091 Aetna Better Health — Managed Medicaid: $706.21 Cigna — Local Plus: $720 Cigna — Managed Care/PPO: $1,200 Cigna — Shared Administration: $9,808.50 Clover — Medicare Advantage: $469.45 Fidelis — Commercial: $744.59 Fidelis Managed Medicaid — Managed Medicaid: $558.43 Fidelis Medicare Advantage — Medicare Advantage: $479.33 Horizon Blue Cross — Indemnity: $1,641
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LEVEL 4	$13,078	$13,078	$9,808.50 – $11,116.30
Emergency room visit (moderately high): rates for 2 insurance plans Cigna — Shared Administration: $9,808.50 MultiPlan — Commercial: $11,116.30
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL 5	$16,459	$16,459	$533.38 – $13,990.15
Emergency room visit (high): 10 of 21 insurance plan rates Aetna — Commercial: $3,091 Aetna Better Health — Managed Medicaid: $888.79 Cigna — Local Plus: $720 Cigna — Managed Care/PPO: $1,200 Cigna — Shared Administration: $12,344.25 Clover — Medicare Advantage: $670.02 Fidelis — Commercial: $1,072.06 Fidelis Managed Medicaid — Managed Medicaid: $702.80 Fidelis Medicare Advantage — Medicare Advantage: $690.14 Horizon Blue Cross — Indemnity: $1,641
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: P LEVEL 5	$16,459	$16,459	$533.38 – $13,990.15
Emergency room visit (high): 10 of 21 insurance plan rates Aetna — Commercial: $3,091 Aetna Better Health — Managed Medicaid: $888.79 Cigna — Local Plus: $720 Cigna — Managed Care/PPO: $1,200 Cigna — Shared Administration: $12,344.25 Clover — Medicare Advantage: $670.02 Fidelis — Commercial: $1,072.06 Fidelis Managed Medicaid — Managed Medicaid: $702.80 Fidelis Medicare Advantage — Medicare Advantage: $690.14 Horizon Blue Cross — Indemnity: $1,641
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LEVEL 5	$16,459	$16,459	$12,344.25 – $13,990.15
Emergency room visit (high): rates for 2 insurance plans Cigna — Shared Administration: $12,344.25 MultiPlan — Commercial: $13,990.15

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$755	$755	$8.46 – $641.75
Basic metabolic panel (blood test): 10 of 21 insurance plan rates Aetna — Commercial: $268.03 Aetna Better Health — Managed Medicaid: $40.77 Cigna — Local Plus: $30.80 Cigna — Managed Care/PPO: $30.80 Cigna — Shared Administration: $566.25 Clover — Medicare Advantage: $8.46 Fidelis — Commercial: $13.54 Fidelis Managed Medicaid — Managed Medicaid: $32.24 Fidelis Medicare Advantage — Medicare Advantage: $8.71 Horizon Blue Cross — Indemnity: $90.30
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$755	$755	$566.25 – $641.75
Basic metabolic panel (blood test): rates for 2 insurance plans Cigna — Shared Administration: $566.25 MultiPlan — Commercial: $641.75
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOL PAN	$1,434	$1,434	$10.50 – $1,218.90
Comprehensive metabolic panel (blood test): 10 of 21 insurance plan rates Aetna — Commercial: $509.07 Aetna Better Health — Managed Medicaid: $77.44 Cigna — Local Plus: $38.23 Cigna — Managed Care/PPO: $38.23 Cigna — Shared Administration: $1,075.50 Clover — Medicare Advantage: $10.56 Fidelis — Commercial: $16.90 Fidelis Managed Medicaid — Managed Medicaid: $61.23 Fidelis Medicare Advantage — Medicare Advantage: $10.88 Horizon Blue Cross — Indemnity: $171.51
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CMP, SERUM	$1,434	$1,434	$10.50 – $1,218.90
Comprehensive metabolic panel (blood test): 10 of 21 insurance plan rates Aetna — Commercial: $509.07 Aetna Better Health — Managed Medicaid: $77.44 Cigna — Local Plus: $38.23 Cigna — Managed Care/PPO: $38.23 Cigna — Shared Administration: $1,075.50 Clover — Medicare Advantage: $10.56 Fidelis — Commercial: $16.90 Fidelis Managed Medicaid — Managed Medicaid: $61.23 Fidelis Medicare Advantage — Medicare Advantage: $10.88 Horizon Blue Cross — Indemnity: $171.51
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOL PAN	$1,434	$1,434	$1,075.50 – $1,218.90
Comprehensive metabolic panel (blood test): rates for 2 insurance plans Cigna — Shared Administration: $1,075.50 MultiPlan — Commercial: $1,218.90
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	$15 – $76.50
Obstetric blood test panel: rates for 3 insurance plans Fidelis — Commercial: $76.50 Fidelis Medicare Advantage — Medicare Advantage: $49.24 United Healthcare — Managed Medicaid: $15
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYPERSENSITIVITY PNEU QUA	$200	$200	$8.54 – $170
Cholesterol panel (lipid panel): 10 of 21 insurance plan rates Aetna — Commercial: $71 Aetna Better Health — Managed Medicaid: $10.80 Cigna — Local Plus: $48.85 Cigna — Managed Care/PPO: $48.85 Cigna — Shared Administration: $150 Clover — Medicare Advantage: $13.39 Fidelis — Commercial: $21.42 Fidelis Managed Medicaid — Managed Medicaid: $8.54 Fidelis Medicare Advantage — Medicare Advantage: $13.79 Horizon Blue Cross — Indemnity: $23.92
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARDIAC IQ LIPID	$316	$316	$13.39 – $268.60
Cholesterol panel (lipid panel): 10 of 21 insurance plan rates Aetna — Commercial: $112.18 Aetna Better Health — Managed Medicaid: $17.06 Cigna — Local Plus: $48.85 Cigna — Managed Care/PPO: $48.85 Cigna — Shared Administration: $237 Clover — Medicare Advantage: $13.39 Fidelis — Commercial: $21.42 Fidelis Managed Medicaid — Managed Medicaid: $13.49 Fidelis Medicare Advantage — Medicare Advantage: $13.79 Horizon Blue Cross — Indemnity: $37.79
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$4,098	$4,098	$13.39 – $3,483.30
Cholesterol panel (lipid panel): 10 of 21 insurance plan rates Aetna — Commercial: $1,454.79 Aetna Better Health — Managed Medicaid: $221.29 Cigna — Local Plus: $48.85 Cigna — Managed Care/PPO: $48.85 Cigna — Shared Administration: $3,073.50 Clover — Medicare Advantage: $13.39 Fidelis — Commercial: $21.42 Fidelis Managed Medicaid — Managed Medicaid: $174.98 Fidelis Medicare Advantage — Medicare Advantage: $13.79 Horizon Blue Cross — Indemnity: $490.12
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$642	$642	$4.92 – $545.70
Kidney function panel: 10 of 21 insurance plan rates Aetna — Commercial: $227.91 Aetna Better Health — Managed Medicaid: $34.67 Cigna — Local Plus: $31.86 Cigna — Managed Care/PPO: $31.86 Cigna — Shared Administration: $481.50 Clover — Medicare Advantage: $8.68 Fidelis — Commercial: $13.89 Fidelis Managed Medicaid — Managed Medicaid: $27.41 Fidelis Medicare Advantage — Medicare Advantage: $8.94 Horizon Blue Cross — Indemnity: $76.78
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$642	$642	$481.50 – $545.70
Kidney function panel: rates for 2 insurance plans Cigna — Shared Administration: $481.50 MultiPlan — Commercial: $545.70
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FIBROSIS RISK	$48	$48	$2.05 – $40.80
Liver function panel: 10 of 21 insurance plan rates Aetna — Commercial: $17.04 Aetna Better Health — Managed Medicaid: $2.59 Cigna — Local Plus: $29.74 Cigna — Managed Care/PPO: $29.74 Cigna — Shared Administration: $36 Clover — Medicare Advantage: $8.17 Fidelis — Commercial: $13.07 Fidelis Managed Medicaid — Managed Medicaid: $2.05 Fidelis Medicare Advantage — Medicare Advantage: $8.42 Horizon Blue Cross — Indemnity: $5.74
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$914	$914	$7 – $776.90
Liver function panel: 10 of 21 insurance plan rates Aetna — Commercial: $324.47 Aetna Better Health — Managed Medicaid: $49.36 Cigna — Local Plus: $29.74 Cigna — Managed Care/PPO: $29.74 Cigna — Shared Administration: $685.50 Clover — Medicare Advantage: $8.17 Fidelis — Commercial: $13.07 Fidelis Managed Medicaid — Managed Medicaid: $39.03 Fidelis Medicare Advantage — Medicare Advantage: $8.42 Horizon Blue Cross — Indemnity: $109.31
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNC (BABY)	$914	$914	$7 – $776.90
Liver function panel: 10 of 21 insurance plan rates Aetna — Commercial: $324.47 Aetna Better Health — Managed Medicaid: $49.36 Cigna — Local Plus: $29.74 Cigna — Managed Care/PPO: $29.74 Cigna — Shared Administration: $685.50 Clover — Medicare Advantage: $8.17 Fidelis — Commercial: $13.07 Fidelis Managed Medicaid — Managed Medicaid: $39.03 Fidelis Medicare Advantage — Medicare Advantage: $8.42 Horizon Blue Cross — Indemnity: $109.31
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS W/MICRO	$94	$94	$1.20 – $79.90
Urine test (automated, with microscope): 10 of 21 insurance plan rates Aetna — Commercial: $33.37 Aetna Better Health — Managed Medicaid: $5.08 Cigna — Local Plus: $11.68 Cigna — Managed Care/PPO: $11.68 Cigna — Shared Administration: $70.50 Clover — Medicare Advantage: $3.17 Fidelis — Commercial: $5.07 Fidelis Managed Medicaid — Managed Medicaid: $4.01 Fidelis Medicare Advantage — Medicare Advantage: $3.27 Horizon Blue Cross — Indemnity: $11.24
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS W/MICRO	$94	$94	$70.50 – $79.90
Urine test (automated, with microscope): rates for 2 insurance plans Cigna — Shared Administration: $70.50 MultiPlan — Commercial: $79.90
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC URINALYSIS	$604	$604	$1 – $513.40
Urine test (manual, without microscope): 10 of 21 insurance plan rates Aetna — Commercial: $214.42 Aetna Better Health — Managed Medicaid: $32.62 Cigna — Local Plus: $10.62 Cigna — Managed Care/PPO: $10.62 Cigna — Shared Administration: $453 Clover — Medicare Advantage: $3.48 Fidelis — Commercial: $5.57 Fidelis Managed Medicaid — Managed Medicaid: $25.79 Fidelis Medicare Advantage — Medicare Advantage: $3.58 Horizon Blue Cross — Indemnity: $72.24
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC UA DIPSTICK	$604	$604	$1 – $513.40
Urine test (manual, without microscope): 10 of 21 insurance plan rates Aetna — Commercial: $214.42 Aetna Better Health — Managed Medicaid: $32.62 Cigna — Local Plus: $10.62 Cigna — Managed Care/PPO: $10.62 Cigna — Shared Administration: $453 Clover — Medicare Advantage: $3.48 Fidelis — Commercial: $5.57 Fidelis Managed Medicaid — Managed Medicaid: $25.79 Fidelis Medicare Advantage — Medicare Advantage: $3.58 Horizon Blue Cross — Indemnity: $72.24
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POC URINALYSIS	$604	$604	$453 – $513.40
Urine test (manual, without microscope): rates for 2 insurance plans Cigna — Shared Administration: $453 MultiPlan — Commercial: $513.40
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEMOGLOBIN, FREE,URINE	$216	$216	$1.50 – $183.60
Urine test (automated, without microscope): 10 of 21 insurance plan rates Aetna — Commercial: $76.68 Aetna Better Health — Managed Medicaid: $11.66 Cigna — Local Plus: $8.50 Cigna — Managed Care/PPO: $8.50 Cigna — Shared Administration: $162 Clover — Medicare Advantage: $2.25 Fidelis — Commercial: $3.60 Fidelis Managed Medicaid — Managed Medicaid: $9.22 Fidelis Medicare Advantage — Medicare Advantage: $2.32 Horizon Blue Cross — Indemnity: $25.83
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY STONE/URINE SAT	$50	$50	$1.50 – $42.50
Urine test (automated, without microscope): 10 of 21 insurance plan rates Aetna — Commercial: $17.75 Aetna Better Health — Managed Medicaid: $2.70 Cigna — Local Plus: $8.50 Cigna — Managed Care/PPO: $8.50 Cigna — Shared Administration: $37.50 Clover — Medicare Advantage: $2.25 Fidelis — Commercial: $3.60 Fidelis Managed Medicaid — Managed Medicaid: $2.14 Fidelis Medicare Advantage — Medicare Advantage: $2.32 Horizon Blue Cross — Indemnity: $5.98
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPECIFIC GRAVITY, URINE	$252	$252	$1.50 – $214.20
Urine test (automated, without microscope): 10 of 21 insurance plan rates Aetna — Commercial: $89.46 Aetna Better Health — Managed Medicaid: $13.61 Cigna — Local Plus: $8.50 Cigna — Managed Care/PPO: $8.50 Cigna — Shared Administration: $189 Clover — Medicare Advantage: $2.25 Fidelis — Commercial: $3.60 Fidelis Managed Medicaid — Managed Medicaid: $10.76 Fidelis Medicare Advantage — Medicare Advantage: $2.32 Horizon Blue Cross — Indemnity: $30.14
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL/FREE	$1,128	$1,128	$18.39 – $958.80
PSA (prostate specific antigen) blood test: 10 of 21 insurance plan rates Aetna — Commercial: $400.44 Aetna Better Health — Managed Medicaid: $60.91 Cigna — Local Plus: $66.91 Cigna — Managed Care/PPO: $66.91 Cigna — Shared Administration: $846 Clover — Medicare Advantage: $18.39 Fidelis — Commercial: $29.42 Fidelis Managed Medicaid — Managed Medicaid: $48.17 Fidelis Medicare Advantage — Medicare Advantage: $18.94 Horizon Blue Cross — Indemnity: $134.91
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA/PROSTATIC SPECIFIC AG	$3,326	$3,326	$18.39 – $2,827.10
PSA (prostate specific antigen) blood test: 10 of 21 insurance plan rates Aetna — Commercial: $1,180.73 Aetna Better Health — Managed Medicaid: $179.60 Cigna — Local Plus: $66.91 Cigna — Managed Care/PPO: $66.91 Cigna — Shared Administration: $2,494.50 Clover — Medicare Advantage: $18.39 Fidelis — Commercial: $29.42 Fidelis Managed Medicaid — Managed Medicaid: $142.02 Fidelis Medicare Advantage — Medicare Advantage: $18.94 Horizon Blue Cross — Indemnity: $397.79
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA TOTAL/FREE	$1,128	$1,128	$846 – $958.80
PSA (prostate specific antigen) blood test: rates for 2 insurance plans Cigna — Shared Administration: $846 MultiPlan — Commercial: $958.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH WITH REFLEX	$252	$252	$10.76 – $214.20
Thyroid stimulating hormone (TSH) test: 10 of 21 insurance plan rates Aetna — Commercial: $89.46 Aetna Better Health — Managed Medicaid: $13.61 Cigna — Local Plus: $61.60 Cigna — Managed Care/PPO: $61.60 Cigna — Shared Administration: $189 Clover — Medicare Advantage: $16.80 Fidelis — Commercial: $26.88 Fidelis Managed Medicaid — Managed Medicaid: $10.76 Fidelis Medicare Advantage — Medicare Advantage: $17.30 Horizon Blue Cross — Indemnity: $30.14
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID CASCADE REFLEX	$208	$208	$8.88 – $176.80
Thyroid stimulating hormone (TSH) test: 10 of 21 insurance plan rates Aetna — Commercial: $73.84 Aetna Better Health — Managed Medicaid: $11.23 Cigna — Local Plus: $61.60 Cigna — Managed Care/PPO: $61.60 Cigna — Shared Administration: $156 Clover — Medicare Advantage: $16.80 Fidelis — Commercial: $26.88 Fidelis Managed Medicaid — Managed Medicaid: $8.88 Fidelis Medicare Advantage — Medicare Advantage: $17.30 Horizon Blue Cross — Indemnity: $24.88
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIM.HORMONE	$3,083	$3,083	$16.80 – $2,620.55
Thyroid stimulating hormone (TSH) test: 10 of 21 insurance plan rates Aetna — Commercial: $1,094.47 Aetna Better Health — Managed Medicaid: $166.48 Cigna — Local Plus: $61.60 Cigna — Managed Care/PPO: $61.60 Cigna — Shared Administration: $2,312.25 Clover — Medicare Advantage: $16.80 Fidelis — Commercial: $26.88 Fidelis Managed Medicaid — Managed Medicaid: $131.64 Fidelis Medicare Advantage — Medicare Advantage: $17.30 Horizon Blue Cross — Indemnity: $368.73
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB PANEL W/4TH HIV	$70	$70	$2.80 – $59.50
Complete blood count (CBC) with differential: 10 of 21 insurance plan rates Aetna — Commercial: $24.85 Aetna Better Health — Managed Medicaid: $3.78 Cigna — Local Plus: $28.67 Cigna — Managed Care/PPO: $28.67 Cigna — Shared Administration: $52.50 Clover — Medicare Advantage: $7.77 Fidelis — Commercial: $12.43 Fidelis Managed Medicaid — Managed Medicaid: $2.99 Fidelis Medicare Advantage — Medicare Advantage: $8 Horizon Blue Cross — Indemnity: $8.37
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FIBROSIS RISK P2	$48	$48	$1.92 – $40.80
Complete blood count (CBC) with differential: 10 of 21 insurance plan rates Aetna — Commercial: $17.04 Aetna Better Health — Managed Medicaid: $2.59 Cigna — Local Plus: $28.67 Cigna — Managed Care/PPO: $28.67 Cigna — Shared Administration: $36 Clover — Medicare Advantage: $7.77 Fidelis — Commercial: $12.43 Fidelis Managed Medicaid — Managed Medicaid: $2.05 Fidelis Medicare Advantage — Medicare Advantage: $8 Horizon Blue Cross — Indemnity: $5.74
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC WITH DIFFERENTIAL	$1,634	$1,634	$5 – $1,388.90
Complete blood count (CBC) with differential: 10 of 21 insurance plan rates Aetna — Commercial: $580.07 Aetna Better Health — Managed Medicaid: $88.24 Cigna — Local Plus: $28.67 Cigna — Managed Care/PPO: $28.67 Cigna — Shared Administration: $1,225.50 Clover — Medicare Advantage: $7.77 Fidelis — Commercial: $12.43 Fidelis Managed Medicaid — Managed Medicaid: $69.77 Fidelis Medicare Advantage — Medicare Advantage: $8 Horizon Blue Cross — Indemnity: $195.43
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC	$466	$466	$4.80 – $396.10
Complete blood count (CBC), automated: 10 of 21 insurance plan rates Aetna — Commercial: $165.43 Aetna Better Health — Managed Medicaid: $25.16 Cigna — Local Plus: $23.36 Cigna — Managed Care/PPO: $23.36 Cigna — Shared Administration: $349.50 Clover — Medicare Advantage: $6.47 Fidelis — Commercial: $10.35 Fidelis Managed Medicaid — Managed Medicaid: $19.90 Fidelis Medicare Advantage — Medicare Advantage: $6.66 Horizon Blue Cross — Indemnity: $55.73
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC CBC	$41	$41	$1.75 – $34.85
Complete blood count (CBC), automated: 10 of 21 insurance plan rates Aetna — Commercial: $14.56 Aetna Better Health — Managed Medicaid: $2.21 Cigna — Local Plus: $23.36 Cigna — Managed Care/PPO: $23.36 Cigna — Shared Administration: $30.75 Clover — Medicare Advantage: $6.47 Fidelis — Commercial: $10.35 Fidelis Managed Medicaid — Managed Medicaid: $1.75 Fidelis Medicare Advantage — Medicare Advantage: $6.66 Horizon Blue Cross — Indemnity: $4.90
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC ANGIOJET	$466	$466	$4.80 – $396.10
Complete blood count (CBC), automated: 10 of 21 insurance plan rates Aetna — Commercial: $165.43 Aetna Better Health — Managed Medicaid: $25.16 Cigna — Local Plus: $23.36 Cigna — Managed Care/PPO: $23.36 Cigna — Shared Administration: $349.50 Clover — Medicare Advantage: $6.47 Fidelis — Commercial: $10.35 Fidelis Managed Medicaid — Managed Medicaid: $19.90 Fidelis Medicare Advantage — Medicare Advantage: $6.66 Horizon Blue Cross — Indemnity: $55.73
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOSIS VENOUS RISK P8	$1,060	$1,060	$3 – $901
Blood clotting time test (prothrombin time, PT): 10 of 21 insurance plan rates Aetna — Commercial: $376.30 Aetna Better Health — Managed Medicaid: $57.24 Cigna — Local Plus: $13.81 Cigna — Managed Care/PPO: $13.81 Cigna — Shared Administration: $795 Clover — Medicare Advantage: $4.29 Fidelis — Commercial: $6.86 Fidelis Managed Medicaid — Managed Medicaid: $45.26 Fidelis Medicare Advantage — Medicare Advantage: $4.42 Horizon Blue Cross — Indemnity: $126.78
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUPUS ANTICOAG/CARDIO P2	$101	$101	$3 – $85.85
Blood clotting time test (prothrombin time, PT): 10 of 21 insurance plan rates Aetna — Commercial: $35.86 Aetna Better Health — Managed Medicaid: $5.45 Cigna — Local Plus: $13.81 Cigna — Managed Care/PPO: $13.81 Cigna — Shared Administration: $75.75 Clover — Medicare Advantage: $4.29 Fidelis — Commercial: $6.86 Fidelis Managed Medicaid — Managed Medicaid: $4.31 Fidelis Medicare Advantage — Medicare Advantage: $4.42 Horizon Blue Cross — Indemnity: $12.08
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT* PROTHROMBIN TIME/INR	$800	$800	$3 – $680
Blood clotting time test (prothrombin time, PT): 10 of 21 insurance plan rates Aetna — Commercial: $284 Aetna Better Health — Managed Medicaid: $43.20 Cigna — Local Plus: $13.81 Cigna — Managed Care/PPO: $13.81 Cigna — Shared Administration: $600 Clover — Medicare Advantage: $4.29 Fidelis — Commercial: $6.86 Fidelis Managed Medicaid — Managed Medicaid: $34.16 Fidelis Medicare Advantage — Medicare Advantage: $4.42 Horizon Blue Cross — Indemnity: $95.68
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FACTOR INHIBITOR PANEL	$2,574	$2,574	$3 – $2,187.90
Blood clotting test (partial thromboplastin time, PTT): 10 of 21 insurance plan rates Aetna — Commercial: $913.77 Aetna Better Health — Managed Medicaid: $139 Cigna — Local Plus: $22.30 Cigna — Managed Care/PPO: $22.30 Cigna — Shared Administration: $1,930.50 Clover — Medicare Advantage: $6.01 Fidelis — Commercial: $9.62 Fidelis Managed Medicaid — Managed Medicaid: $109.91 Fidelis Medicare Advantage — Medicare Advantage: $6.19 Horizon Blue Cross — Indemnity: $307.85
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOSI VENOUS RISK P11	$1,060	$1,060	$3 – $901
Blood clotting test (partial thromboplastin time, PTT): 10 of 21 insurance plan rates Aetna — Commercial: $376.30 Aetna Better Health — Managed Medicaid: $57.24 Cigna — Local Plus: $22.30 Cigna — Managed Care/PPO: $22.30 Cigna — Shared Administration: $795 Clover — Medicare Advantage: $6.01 Fidelis — Commercial: $9.62 Fidelis Managed Medicaid — Managed Medicaid: $45.26 Fidelis Medicare Advantage — Medicare Advantage: $6.19 Horizon Blue Cross — Indemnity: $126.78
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ANTIPHOSPHOLIP SYNDROM P4	$228	$228	$3 – $193.80
Blood clotting test (partial thromboplastin time, PTT): 10 of 21 insurance plan rates Aetna — Commercial: $80.94 Aetna Better Health — Managed Medicaid: $12.31 Cigna — Local Plus: $22.30 Cigna — Managed Care/PPO: $22.30 Cigna — Shared Administration: $171 Clover — Medicare Advantage: $6.01 Fidelis — Commercial: $9.62 Fidelis Managed Medicaid — Managed Medicaid: $9.74 Fidelis Medicare Advantage — Medicare Advantage: $6.19 Horizon Blue Cross — Indemnity: $27.27

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 W/O CON	$18,988	$18,988	$117.62 – $16,139.80
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna — Commercial: $6,740.74 Aetna Better Health — Managed Medicaid: $1,025.35 Cigna — Local Plus: $183.55 Cigna — Managed Care/PPO: $183.55 Cigna — Shared Administration: $14,241 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $810.79 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $2,270.96
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PORT HEAD W/O CON	$3,078	$3,078	$117.62 – $2,616.30
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna — Commercial: $1,092.69 Aetna Better Health — Managed Medicaid: $166.21 Cigna — Local Plus: $183.55 Cigna — Managed Care/PPO: $183.55 Cigna — Shared Administration: $2,308.50 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $131.43 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $368.13
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD TRAUMATIC INJ W/O	$18,988	$18,988	$117.62 – $16,139.80
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates Aetna — Commercial: $6,740.74 Aetna Better Health — Managed Medicaid: $1,025.35 Cigna — Local Plus: $183.55 Cigna — Managed Care/PPO: $183.55 Cigna — Shared Administration: $14,241 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $810.79 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $2,270.96
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN WO/W CON	$27,735	$27,735	$392.51 – $23,574.75
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna — Commercial: $9,845.93 Aetna Better Health — Managed Medicaid: $1,497.69 Cigna — Local Plus: $661.81 Cigna — Managed Care/PPO: $661.81 Cigna — Shared Administration: $20,801.25 Clover — Medicare Advantage: $392.51 Fidelis — Commercial: $624.48 Fidelis Managed Medicaid — Managed Medicaid: $1,184.28 Fidelis Medicare Advantage — Medicare Advantage: $402.01 Horizon Blue Cross — Indemnity: $3,317.11
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN WO/W CINE	$27,735	$27,735	$392.51 – $23,574.75
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna — Commercial: $9,845.93 Aetna Better Health — Managed Medicaid: $1,497.69 Cigna — Local Plus: $661.81 Cigna — Managed Care/PPO: $661.81 Cigna — Shared Administration: $20,801.25 Clover — Medicare Advantage: $392.51 Fidelis — Commercial: $624.48 Fidelis Managed Medicaid — Managed Medicaid: $1,184.28 Fidelis Medicare Advantage — Medicare Advantage: $402.01 Horizon Blue Cross — Indemnity: $3,317.11
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN TRAUMATIC W&W/O	$27,735	$27,735	$392.51 – $23,574.75
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates Aetna — Commercial: $9,845.93 Aetna Better Health — Managed Medicaid: $1,497.69 Cigna — Local Plus: $661.81 Cigna — Managed Care/PPO: $661.81 Cigna — Shared Administration: $20,801.25 Clover — Medicare Advantage: $392.51 Fidelis — Commercial: $624.48 Fidelis Managed Medicaid — Managed Medicaid: $1,184.28 Fidelis Medicare Advantage — Medicare Advantage: $402.01 Horizon Blue Cross — Indemnity: $3,317.11
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SNIFF TEST	$5,004	$5,004	$48.64 – $4,253.40
Chest X-ray, 2 views: 10 of 21 insurance plan rates Aetna — Commercial: $234.30 Aetna Better Health — Managed Medicaid: $270.22 Cigna — Local Plus: $48.64 Cigna — Managed Care/PPO: $48.64 Cigna — Shared Administration: $3,753 Clover — Medicare Advantage: $97.91 Fidelis — Commercial: $153.97 Fidelis Managed Medicaid — Managed Medicaid: $213.67 Fidelis Medicare Advantage — Medicare Advantage: $99.12 Horizon Blue Cross — Indemnity: $598.48
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHC CHEST PA/LAT XRAY	$383	$383	$15.32 – $325.55
Chest X-ray, 2 views: 10 of 21 insurance plan rates Aetna — Commercial: $234.30 Aetna Better Health — Managed Medicaid: $20.68 Cigna — Local Plus: $48.64 Cigna — Managed Care/PPO: $48.64 Cigna — Shared Administration: $287.25 Clover — Medicare Advantage: $97.91 Fidelis — Commercial: $153.97 Fidelis Managed Medicaid — Managed Medicaid: $16.35 Fidelis Medicare Advantage — Medicare Advantage: $99.12 Horizon Blue Cross — Indemnity: $45.81
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHC CHEST INSP/EXP XRAY	$383	$383	$15.32 – $325.55
Chest X-ray, 2 views: 10 of 21 insurance plan rates Aetna — Commercial: $234.30 Aetna Better Health — Managed Medicaid: $20.68 Cigna — Local Plus: $48.64 Cigna — Managed Care/PPO: $48.64 Cigna — Shared Administration: $287.25 Clover — Medicare Advantage: $97.91 Fidelis — Commercial: $153.97 Fidelis Managed Medicaid — Managed Medicaid: $16.35 Fidelis Medicare Advantage — Medicare Advantage: $99.12 Horizon Blue Cross — Indemnity: $45.81
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR LUMBOSACRAL ROUTINE	$21,797	$21,797	$82.37 – $18,527.45
X-ray of the lower spine, at least 4 views: 10 of 21 insurance plan rates Aetna — Commercial: $379.68 Aetna Better Health — Managed Medicaid: $1,177.04 Cigna — Local Plus: $82.37 Cigna — Managed Care/PPO: $82.37 Cigna — Shared Administration: $16,347.75 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $930.73 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $2,606.92
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHC LUMBAR SPINE XRAY	$837	$837	$33.48 – $711.45
X-ray of the lower spine, at least 4 views: 10 of 21 insurance plan rates Aetna — Commercial: $379.68 Aetna Better Health — Managed Medicaid: $45.20 Cigna — Local Plus: $82.37 Cigna — Managed Care/PPO: $82.37 Cigna — Shared Administration: $627.75 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $35.74 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $100.11
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CHC LUMBAR SPINE XRAY	$837	$837	$627.75 – $711.45
X-ray of the lower spine, at least 4 views: rates for 2 insurance plans Cigna — Shared Administration: $627.75 MultiPlan — Commercial: $711.45
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI L-SPINE	$32,281	$32,281	$268.44 – $27,438.85
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates Aetna — Commercial: $11,459.76 Aetna Better Health — Managed Medicaid: $1,743.17 Cigna — Local Plus: $377.06 Cigna — Managed Care/PPO: $377.06 Cigna — Shared Administration: $24,210.75 Clover — Medicare Advantage: $268.44 Fidelis — Commercial: $422.67 Fidelis Managed Medicaid — Managed Medicaid: $1,378.40 Fidelis Medicare Advantage — Medicare Advantage: $272.10 Horizon Blue Cross — Indemnity: $3,860.81
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI L-SPINE	$32,281	$32,281	$24,210.75 – $27,438.85
MRI of the lower back (lumbar spine), without contrast: rates for 2 insurance plans Cigna — Shared Administration: $24,210.75 MultiPlan — Commercial: $27,438.85
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/ CON	$44,856	$44,856	$197.34 – $38,127.60
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates Aetna — Commercial: $15,923.88 Aetna Better Health — Managed Medicaid: $2,422.22 Cigna — Local Plus: $419.66 Cigna — Managed Care/PPO: $419.66 Cigna — Shared Administration: $33,642 Clover — Medicare Advantage: $197.34 Fidelis — Commercial: $311.28 Fidelis Managed Medicaid — Managed Medicaid: $1,915.35 Fidelis Medicare Advantage — Medicare Advantage: $200.39 Horizon Blue Cross — Indemnity: $5,364.78
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS W/ CON	$44,856	$44,856	$33,642 – $38,127.60
CT scan of the pelvis, with contrast: rates for 2 insurance plans Cigna — Shared Administration: $33,642 MultiPlan — Commercial: $38,127.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI ANKLE W/O CON LT	$18,997	$18,997	$268.44 – $16,147.45
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna — Commercial: $6,743.94 Aetna Better Health — Managed Medicaid: $1,025.84 Cigna — Local Plus: $424.81 Cigna — Managed Care/PPO: $424.81 Cigna — Shared Administration: $14,247.75 Clover — Medicare Advantage: $268.44 Fidelis — Commercial: $422.67 Fidelis Managed Medicaid — Managed Medicaid: $811.17 Fidelis Medicare Advantage — Medicare Advantage: $272.10 Horizon Blue Cross — Indemnity: $2,272.04
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI ANKLE W/O RT	$18,997	$18,997	$268.44 – $16,147.45
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna — Commercial: $6,743.94 Aetna Better Health — Managed Medicaid: $1,025.84 Cigna — Local Plus: $424.81 Cigna — Managed Care/PPO: $424.81 Cigna — Shared Administration: $14,247.75 Clover — Medicare Advantage: $268.44 Fidelis — Commercial: $422.67 Fidelis Managed Medicaid — Managed Medicaid: $811.17 Fidelis Medicare Advantage — Medicare Advantage: $272.10 Horizon Blue Cross — Indemnity: $2,272.04
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI KNEE W/O CON LT	$15,487	$15,487	$268.44 – $13,163.95
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates Aetna — Commercial: $5,497.89 Aetna Better Health — Managed Medicaid: $836.30 Cigna — Local Plus: $424.81 Cigna — Managed Care/PPO: $424.81 Cigna — Shared Administration: $11,615.25 Clover — Medicare Advantage: $268.44 Fidelis — Commercial: $422.67 Fidelis Managed Medicaid — Managed Medicaid: $661.29 Fidelis Medicare Advantage — Medicare Advantage: $272.10 Horizon Blue Cross — Indemnity: $1,852.25
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD/PELVIS W/ CON	$44,856	$44,856	$392.51 – $38,127.60
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Aetna — Commercial: $15,923.88 Aetna Better Health — Managed Medicaid: $2,422.22 Cigna — Local Plus: $551.92 Cigna — Managed Care/PPO: $551.92 Cigna — Shared Administration: $33,642 Clover — Medicare Advantage: $392.51 Fidelis — Commercial: $624.48 Fidelis Managed Medicaid — Managed Medicaid: $1,915.35 Fidelis Medicare Advantage — Medicare Advantage: $402.01 Horizon Blue Cross — Indemnity: $5,364.78
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ENTEROGRAPHY	$44,856	$44,856	$392.51 – $38,127.60
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Aetna — Commercial: $15,923.88 Aetna Better Health — Managed Medicaid: $2,422.22 Cigna — Local Plus: $551.92 Cigna — Managed Care/PPO: $551.92 Cigna — Shared Administration: $33,642 Clover — Medicare Advantage: $392.51 Fidelis — Commercial: $624.48 Fidelis Managed Medicaid — Managed Medicaid: $1,915.35 Fidelis Medicare Advantage — Medicare Advantage: $402.01 Horizon Blue Cross — Indemnity: $5,364.78
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IR CT ABDN/PELVIS WI CONT	$44,856	$44,856	$392.51 – $38,127.60
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates Aetna — Commercial: $15,923.88 Aetna Better Health — Managed Medicaid: $2,422.22 Cigna — Local Plus: $551.92 Cigna — Managed Care/PPO: $551.92 Cigna — Shared Administration: $33,642 Clover — Medicare Advantage: $392.51 Fidelis — Commercial: $624.48 Fidelis Managed Medicaid — Managed Medicaid: $1,915.35 Fidelis Medicare Advantage — Medicare Advantage: $402.01 Horizon Blue Cross — Indemnity: $5,364.78
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMEN COMPLETE	$11,128	$11,128	$117.62 – $9,458.80
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates Aetna — Commercial: $3,950.44 Aetna Better Health — Managed Medicaid: $600.91 Cigna — Local Plus: $207.53 Cigna — Managed Care/PPO: $207.53 Cigna — Shared Administration: $8,346 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $475.17 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $1,330.91
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US ABDOMEN COMPLETE	$11,128	$11,128	$8,346 – $9,458.80
Ultrasound of the abdomen, complete: rates for 2 insurance plans Cigna — Shared Administration: $8,346 MultiPlan — Commercial: $9,458.80
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US 1ST TRIMESTER >14WKS	$4,549	$4,549	$117.62 – $3,866.65
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — Commercial: $1,614.90 Aetna Better Health — Managed Medicaid: $245.65 Cigna — Local Plus: $232.37 Cigna — Managed Care/PPO: $232.37 Cigna — Shared Administration: $3,411.75 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $194.24 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $544.06
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US MF COMP ANAT SING	$4,549	$4,549	$117.62 – $3,866.65
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — Commercial: $1,614.90 Aetna Better Health — Managed Medicaid: $245.65 Cigna — Local Plus: $232.37 Cigna — Managed Care/PPO: $232.37 Cigna — Shared Administration: $3,411.75 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $194.24 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $544.06
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRNSAB SNG FETUS >14WK	$4,549	$4,549	$117.62 – $3,866.65
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates Aetna — Commercial: $1,614.90 Aetna Better Health — Managed Medicaid: $245.65 Cigna — Local Plus: $232.37 Cigna — Managed Care/PPO: $232.37 Cigna — Shared Administration: $3,411.75 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $194.24 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $544.06
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAGINAL NON OB	$21,997	$21,997	$117.62 – $18,697.45
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — Commercial: $7,808.94 Aetna Better Health — Managed Medicaid: $1,187.84 Cigna — Local Plus: $220.84 Cigna — Managed Care/PPO: $220.84 Cigna — Shared Administration: $16,497.75 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $939.27 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $2,630.84
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAG ONLY (NON OB)	$21,997	$21,997	$117.62 – $18,697.45
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — Commercial: $7,808.94 Aetna Better Health — Managed Medicaid: $1,187.84 Cigna — Local Plus: $220.84 Cigna — Managed Care/PPO: $220.84 Cigna — Shared Administration: $16,497.75 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $939.27 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $2,630.84
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAGINAL (NON OB)	$21,997	$21,997	$117.62 – $18,697.45
Transvaginal ultrasound: 10 of 20 insurance plan rates Aetna — Commercial: $7,808.94 Aetna Better Health — Managed Medicaid: $1,187.84 Cigna — Local Plus: $220.84 Cigna — Managed Care/PPO: $220.84 Cigna — Shared Administration: $16,497.75 Clover — Medicare Advantage: $117.62 Fidelis — Commercial: $185.95 Fidelis Managed Medicaid — Managed Medicaid: $939.27 Fidelis Medicare Advantage — Medicare Advantage: $119.71 Horizon Blue Cross — Indemnity: $2,630.84
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO DIG DIAG LT	$4,566	$4,566	$96.88 – $3,881.10
Diagnostic mammogram, one breast: 10 of 20 insurance plan rates Aetna — Commercial: $1,620.93 Aetna Better Health — Managed Medicaid: $246.56 Cigna — Local Plus: $236.81 Cigna — Managed Care/PPO: $236.81 Cigna — Shared Administration: $3,424.50 Clover — Medicare Advantage: $133.96 Fidelis — Commercial: $150.50 Fidelis Managed Medicaid — Managed Medicaid: $194.97 Fidelis Medicare Advantage — Medicare Advantage: $96.88 Horizon Blue Cross — Indemnity: $546.09
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO DIG DIAG RT	$4,566	$4,566	$96.88 – $3,881.10
Diagnostic mammogram, one breast: 10 of 20 insurance plan rates Aetna — Commercial: $1,620.93 Aetna Better Health — Managed Medicaid: $246.56 Cigna — Local Plus: $236.81 Cigna — Managed Care/PPO: $236.81 Cigna — Shared Administration: $3,424.50 Clover — Medicare Advantage: $133.96 Fidelis — Commercial: $150.50 Fidelis Managed Medicaid — Managed Medicaid: $194.97 Fidelis Medicare Advantage — Medicare Advantage: $96.88 Horizon Blue Cross — Indemnity: $546.09
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MG MAMMO DIG DIAG LT	$4,566	$4,566	$3,424.50 – $3,881.10
Diagnostic mammogram, one breast: rates for 2 insurance plans Cigna — Shared Administration: $3,424.50 MultiPlan — Commercial: $3,881.10
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO DIG DIAGNOS BILA	$13,663	$13,663	$123.41 – $11,613.55
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates Aetna — Commercial: $4,850.37 Aetna Better Health — Managed Medicaid: $737.80 Cigna — Local Plus: $302.50 Cigna — Managed Care/PPO: $302.50 Cigna — Shared Administration: $10,247.25 Clover — Medicare Advantage: $169.74 Fidelis — Commercial: $191.71 Fidelis Managed Medicaid — Managed Medicaid: $583.41 Fidelis Medicare Advantage — Medicare Advantage: $123.41 Horizon Blue Cross — Indemnity: $1,634.09
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MG MAMMO DIG DIAGNOS BILA	$13,663	$13,663	$10,247.25 – $11,613.55
Diagnostic mammogram, both breasts: rates for 2 insurance plans Cigna — Shared Administration: $10,247.25 MultiPlan — Commercial: $11,613.55
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO DIG SCREEN BILAT	$11,598	$11,598	$102.06 – $9,858.30
Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna — Commercial: $4,117.29 Aetna Better Health — Managed Medicaid: $626.29 Cigna — Local Plus: $250.13 Cigna — Managed Care/PPO: $250.13 Cigna — Shared Administration: $8,698.50 Clover — Medicare Advantage: $136.59 Fidelis — Commercial: $158.54 Fidelis Managed Medicaid — Managed Medicaid: $495.23 Fidelis Medicare Advantage — Medicare Advantage: $102.06 Horizon Blue Cross — Indemnity: $1,387.12
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO DIG SCREEN LT	$5,799	$5,799	$102.06 – $4,929.15
Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna — Commercial: $2,058.65 Aetna Better Health — Managed Medicaid: $313.15 Cigna — Local Plus: $250.13 Cigna — Managed Care/PPO: $250.13 Cigna — Shared Administration: $4,349.25 Clover — Medicare Advantage: $136.59 Fidelis — Commercial: $158.54 Fidelis Managed Medicaid — Managed Medicaid: $247.62 Fidelis Medicare Advantage — Medicare Advantage: $102.06 Horizon Blue Cross — Indemnity: $693.56
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO DIG SCREEN RT	$5,799	$5,799	$102.06 – $4,929.15
Screening mammogram, both breasts: 10 of 20 insurance plan rates Aetna — Commercial: $2,058.65 Aetna Better Health — Managed Medicaid: $313.15 Cigna — Local Plus: $250.13 Cigna — Managed Care/PPO: $250.13 Cigna — Shared Administration: $4,349.25 Clover — Medicare Advantage: $136.59 Fidelis — Commercial: $158.54 Fidelis Managed Medicaid — Managed Medicaid: $247.62 Fidelis Medicare Advantage — Medicare Advantage: $102.06 Horizon Blue Cross — Indemnity: $693.56

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HEART CATH	$111,486	$111,486	$3,620.60 – $111,486
Left heart catheterization (diagnostic): 10 of 18 insurance plan rates Aetna — Commercial: $17,536 Aetna Better Health — Managed Medicaid: $6,020.24 Cigna — Local Plus: $6,600 Cigna — Managed Care/PPO: $11,000 Cigna — Shared Administration: $83,614.50 Clover — Medicare Advantage: $3,647.41 Fidelis — Commercial: $5,624.24 Fidelis Managed Medicaid — Managed Medicaid: $4,760.45 Fidelis Medicare Advantage — Medicare Advantage: $3,620.60 Horizon Blue Cross — Indemnity: $111,486
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CATH LAB KIT G	$119,803	$119,803	$3,620.60 – $119,803
Left heart catheterization (diagnostic): 10 of 18 insurance plan rates Aetna — Commercial: $17,536 Aetna Better Health — Managed Medicaid: $6,469.36 Cigna — Local Plus: $6,600 Cigna — Managed Care/PPO: $11,000 Cigna — Shared Administration: $89,852.25 Clover — Medicare Advantage: $3,647.41 Fidelis — Commercial: $5,624.24 Fidelis Managed Medicaid — Managed Medicaid: $5,115.59 Fidelis Medicare Advantage — Medicare Advantage: $3,620.60 Horizon Blue Cross — Indemnity: $119,803
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LEFT HEART CATH	$111,486	$111,486	$16,732 – $94,763.10
Left heart catheterization (diagnostic): rates for 3 insurance plans Aetna — Commercial: $16,732 Cigna — Shared Administration: $83,614.50 MultiPlan — Commercial: $94,763.10
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EP EVAL W/O INDUCT ARRH	$38,706	$38,706	$1,548.24 – $38,706
Heart rhythm study (electrophysiology evaluation): 10 of 18 insurance plan rates Aetna — Commercial: $17,536 Aetna Better Health — Managed Medicaid: $2,090.12 Cigna — Local Plus: $6,600 Cigna — Managed Care/PPO: $11,000 Cigna — Shared Administration: $29,029.50 Clover — Medicare Advantage: $8,775.18 Fidelis — Commercial: $13,268.61 Fidelis Managed Medicaid — Managed Medicaid: $1,652.75 Fidelis Medicare Advantage — Medicare Advantage: $8,541.67 Horizon Blue Cross — Indemnity: $38,706
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EP EVAL W/O INDUCT ARRH	$38,706	$38,706	$16,732 – $32,900.10
Heart rhythm study (electrophysiology evaluation): rates for 3 insurance plans Aetna — Commercial: $16,732 Cigna — Shared Administration: $29,029.50 MultiPlan — Commercial: $32,900.10
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EP ABLATION ATRIAL FIB	$135,001	$135,001	$4,015 – $135,001
Heart rhythm study with ablation for atrial fibrillation: 10 of 18 insurance plan rates Aetna — Commercial: $17,536 Aetna Better Health — Managed Medicaid: $7,290.05 Cigna — Local Plus: $6,600 Cigna — Managed Care/PPO: $11,000 Cigna — Shared Administration: $101,250.75 Clover — Medicare Advantage: $29,406.97 Fidelis — Commercial: $42,897.38 Fidelis Managed Medicaid — Managed Medicaid: $5,764.54 Fidelis Medicare Advantage — Medicare Advantage: $27,615.19 Horizon Blue Cross — Indemnity: $135,001
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EP ABLATION ATRIAL FIB	$135,001	$135,001	$16,732 – $114,750.85
Heart rhythm study with ablation for atrial fibrillation: rates for 3 insurance plans Aetna — Commercial: $16,732 Cigna — Shared Administration: $101,250.75 MultiPlan — Commercial: $114,750.85
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPHY	$56,305	$56,305	$966.14 – $47,859.25
Sleep study (overnight, in a sleep lab): 10 of 21 insurance plan rates Aetna — Commercial: $5,984.01 Aetna Better Health — Managed Medicaid: $3,040.47 Cigna — Local Plus: $4,864.75 Cigna — Managed Care/PPO: $14,464.75 Cigna — Shared Administration: $42,228.75 Clover — Medicare Advantage: $966.14 Fidelis — Commercial: $1,779.02 Fidelis Managed Medicaid — Managed Medicaid: $2,404.22 Fidelis Medicare Advantage — Medicare Advantage: $1,145.25 Horizon Blue Cross — Indemnity: $6,734.08
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: < 6HRS PSG ADULT	$33,788	$33,788	$966.14 – $28,719.80
Sleep study (overnight, in a sleep lab): 10 of 21 insurance plan rates Aetna — Commercial: $5,984.01 Aetna Better Health — Managed Medicaid: $1,824.55 Cigna — Local Plus: $2,919.28 Cigna — Managed Care/PPO: $8,680.14 Cigna — Shared Administration: $25,341 Clover — Medicare Advantage: $966.14 Fidelis — Commercial: $1,779.02 Fidelis Managed Medicaid — Managed Medicaid: $1,442.75 Fidelis Medicare Advantage — Medicare Advantage: $1,145.25 Horizon Blue Cross — Indemnity: $4,041.04
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPHY	$56,305	$56,305	$42,228.75 – $47,859.25
Sleep study (overnight, in a sleep lab): rates for 2 insurance plans Cigna — Shared Administration: $42,228.75 MultiPlan — Commercial: $47,859.25

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 EXER/PROC 15M	$1,043	$1,043	$30.95 – $886.55
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 21 insurance plan rates Aetna — Commercial: $313.94 Aetna Better Health — Managed Medicaid: $56.32 Cigna — Local Plus: $177 Cigna — Managed Care/PPO: $295 Cigna — Shared Administration: $782.25 Clover — Medicare Advantage: $30.95 Fidelis — Commercial: $49.44 Fidelis Managed Medicaid — Managed Medicaid: $44.54 Fidelis Medicare Advantage — Medicare Advantage: $31.83 Horizon Blue Cross — Indemnity: $124.74
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BC THERAPEUTIC EXER 15M	$1,043	$1,043	$30.95 – $886.55
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 21 insurance plan rates Aetna — Commercial: $313.94 Aetna Better Health — Managed Medicaid: $56.32 Cigna — Local Plus: $177 Cigna — Managed Care/PPO: $295 Cigna — Shared Administration: $782.25 Clover — Medicare Advantage: $30.95 Fidelis — Commercial: $49.44 Fidelis Managed Medicaid — Managed Medicaid: $44.54 Fidelis Medicare Advantage — Medicare Advantage: $31.83 Horizon Blue Cross — Indemnity: $124.74
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OT THERAPEUTIC EX/PROC	$1,043	$1,043	$30.95 – $886.55
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 21 insurance plan rates Aetna — Commercial: $313.94 Aetna Better Health — Managed Medicaid: $56.32 Cigna — Local Plus: $177 Cigna — Managed Care/PPO: $295 Cigna — Shared Administration: $782.25 Clover — Medicare Advantage: $30.95 Fidelis — Commercial: $49.44 Fidelis Managed Medicaid — Managed Medicaid: $44.54 Fidelis Medicare Advantage — Medicare Advantage: $31.83 Horizon Blue Cross — Indemnity: $124.74
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POST OFFER SCREEN RP DRIV	$322	$322	$12.88 – $368
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates Aetna — Commercial: $96.92 Aetna Better Health — Managed Medicaid: $17.39 Cigna — Local Plus: $177 Cigna — Managed Care/PPO: $295 Cigna — Shared Administration: $241.50 Clover — Medicare Advantage: $104.20 Fidelis — Commercial: $168.26 Fidelis Managed Medicaid — Managed Medicaid: $13.75 Fidelis Medicare Advantage — Medicare Advantage: $108.31 Horizon Blue Cross — Indemnity: $38.51
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SULLIVAN POSTOFFER SCREEN	$306	$306	$12.24 – $368
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates Aetna — Commercial: $92.11 Aetna Better Health — Managed Medicaid: $16.52 Cigna — Local Plus: $177 Cigna — Managed Care/PPO: $295 Cigna — Shared Administration: $229.50 Clover — Medicare Advantage: $104.20 Fidelis — Commercial: $168.26 Fidelis Managed Medicaid — Managed Medicaid: $13.07 Fidelis Medicare Advantage — Medicare Advantage: $108.31 Horizon Blue Cross — Indemnity: $36.60
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT PEDIATRIC BRIEF EVAL	$857	$857	$34.28 – $728.45
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates Aetna — Commercial: $257.96 Aetna Better Health — Managed Medicaid: $46.28 Cigna — Local Plus: $177 Cigna — Managed Care/PPO: $295 Cigna — Shared Administration: $642.75 Clover — Medicare Advantage: $104.20 Fidelis — Commercial: $168.26 Fidelis Managed Medicaid — Managed Medicaid: $36.59 Fidelis Medicare Advantage — Medicare Advantage: $108.31 Horizon Blue Cross — Indemnity: $102.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION MC	$1,093	$1,093	$43.72 – $929.05
Physical therapy evaluation (moderate complexity): 10 of 21 insurance plan rates Aetna — Commercial: $328.99 Aetna Better Health — Managed Medicaid: $59.02 Cigna — Local Plus: $177 Cigna — Managed Care/PPO: $295 Cigna — Shared Administration: $819.75 Clover — Medicare Advantage: $104.20 Fidelis — Commercial: $168.26 Fidelis Managed Medicaid — Managed Medicaid: $46.67 Fidelis Medicare Advantage — Medicare Advantage: $108.31 Horizon Blue Cross — Indemnity: $130.72
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVALUATION MC	$1,093	$1,093	$819.75 – $929.05
Physical therapy evaluation (moderate complexity): rates for 2 insurance plans Cigna — Shared Administration: $819.75 MultiPlan — Commercial: $929.05
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION HC	$1,375	$1,375	$55 – $1,168.75
Physical therapy evaluation (high complexity): 10 of 21 insurance plan rates Aetna — Commercial: $413.88 Aetna Better Health — Managed Medicaid: $74.25 Cigna — Local Plus: $177 Cigna — Managed Care/PPO: $295 Cigna — Shared Administration: $1,031.25 Clover — Medicare Advantage: $104.20 Fidelis — Commercial: $168.26 Fidelis Managed Medicaid — Managed Medicaid: $58.71 Fidelis Medicare Advantage — Medicare Advantage: $108.31 Horizon Blue Cross — Indemnity: $164.45
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVALUATION HC	$1,375	$1,375	$1,031.25 – $1,168.75
Physical therapy evaluation (high complexity): rates for 2 insurance plans Cigna — Shared Administration: $1,031.25 MultiPlan — Commercial: $1,168.75
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP PSYCHOTHY W/ PT 30 MIN	$788	$788	$31.52 – $669.80
Psychotherapy, 30 minutes: 10 of 18 insurance plan rates Aetna — Commercial: $279.74 Aetna Better Health — Managed Medicaid: $42.55 Cigna — Local Plus: $68.08 Cigna — Managed Care/PPO: $202.44 Cigna — Shared Administration: $591 Clover — Medicare Advantage: $199.70 Fidelis — Commercial: $280.94 Fidelis Managed Medicaid — Managed Medicaid: $33.65 Fidelis Medicare Advantage — Medicare Advantage: $180.86 Horizon Blue Cross — Indemnity: $94.24
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OP PSYCHOTHY W/ PT 30 MIN	$788	$788	$591 – $712
Psychotherapy, 30 minutes: rates for 3 insurance plans Cigna — Shared Administration: $591 Horizon NJ Health — Managed Medicaid: $712 MultiPlan — Commercial: $669.80
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	$180.86 – $280.94
Psychotherapy, 45 minutes: rates for 2 insurance plans Fidelis — Commercial: $280.94 Fidelis Medicare Advantage — Medicare Advantage: $180.86
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	$180.86 – $280.94
Psychotherapy, 60 minutes: rates for 2 insurance plans Fidelis — Commercial: $280.94 Fidelis Medicare Advantage — Medicare Advantage: $180.86
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	$180.86 – $280.94
Family psychotherapy, without the patient: rates for 2 insurance plans Fidelis — Commercial: $280.94 Fidelis Medicare Advantage — Medicare Advantage: $180.86
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP PSYCHO FAM W/PT 50 MIN	$788	$788	$31.52 – $669.80
Family psychotherapy, with the patient: 10 of 19 insurance plan rates Aetna — Commercial: $279.74 Aetna Better Health — Managed Medicaid: $42.55 Cigna — Local Plus: $68.08 Cigna — Managed Care/PPO: $202.44 Cigna — Shared Administration: $591 Clover — Medicare Advantage: $199.70 Fidelis — Commercial: $280.94 Fidelis Managed Medicaid — Managed Medicaid: $33.65 Fidelis Medicare Advantage — Medicare Advantage: $180.86 Horizon Blue Cross — Indemnity: $94.24
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OP PSYCHO FAM W/PT 50 MIN	$788	$788	$591 – $712
Family psychotherapy, with the patient: rates for 3 insurance plans Cigna — Shared Administration: $591 Horizon NJ Health — Managed Medicaid: $712 MultiPlan — Commercial: $669.80
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	$104.12 – $161.74
Group psychotherapy: rates for 2 insurance plans Fidelis — Commercial: $161.74 Fidelis Medicare Advantage — Medicare Advantage: $104.12

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	$4,310.49 – $6,695.90
Removal of breast growth (open surgery): rates for 2 insurance plans Fidelis — Commercial: $6,695.90 Fidelis Medicare Advantage — Medicare Advantage: $4,310.49
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	$14,483.75 – $22,499.02
Total hip replacement: rates for 2 insurance plans Fidelis — Commercial: $22,499.02 Fidelis Medicare Advantage — Medicare Advantage: $14,483.75
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	$14,483.75 – $22,499.02
Total knee replacement: rates for 2 insurance plans Fidelis — Commercial: $22,499.02 Fidelis Medicare Advantage — Medicare Advantage: $14,483.75
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$3,652.35 – $5,673.55
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 2 insurance plans Fidelis — Commercial: $5,673.55 Fidelis Medicare Advantage — Medicare Advantage: $3,652.35
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	$6,659.06 – $10,344.18
Removal of tonsils and adenoids (under age 12): rates for 2 insurance plans Fidelis — Commercial: $10,344.18 Fidelis Medicare Advantage — Medicare Advantage: $6,659.06
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UPPER GI ENDO	$25,106	$25,106	$152.51 – $25,106
Upper GI endoscopy (diagnostic): 10 of 18 insurance plan rates Aetna — Commercial: $6,481.72 Aetna Better Health — Managed Medicaid: $1,355.72 Cigna — Local Plus: $6,678.20 Cigna — Managed Care/PPO: $9,658.28 Cigna — Shared Administration: $18,829.50 Clover — Medicare Advantage: $1,020.42 Fidelis — Commercial: $1,639.42 Fidelis Managed Medicaid — Managed Medicaid: $1,072.03 Fidelis Medicare Advantage — Medicare Advantage: $1,055.38 Horizon Blue Cross — Indemnity: $25,106
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UPPER GI ENDO	$25,106	$25,106	$18,829.50 – $21,340.10
Upper GI endoscopy (diagnostic): rates for 2 insurance plans Cigna — Shared Administration: $18,829.50 MultiPlan — Commercial: $21,340.10
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	$1,055.38 – $1,639.42
Upper GI endoscopy with biopsy: rates for 2 insurance plans Fidelis — Commercial: $1,639.42 Fidelis Medicare Advantage — Medicare Advantage: $1,055.38
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY	$31,686	$31,686	$167.76 – $31,686
Colonoscopy (diagnostic): 10 of 18 insurance plan rates Aetna — Commercial: $7,684 Aetna Better Health — Managed Medicaid: $1,711.04 Cigna — Local Plus: $8,428.48 Cigna — Managed Care/PPO: $12,189.60 Cigna — Shared Administration: $23,764.50 Clover — Medicare Advantage: $1,046.27 Fidelis — Commercial: $1,594.22 Fidelis Managed Medicaid — Managed Medicaid: $1,352.99 Fidelis Medicare Advantage — Medicare Advantage: $1,026.28 Horizon Blue Cross — Indemnity: $31,686
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY	$31,686	$31,686	$23,764.50 – $26,933.10
Colonoscopy (diagnostic): rates for 2 insurance plans Cigna — Shared Administration: $23,764.50 MultiPlan — Commercial: $26,933.10
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	$1,327.25 – $2,061.74
Colonoscopy with biopsy: rates for 2 insurance plans Fidelis — Commercial: $2,061.74 Fidelis Medicare Advantage — Medicare Advantage: $1,327.25
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	$1,327.25 – $2,061.74
Colonoscopy with removal of polyps (snare): rates for 2 insurance plans Fidelis — Commercial: $2,061.74 Fidelis Medicare Advantage — Medicare Advantage: $1,327.25
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	$1,327.25 – $2,061.74
Ultrasound of the lower bowel by endoscope: rates for 2 insurance plans Fidelis — Commercial: $2,061.74 Fidelis Medicare Advantage — Medicare Advantage: $1,327.25
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	$1,026.28 – $1,594.22
Screening colonoscopy (not high risk): rates for 2 insurance plans Fidelis — Commercial: $1,594.22 Fidelis Medicare Advantage — Medicare Advantage: $1,026.28
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	$6,567.55 – $10,202.02
Gallbladder removal by laparoscope: rates for 2 insurance plans Fidelis — Commercial: $10,202.02 Fidelis Medicare Advantage — Medicare Advantage: $6,567.55
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	$3,972.55 – $6,170.94
Groin (inguinal) hernia repair, age 5 or older: rates for 2 insurance plans Fidelis — Commercial: $6,170.94 Fidelis Medicare Advantage — Medicare Advantage: $3,972.55
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Outpatient Services	Not listed in the file	Not listed in the file	$2,305.94 – $3,582.05
Prostate biopsy: rates for 2 insurance plans Fidelis — Commercial: $3,582.05 Fidelis Medicare Advantage — Medicare Advantage: $2,305.94
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$11,719.56 – $18,205.14
Prostate removal by laparoscope (radical prostatectomy): rates for 2 insurance plans Fidelis — Commercial: $18,205.14 Fidelis Medicare Advantage — Medicare Advantage: $11,719.56
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	$3,579.09 – $5,559.74
Hysteroscopy with biopsy of the uterus lining: rates for 2 insurance plans Fidelis — Commercial: $5,559.74 Fidelis Medicare Advantage — Medicare Advantage: $3,579.09
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EPIDURAL INJ/ANESTHESIA	$7,160	$7,160	$127.27 – $7,160
Spinal injection, lower back (epidural), with imaging guidance: 10 of 18 insurance plan rates Aetna — Commercial: $6,481.72 Aetna Better Health — Managed Medicaid: $386.64 Cigna — Local Plus: $1,904.56 Cigna — Managed Care/PPO: $2,754.45 Cigna — Shared Administration: $5,370 Clover — Medicare Advantage: $794.17 Fidelis — Commercial: $1,210.94 Fidelis Managed Medicaid — Managed Medicaid: $305.73 Fidelis Medicare Advantage — Medicare Advantage: $779.55 Horizon Blue Cross — Indemnity: $7,160
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EPIDURAL INJ LUMB/SAC	$7,876	$7,876	$127.27 – $7,876
Spinal injection, lower back (epidural), with imaging guidance: 10 of 18 insurance plan rates Aetna — Commercial: $6,481.72 Aetna Better Health — Managed Medicaid: $425.30 Cigna — Local Plus: $2,095.02 Cigna — Managed Care/PPO: $3,029.90 Cigna — Shared Administration: $5,907 Clover — Medicare Advantage: $794.17 Fidelis — Commercial: $1,210.94 Fidelis Managed Medicaid — Managed Medicaid: $336.31 Fidelis Medicare Advantage — Medicare Advantage: $779.55 Horizon Blue Cross — Indemnity: $7,876
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EPIDURAL INJ/ANESTHESIA	$7,160	$7,160	$5,370 – $6,086
Spinal injection, lower back (epidural), with imaging guidance: rates for 2 insurance plans Cigna — Shared Administration: $5,370 MultiPlan — Commercial: $6,086
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IR INJ LUMBAR TRANSF BIL	$14,433	$14,433	$141.31 – $14,433
Nerve root injection, lower back, with imaging guidance: 10 of 18 insurance plan rates Aetna — Commercial: $6,481.72 Aetna Better Health — Managed Medicaid: $779.38 Cigna — Local Plus: $3,839.18 Cigna — Managed Care/PPO: $5,552.38 Cigna — Shared Administration: $10,824.75 Clover — Medicare Advantage: $995.10 Fidelis — Commercial: $1,556.77 Fidelis Managed Medicaid — Managed Medicaid: $616.29 Fidelis Medicare Advantage — Medicare Advantage: $1,002.17 Horizon Blue Cross — Indemnity: $14,433
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IR INJ LUMBAR TRANSF LT	$7,216	$7,216	$141.31 – $7,216
Nerve root injection, lower back, with imaging guidance: 10 of 18 insurance plan rates Aetna — Commercial: $6,481.72 Aetna Better Health — Managed Medicaid: $389.66 Cigna — Local Plus: $1,919.46 Cigna — Managed Care/PPO: $2,776 Cigna — Shared Administration: $5,412 Clover — Medicare Advantage: $995.10 Fidelis — Commercial: $1,556.77 Fidelis Managed Medicaid — Managed Medicaid: $308.12 Fidelis Medicare Advantage — Medicare Advantage: $1,002.17 Horizon Blue Cross — Indemnity: $7,216
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IR INJ LUMBAR TRANSF RT	$7,216	$7,216	$141.31 – $7,216
Nerve root injection, lower back, with imaging guidance: 10 of 18 insurance plan rates Aetna — Commercial: $6,481.72 Aetna Better Health — Managed Medicaid: $389.66 Cigna — Local Plus: $1,919.46 Cigna — Managed Care/PPO: $2,776 Cigna — Shared Administration: $5,412 Clover — Medicare Advantage: $995.10 Fidelis — Commercial: $1,556.77 Fidelis Managed Medicaid — Managed Medicaid: $308.12 Fidelis Medicare Advantage — Medicare Advantage: $1,002.17 Horizon Blue Cross — Indemnity: $7,216
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	$2,198.16 – $3,414.62
Carpal tunnel release: rates for 2 insurance plans Fidelis — Commercial: $3,414.62 Fidelis Medicare Advantage — Medicare Advantage: $2,198.16
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	$617.54 – $959.28
Laser treatment of clouding after cataract surgery: rates for 2 insurance plans Fidelis — Commercial: $959.28 Fidelis Medicare Advantage — Medicare Advantage: $617.54
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$2,567.34 – $3,988.10
Cataract removal with lens implant: rates for 2 insurance plans Fidelis — Commercial: $3,988.10 Fidelis Medicare Advantage — Medicare Advantage: $2,567.34

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	$92,452.30 – $170,387
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 9 insurance plans Clover — Medicare Advantage: $92,452.30 Fidelis — Commercial: $147,923.68 Fidelis Medicare Advantage — Medicare Advantage: $95,225.87 Horizon Blue Cross — Indemnity: $170,387 Horizon Blue Cross — Managed Care: $170,387 Horizon Blue Cross — Omnia: $170,387 Horizon Blue Cross — PPO: $170,387 Humana — Medicare Advantage: $94,301.35 Wellpoint — Medicare Advantage: $92,452.30
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Inpatient MS-DRG	Not listed in the file	Not listed in the file	$66,711.84
Spinal fusion (not neck), without major complications: rates for 4 insurance plans Horizon Blue Cross — Indemnity: $66,711.84 Horizon Blue Cross — Managed Care: $66,711.84 Horizon Blue Cross — Omnia: $66,711.84 Horizon Blue Cross — PPO: $66,711.84
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	$19,984.21 – $32,251.89
Hip or knee replacement (major joint of the leg), without major complications: rates for 9 insurance plans Clover — Medicare Advantage: $19,984.21 Fidelis — Commercial: $31,974.74 Fidelis Medicare Advantage — Medicare Advantage: $20,583.74 Horizon Blue Cross — Indemnity: $32,251.89 Horizon Blue Cross — Managed Care: $32,251.89 Horizon Blue Cross — Omnia: $32,251.89 Horizon Blue Cross — PPO: $32,251.89 Humana — Medicare Advantage: $20,383.89 Wellpoint — Medicare Advantage: $19,984.21
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	$24,712.12 – $43,091.91
Neck (cervical) spinal fusion, without complications: rates for 9 insurance plans Clover — Medicare Advantage: $24,712.12 Fidelis — Commercial: $39,539.39 Fidelis Medicare Advantage — Medicare Advantage: $25,453.48 Horizon Blue Cross — Indemnity: $43,091.91 Horizon Blue Cross — Managed Care: $43,091.91 Horizon Blue Cross — Omnia: $43,091.91 Horizon Blue Cross — PPO: $43,091.91 Humana — Medicare Advantage: $25,206.36 Wellpoint — Medicare Advantage: $24,712.12
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	$13,634.16 – $21,814.66
Uterus and ovary surgery (not for cancer), without complications: rates for 9 insurance plans Clover — Medicare Advantage: $13,634.16 Fidelis — Commercial: $21,814.66 Fidelis Medicare Advantage — Medicare Advantage: $14,043.18 Horizon Blue Cross — Indemnity: $19,225.88 Horizon Blue Cross — Managed Care: $19,225.88 Horizon Blue Cross — Omnia: $19,225.88 Horizon Blue Cross — PPO: $19,225.88 Humana — Medicare Advantage: $13,906.84 Wellpoint — Medicare Advantage: $13,634.16

Source: Capital Health Medical Center - Hopewell’s standard charges file (sthpiprd.blob.core.windows.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 24, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	One Capital Way, Pennington, NJ 08534
County	Mercer County
State	New Jersey
Phone	(609) 303‑4000
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	310044
Name in Medicare records	CAPITAL HEALTH MEDICAL CENTER - HOPEWELL
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(800) 637‑2374^[4]
Official website	capitalhealth.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Capital Health Medical Center – Hopewell | Capital Health Hospitals — capitalhealth.org