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Acute Care Hospital

Capital Health Regional Medical Center

Trenton, New Jersey · Mercer County · Emergency services listed

Summary

Capital Health Regional Medical Center is an acute care hospital in Trenton, New Jersey. Medicare data lists emergency services. CMS overall star rating: 2 of 5 stars. Its official website lists 28 services, specialties and programs. Medicare lists 542 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

Call(609) 394‑6000 Directions Website Medicare profile
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Exterior of Capital Health Regional Medical Center
Photo: Famartin, CC BY-SA 4.0, via Wikimedia Commons · source · licence

Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-11-02). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
2 of 5 stars2 of 5 stars · Medicare rating
542Doctors and clinicians
28Services listed

Quick answers

Does Capital Health Regional Medical Center have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Capital Health Regional Medical Center. In a medical emergency, call 911.
Where is Capital Health Regional Medical Center?
750 Brunswick Ave, Trenton, NJ 08638, in Mercer County, New Jersey.
What is the phone number of Capital Health Regional Medical Center?
(609) 394-6000, as listed by Medicare (CMS).
What is the Medicare star rating of Capital Health Regional Medical Center?
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]

Procedures[4]

  • Magnetic resonance imaging (MRI)
  • Videofluoroscopic and clinical swallowing evaluation

Programs and centers[4]

  • Comprehensive Stroke Center (Capital Institute for Neurosciences)
  • Bristol-Myers Squibb Trauma Center
  • Emergency Mental Health Services Center for Mercer County
  • Drug treatment program for pregnant women and new mothers
  • Neurophysiology Laboratory

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

Emergency roomYes
Trauma designationLevel II
Stroke designationState-designated Comprehensive Stroke Center

Visiting and practical information

VisitingAll visitors need a pass with photo ID; generally two visitors at the bedside; specialty units have their own hours[5]
ParkingGuests may use Lot A across Brunswick Ave; ER patients park next to the ER entrance; accessible parking is marked[6]
Patient portalCapital Health Patient Portals

Recognition[4]

  • State-designated Level II Trauma Center
  • State-designated Comprehensive Stroke Center

Doctors and clinicians (542)

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

Main specialties

Doctors with a page on this site (542)

And 518 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

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

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 2 of 5 stars
Overall rating of the hospital1 of 5 stars
Would recommend the hospital1 of 5 stars
Nurses communicated well1 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean1 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1052%National average: 72%
Would definitely recommend the hospital50%National average: 71%
Nurses “always” communicated well67%National average: 80%
Doctors “always” communicated well72%National average: 80%
Staff “always” explained medicines before giving them53%National average: 62%
Were given information about recovery at home81%National average: 86%
Room and bathroom “always” clean60%National average: 74%
Area around the room “always” quiet at night43%National average: 60%
Completed surveys610Response rate: 12%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.634No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.314Better than the national benchmark
Surgical site infections after colon surgery0.587No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections1.586No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.445Better 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 patients11.7%
Deaths within 30 days: heart failure patients10.3%
Deaths within 30 days: pneumonia patients19.2%
Deaths within 30 days: COPD patients8.4%
Deaths within 30 days: stroke patients13.8%
Deaths within 30 days: coronary bypass surgery (CABG)2.5%
Serious complications (patient safety indicator PSI-90)1.21No different from the national rate
Complications after hip or knee replacementToo few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack13.5%
Readmitted within 30 days: heart failure21.6%
Readmitted within 30 days: pneumonia17.7%
Readmitted within 30 days: COPD21%
Readmitted within 30 days: coronary bypass surgery9.9%
Readmitted within 30 days: hip or knee replacementToo few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)180 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)4%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)66%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 JerseyBest 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 Regional Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 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 $302.61 – $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: $302.61
  • 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 $302.61 – $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: $302.61
  • 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 $465.37 – $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: $465.37
  • 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 $465.37 – $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: $465.37
  • 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: $670.04
  • 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: $670.04
  • 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: P 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

ServiceHospital chargeCash priceInsurance 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: $8.46
  • 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: $10.56
  • 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: $10.56
  • 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 – $49.24
Obstetric blood test panel: rates for 3 insurance plans
  • Fidelis — Commercial: $47.81
  • 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: $13.39
  • 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: $13.39
  • 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: $13.39
  • 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: $8.68
  • 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: $8.17
  • 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: $8.17
  • 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: $8.17
  • 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: $3.17
  • 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: $3.48
  • 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: $3.48
  • 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: $2.25
  • 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: $2.25
  • 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: $2.25
  • 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: $18.39
  • 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: $18.39
  • 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/PROSTATIC SPECIFIC AG $3,326 $3,326 $2,494.50 – $2,827.10
PSA (prostate specific antigen) blood test: rates for 2 insurance plans
  • Cigna — Shared Administration: $2,494.50
  • MultiPlan — Commercial: $2,827.10
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: $16.80
  • 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: $16.80
  • 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: $16.80
  • 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: $7.77
  • 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: $7.77
  • 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: $7.77
  • 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: $6.47
  • 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: $6.47
  • 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: $6.47
  • 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: $4.29
  • 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: $4.29
  • 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: $4.29
  • 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: $6.01
  • 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: $6.01
  • 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: $6.01
  • 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)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD W/O CON $18,988 $18,988 $116.22 – $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: $116.22
  • 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 $116.22 – $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: $116.22
  • 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 $116.22 – $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: $116.22
  • 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 $390.30 – $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: $390.30
  • 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 $390.30 – $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: $390.30
  • 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 $390.30 – $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: $390.30
  • 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: 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: $96.23
  • 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: $96.23
  • 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: CHEST INSPIRATION & EXPIR $5,007 $5,007 $48.64 – $4,255.95
Chest X-ray, 2 views: 10 of 21 insurance plan rates
  • Aetna — Commercial: $234.30
  • Aetna Better Health — Managed Medicaid: $270.38
  • Cigna — Local Plus: $48.64
  • Cigna — Managed Care/PPO: $48.64
  • Cigna — Shared Administration: $3,755.25
  • Clover — Medicare Advantage: $97.91
  • Fidelis — Commercial: $96.23
  • Fidelis Managed Medicaid — Managed Medicaid: $213.80
  • Fidelis Medicare Advantage — Medicare Advantage: $99.12
  • Horizon Blue Cross — Indemnity: $598.84
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: $116.22
  • 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 · 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: $116.22
  • 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 · 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 $264.17 – $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: $264.17
  • 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 $194.55 – $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: $194.55
  • 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 $264.17 – $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: $264.17
  • 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 $264.17 – $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: $264.17
  • 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 $264.17 – $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: $264.17
  • 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 $390.30 – $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: $390.30
  • 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 $390.30 – $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: $390.30
  • 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 $390.30 – $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: $390.30
  • 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 $116.22 – $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: $116.22
  • 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 $116.22 – $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: $116.22
  • 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 $116.22 – $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: $116.22
  • 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 $116.22 – $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: $116.22
  • 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 $116.22 – $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: $116.22
  • 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 $116.22 – $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: $116.22
  • 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 $116.22 – $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: $116.22
  • 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 $94.06 – $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: $94.06
  • 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 $94.06 – $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: $94.06
  • 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 $119.82 – $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: $119.82
  • 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 $99.09 – $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: $99.09
  • 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 $99.09 – $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: $99.09
  • 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 $99.09 – $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: $99.09
  • 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

ServiceHospital chargeCash priceInsurance 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 $3,515.15 – $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: $3,515.15
  • 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 $3,515.15 – $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: $3,515.15
  • 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: $8,292.88
  • 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: $26,810.86
  • 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: $1,111.89
  • 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: $1,111.89
  • 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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXER/PROC 15M $1,043 $1,043 $30.90 – $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: $30.90
  • 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 $30.90 – $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: $30.90
  • 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 $30.90 – $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: $30.90
  • 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: 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: $105.16
  • Fidelis Managed Medicaid — Managed Medicaid: $36.59
  • Fidelis Medicare Advantage — Medicare Advantage: $108.31
  • Horizon Blue Cross — Indemnity: $102.50
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POST OFFER SCREEN RC $799 $799 $31.96 – $679.15
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates
  • Aetna — Commercial: $240.50
  • Aetna Better Health — Managed Medicaid: $43.15
  • Cigna — Local Plus: $177
  • Cigna — Managed Care/PPO: $295
  • Cigna — Shared Administration: $599.25
  • Clover — Medicare Advantage: $104.20
  • Fidelis — Commercial: $105.16
  • Fidelis Managed Medicaid — Managed Medicaid: $34.12
  • Fidelis Medicare Advantage — Medicare Advantage: $108.31
  • Horizon Blue Cross — Indemnity: $95.56
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRENTON AVIATION $557 $557 $22.28 – $473.45
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates
  • Aetna — Commercial: $167.66
  • Aetna Better Health — Managed Medicaid: $30.08
  • Cigna — Local Plus: $177
  • Cigna — Managed Care/PPO: $295
  • Cigna — Shared Administration: $417.75
  • Clover — Medicare Advantage: $104.20
  • Fidelis — Commercial: $105.16
  • Fidelis Managed Medicaid — Managed Medicaid: $23.78
  • Fidelis Medicare Advantage — Medicare Advantage: $108.31
  • Horizon Blue Cross — Indemnity: $66.62
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: $105.16
  • 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: $105.16
  • 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: $175.59
  • 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 $175.59 – $180.86
Psychotherapy, 45 minutes: rates for 2 insurance plans
  • Fidelis — Commercial: $175.59
  • 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 $175.59 – $180.86
Psychotherapy, 60 minutes: rates for 2 insurance plans
  • Fidelis — Commercial: $175.59
  • 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 $175.59 – $180.86
Family psychotherapy, without the patient: rates for 2 insurance plans
  • Fidelis — Commercial: $175.59
  • 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: $175.59
  • 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 $101.09 – $104.12
Group psychotherapy: rates for 2 insurance plans
  • Fidelis — Commercial: $101.09
  • Fidelis Medicare Advantage — Medicare Advantage: $104.12

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION Not listed in the file Not listed in the file $4,184.94 – $4,310.49
Removal of breast growth (open surgery): rates for 2 insurance plans
  • Fidelis — Commercial: $4,184.94
  • 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 $14,061.89 – $14,483.75
Total hip replacement: rates for 2 insurance plans
  • Fidelis — Commercial: $14,061.89
  • 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 $14,061.89 – $14,483.75
Total knee replacement: rates for 2 insurance plans
  • Fidelis — Commercial: $14,061.89
  • 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 $3,545.97 – $3,652.35
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 2 insurance plans
  • Fidelis — Commercial: $3,545.97
  • 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 $6,465.11 – $6,659.06
Removal of tonsils and adenoids (under age 12): rates for 2 insurance plans
  • Fidelis — Commercial: $6,465.11
  • 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: $1,024.64
  • 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 $1,024.64 – $1,055.38
Upper GI endoscopy with biopsy: rates for 2 insurance plans
  • Fidelis — Commercial: $1,024.64
  • 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: $996.39
  • 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 $1,288.59 – $1,327.25
Colonoscopy with biopsy: rates for 2 insurance plans
  • Fidelis — Commercial: $1,288.59
  • 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 $1,288.59 – $1,327.25
Colonoscopy with removal of polyps (snare): rates for 2 insurance plans
  • Fidelis — Commercial: $1,288.59
  • 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 $1,288.59 – $1,327.25
Ultrasound of the lower bowel by endoscope: rates for 2 insurance plans
  • Fidelis — Commercial: $1,288.59
  • 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 $996.39 – $1,026.28
Screening colonoscopy (not high risk): rates for 2 insurance plans
  • Fidelis — Commercial: $996.39
  • 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 $6,376.26 – $6,567.55
Gallbladder removal by laparoscope: rates for 2 insurance plans
  • Fidelis — Commercial: $6,376.26
  • 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 $3,856.84 – $3,972.55
Groin (inguinal) hernia repair, age 5 or older: rates for 2 insurance plans
  • Fidelis — Commercial: $3,856.84
  • 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 $2,238.78 – $2,305.94
Prostate biopsy: rates for 2 insurance plans
  • Fidelis — Commercial: $2,238.78
  • 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 $11,378.21 – $11,719.56
Prostate removal by laparoscope (radical prostatectomy): rates for 2 insurance plans
  • Fidelis — Commercial: $11,378.21
  • 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 $3,474.84 – $3,579.09
Hysteroscopy with biopsy of the uterus lining: rates for 2 insurance plans
  • Fidelis — Commercial: $3,474.84
  • 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: $756.84
  • 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: $756.84
  • 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 LUMB/SAC $7,876 $7,876 $5,907 – $6,694.60
Spinal injection, lower back (epidural), with imaging guidance: rates for 2 insurance plans
  • Cigna — Shared Administration: $5,907
  • MultiPlan — Commercial: $6,694.60
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: $972.98
  • 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: $972.98
  • 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: $972.98
  • 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 $2,134.14 – $2,198.16
Carpal tunnel release: rates for 2 insurance plans
  • Fidelis — Commercial: $2,134.14
  • 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 $599.55 – $617.54
Laser treatment of clouding after cataract surgery: rates for 2 insurance plans
  • Fidelis — Commercial: $599.55
  • 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 $2,492.56 – $2,567.34
Cataract removal with lens implant: rates for 2 insurance plans
  • Fidelis — Commercial: $2,492.56
  • Fidelis Medicare Advantage — Medicare Advantage: $2,567.34

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $102,694.38 – $170,387
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 9 insurance plans
  • Clover — Medicare Advantage: $102,694.38
  • Fidelis — Commercial: $164,311.01
  • Fidelis Medicare Advantage — Medicare Advantage: $105,775.21
  • 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: $104,748.27
  • Wellpoint — Medicare Advantage: $102,694.38
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 $24,511.46 – $39,218.34
Hip or knee replacement (major joint of the leg), without major complications: rates for 9 insurance plans
  • Clover — Medicare Advantage: $24,511.46
  • Fidelis — Commercial: $39,218.34
  • Fidelis Medicare Advantage — Medicare Advantage: $25,246.80
  • 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: $25,001.69
  • Wellpoint — Medicare Advantage: $24,511.46
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 $29,612.22 – $47,379.55
Neck (cervical) spinal fusion, without complications: rates for 9 insurance plans
  • Clover — Medicare Advantage: $29,612.22
  • Fidelis — Commercial: $47,379.55
  • Fidelis Medicare Advantage — Medicare Advantage: $30,500.59
  • 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: $30,204.46
  • Wellpoint — Medicare Advantage: $29,612.22
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 $17,660.64 – $28,257.02
Uterus and ovary surgery (not for cancer), without complications: rates for 9 insurance plans
  • Clover — Medicare Advantage: $17,660.64
  • Fidelis — Commercial: $28,257.02
  • Fidelis Medicare Advantage — Medicare Advantage: $18,190.46
  • 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: $18,013.85
  • Wellpoint — Medicare Advantage: $17,660.64

Source: Capital Health Regional Medical Center’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 typeAcute Care Hospital
Address750 Brunswick Ave, Trenton, NJ 08638
CountyMercer County
StateNew Jersey
Phone(609) 394‑6000
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating2 of 5 stars
CMS Certification Number310092
Name in Medicare recordsCAPITAL HEALTH REGIONAL MEDICAL CENTER
Profile levelMedicare data + hospital website
Official websitecapitalhealth.org
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

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

  1. Capital Health Regional Medical Center | Capital Health Hospitals — capitalhealth.org
  2. Visiting Information at Capital Health Regional Medical Center | Capital Health Hospitals — capitalhealth.org
  3. Parking at Capital Health Regional Medical Center | Capital Health Hospitals — capitalhealth.org