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Acute Care Hospital

Conemaugh Memorial Medical Center

Johnstown, Pennsylvania · Cambria County · Emergency services listed

Summary

Conemaugh Memorial Medical Center is an acute care hospital in Johnstown, Pennsylvania. Medicare data lists emergency services. CMS overall star rating: 2 of 5 stars. Its official website lists 38 services, specialties and programs. Medicare lists 537 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

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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
2 of 5 stars2 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
38Services listed

Quick answers

Does Conemaugh Memorial Medical Center have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Conemaugh Memorial Medical Center. In a medical emergency, call 911.
Where is Conemaugh Memorial Medical Center?
1086 Franklin Street, Johnstown, PA 15905, in Cambria County, Pennsylvania.
What is the phone number of Conemaugh Memorial Medical Center?
(814) 534-9000, as listed by Medicare (CMS).
What is the Medicare star rating of Conemaugh Memorial 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][7]

Treatments[4]

Procedures[4]

Programs and centers[4][8]

  • Transitional Care Unit
  • SMART Program (geriatric trauma follow-up)

Emergency care (hospital website)[4][6][9]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel I
Stroke designationPrimary Stroke Center

Visiting and practical information

ParkingFree outpatient/visitor lots open 24/7; garage visitor tokens $3; valet weekdays at Main Entrance[5]
Patient portalMyChart

Recognition[6][7]

  • Level I Trauma Center
  • Chest Pain with Primary PCI and Cardiac Cath Lab Accreditation (American College of Cardiology)

Doctors and clinicians (537)

537 doctors and other clinicians list Conemaugh Memorial 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 (537)

And 513 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 Conemaugh Memorial 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 hospital2 of 5 stars
Would recommend the hospital2 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean1 of 5 stars
Quiet at night1 of 5 stars
Rated the hospital 9 or 10 out of 1054%National average: 72%
Would definitely recommend the hospital49%National average: 71%
Nurses “always” communicated well78%National average: 80%
Doctors “always” communicated well73%National average: 80%
Staff “always” explained medicines before giving them57%National average: 62%
Were given information about recovery at home86%National average: 86%
Room and bathroom “always” clean55%National average: 74%
Area around the room “always” quiet at night39%National average: 60%
Completed surveys2,404Response rate: 28%

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)0.129Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.961No different from the national benchmark
Surgical site infections after colon surgery0.721No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0.931No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.769No different from 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 patients12%
Deaths within 30 days: heart failure patients12.2%
Deaths within 30 days: pneumonia patients14%
Deaths within 30 days: COPD patients9.8%
Deaths within 30 days: stroke patients11.3%
Deaths within 30 days: coronary bypass surgery (CABG)2%
Serious complications (patient safety indicator PSI-90)1.1No 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 attack14.8%
Readmitted within 30 days: heart failure21.9%
Readmitted within 30 days: pneumonia18.8%
Readmitted within 30 days: COPD20.3%
Readmitted within 30 days: coronary bypass surgery10.7%
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)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)176 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)46%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.

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 81 common services exactly as Conemaugh Memorial 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: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e $680 $272 $25.84 – $680
New patient office visit (about 30–44 minutes): rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $25.84
  • UPMC Health Plan — UPMC Health: $233.99
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e $680 $272 $28.26 – $680
New patient office visit (about 45–59 minutes): rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $28.26
  • UPMC Health Plan — UPMC Health: $300.18
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or e $680 $272 $30.33 – $680
New patient office visit (about 60–74 minutes): rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $30.33
  • UPMC Health Plan — UPMC Health: $366.23
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history $680 $272 $18.23 – $680
Established patient office visit (about 20–29 minutes): rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $18.23
  • UPMC Health Plan — UPMC Health: $126.08
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history $680 $272 $23.78 – $680
Established patient office visit (about 30–39 minutes): rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $23.78
  • UPMC Health Plan — UPMC Health: $149.73
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination $680 $272 $22.33 – $680
Office consultation with a specialist (moderate): rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $22.33
  • UPMC Health Plan — UPMC Health: $205.36
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination $680 $272 $24.07 – $680
Office consultation with a specialist (moderate to high): rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $24.07
  • UPMC Health Plan — UPMC Health: $345.34
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin $243 $97.20 $55.54 – $243
Preventive checkup, new patient, age 18–39: rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $55.54
  • UPMC Health Plan — UPMC Health: $138.94
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin $268 $107.20 $60.33 – $268
Preventive checkup, new patient, age 40–64: rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $60.33
  • UPMC Health Plan — UPMC Health: $138.17
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination $898 $359.20 $116.17 – $898
Emergency room visit (moderate): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $116.17
  • UPMC Health Plan — UPMC Health: $287.27
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination $1,548 $619.20 $147.64 – $1,548
Emergency room visit (moderately high): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $147.64
  • UPMC Health Plan — UPMC Health: $362.83
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination $2,347 $938.80 $181.16 – $2,347
Emergency room visit (high): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $181.16
  • UPMC Health Plan — UPMC Health: $442.52
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)

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 (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch $141 $56.40 $8.46 – $141
Basic metabolic panel (blood test): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $23.37
  • Cigna — Cigna: $16.94
  • UHC — UHC All Payer: $14.38
  • UPMC Health Plan — UPMC Health: $44.44
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon $150 $60 $10.56 – $150
Comprehensive metabolic panel (blood test): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $29.19
  • Cigna — Cigna: $21.13
  • UHC — UHC All Payer: $17.96
  • UPMC Health Plan — UPMC Health: $58.30
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or $182 $72.80 $37.87 – $182
Obstetric blood test panel: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $37.87
  • Cigna — Cigna: $95.73
  • UHC — UHC All Payer: $69.02
  • UPMC Health Plan — UPMC Health: $78.15
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester $92 $36.80 $13.39 – $92
Cholesterol panel (lipid panel): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $28.32
  • Cigna — Cigna: $26.80
  • UHC — UHC All Payer: $22.76
  • UPMC Health Plan — UPMC Health: $56.95
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo $198 $79.20 $8.68 – $198
Kidney function panel: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $23.97
  • Cigna — Cigna: $17.37
  • UHC — UHC All Payer: $14.76
  • UPMC Health Plan — UPMC Health: $59.57
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase $147 $58.80 $8.17 – $147
Liver function panel: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $22.56
  • Cigna — Cigna: $16.35
  • UHC — UHC All Payer: $13.88
  • UPMC Health Plan — UPMC Health: $44.35
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, $78 $31.20 $3.17 – $78
Urine test (automated, with microscope): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $8.74
  • Cigna — Cigna: $6.34
  • UHC — UHC All Payer: $5.38
  • UPMC Health Plan — UPMC Health: $11.10
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, $44 $17.60 $3.48 – $44
Urine test (manual, without microscope): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $7.23
  • Cigna — Cigna: $6.96
  • UHC — UHC All Payer: $4.34
  • UPMC Health Plan — UPMC Health: $21.25
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, $44 $17.60 $2.25 – $44
Urine test (automated, without microscope): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $6.36
  • Cigna — Cigna: $4.50
  • UHC — UHC All Payer: $3.82
  • UPMC Health Plan — UPMC Health: $19.48
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prostate specific antigen (PSA); total $135 $54 $18.39 – $135
PSA (prostate specific antigen) blood test: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $36.98
  • Cigna — Cigna: $36.81
  • UHC — UHC All Payer: $31.27
  • UPMC Health Plan — UPMC Health: $76.47
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thyroid stimulating hormone (TSH) $133 $53.20 $16.80 – $133
Thyroid stimulating hormone (TSH) test: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $33.77
  • Cigna — Cigna: $33.63
  • UHC — UHC All Payer: $28.56
  • UPMC Health Plan — UPMC Health: $81.95
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count $92 $36.80 $7.77 – $92
Complete blood count (CBC) with differential: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $15.62
  • Cigna — Cigna: $15.55
  • UHC — UHC All Payer: $13.22
  • UPMC Health Plan — UPMC Health: $40
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) $61 $24.40 $6.47 – $61
Complete blood count (CBC), automated: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $13.01
  • Cigna — Cigna: $12.97
  • UHC — UHC All Payer: $11
  • UPMC Health Plan — UPMC Health: $21.29
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time $73 $29.20 $4.29 – $73
Blood clotting time test (prothrombin time, PT): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $7.93
  • Cigna — Cigna: $8.59
  • UHC — UHC All Payer: $6.67
  • UPMC Health Plan — UPMC Health: $10.51
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time, partial (PTT); plasma or whole blood $133 $53.20 $6.01 – $133
Blood clotting test (partial thromboplastin time, PTT): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $12.06
  • Cigna — Cigna: $12.04
  • UHC — UHC All Payer: $10.20
  • UPMC Health Plan — UPMC Health: $20.48
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)

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: Computed tomography, head or brain; without contrast material $2,061 $824.40 $102.30 – $2,061
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $267.78
  • Cigna — Cigna: $234.51
  • UHC — UHC All Payer: $307.02
  • UPMC Health Plan — UPMC Health: $664.01
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Computed tomography, head or brain; without contrast material $2,061 $824.40 $102.30 – $2,061
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $267.78
  • Cigna — Cigna: $234.51
  • UHC — UHC All Payer: $307.02
  • UPMC Health Plan — UPMC Health: $664.01
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth $4,962 $1,984.80 $343.57 – $4,962
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $1,250.65
  • Cigna — Cigna: $820.32
  • UHC — UHC All Payer: $854.45
  • UPMC Health Plan — UPMC Health: $3,084.05
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth $4,962 $1,984.80 $343.57 – $4,962
MRI of the brain, before and after contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $1,250.65
  • Cigna — Cigna: $820.32
  • UHC — UHC All Payer: $854.45
  • UPMC Health Plan — UPMC Health: $3,084.05
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Radiologic examination, chest; 2 views $384 $153.60 $12.26 – $384
Chest X-ray, 2 views: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $12.26
  • Cigna — Cigna: $193.83
  • UHC — UHC All Payer: $99.38
  • UPMC Health Plan — UPMC Health: $109.23
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Radiologic examination, chest; 2 views $162 $64.80 $12.26 – $384
Chest X-ray, 2 views: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $12.26
  • Cigna — Cigna: $193.83
  • UHC — UHC All Payer: $99.38
  • UPMC Health Plan — UPMC Health: $109.23
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views $784 $313.60 $60.73 – $784
X-ray of the lower spine, at least 4 views: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $60.73
  • Cigna — Cigna: $234.51
  • UHC — UHC All Payer: $120.77
  • UPMC Health Plan — UPMC Health: $155.34
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views $784 $313.60 $60.73 – $784
X-ray of the lower spine, at least 4 views: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $60.73
  • Cigna — Cigna: $234.51
  • UHC — UHC All Payer: $120.77
  • UPMC Health Plan — UPMC Health: $155.34
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material $2,542 $1,016.80 $232.54 – $2,542
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $644.21
  • Cigna — Cigna: $522.68
  • UHC — UHC All Payer: $541.46
  • UPMC Health Plan — UPMC Health: $1,576.59
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material $2,542 $1,016.80 $232.54 – $2,542
MRI of the lower back (lumbar spine), without contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $644.21
  • Cigna — Cigna: $522.68
  • UHC — UHC All Payer: $541.46
  • UPMC Health Plan — UPMC Health: $1,576.59
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, pelvis; with contrast material(s) $2,211 $884.40 $171.26 – $2,211
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $376.68
  • Cigna — Cigna: $391.92
  • UHC — UHC All Payer: $480.78
  • UPMC Health Plan — UPMC Health: $933.65
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Computed tomography, pelvis; with contrast material(s) $2,211 $884.40 $171.26 – $2,211
CT scan of the pelvis, with contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $376.68
  • Cigna — Cigna: $391.92
  • UHC — UHC All Payer: $480.78
  • UPMC Health Plan — UPMC Health: $933.65
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material $2,195 $878 $232.54 – $2,195
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $555.39
  • Cigna — Cigna: $522.68
  • UHC — UHC All Payer: $541.46
  • UPMC Health Plan — UPMC Health: $1,359.41
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material $2,195 $878 $232.54 – $2,195
MRI of a leg joint (such as the knee), without contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $555.39
  • Cigna — Cigna: $522.68
  • UHC — UHC All Payer: $541.46
  • UPMC Health Plan — UPMC Health: $1,359.41
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Computed tomography, abdomen and pelvis; with contrast material(s) $5,148 $2,059.20 $343.57 – $5,148
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $570.54
  • Cigna — Cigna: $820.32
  • UHC — UHC All Payer: $928.86
  • UPMC Health Plan — UPMC Health: $3,197.44
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Computed tomography, abdomen and pelvis; with contrast material(s) $5,148 $2,059.20 $343.57 – $5,148
CT scan of the abdomen and pelvis, with contrast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $570.54
  • Cigna — Cigna: $820.32
  • UHC — UHC All Payer: $928.86
  • UPMC Health Plan — UPMC Health: $3,197.44
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, abdominal, real time with image documentation; complete $2,423 $969.20 $102.30 – $2,423
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $139.87
  • Cigna — Cigna: $234.51
  • UHC — UHC All Payer: $154.10
  • UPMC Health Plan — UPMC Health: $336.65
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Ultrasound, abdominal, real time with image documentation; complete $2,423 $969.20 $102.30 – $2,423
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $139.87
  • Cigna — Cigna: $234.51
  • UHC — UHC All Payer: $154.10
  • UPMC Health Plan — UPMC Health: $336.65
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day $635 $254 $102.30 – $635
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $157.73
  • Cigna — Cigna: $234.51
  • UHC — UHC All Payer: $154.10
  • UPMC Health Plan — UPMC Health: $393.95
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day $635 $254 $102.30 – $635
Pregnancy ultrasound (after the first trimester): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $157.73
  • Cigna — Cigna: $234.51
  • UHC — UHC All Payer: $154.10
  • UPMC Health Plan — UPMC Health: $393.95
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ultrasound, transvaginal $954 $381.60 $102.30 – $954
Transvaginal ultrasound: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $113.20
  • Cigna — Cigna: $234.51
  • UHC — UHC All Payer: $154.10
  • UPMC Health Plan — UPMC Health: $283.60
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Ultrasound, transvaginal $954 $381.60 $102.30 – $954
Transvaginal ultrasound: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $113.20
  • Cigna — Cigna: $234.51
  • UHC — UHC All Payer: $154.10
  • UPMC Health Plan — UPMC Health: $283.60
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral $596 $238.40 $60.02 – $596
Diagnostic mammogram, one breast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $60.02
  • Cigna — Cigna: $189.99
  • UHC — UHC All Payer: $157.94
  • UPMC Health Plan — UPMC Health: $294.79
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral $596 $238.40 $60.02 – $596
Diagnostic mammogram, one breast: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $60.02
  • Cigna — Cigna: $189.99
  • UHC — UHC All Payer: $157.94
  • UPMC Health Plan — UPMC Health: $294.79
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral $686 $274.40 $76.55 – $686
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $76.55
  • Cigna — Cigna: $243.65
  • UHC — UHC All Payer: $200.96
  • UPMC Health Plan — UPMC Health: $546.08
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral $686 $274.40 $76.55 – $686
Diagnostic mammogram, both breasts: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $76.55
  • Cigna — Cigna: $243.65
  • UHC — UHC All Payer: $200.96
  • UPMC Health Plan — UPMC Health: $546.08
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed $686 $274.40 $63.38 – $686
Screening mammogram, both breasts: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $63.38
  • Cigna — Cigna: $200.87
  • UHC — UHC All Payer: $168.29
  • UPMC Health Plan — UPMC Health: $446.10
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed $686 $274.40 $63.38 – $686
Screening mammogram, both breasts: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $63.38
  • Cigna — Cigna: $200.87
  • UHC — UHC All Payer: $168.29
  • UPMC Health Plan — UPMC Health: $446.10
  • Aetna — Aetna: 375% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report $453 $181.20 $23.45 – $453
Electrocardiogram (ECG/EKG) with reading: rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $23.45
  • UPMC Health Plan — UPMC Health: $49.38
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe $8,683 $3,473.20 $1,088.12 – $8,683
Left heart catheterization (diagnostic): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $1,088.12
  • UPMC Health Plan — UPMC Health: $2,770.60
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe $9,551 $3,820.40 $1,088.12 – $8,683
Left heart catheterization (diagnostic): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $1,088.12
  • UPMC Health Plan — UPMC Health: $2,770.60
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recor $8,027 $3,210.80 $752.54 – $17,154.77
Heart rhythm study (electrophysiology evaluation): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $752.54
  • UPMC Health Plan — UPMC Health: $1,822.58
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recor $8,027 $3,210.80 $752.54 – $17,154.77
Heart rhythm study (electrophysiology evaluation): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $752.54
  • UPMC Health Plan — UPMC Health: $1,822.58
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, $31,371 $12,548.40 $969.26 – $55,461.32
Heart rhythm study with ablation for atrial fibrillation: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $969.26
  • UPMC Health Plan — UPMC Health: $12,303.39
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist $4,756 $1,902.40 $524.69 – $4,756
Sleep study (overnight, in a sleep lab): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $524.69
  • UPMC Health Plan — UPMC Health: $763.85
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist $4,756 $1,902.40 $524.69 – $4,756
Sleep study (overnight, in a sleep lab): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $524.69
  • UPMC Health Plan — UPMC Health: $763.85
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)

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 procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib $222 $88.80 $26.50 – $255.72
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $26.50
  • UPMC Health Plan — UPMC Health: $255.72
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact $488 $195.20 $53.62 – $488
Physical therapy evaluation (low complexity): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $53.62
  • UPMC Health Plan — UPMC Health: $255.72
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or $532 $212.80 $53.62 – $532
Physical therapy evaluation (moderate complexity): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $53.62
  • UPMC Health Plan — UPMC Health: $255.72
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o $579 $231.60 $53.62 – $579
Physical therapy evaluation (high complexity): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $53.62
  • UPMC Health Plan — UPMC Health: $255.72
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy, 30 minutes with patient $1,027 $410.80 $123.71 – $1,027
Psychotherapy, 30 minutes: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $123.71
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 103% (a percentage in the contract, not a dollar amount)
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier AH In the file: Psychotherapy, 30 minutes with patient $69 $27.60 $123.71 – $1,027
Psychotherapy, 30 minutes: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $123.71
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 103% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy, 45 minutes with patient $263 $105.20 $118.35 – $363.23
Psychotherapy, 45 minutes: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $182.67
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 103% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier AH In the file: Psychotherapy, 45 minutes with patient $146 $58.40 $118.35 – $363.23
Psychotherapy, 45 minutes: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $182.67
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 103% (a percentage in the contract, not a dollar amount)
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy, 60 minutes with patient $372 $148.80 $122.54 – $372
Psychotherapy, 60 minutes: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $266.75
  • UPMC Health Plan — UPMC Health: $122.54
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier AH In the file: Psychotherapy, 60 minutes with patient $172 $68.80 $122.54 – $372
Psychotherapy, 60 minutes: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $266.75
  • UPMC Health Plan — UPMC Health: $122.54
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psychotherapy (without the patient present), 50 minutes $42 $16.80 $22.26 – $363.23
Family psychotherapy, without the patient: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $75.83
  • UPMC Health Plan — UPMC Health: $174.01
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier AH In the file: Family psychotherapy (without the patient present), 50 minutes $42 $16.80 $22.26 – $363.23
Family psychotherapy, without the patient: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $75.83
  • UPMC Health Plan — UPMC Health: $174.01
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes $491 $196.40 $88.22 – $491
Family psychotherapy, with the patient: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $88.22
  • UPMC Health Plan — UPMC Health: $205.09
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier AH In the file: Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes $42 $16.80 $88.22 – $491
Family psychotherapy, with the patient: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $88.22
  • UPMC Health Plan — UPMC Health: $205.09
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group psychotherapy (other than of a multiple-family group) $430 $172 $88.99 – $430
Group psychotherapy: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $111.90
  • UPMC Health Plan — UPMC Health: $261.76
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier AH In the file: Group psychotherapy (other than of a multiple-family group) $17 $6.80 $88.99 – $430
Group psychotherapy: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $111.90
  • UPMC Health Plan — UPMC Health: $261.76
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)

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: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19 $12,407.21 $4,962.88 $870.37 – $12,407.21
Removal of breast growth (open surgery): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $870.37
  • UPMC Health Plan — UPMC Health: $2,147.72
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft $22,277.72 $8,911.09 $2,567.87 – $29,088.62
Total hip replacement: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $2,567.87
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 103% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty) $19,925.47 $7,970.19 $2,771.86 – $29,088.62
Total knee replacement: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $2,771.86
  • UPMC Health Plan — UPMC Health: $12,044.16
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) rele $10,365.30 $4,146.12 $870.37 – $10,365.30
Shoulder arthroscopy: shaving of shoulder bone: rates for 7 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $870.37
  • UPMC Health Plan — UPMC Health: $2,148.31
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articula $13,234.41 $5,293.76 $1,072.12 – $13,234.41
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $1,072.12
  • UPMC Health Plan — UPMC Health: $2,629.43
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (sep $3,804 $1,521.60 $566.79 – $3,804
Upper GI endoscopy (diagnostic): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $566.79
  • UPMC Health Plan — UPMC Health: $1,386.14
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $3,965.53 $1,586.21 $758.93 – $3,965.53
Upper GI endoscopy with biopsy: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $758.93
  • UPMC Health Plan — UPMC Health: $1,874
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) $4,067 $1,626.80 $758.93 – $4,067
Colonoscopy (diagnostic): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $758.93
  • UPMC Health Plan — UPMC Health: $1,873.28
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with biopsy, single or multiple $4,395.33 $1,758.13 $758.93 – $4,395.33
Colonoscopy with biopsy: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $758.93
  • UPMC Health Plan — UPMC Health: $1,859.82
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique $5,800.79 $2,320.31 $758.93 – $5,800.78
Colonoscopy with removal of polyps (snare): 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $758.93
  • UPMC Health Plan — UPMC Health: $1,858.65
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk $3,804 $1,521.60 $645.31 – $3,804
Screening colonoscopy (not high risk): 10 of 20 insurance plan rates
  • AmeriHealth Caritas Health Plan — AmeriHealth: $809.52
  • BCBS of PA — Highmark Medicare Advantage: $645.31
  • UPMC Health Plan — UPMC Health: $1,765.82
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopy, surgical; cholecystectomy $28,838.33 $11,535.33 $1,696.56 – $28,838.33
Gallbladder removal by laparoscope: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $1,696.56
  • UPMC Health Plan — UPMC Health: $4,166.56
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Repair initial inguinal hernia, age 5 years or older; reducible $7,649.65 $3,059.86 $1,072.12 – $7,978.31
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $1,072.12
  • UPMC Health Plan — UPMC Health: $2,629.66
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy, prostate; needle or punch, single or multiple, any approach $3,017 $1,206.80 $758.93 – $4,631.16
Prostate biopsy: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $758.93
  • UPMC Health Plan — UPMC Health: $1,874.23
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C $13,661.35 $5,464.54 $933.62 – $13,661.35
Hysteroscopy with biopsy of the uterus lining: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $933.62
  • UPMC Health Plan — UPMC Health: $1,080.88
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neur $2,020 $808 $159.78 – $2,020
Spinal injection, lower back (epidural), with imaging guidance: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $159.78
  • UPMC Health Plan — UPMC Health: $1,484.13
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing $1,986 $794.40 $514.91 – $2,012.72
Nerve root injection, lower back, with imaging guidance: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $609.59
  • UPMC Health Plan — UPMC Health: $514.91
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel $8,610.51 $3,444.20 $758.93 – $8,610.50
Carpal tunnel release: 10 of 20 insurance plan rates
  • BCBS of PA — Highmark Medicare Advantage: $758.93
  • UPMC Health Plan — UPMC Health: $1,860.01
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Aetna — Aetna Medicare: 104% (a percentage in the contract, not a dollar amount)
  • American Progressive — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)
  • AmeriHealth Caritas Health Plan — AmeriHealth: 102% (a percentage in the contract, not a dollar amount)
  • BCBS of PA — Highmark BCBS Traditional: 253.25% (a percentage in the contract, not a dollar amount)
  • Centene — Centene: 235% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Cigna — Managed Medicare 100%: 100% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care $9,396 $3,758.40 $2,166.98 – $9,396
Vaginal delivery, with care before and after: rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $3,035.70
  • UPMC Health Plan — UPMC Health: $2,166.98
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Routine obstetric care including antepartum care, cesarean delivery, and postpartum care $10,650 $4,260 $3,195 – $10,650
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $3,440.91
  • UPMC Health Plan — UPMC Health: $3,396.23
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after p $9,926 $3,970.40 $2,977.80 – $9,926
Vaginal delivery after a previous C-section, with care before and after: rates for 8 insurance plans
  • BCBS of PA — Highmark Medicare Advantage: $3,207.33
  • Aetna — Aetna: 55.4% (a percentage in the contract, not a dollar amount)
  • Cigna — Cigna: 60% (a percentage in the contract, not a dollar amount)
  • Devoted Health — Devoted: 30% (a percentage in the contract, not a dollar amount)
  • Geisinger — Geisinger: 52.99% (a percentage in the contract, not a dollar amount)
  • UHC — UHC All Payer: 62.3% (a percentage in the contract, not a dollar amount)
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
  • UPMC Health Plan — UPMC Health: 45% (a percentage in the contract, not a dollar amount)

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 $387,533.28 $155,013.31 $75,760.46 – $387,533.28
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 20 insurance plan rates
  • Aetna — Aetna: $120,638.75
  • Aetna — Aetna Medicare: $88,242.32
  • American Progressive — Managed Medicare 100%: $84,848.42
  • AmeriHealth Caritas Health Plan — AmeriHealth: $86,545.37
  • BCBS of PA — Highmark BCBS Traditional: $131,818.68
  • BCBS of PA — Highmark Medicare Advantage: $89,996.99
  • Centene — Centene: $172,851.49
  • Cigna — Cigna: $116,054.48
  • Cigna — Managed Medicare 100%: $84,848.42
  • Devoted Health — Devoted: $75,760.46
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: spinal fusion except cervical $138,668.71 $55,467.48 $41,149.85 – $138,668.71
Spinal fusion (not neck), without major complications: rates for 2 insurance plans
  • BCBS of PA — Highmark BCBS Traditional: $41,149.85
  • UHC — UHC OneNet: 59.8% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major Hip and Knee Joint Repla $84,579.19 $33,831.68 $14,801.04 – $84,579.19
Hip or knee replacement (major joint of the leg), without major complications: 10 of 20 insurance plan rates
  • Aetna — Aetna: $23,568.75
  • Aetna — Aetna Medicare: $17,239.58
  • American Progressive — Managed Medicare 100%: $16,576.52
  • AmeriHealth Caritas Health Plan — AmeriHealth: $16,908.05
  • BCBS of PA — Highmark BCBS Traditional: $22,831.77
  • BCBS of PA — Highmark Medicare Advantage: $17,582.38
  • Centene — Centene: $33,769.36
  • Cigna — Cigna: $22,673.14
  • Cigna — Managed Medicare 100%: $16,576.52
  • Devoted Health — Devoted: $14,801.04
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 $35,942.18 $14,376.87 $9,409.71 – $35,942.18
Uterus and ovary surgery (not for cancer), without complications: 10 of 20 insurance plan rates
  • Aetna — Aetna: $14,983.75
  • Aetna — Aetna Medicare: $10,960
  • American Progressive — Managed Medicare 100%: $10,538.47
  • AmeriHealth Caritas Health Plan — AmeriHealth: $10,749.23
  • BCBS of PA — Highmark BCBS Traditional: $15,891.97
  • BCBS of PA — Highmark Medicare Advantage: $11,177.94
  • Centene — Centene: $21,468.75
  • Cigna — Cigna: $14,414.37
  • Cigna — Managed Medicare 100%: $10,538.47
  • Devoted Health — Devoted: $9,409.71

Source: Conemaugh Memorial Medical Center’s standard charges file (conemaugh.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 15, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address1086 Franklin Street, Johnstown, PA 15905
CountyCambria County
StatePennsylvania
Phone(814) 534‑9000
Emergency servicesYes
OwnershipProprietary
Medicare overall rating2 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number390110
Name in Medicare recordsCONEMAUGH MEMORIAL MEDICAL CENTER
Profile levelMedicare data + hospital website
Official websiteconemaugh.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 2026-10-30.

  1. Conemaugh Memorial Medical Center — conemaugh.org
  2. Parking & Directions | Conemaugh Memorial Medical Center — conemaugh.org
  3. Emergency Care | West Central Pennsylvania Emergency Room — conemaugh.org
  4. Level 1 Trauma Care Services | Johnstown & Hastings, PA — conemaugh.org
  5. SMART Program | Trauma Services — conemaugh.org
  6. Emergency Room (ER) Location | Conemaugh Memorial Med Center — conemaugh.org