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Acute Care Hospital

Fairview Hospital

Also listed as: Cleveland Clinic Fairview Hospital

Cleveland, Ohio · Cuyahoga County · Emergency services listed

Fairview Hospital is an acute care hospital at 18101 Lorain Avenue, Cleveland, OH 44111. Phone: (216) 476-7000. It has an emergency department. Medicare overall rating: 5 of 5 stars (CMS, October 2026).

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

Summary

Fairview Hospital is an acute care hospital in Cleveland, Ohio. Medicare data lists emergency services. CMS overall star rating: 5 of 5 stars. Its official website lists 76 services, specialties and programs. Medicare lists 1,830 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

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

Call(216) 476‑7000 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
5 of 5 stars5 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
488Beds (hospital website)
1,830Doctors and clinicians
76Services listed

Quick answers

Does Fairview Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Fairview Hospital. In a medical emergency, call 911.
Where is Fairview Hospital?
18101 Lorain Avenue, Cleveland, OH 44111, in Cuyahoga County, Ohio.
What is the phone number of Fairview Hospital?
(216) 476-7000, as listed by Medicare (CMS).
What is the Medicare star rating of Fairview Hospital?
5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Fairview Hospital for hospital-acquired conditions?
No. For fiscal year 2026, CMS lists no Medicare payment reduction for Fairview Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.3216; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4][5]

Conditions treated[11][13][16][17][19]

Treatments[5][9][16][17]

  • Aquatic Therapy
  • Outpatient Lymphedema Program
  • Blood Management
  • Tenecteplase (tPA) for ischemic stroke
  • Mechanical thrombectomy
  • Angiography
  • CT scan
  • MRI
  • PET scan
  • Nuclear medicine imaging
  • Mammography
  • Ultrasound
  • Radiography (X-ray)
  • Electrocardiogram (EKG)
  • Echocardiogram
  • Holter monitoring
  • Stress testing
  • Cardiac catheterization

Procedures[10][12][14][17][18]

  • Robotic surgery
  • Minimally invasive surgery
  • Electrophysiology study
  • Open heart surgery
  • Bariatric (weight loss) surgery
  • Cesarean birth
  • Cardiac rehabilitation
  • Physical therapy
  • Occupational therapy
  • Speech therapy

Programs and centers[5][11][12][15][16][17][19]

  • Wellness Center
  • Chest Pain Center
  • Kemper Cardiac Intensive Care Unit
  • Pediatric Emergency Department
  • Geriatric Emergency Department
  • SANE Unit (sexual assault care)
  • Family Birth Place
  • Level III Neonatal Intensive Care Unit
  • Pediatric Inpatient Unit
  • Geriatric Hip Fracture Program
  • Stroke Support Group

Emergency care (hospital website)[4][7][11][16]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel II
Stroke designationThrombectomy-Capable Stroke Center (The Joint Commission)

Visiting and practical information

VisitingOpen visitation 24/7, except in some ICU settings[6]
ParkingSelf-parking free the first hour, then $5-$8; valet $8 per vehicle[6]
Patient portalMyChart

Recognition[4][9][11][12][16][17][18]

  • Magnet Recognition (ANCC)
  • Joint Commission accreditation
  • Level II Trauma Center (ACS-verified)
  • Thrombectomy-Capable Stroke Center (The Joint Commission)
  • Get With The Guidelines Stroke Gold Plus, Target: Stroke Honor Roll-Elite Plus 2026
  • Baby-Friendly Designation (Baby-Friendly USA)
  • Chest Pain Center Accreditation with Primary PCI (American College of Cardiology)
  • Geriatric Emergency Department Accreditation (GEDA), bronze (ACEP)
  • Accredited by the American College of Radiology (imaging)
  • MBSAQIP accreditation (bariatric surgery)

Doctors and clinicians (1,830)

1,830 doctors and other clinicians list Fairview Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (1,830)

And 1,806 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Cleveland

All hospitals in Cleveland · Hospitals in Cuyahoga County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

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 license list, by straight-line distance.

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 3 of 5 stars
Overall rating of the hospital4 of 5 stars
Would recommend the hospital4 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well3 of 5 stars
Patients got help quickly from staff3 of 5 stars
Staff explained medicines3 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean4 of 5 stars
Restfulness of Environment2 of 5 stars
Care Coordination3 of 5 stars
Symptoms After Stay4 of 5 stars
Rated the hospital 9 or 10 out of 1075%National average: 72%
Would definitely recommend the hospital76%National average: 71%
Nurses “always” communicated well80%National average: 80%
Doctors “always” communicated well78%National average: 80%
“Always” got help as soon as they wanted63%National average: 64%
Staff “always” explained medicines before giving them61%National average: 62%
Were given information about recovery at home88%National average: 86%
Room and bathroom “always” clean77%National average: 73%
Completed surveys2,225Response rate: 19%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.505No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.589No different from the national benchmark
Surgical site infections after colon surgery0.873No different from the national benchmark
MRSA bloodstream infections1.242No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.897No different from the national benchmark
Not reported to MedicareSurgical site infections after abdominal hysterectomy

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

Complications and deaths

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

Deaths within 30 days: heart attack patients8.5%
Deaths within 30 days: heart failure patients7.6%
Deaths within 30 days: pneumonia patients12.2%
Deaths within 30 days: COPD patients6.5%
Deaths within 30 days: stroke patients9.4%
Deaths within 30 days: coronary bypass surgery (CABG)1.6%
Serious complications (patient safety indicator PSI-90)0.64Better than the national rate
Too few cases to reportComplications after hip or knee replacement

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)16.6%
Readmitted within 30 days: heart attack14.7%
Readmitted within 30 days: heart failure22.3%
Readmitted within 30 days: pneumonia17.4%
Readmitted within 30 days: COPD19.7%
Readmitted within 30 days: coronary bypass surgery9.6%
Too few cases to reportReadmitted within 30 days: hip or knee replacement

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)243 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)61%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026NoCMS lists no payment reduction for this hospital.
Total HAC Score-0.3216Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack1.0074More readmissions than expected
Heart failure0.9312Fewer readmissions than expected
Pneumonia1.1121More readmissions than expected
COPD (chronic lung disease)0.8896Fewer readmissions than expected
Hip or knee replacement1.1115More readmissions than expected
Coronary bypass surgery (CABG)0.8928Fewer readmissions than expected

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score43.50 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)81.67 out of 100
Person and community engagement (patient survey)49.00 out of 100
Safety (infections and sepsis care)33.33 out of 100
Efficiency and cost reduction (Medicare spending)10.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

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

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

ER wait times and Medicare ratings nearby

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

ER wait times in ClevelandBest hospitals in Cleveland

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Fairview Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

$ 38 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Show the prices of 86 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES $139 $90.35 $30.30 – $139
New patient office visit (about 30–44 minutes): 10 of 49 insurance plan rates
  • AETNA — Acop: $48.59
  • AETNA — ALL PRODUCTS: $104.25
  • AETNA — Asa_Whirlpool_Peia: $56.71
  • AETNA — International: $60
  • AETNA — MEDICARE ADVANTAGE: $30.30
  • AETNA — Qhp/Ipf: $139
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $62.55
  • ANTHEM — HPN: $131.64
  • ANTHEM — Managed Medicaid: $62.24
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES $139 $90.35 $30.30 – $139
New patient office visit (about 30–44 minutes): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $69.50
  • ANTHEM — TRADITIONAL: $80.11
  • OSCAR — ALL PRODUCTS: $50.17
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES $174 $113.10 $37.93 – $174
New patient office visit (about 45–59 minutes): 10 of 49 insurance plan rates
  • AETNA — Acop: $48.59
  • AETNA — ALL PRODUCTS: $130.50
  • AETNA — Asa_Whirlpool_Peia: $56.71
  • AETNA — International: $60
  • AETNA — MEDICARE ADVANTAGE: $37.93
  • AETNA — Qhp/Ipf: $174
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $78.30
  • ANTHEM — HPN: $215.49
  • ANTHEM — Managed Medicaid: $62.24
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES $174 $113.10 $37.93 – $174
New patient office visit (about 45–59 minutes): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $87
  • ANTHEM — TRADITIONAL: $100.28
  • OSCAR — ALL PRODUCTS: $62.80
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES $235 $152.75 $51.23 – $235
New patient office visit (about 60–74 minutes): 10 of 49 insurance plan rates
  • AETNA — Acop: $48.59
  • AETNA — ALL PRODUCTS: $176.25
  • AETNA — Asa_Whirlpool_Peia: $56.71
  • AETNA — International: $60
  • AETNA — MEDICARE ADVANTAGE: $51.23
  • AETNA — Qhp/Ipf: $235
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $105.75
  • ANTHEM — HPN: $293.51
  • ANTHEM — Managed Medicaid: $62.24
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES $235 $152.75 $51.23 – $235
New patient office visit (about 60–74 minutes): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $117.50
  • ANTHEM — TRADITIONAL: $135.43
  • OSCAR — ALL PRODUCTS: $84.81
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN $150 $97.50 $32.70 – $150
Established patient office visit (about 20–29 minutes): 10 of 49 insurance plan rates
  • AETNA — Acop: $48.59
  • AETNA — ALL PRODUCTS: $112.50
  • AETNA — Asa_Whirlpool_Peia: $56.71
  • AETNA — International: $60
  • AETNA — MEDICARE ADVANTAGE: $32.70
  • AETNA — Qhp/Ipf: $150
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $67.50
  • ANTHEM — HPN: $107
  • ANTHEM — Managed Medicaid: $62.24
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB ASSESSMENT $150 $97.50 $32.70 – $150
Established patient office visit (about 20–29 minutes): 10 of 49 insurance plan rates
  • AETNA — Acop: $48.59
  • AETNA — ALL PRODUCTS: $112.50
  • AETNA — Asa_Whirlpool_Peia: $56.71
  • AETNA — International: $60
  • AETNA — MEDICARE ADVANTAGE: $32.70
  • AETNA — Qhp/Ipf: $150
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $67.50
  • ANTHEM — HPN: $107
  • ANTHEM — Managed Medicaid: $62.24
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN $150 $97.50 $32.70 – $150
Established patient office visit (about 20–29 minutes): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $75
  • ANTHEM — TRADITIONAL: $86.45
  • OSCAR — ALL PRODUCTS: $54.14
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN $187 $121.55 $40.77 – $187
Established patient office visit (about 30–39 minutes): 10 of 49 insurance plan rates
  • AETNA — Acop: $48.59
  • AETNA — ALL PRODUCTS: $140.25
  • AETNA — Asa_Whirlpool_Peia: $56.71
  • AETNA — International: $60
  • AETNA — MEDICARE ADVANTAGE: $40.77
  • AETNA — Qhp/Ipf: $187
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $84.15
  • ANTHEM — HPN: $157.36
  • ANTHEM — Managed Medicaid: $62.24
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN $187 $121.55 $40.77 – $187
Established patient office visit (about 30–39 minutes): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $93.50
  • ANTHEM — TRADITIONAL: $107.77
  • OSCAR — ALL PRODUCTS: $67.49
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Off/op cnsltj new/est low 30 Not listed in the file Not listed in the file $56.32 – $65.21
Office consultation with a specialist (moderate): rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $65.21
  • ANTHEM — Managed Medicaid: $62.24
  • Buckeye — Managed Medicaid: $62.24
  • CARESOURCE — Managed Medicaid: $63.43
  • MOLINA — Managed Medicaid: $62.24
  • OPTUM — Managed Medicaid Transplant: $56.32
  • Paramount — Managed Medicaid: $61.06
  • UNITED — Managed Medicaid: $63.43
  • United BH — Managed Medicaid: $62.84
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Off/op cnsltj new/est mod 40 Not listed in the file Not listed in the file $56.32 – $65.21
Office consultation with a specialist (moderate to high): rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $65.21
  • ANTHEM — Managed Medicaid: $62.24
  • Buckeye — Managed Medicaid: $62.24
  • CARESOURCE — Managed Medicaid: $63.43
  • MOLINA — Managed Medicaid: $62.24
  • OPTUM — Managed Medicaid Transplant: $56.32
  • Paramount — Managed Medicaid: $61.06
  • UNITED — Managed Medicaid: $63.43
  • United BH — Managed Medicaid: $62.84
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS $184 $119.60 $48.59 – $60
Preventive checkup, new patient, age 18–39: 10 of 49 insurance plan rates
  • AETNA — Acop: $48.59
  • AETNA — ALL PRODUCTS: $138
  • AETNA — Asa_Whirlpool_Peia: $56.71
  • AETNA — International: $60
  • AETNA — MEDICARE ADVANTAGE: $40.11
  • AETNA — Qhp/Ipf: $184
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $82.80
  • ANTHEM — HPN: $28.59
  • ANTHEM — Managed Medicaid: $62.24
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS $184 $119.60 $28.59 – $184
Preventive checkup, new patient, age 18–39: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $92
  • ANTHEM — TRADITIONAL: $106.04
  • OSCAR — ALL PRODUCTS: $66.41
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS $254 $165.10 $48.59 – $60
Preventive checkup, new patient, age 40–64: 10 of 49 insurance plan rates
  • AETNA — Acop: $48.59
  • AETNA — ALL PRODUCTS: $190.50
  • AETNA — Asa_Whirlpool_Peia: $56.71
  • AETNA — International: $60
  • AETNA — MEDICARE ADVANTAGE: $55.37
  • AETNA — Qhp/Ipf: $254
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $114.30
  • ANTHEM — HPN: $39.47
  • ANTHEM — Managed Medicaid: $62.24
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS $254 $165.10 $39.47 – $254
Preventive checkup, new patient, age 40–64: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $127
  • ANTHEM — TRADITIONAL: $146.38
  • OSCAR — ALL PRODUCTS: $91.67
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT LOW MDM $1,911 $1,242.15 $56.32 – $2,453
Emergency room visit (moderate): 10 of 67 insurance plan rates
  • AETNA — Acop: $812
  • AETNA — ALL PRODUCTS: $1,433.25
  • AETNA — Asa_Whirlpool_Peia: $948
  • AETNA — International: $996
  • AETNA — MEDICARE ADVANTAGE: $258.26
  • AETNA — Qhp/Ipf: $1,337.70
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $859.95
  • ANTHEM — HPN: $127.80
  • ANTHEM — Managed Medicaid: $62.24
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT LOW MDM $1,911 $1,242.15 $540.43 – $1,719.90
Emergency room visit (moderate): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $955.50
  • ANTHEM — TRADITIONAL: $1,101.31
  • OSCAR — ALL PRODUCTS: $689.68
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT MODERATE MDM $2,938 $1,909.70 $56.32 – $2,735
Emergency room visit (moderately high): 10 of 67 insurance plan rates
  • AETNA — Acop: $1,145
  • AETNA — ALL PRODUCTS: $2,203.50
  • AETNA — Asa_Whirlpool_Peia: $1,336
  • AETNA — International: $1,403
  • AETNA — MEDICARE ADVANTAGE: $394.76
  • AETNA — Qhp/Ipf: $2,056.60
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $1,322.10
  • ANTHEM — HPN: $217.63
  • ANTHEM — Managed Medicaid: $62.24
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT MODERATE MDM $2,938 $1,909.70 $830.87 – $2,644.20
Emergency room visit (moderately high): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $1,469
  • ANTHEM — TRADITIONAL: $1,693.17
  • OSCAR — ALL PRODUCTS: $1,060.32
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT HIGH MDM $4,230 $2,749.50 $56.32 – $2,753
Emergency room visit (high): 10 of 67 insurance plan rates
  • AETNA — Acop: $1,145
  • AETNA — ALL PRODUCTS: $3,172.50
  • AETNA — Asa_Whirlpool_Peia: $1,336
  • AETNA — International: $1,403
  • AETNA — MEDICARE ADVANTAGE: $563.42
  • AETNA — Qhp/Ipf: $2,961
  • AMERIHEALTH — Managed Medicaid: $65.21
  • Amish Community Aid Plan — ALL PRODUCTS: $1,903.50
  • ANTHEM — HPN: $316.59
  • ANTHEM — Managed Medicaid: $62.24
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT HIGH MDM $4,230 $2,749.50 $1,196.24 – $3,807
Emergency room visit (high): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $2,115
  • ANTHEM — TRADITIONAL: $2,437.75
  • OSCAR — ALL PRODUCTS: $1,526.61

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 $58 $37.70 $0.95 – $19.04
Basic metabolic panel (blood test): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $43.50
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $17.83
  • AETNA — MEDICARE ADVANTAGE: $8.46
  • AETNA — Qhp/Ipf: $58
  • AMERIHEALTH — Managed Medicaid: $18.66
  • Amish Community Aid Plan — ALL PRODUCTS: $26.10
  • ANTHEM — HPN: $13.30
  • ANTHEM — Managed Medicaid: $17.81
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL $58 $37.70 $16.40 – $58
Basic metabolic panel (blood test): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $29
  • ANTHEM — TRADITIONAL: $33.43
  • OSCAR — ALL PRODUCTS: $20.93
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BASIC METABOLIC PNL TOTAL CA Not listed in the file Not listed in the file $8.78
Basic metabolic panel (blood test): rates for 1 insurance plan
  • CC EHP — ALL PRODUCTS: $8.78
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE META PANL $73 $47.45 $0.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $30.14
Comprehensive metabolic panel (blood test): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $54.75
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $22.27
  • AETNA — MEDICARE ADVANTAGE: $10.56
  • AETNA — Qhp/Ipf: $73
  • AMERIHEALTH — Managed Medicaid: $18.66
  • Amish Community Aid Plan — ALL PRODUCTS: $32.85
  • ANTHEM — HPN: $16.60
  • ANTHEM — Managed Medicaid: $17.81
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPRE META PANL $73 $47.45 $20.64 – $73
Comprehensive metabolic panel (blood test): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $36.50
  • ANTHEM — TRADITIONAL: $42.07
  • OSCAR — ALL PRODUCTS: $26.35
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: COMPREHEN METABOLIC PANEL Not listed in the file Not listed in the file $10.96
Comprehensive metabolic panel (blood test): rates for 1 insurance plan
  • CC EHP — ALL PRODUCTS: $10.96
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB PANEL $330 $214.50 $16.11 – $138.70
Obstetric blood test panel: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $247.50
  • AETNA — Asa_Whirlpool_Peia: $1.11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $100.80
  • AETNA — MEDICARE ADVANTAGE: $47.81
  • AETNA — Qhp/Ipf: $330
  • AMERIHEALTH — Managed Medicaid: $18.66
  • Amish Community Aid Plan — ALL PRODUCTS: $148.50
  • ANTHEM — HPN: $75.15
  • ANTHEM — Managed Medicaid: $17.81
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB PANEL $330 $214.50 $93.32 – $330
Obstetric blood test panel: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $165
  • ANTHEM — TRADITIONAL: $190.18
  • OSCAR — ALL PRODUCTS: $119.10
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL $92 $59.80 $26.02 – $92
Cholesterol panel (lipid panel): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $69
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $28.23
  • AETNA — MEDICARE ADVANTAGE: $13.39
  • AETNA — Qhp/Ipf: $92
  • AMERIHEALTH — Managed Medicaid: $18.66
  • Amish Community Aid Plan — ALL PRODUCTS: $41.40
  • ANTHEM — HPN: $21.05
  • ANTHEM — Managed Medicaid: $17.81
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID-LIPO PANEL 1 $92 $59.80 $0.95 – $31.73
Cholesterol panel (lipid panel): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $69
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $28.23
  • AETNA — MEDICARE ADVANTAGE: $13.39
  • AETNA — Qhp/Ipf: $92
  • AMERIHEALTH — Managed Medicaid: $18.66
  • Amish Community Aid Plan — ALL PRODUCTS: $41.40
  • ANTHEM — HPN: $21.05
  • ANTHEM — Managed Medicaid: $17.81
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: %NMRLIP CHOLESTEROL $92 $59.80 $0.95 – $31.73
Cholesterol panel (lipid panel): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $69
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $28.23
  • AETNA — MEDICARE ADVANTAGE: $13.39
  • AETNA — Qhp/Ipf: $92
  • AMERIHEALTH — Managed Medicaid: $18.66
  • Amish Community Aid Plan — ALL PRODUCTS: $41.40
  • ANTHEM — HPN: $21.05
  • ANTHEM — Managed Medicaid: $17.81
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNC PANL $60 $39 $0.95 – $21.67
Kidney function panel: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $45
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $18.30
  • AETNA — MEDICARE ADVANTAGE: $8.68
  • AETNA — Qhp/Ipf: $60
  • AMERIHEALTH — Managed Medicaid: $18.66
  • Amish Community Aid Plan — ALL PRODUCTS: $27
  • ANTHEM — HPN: $13.64
  • ANTHEM — Managed Medicaid: $17.81
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNC PANL $60 $39 $16.97 – $60
Kidney function panel: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $30
  • ANTHEM — TRADITIONAL: $34.58
  • OSCAR — ALL PRODUCTS: $21.65
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: RENAL FUNCTION PANEL Not listed in the file Not listed in the file $9
Kidney function panel: rates for 1 insurance plan
  • CC EHP — ALL PRODUCTS: $9
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEP FUNC PANL $56 $36.40 $0.95 – $18.39
Liver function panel: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $42
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $17.22
  • AETNA — MEDICARE ADVANTAGE: $8.17
  • AETNA — Qhp/Ipf: $56
  • AMERIHEALTH — Managed Medicaid: $18.66
  • Amish Community Aid Plan — ALL PRODUCTS: $25.20
  • ANTHEM — HPN: $12.84
  • ANTHEM — Managed Medicaid: $17.81
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEP FUNC PANL $56 $36.40 $15.84 – $56
Liver function panel: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $28
  • ANTHEM — TRADITIONAL: $32.27
  • OSCAR — ALL PRODUCTS: $20.21
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W SCPE $22 $14.30 $3.17 – $9.20
Urine test (automated, with microscope): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $16.50
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $9.63
  • AETNA — MEDICARE ADVANTAGE: $3.17
  • AETNA — Qhp/Ipf: $22
  • AMERIHEALTH — Managed Medicaid: $6.05
  • Amish Community Aid Plan — ALL PRODUCTS: $9.90
  • ANTHEM — HPN: $4.98
  • ANTHEM — Managed Medicaid: $5.78
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS WITH MICRO (POINT OF CARE LAB) $22 $14.30 $0.95 – $9.63
Urine test (automated, with microscope): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $16.50
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $9.63
  • AETNA — MEDICARE ADVANTAGE: $3.17
  • AETNA — Qhp/Ipf: $22
  • AMERIHEALTH — Managed Medicaid: $6.05
  • Amish Community Aid Plan — ALL PRODUCTS: $9.90
  • ANTHEM — HPN: $4.98
  • ANTHEM — Managed Medicaid: $5.78
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W SCPE $22 $14.30 $6.22 – $22
Urine test (automated, with microscope): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $11
  • ANTHEM — TRADITIONAL: $12.68
  • OSCAR — ALL PRODUCTS: $7.94
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA NON-AUTO W/O MICRO (POINT OF CARE LAB) $24 $15.60 $0.95 – $10.58
Urine test (manual, without microscope): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $18
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $10.58
  • AETNA — MEDICARE ADVANTAGE: $3.48
  • AETNA — Qhp/Ipf: $24
  • AMERIHEALTH — Managed Medicaid: $6.05
  • Amish Community Aid Plan — ALL PRODUCTS: $10.80
  • ANTHEM — HPN: $5.47
  • ANTHEM — Managed Medicaid: $5.78
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB) $24 $15.60 $3.48 – $10.10
Urine test (manual, without microscope): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $18
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $10.58
  • AETNA — MEDICARE ADVANTAGE: $3.48
  • AETNA — Qhp/Ipf: $24
  • AMERIHEALTH — Managed Medicaid: $6.05
  • Amish Community Aid Plan — ALL PRODUCTS: $10.80
  • ANTHEM — HPN: $5.47
  • ANTHEM — Managed Medicaid: $5.78
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UA NON-AUTO W/O MICRO (POINT OF CARE LAB) $24 $15.60 $6.79 – $24
Urine test (manual, without microscope): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $12
  • ANTHEM — TRADITIONAL: $13.83
  • OSCAR — ALL PRODUCTS: $8.66
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS (POINT OF CARE LAB) $16 $10.40 $4.52 – $16
Urine test (automated, without microscope): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $12
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $6.83
  • AETNA — MEDICARE ADVANTAGE: $2.25
  • AETNA — Qhp/Ipf: $16
  • AMERIHEALTH — Managed Medicaid: $6.05
  • Amish Community Aid Plan — ALL PRODUCTS: $7.20
  • ANTHEM — HPN: $3.54
  • ANTHEM — Managed Medicaid: $5.78
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO WO SCPE (POINT OF CARE LAB) $16 $10.40 $0.95 – $16.03
Urine test (automated, without microscope): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $12
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $6.83
  • AETNA — MEDICARE ADVANTAGE: $2.25
  • AETNA — Qhp/Ipf: $16
  • AMERIHEALTH — Managed Medicaid: $6.05
  • Amish Community Aid Plan — ALL PRODUCTS: $7.20
  • ANTHEM — HPN: $3.54
  • ANTHEM — Managed Medicaid: $5.78
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO WO SCPE $16 $10.40 $2.25 – $6.53
Urine test (automated, without microscope): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $12
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $6.83
  • AETNA — MEDICARE ADVANTAGE: $2.25
  • AETNA — Qhp/Ipf: $16
  • AMERIHEALTH — Managed Medicaid: $6.05
  • Amish Community Aid Plan — ALL PRODUCTS: $7.20
  • ANTHEM — HPN: $3.54
  • ANTHEM — Managed Medicaid: $5.78
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA DIAGNOSTIC $127 $82.55 $0.95 – $41.39
PSA (prostate specific antigen) blood test: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $95.25
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $38.77
  • AETNA — MEDICARE ADVANTAGE: $18.39
  • AETNA — Qhp/Ipf: $127
  • AMERIHEALTH — Managed Medicaid: $17.22
  • Amish Community Aid Plan — ALL PRODUCTS: $57.15
  • ANTHEM — HPN: $28.91
  • ANTHEM — Managed Medicaid: $16.43
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA SCREENING $127 $82.55 $35.92 – $127
PSA (prostate specific antigen) blood test: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $95.25
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $38.77
  • AETNA — MEDICARE ADVANTAGE: $18.39
  • AETNA — Qhp/Ipf: $127
  • AMERIHEALTH — Managed Medicaid: $17.22
  • Amish Community Aid Plan — ALL PRODUCTS: $57.15
  • ANTHEM — HPN: $28.91
  • ANTHEM — Managed Medicaid: $16.43
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: %PHI PROST SPEC AG TOT $127 $82.55 $35.92 – $127
PSA (prostate specific antigen) blood test: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $95.25
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $38.77
  • AETNA — MEDICARE ADVANTAGE: $18.39
  • AETNA — Qhp/Ipf: $127
  • AMERIHEALTH — Managed Medicaid: $17.22
  • Amish Community Aid Plan — ALL PRODUCTS: $57.15
  • ANTHEM — HPN: $28.91
  • ANTHEM — Managed Medicaid: $16.43
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: %NEO TSH $116 $75.40 $0.95 – $37.80
Thyroid stimulating hormone (TSH) test: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $87
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $35.42
  • AETNA — MEDICARE ADVANTAGE: $16.80
  • AETNA — Qhp/Ipf: $116
  • AMERIHEALTH — Managed Medicaid: $20.87
  • Amish Community Aid Plan — ALL PRODUCTS: $52.20
  • ANTHEM — HPN: $26.41
  • ANTHEM — Managed Medicaid: $19.92
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE (TSH) $116 $75.40 $0.95 – $37.80
Thyroid stimulating hormone (TSH) test: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $87
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $35.42
  • AETNA — MEDICARE ADVANTAGE: $16.80
  • AETNA — Qhp/Ipf: $116
  • AMERIHEALTH — Managed Medicaid: $20.87
  • Amish Community Aid Plan — ALL PRODUCTS: $52.20
  • ANTHEM — HPN: $26.41
  • ANTHEM — Managed Medicaid: $19.92
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: %NEO TSH $116 $75.40 $32.80 – $116
Thyroid stimulating hormone (TSH) test: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $58
  • ANTHEM — TRADITIONAL: $66.85
  • OSCAR — ALL PRODUCTS: $41.86
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC AUTO W AUTO DIFF $54 $35.10 $15.27 – $54
Complete blood count (CBC) with differential: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $40.50
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $23.61
  • AETNA — MEDICARE ADVANTAGE: $7.77
  • AETNA — Qhp/Ipf: $54
  • AMERIHEALTH — Managed Medicaid: $8.05
  • Amish Community Aid Plan — ALL PRODUCTS: $24.30
  • ANTHEM — HPN: $12.21
  • ANTHEM — Managed Medicaid: $7.69
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC AUTO W AUTO DIFF $54 $35.10 $15.27 – $54
Complete blood count (CBC) with differential: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $27
  • ANTHEM — TRADITIONAL: $31.12
  • OSCAR — ALL PRODUCTS: $19.49
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: COMPLETE CBC W/AUTO DIFF WBC Not listed in the file Not listed in the file $8.06
Complete blood count (CBC) with differential: rates for 1 insurance plan
  • CC EHP — ALL PRODUCTS: $8.06
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC AUTO WO DIFF $45 $29.25 $12.73 – $45
Complete blood count (CBC), automated: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $33.75
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $19.66
  • AETNA — MEDICARE ADVANTAGE: $6.47
  • AETNA — Qhp/Ipf: $45
  • AMERIHEALTH — Managed Medicaid: $8.05
  • Amish Community Aid Plan — ALL PRODUCTS: $20.25
  • ANTHEM — HPN: $10.17
  • ANTHEM — Managed Medicaid: $7.69
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC AUTO WO DIFF $45 $29.25 $12.73 – $45
Complete blood count (CBC), automated: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $22.50
  • ANTHEM — TRADITIONAL: $25.93
  • OSCAR — ALL PRODUCTS: $16.24
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME AND INR (POINT OF CARE LAB) $30 $19.50 $8.48 – $30
Blood clotting time test (prothrombin time, PT): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $22.50
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $13.03
  • AETNA — MEDICARE ADVANTAGE: $4.29
  • AETNA — Qhp/Ipf: $30
  • AMERIHEALTH — Managed Medicaid: $9.22
  • Amish Community Aid Plan — ALL PRODUCTS: $13.50
  • ANTHEM — HPN: $6.74
  • ANTHEM — Managed Medicaid: $8.80
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLOTTING TEST (POINT OF CARE LAB) $30 $19.50 $8.48 – $30
Blood clotting time test (prothrombin time, PT): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $22.50
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $13.03
  • AETNA — MEDICARE ADVANTAGE: $4.29
  • AETNA — Qhp/Ipf: $30
  • AMERIHEALTH — Managed Medicaid: $9.22
  • Amish Community Aid Plan — ALL PRODUCTS: $13.50
  • ANTHEM — HPN: $6.74
  • ANTHEM — Managed Medicaid: $8.80
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *PRO TIME $30 $19.50 $8.48 – $30
Blood clotting time test (prothrombin time, PT): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $22.50
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $13.03
  • AETNA — MEDICARE ADVANTAGE: $4.29
  • AETNA — Qhp/Ipf: $30
  • AMERIHEALTH — Managed Medicaid: $9.22
  • Amish Community Aid Plan — ALL PRODUCTS: $13.50
  • ANTHEM — HPN: $6.74
  • ANTHEM — Managed Medicaid: $8.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *PTT PLASMA/WHOLE BLOOD $41 $26.65 $11.59 – $41
Blood clotting test (partial thromboplastin time, PTT): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $30.75
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $18.26
  • AETNA — MEDICARE ADVANTAGE: $6.01
  • AETNA — Qhp/Ipf: $41
  • AMERIHEALTH — Managed Medicaid: $9.22
  • Amish Community Aid Plan — ALL PRODUCTS: $18.45
  • ANTHEM — HPN: $9.45
  • ANTHEM — Managed Medicaid: $8.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL HEME - PTT PLASMA/WHOLE BLOOD $41 $26.65 $0.95 – $18.26
Blood clotting test (partial thromboplastin time, PTT): 10 of 66 insurance plan rates
  • AETNA — Acop: $0.95
  • AETNA — ALL PRODUCTS: $30.75
  • AETNA — Asa_Whirlpool_Peia: $1.11
  • AETNA — International: $18.26
  • AETNA — MEDICARE ADVANTAGE: $6.01
  • AETNA — Qhp/Ipf: $41
  • AMERIHEALTH — Managed Medicaid: $9.22
  • Amish Community Aid Plan — ALL PRODUCTS: $18.45
  • ANTHEM — HPN: $9.45
  • ANTHEM — Managed Medicaid: $8.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: *PTT PLASMA/WHOLE BLOOD $41 $26.65 $11.59 – $41
Blood clotting test (partial thromboplastin time, PTT): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $20.50
  • ANTHEM — TRADITIONAL: $23.63
  • OSCAR — ALL PRODUCTS: $14.80

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O CONTRAST MATERIAL $734 $477.10 $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $551.66
CT scan of the head or brain, without contrast: 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $550.50
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $462.01
  • AETNA — MEDICARE ADVANTAGE: $98.91
  • AETNA — Qhp/Ipf: $734
  • AMERIHEALTH — Managed Medicaid: $373.56
  • Amish Community Aid Plan — ALL PRODUCTS: $330.30
  • ANTHEM — HPN: $194.32
  • ANTHEM — Managed Medicaid: $356.58
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O CONTRAST MATERIAL $734 $477.10 $207.58 – $734
CT scan of the head or brain, without contrast: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $367
  • ANTHEM — TRADITIONAL: $423
  • OSCAR — ALL PRODUCTS: $264.90
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL $2,464 $1,601.60 $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,863.61
MRI of the brain, before and after contrast: 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $1,848
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $1,562.73
  • AETNA — MEDICARE ADVANTAGE: $330.06
  • AETNA — Qhp/Ipf: $2,464
  • AMERIHEALTH — Managed Medicaid: $366.29
  • Amish Community Aid Plan — ALL PRODUCTS: $1,108.80
  • ANTHEM — HPN: $582.48
  • ANTHEM — Managed Medicaid: $349.64
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL $2,464 $1,601.60 $696.82 – $2,464
MRI of the brain, before and after contrast: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $1,232
  • ANTHEM — TRADITIONAL: $1,420
  • OSCAR — ALL PRODUCTS: $889.26
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS $608 $395.20 $46.52 – $238.85
Chest X-ray, 2 views: 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $456
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $205.96
  • AETNA — MEDICARE ADVANTAGE: $82.33
  • AETNA — Qhp/Ipf: $608
  • AMERIHEALTH — Managed Medicaid: $53.87
  • Amish Community Aid Plan — ALL PRODUCTS: $273.60
  • ANTHEM — HPN: $60.97
  • ANTHEM — Managed Medicaid: $51.42
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS $608 $395.20 $171.94 – $608
Chest X-ray, 2 views: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $304
  • ANTHEM — TRADITIONAL: $350.39
  • OSCAR — ALL PRODUCTS: $219.43
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $734 $477.10 $46.52 – $286.93
X-ray of the lower spine, at least 4 views: 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $550.50
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $277.21
  • AETNA — MEDICARE ADVANTAGE: $98.91
  • AETNA — Qhp/Ipf: $734
  • AMERIHEALTH — Managed Medicaid: $53.87
  • Amish Community Aid Plan — ALL PRODUCTS: $330.30
  • ANTHEM — HPN: $99.98
  • ANTHEM — Managed Medicaid: $51.42
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $734 $477.10 $207.58 – $734
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $367
  • ANTHEM — TRADITIONAL: $423
  • OSCAR — ALL PRODUCTS: $264.90
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL $1,668 $1,084.20 $471.71 – $1,668
MRI of the lower back (lumbar spine), without contrast: 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $1,251
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $976.47
  • AETNA — MEDICARE ADVANTAGE: $225.74
  • AETNA — Qhp/Ipf: $1,668
  • AMERIHEALTH — Managed Medicaid: $242.39
  • Amish Community Aid Plan — ALL PRODUCTS: $750.60
  • ANTHEM — HPN: $350.80
  • ANTHEM — Managed Medicaid: $231.37
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL $1,668 $1,084.20 $471.71 – $1,668
MRI of the lower back (lumbar spine), without contrast: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $834
  • ANTHEM — TRADITIONAL: $961.27
  • OSCAR — ALL PRODUCTS: $601.98
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTRAST MATERIAL $1,228 $798.20 $347.28 – $1,228
CT scan of the pelvis, with contrast: 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $921
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $758.04
  • AETNA — MEDICARE ADVANTAGE: $165.94
  • AETNA — Qhp/Ipf: $1,228
  • AMERIHEALTH — Managed Medicaid: $373.56
  • Amish Community Aid Plan — ALL PRODUCTS: $552.60
  • ANTHEM — HPN: $422.84
  • ANTHEM — Managed Medicaid: $356.58
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTRAST MATERIAL $1,228 $798.20 $347.28 – $1,228
CT scan of the pelvis, with contrast: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $614
  • ANTHEM — TRADITIONAL: $707.70
  • OSCAR — ALL PRODUCTS: $443.19
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL $1,668 $1,084.20 $471.71 – $1,668
MRI of a leg joint (such as the knee), without contrast: 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $1,251
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $976.47
  • AETNA — MEDICARE ADVANTAGE: $225.74
  • AETNA — Qhp/Ipf: $1,668
  • AMERIHEALTH — Managed Medicaid: $242.39
  • Amish Community Aid Plan — ALL PRODUCTS: $750.60
  • ANTHEM — HPN: $377.96
  • ANTHEM — Managed Medicaid: $231.37
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL $1,668 $1,084.20 $471.71 – $1,668
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $834
  • ANTHEM — TRADITIONAL: $961.27
  • OSCAR — ALL PRODUCTS: $601.98
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABDOMEN & PELVIS W/CONTRAST MATERIAL $2,464 $1,601.60 $696.82 – $2,464
CT scan of the abdomen and pelvis, with contrast: 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $1,848
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $1,562.73
  • AETNA — MEDICARE ADVANTAGE: $330.06
  • AETNA — Qhp/Ipf: $2,464
  • AMERIHEALTH — Managed Medicaid: $373.56
  • Amish Community Aid Plan — ALL PRODUCTS: $1,108.80
  • ANTHEM — HPN: $557.85
  • ANTHEM — Managed Medicaid: $356.58
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT ABDOMEN & PELVIS W/CONTRAST MATERIAL $2,464 $1,601.60 $696.82 – $2,464
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $1,232
  • ANTHEM — TRADITIONAL: $1,420
  • OSCAR — ALL PRODUCTS: $889.26
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION $734 $477.10 $95.38 – $286.93
Ultrasound of the abdomen, complete: 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $550.50
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $277.21
  • AETNA — MEDICARE ADVANTAGE: $98.91
  • AETNA — Qhp/Ipf: $734
  • AMERIHEALTH — Managed Medicaid: $142.56
  • Amish Community Aid Plan — ALL PRODUCTS: $330.30
  • ANTHEM — HPN: $210.03
  • ANTHEM — Managed Medicaid: $136.08
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION $734 $477.10 $207.58 – $734
Ultrasound of the abdomen, complete: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $367
  • ANTHEM — TRADITIONAL: $423
  • OSCAR — ALL PRODUCTS: $264.90
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION $734 $477.10 $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $551.66
Pregnancy ultrasound (after the first trimester): 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $550.50
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $277.21
  • AETNA — MEDICARE ADVANTAGE: $98.91
  • AETNA — Qhp/Ipf: $734
  • AMERIHEALTH — Managed Medicaid: $110.90
  • Amish Community Aid Plan — ALL PRODUCTS: $330.30
  • ANTHEM — HPN: $249.54
  • ANTHEM — Managed Medicaid: $105.86
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION $734 $477.10 $207.58 – $734
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $367
  • ANTHEM — TRADITIONAL: $423
  • OSCAR — ALL PRODUCTS: $264.90
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAGINAL $734 $477.10 $207.58 – $734
Transvaginal ultrasound: 10 of 67 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $550.50
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $277.21
  • AETNA — MEDICARE ADVANTAGE: $98.91
  • AETNA — Qhp/Ipf: $734
  • AMERIHEALTH — Managed Medicaid: $92.70
  • Amish Community Aid Plan — ALL PRODUCTS: $330.30
  • ANTHEM — HPN: $218.40
  • ANTHEM — Managed Medicaid: $88.48
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US TRANSVAGINAL $734 $477.10 $207.58 – $734
Transvaginal ultrasound: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $367
  • ANTHEM — TRADITIONAL: $423
  • OSCAR — ALL PRODUCTS: $264.90
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI $563 $365.95 $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $462.83
Diagnostic mammogram, one breast: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $422.25
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $394.10
  • AETNA — MEDICARE ADVANTAGE: $168.11
  • AETNA — Qhp/Ipf: $563
  • AMERIHEALTH — Managed Medicaid: $49.18
  • Amish Community Aid Plan — ALL PRODUCTS: $253.35
  • ANTHEM — HPN: $229.05
  • ANTHEM — Managed Medicaid: $46.95
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI $563 $365.95 $159.22 – $563
Diagnostic mammogram, one breast: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $281.50
  • ANTHEM — TRADITIONAL: $324.46
  • OSCAR — ALL PRODUCTS: $203.19
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI $706 $458.90 $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $591.75
Diagnostic mammogram, both breasts: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $529.50
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $494.20
  • AETNA — MEDICARE ADVANTAGE: $213.08
  • AETNA — Qhp/Ipf: $706
  • AMERIHEALTH — Managed Medicaid: $49.18
  • Amish Community Aid Plan — ALL PRODUCTS: $317.70
  • ANTHEM — HPN: $290.32
  • ANTHEM — Managed Medicaid: $46.95
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI $706 $458.90 $199.66 – $706
Diagnostic mammogram, both breasts: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $353
  • ANTHEM — TRADITIONAL: $406.87
  • OSCAR — ALL PRODUCTS: $254.80
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD $609 $395.85 $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $489.29
Screening mammogram, both breasts: 10 of 66 insurance plan rates
  • AETNA — Acop: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — ALL PRODUCTS: $456.75
  • AETNA — Asa_Whirlpool_Peia: $1.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AETNA — International: $426.30
  • AETNA — MEDICARE ADVANTAGE: $172.34
  • AETNA — Qhp/Ipf: $609
  • AMERIHEALTH — Managed Medicaid: $49.18
  • Amish Community Aid Plan — ALL PRODUCTS: $274.05
  • ANTHEM — HPN: $234.81
  • ANTHEM — Managed Medicaid: $46.95
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD $609 $395.85 $172.23 – $609
Screening mammogram, both breasts: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $304.50
  • ANTHEM — TRADITIONAL: $350.97
  • OSCAR — ALL PRODUCTS: $219.79

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: ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $415 $269.75 $90.47 – $415
Electrocardiogram (ECG/EKG) with reading: 10 of 49 insurance plan rates
  • AETNA — Acop: $249
  • AETNA — ALL PRODUCTS: $311.25
  • AETNA — Asa_Whirlpool_Peia: $311.25
  • AETNA — International: $300.88
  • AETNA — MEDICARE ADVANTAGE: $90.47
  • AETNA — Qhp/Ipf: $415
  • AMERIHEALTH — Managed Medicaid: $22.30
  • Amish Community Aid Plan — ALL PRODUCTS: $186.75
  • ANTHEM — HPN: $26.80
  • ANTHEM — Managed Medicaid: $21.28
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $415 $269.75 $90.47 – $415
Electrocardiogram (ECG/EKG) with reading: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $207.50
  • ANTHEM — TRADITIONAL: $239.16
  • OSCAR — ALL PRODUCTS: $149.77
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I $18,494 $12,021.10 $1,117.68 – $9,996
Left heart catheterization (diagnostic): 10 of 67 insurance plan rates
  • AETNA — Acop: $8,566
  • AETNA — ALL PRODUCTS: $13,870.50
  • AETNA — Asa_Whirlpool_Peia: $9,996
  • AETNA — International: $9,329
  • AETNA — MEDICARE ADVANTAGE: $3,067.12
  • AETNA — Qhp/Ipf: $18,494
  • AMERIHEALTH — Managed Medicaid: $1,848
  • Amish Community Aid Plan — ALL PRODUCTS: $8,322.30
  • ANTHEM — HPN: $1,617.87
  • ANTHEM — Managed Medicaid: $1,764
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I $18,494 $12,021.10 $5,230.10 – $18,494
Left heart catheterization (diagnostic): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $9,247
  • ANTHEM — TRADITIONAL: $10,658.09
  • OSCAR — ALL PRODUCTS: $6,674.48
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION $43,632 $28,360.80 $1,278.27 – $21,406.72
Heart rhythm study (electrophysiology evaluation): 10 of 67 insurance plan rates
  • AETNA — Acop: $26,179.20
  • AETNA — ALL PRODUCTS: $32,724
  • AETNA — Asa_Whirlpool_Peia: $8,885
  • AETNA — International: $9,329
  • AETNA — MEDICARE ADVANTAGE: $7,379.08
  • AETNA — Qhp/Ipf: $43,632
  • AMERIHEALTH — Managed Medicaid: $1,480.11
  • Amish Community Aid Plan — ALL PRODUCTS: $19,634.40
  • ANTHEM — HPN: $18,091.30
  • ANTHEM — Managed Medicaid: $1,412.83
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION $43,632 $28,360.80 $12,339.13 – $43,632
Heart rhythm study (electrophysiology evaluation): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $21,816
  • ANTHEM — TRADITIONAL: $25,145.12
  • OSCAR — ALL PRODUCTS: $15,746.79
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION $69,628 $45,258.20 $1,407.23 – $71,737.17
Heart rhythm study with ablation for atrial fibrillation: 10 of 67 insurance plan rates
  • AETNA — Acop: $41,776.80
  • AETNA — ALL PRODUCTS: $52,221
  • AETNA — Asa_Whirlpool_Peia: $8,885
  • AETNA — International: $9,329
  • AETNA — MEDICARE ADVANTAGE: $24,728.43
  • AETNA — Qhp/Ipf: $69,628
  • AMERIHEALTH — Managed Medicaid: $11,501.07
  • Amish Community Aid Plan — ALL PRODUCTS: $31,332.60
  • ANTHEM — HPN: $1,407.23
  • ANTHEM — Managed Medicaid: $10,978.30
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION $69,628 $45,258.20 $19,690.80 – $69,628
Heart rhythm study with ablation for atrial fibrillation: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $34,814
  • ANTHEM — TRADITIONAL: $40,126.62
  • OSCAR — ALL PRODUCTS: $25,128.75
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $7,020 $4,563 $1,985.26 – $7,020
Sleep study (overnight, in a sleep lab): 10 of 58 insurance plan rates
  • AETNA — Acop: $4,212
  • AETNA — ALL PRODUCTS: $5,265
  • AETNA — Asa_Whirlpool_Peia: $4,914
  • AETNA — International: $4,914
  • AETNA — MEDICARE ADVANTAGE: $812.43
  • AETNA — Qhp/Ipf: $7,020
  • Amish Community Aid Plan — ALL PRODUCTS: $3,159
  • ANTHEM — HPN: $1,276.04
  • ANTHEM — MEDICARE ADVANTAGE: $812.43
  • ANTHEM — PPO/HMO: $2,343.39
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $7,020 $4,563 $1,985.26 – $7,020
Sleep study (overnight, in a sleep lab): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $3,510
  • ANTHEM — TRADITIONAL: $4,045.63
  • OSCAR — ALL PRODUCTS: $2,533.52

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: THERA EXER 1 $258 $167.70 $72.96 – $258
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 66 insurance plan rates
  • AETNA — Acop: $85.66
  • AETNA — ALL PRODUCTS: $193.50
  • AETNA — Asa_Whirlpool_Peia: $100.10
  • AETNA — International: $105.01
  • AETNA — MEDICARE ADVANTAGE: $37.31
  • AETNA — Qhp/Ipf: $258
  • AMERIHEALTH — Managed Medicaid: $80.72
  • Amish Community Aid Plan — ALL PRODUCTS: $116.10
  • ANTHEM — HPN: $50.83
  • ANTHEM — Managed Medicaid: $77.05
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERA EXER 15MIN $258 $167.70 $37.06 – $108.24
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 66 insurance plan rates
  • AETNA — Acop: $85.66
  • AETNA — ALL PRODUCTS: $193.50
  • AETNA — Asa_Whirlpool_Peia: $100.10
  • AETNA — International: $105.01
  • AETNA — MEDICARE ADVANTAGE: $37.31
  • AETNA — Qhp/Ipf: $258
  • AMERIHEALTH — Managed Medicaid: $80.72
  • Amish Community Aid Plan — ALL PRODUCTS: $116.10
  • ANTHEM — HPN: $50.83
  • ANTHEM — Managed Medicaid: $77.05
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT THERAPEUT PROC/EXER, 15 MIN $258 $167.70 $37.06 – $108.24
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 66 insurance plan rates
  • AETNA — Acop: $85.66
  • AETNA — ALL PRODUCTS: $193.50
  • AETNA — Asa_Whirlpool_Peia: $100.10
  • AETNA — International: $105.01
  • AETNA — MEDICARE ADVANTAGE: $37.31
  • AETNA — Qhp/Ipf: $258
  • AMERIHEALTH — Managed Medicaid: $80.72
  • Amish Community Aid Plan — ALL PRODUCTS: $116.10
  • ANTHEM — HPN: $50.83
  • ANTHEM — Managed Medicaid: $77.05
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VV EVALUATION LOW COMPLEXITY (97161) $605 $393.25 $171.09 – $605
Physical therapy evaluation (low complexity): 10 of 66 insurance plan rates
  • AETNA — Acop: $200.86
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $234.74
  • AETNA — International: $246.24
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $88.41
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $172.26
  • ANTHEM — Managed Medicaid: $84.39
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS $605 $393.25 $171.09 – $605
Physical therapy evaluation (low complexity): 10 of 66 insurance plan rates
  • AETNA — Acop: $200.86
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $234.74
  • AETNA — International: $246.24
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $88.41
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $172.26
  • ANTHEM — Managed Medicaid: $84.39
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL - LOW $605 $393.25 $171.09 – $605
Physical therapy evaluation (low complexity): 10 of 66 insurance plan rates
  • AETNA — Acop: $200.86
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $234.74
  • AETNA — International: $246.24
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $88.41
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $172.26
  • ANTHEM — Managed Medicaid: $84.39
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VV EVALUATION MODERATE COMPLEXITY (97162) $605 $393.25 $171.09 – $605
Physical therapy evaluation (moderate complexity): 10 of 66 insurance plan rates
  • AETNA — Acop: $200.86
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $234.74
  • AETNA — International: $246.24
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $88.41
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $172.26
  • ANTHEM — Managed Medicaid: $84.39
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL - MOD $605 $393.25 $171.09 – $605
Physical therapy evaluation (moderate complexity): 10 of 66 insurance plan rates
  • AETNA — Acop: $200.86
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $234.74
  • AETNA — International: $246.24
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $88.41
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $172.26
  • ANTHEM — Managed Medicaid: $84.39
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: VV EVALUATION MODERATE COMPLEXITY (97162) $605 $393.25 $171.09 – $605
Physical therapy evaluation (moderate complexity): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $302.50
  • ANTHEM — TRADITIONAL: $348.66
  • OSCAR — ALL PRODUCTS: $218.34
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VV EVALUATION HIGH COMPLEXITY (97163) $605 $393.25 $171.09 – $605
Physical therapy evaluation (high complexity): 10 of 66 insurance plan rates
  • AETNA — Acop: $200.86
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $234.74
  • AETNA — International: $246.24
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $88.41
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $172.26
  • ANTHEM — Managed Medicaid: $84.39
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL - HIGH $605 $393.25 $171.09 – $605
Physical therapy evaluation (high complexity): 10 of 66 insurance plan rates
  • AETNA — Acop: $200.86
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $234.74
  • AETNA — International: $246.24
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $88.41
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $172.26
  • ANTHEM — Managed Medicaid: $84.39
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: VV EVALUATION HIGH COMPLEXITY (97163) $605 $393.25 $171.09 – $605
Physical therapy evaluation (high complexity): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $302.50
  • ANTHEM — TRADITIONAL: $348.66
  • OSCAR — ALL PRODUCTS: $218.34
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 30 MINUTES $482 $313.30 $136.31 – $482
Psychotherapy, 30 minutes: 10 of 67 insurance plan rates
  • AETNA — Acop: $289.20
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $337.40
  • AETNA — International: $337.40
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $90.23
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $138.99
  • ANTHEM — Managed Medicaid: $86.13
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 30 MINUTES $482 $313.30 $136.31 – $482
Psychotherapy, 30 minutes: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $241
  • ANTHEM — TRADITIONAL: $277.78
  • OSCAR — ALL PRODUCTS: $173.95
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 45 MINUTES $482 $313.30 $136.31 – $482
Psychotherapy, 45 minutes: 10 of 67 insurance plan rates
  • AETNA — Acop: $289.20
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $337.40
  • AETNA — International: $337.40
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $112.87
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $183.49
  • ANTHEM — Managed Medicaid: $107.74
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 45 MINUTES $482 $313.30 $136.31 – $482
Psychotherapy, 45 minutes: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $241
  • ANTHEM — TRADITIONAL: $277.78
  • OSCAR — ALL PRODUCTS: $173.95
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 60 MINUTES $482 $313.30 $136.31 – $482
Psychotherapy, 60 minutes: 10 of 67 insurance plan rates
  • AETNA — Acop: $289.20
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $337.40
  • AETNA — International: $337.40
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $112.87
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $270.65
  • ANTHEM — Managed Medicaid: $107.74
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 60 MINUTES $482 $313.30 $136.31 – $482
Psychotherapy, 60 minutes: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $241
  • ANTHEM — TRADITIONAL: $277.78
  • OSCAR — ALL PRODUCTS: $173.95
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $482 $313.30 $136.31 – $482
Family psychotherapy, without the patient: 10 of 67 insurance plan rates
  • AETNA — Acop: $289.20
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $337.40
  • AETNA — International: $337.40
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $150.67
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $197.48
  • ANTHEM — Managed Medicaid: $143.82
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $482 $313.30 $136.31 – $482
Family psychotherapy, without the patient: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $241
  • ANTHEM — TRADITIONAL: $277.78
  • OSCAR — ALL PRODUCTS: $173.95
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAM THERAPY W PATIENT DTOX $482 $313.30 $136.31 – $482
Family psychotherapy, with the patient: 10 of 67 insurance plan rates
  • AETNA — Acop: $289.20
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $337.40
  • AETNA — International: $337.40
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $150.67
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $205.42
  • ANTHEM — Managed Medicaid: $143.82
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $482 $313.30 $136.31 – $482
Family psychotherapy, with the patient: 10 of 67 insurance plan rates
  • AETNA — Acop: $289.20
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $337.40
  • AETNA — International: $337.40
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $150.67
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $205.42
  • ANTHEM — Managed Medicaid: $143.82
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: FAM THERAPY W PATIENT DTOX $482 $313.30 $136.31 – $482
Family psychotherapy, with the patient: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $241
  • ANTHEM — TRADITIONAL: $277.78
  • OSCAR — ALL PRODUCTS: $173.95
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IOP HALF DAY RATE $834 $542.10 $235.86 – $834
Group psychotherapy: 10 of 67 insurance plan rates
  • AETNA — Acop: $500.40
  • AETNA — ALL PRODUCTS: $625.50
  • AETNA — Asa_Whirlpool_Peia: $583.80
  • AETNA — International: $583.80
  • AETNA — MEDICARE ADVANTAGE: $96.11
  • AETNA — Qhp/Ipf: $834
  • AMERIHEALTH — Managed Medicaid: $125
  • Amish Community Aid Plan — ALL PRODUCTS: $375.30
  • ANTHEM — HPN: $48.41
  • ANTHEM — Managed Medicaid: $119.32
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VIRTUAL VISIT IOP HALF DAY RATE $834 $542.10 $235.86 – $834
Group psychotherapy: 10 of 67 insurance plan rates
  • AETNA — Acop: $500.40
  • AETNA — ALL PRODUCTS: $625.50
  • AETNA — Asa_Whirlpool_Peia: $583.80
  • AETNA — International: $583.80
  • AETNA — MEDICARE ADVANTAGE: $96.11
  • AETNA — Qhp/Ipf: $834
  • AMERIHEALTH — Managed Medicaid: $125
  • Amish Community Aid Plan — ALL PRODUCTS: $375.30
  • ANTHEM — HPN: $48.41
  • ANTHEM — Managed Medicaid: $119.32
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CD IOP DAY $834 $542.10 $235.86 – $834
Group psychotherapy: 10 of 67 insurance plan rates
  • AETNA — Acop: $500.40
  • AETNA — ALL PRODUCTS: $625.50
  • AETNA — Asa_Whirlpool_Peia: $583.80
  • AETNA — International: $583.80
  • AETNA — MEDICARE ADVANTAGE: $96.11
  • AETNA — Qhp/Ipf: $834
  • AMERIHEALTH — Managed Medicaid: $125
  • Amish Community Aid Plan — ALL PRODUCTS: $375.30
  • ANTHEM — HPN: $48.41
  • ANTHEM — Managed Medicaid: $119.32

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: EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION $11,488 $7,467.20 $672.08 – $10,746.18
Removal of breast growth (open surgery): 10 of 67 insurance plan rates
  • AETNA — Acop: $5,355
  • AETNA — ALL PRODUCTS: $8,616
  • AETNA — Asa_Whirlpool_Peia: $6,249
  • AETNA — International: $6,561
  • AETNA — MEDICARE ADVANTAGE: $3,704.30
  • AETNA — Qhp/Ipf: $11,488
  • AMERIHEALTH — Managed Medicaid: $978.91
  • Amish Community Aid Plan — ALL PRODUCTS: $5,169.60
  • ANTHEM — HPN: $672.08
  • ANTHEM — Managed Medicaid: $934.42
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION $11,488 $7,467.20 $3,248.81 – $11,488
Removal of breast growth (open surgery): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $5,744
  • ANTHEM — TRADITIONAL: $6,620.53
  • OSCAR — ALL PRODUCTS: $4,146.02
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY Not listed in the file Not listed in the file $6,458.47 – $35,035.02
Total hip replacement: 10 of 23 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $12,146.38
  • ANTHEM — HPN: $29,779.28
  • ANTHEM — MEDICARE ADVANTAGE: $12,146.38
  • ANTHEM — PPO/HMO: $35,035.02
  • CIGNA — MEDICARE ADVANTAGE: $12,510.77
  • CommuniCare — MEDICARE ADVANTAGE: $12,753.70
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $12,146.38
  • HUMANA — Medicare Advantage HMO: $11,418.01
  • MMO — ALL PRODUCTS: $33,402.55
  • MMO — Medicare Advantage HMO: $11,928.06
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty Not listed in the file Not listed in the file $6,458.47 – $35,035.02
Total hip replacement: rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $7,478.23
  • ANTHEM — Managed Medicaid: $7,138.31
  • Buckeye — Managed Medicaid: $7,138.31
  • CARESOURCE — Managed Medicaid: $7,274.28
  • MOLINA — Managed Medicaid: $7,138.31
  • OPTUM — Managed Medicaid Transplant: $6,458.47
  • Paramount — Managed Medicaid: $7,002.34
  • UNITED — Managed Medicaid: $7,274.28
  • United BH — Managed Medicaid: $7,206.29
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY Not listed in the file Not listed in the file $6,458.47 – $35,035.02
Total knee replacement: 10 of 23 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $12,146.38
  • ANTHEM — HPN: $29,779.28
  • ANTHEM — MEDICARE ADVANTAGE: $12,146.38
  • ANTHEM — PPO/HMO: $35,035.02
  • CIGNA — MEDICARE ADVANTAGE: $12,510.77
  • CommuniCare — MEDICARE ADVANTAGE: $12,753.70
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $12,146.38
  • HUMANA — Medicare Advantage HMO: $11,418.01
  • MMO — ALL PRODUCTS: $33,402.55
  • MMO — Medicare Advantage HMO: $11,928.06
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty Not listed in the file Not listed in the file $6,458.47 – $35,035.02
Total knee replacement: rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $7,478.23
  • ANTHEM — Managed Medicaid: $7,138.31
  • Buckeye — Managed Medicaid: $7,138.31
  • CARESOURCE — Managed Medicaid: $7,274.28
  • MOLINA — Managed Medicaid: $7,138.31
  • OPTUM — Managed Medicaid Transplant: $6,458.47
  • Paramount — Managed Medicaid: $7,002.34
  • UNITED — Managed Medicaid: $7,274.28
  • United BH — Managed Medicaid: $7,206.29
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $1,500.65 – $3,398
Shoulder arthroscopy: shaving of shoulder bone: rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,737.59
  • ANTHEM — Managed Medicaid: $1,658.61
  • Buckeye — Managed Medicaid: $1,658.61
  • CARESOURCE — Managed Medicaid: $1,690.20
  • MOLINA — Managed Medicaid: $1,658.61
  • OPTUM — Managed Medicaid Transplant: $1,500.65
  • Paramount — Managed Medicaid: $1,627.02
  • UNITED — Managed Medicaid: $1,690.20
  • United BH — Managed Medicaid: $1,674.41
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION Not listed in the file Not listed in the file $1,500.65 – $3,398
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan
  • UNITED — ALL PRODUCTS: $3,398
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L Not listed in the file Not listed in the file $1,500.65 – $8,928.85
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $3,095.56
  • ANTHEM — HPN: $7,589.40
  • ANTHEM — MEDICARE ADVANTAGE: $3,095.56
  • ANTHEM — PPO/HMO: $8,928.85
  • CIGNA — MEDICARE ADVANTAGE: $3,188.43
  • CommuniCare — MEDICARE ADVANTAGE: $3,250.34
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $3,095.56
  • HUMANA — Medicare Advantage HMO: $2,808.13
  • MMO — ALL PRODUCTS: $8,512.80
  • MMO — Medicare Advantage HMO: $3,007.88
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrs kne srg mnisectmy m/l Not listed in the file Not listed in the file $1,500.65 – $8,928.85
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,737.59
  • ANTHEM — Managed Medicaid: $1,658.61
  • Buckeye — Managed Medicaid: $1,658.61
  • CARESOURCE — Managed Medicaid: $1,690.20
  • MOLINA — Managed Medicaid: $1,658.61
  • OPTUM — Managed Medicaid Transplant: $1,500.65
  • Paramount — Managed Medicaid: $1,627.02
  • UNITED — Managed Medicaid: $1,690.20
  • United BH — Managed Medicaid: $1,674.41
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS Not listed in the file Not listed in the file $1,175.43 – $16,154.41
Removal of tonsils and adenoids (under age 12): 10 of 23 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $5,600.62
  • ANTHEM — HPN: $13,731.03
  • ANTHEM — MEDICARE ADVANTAGE: $5,600.62
  • ANTHEM — PPO/HMO: $16,154.41
  • CIGNA — MEDICARE ADVANTAGE: $5,768.63
  • CommuniCare — MEDICARE ADVANTAGE: $5,880.65
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $5,600.62
  • HUMANA — Medicare Advantage HMO: $5,080.55
  • MMO — ALL PRODUCTS: $15,401.69
  • MMO — Medicare Advantage HMO: $5,484.05
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $1,175.43 – $16,154.41
Removal of tonsils and adenoids (under age 12): rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,361.02
  • ANTHEM — Managed Medicaid: $1,299.15
  • Buckeye — Managed Medicaid: $1,299.15
  • CARESOURCE — Managed Medicaid: $1,323.90
  • MOLINA — Managed Medicaid: $1,299.15
  • OPTUM — Managed Medicaid Transplant: $1,175.43
  • Paramount — Managed Medicaid: $1,274.41
  • UNITED — Managed Medicaid: $1,323.90
  • United BH — Managed Medicaid: $1,311.53
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $4,313 $2,803.45 $1,219.72 – $4,313
Upper GI endoscopy (diagnostic): 10 of 67 insurance plan rates
  • AETNA — Acop: $2,451
  • AETNA — ALL PRODUCTS: $3,234.75
  • AETNA — Asa_Whirlpool_Peia: $2,860
  • AETNA — International: $3,004
  • AETNA — MEDICARE ADVANTAGE: $858.08
  • AETNA — Qhp/Ipf: $4,313
  • AMERIHEALTH — Managed Medicaid: $740.29
  • Amish Community Aid Plan — ALL PRODUCTS: $1,940.85
  • ANTHEM — HPN: $195.19
  • ANTHEM — Managed Medicaid: $706.64
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $4,313 $2,803.45 $1,219.72 – $4,313
Upper GI endoscopy (diagnostic): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $2,156.50
  • ANTHEM — TRADITIONAL: $2,485.58
  • OSCAR — ALL PRODUCTS: $1,556.56
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $4,313 $2,803.45 $219.13 – $4,001
Upper GI endoscopy with biopsy: 10 of 67 insurance plan rates
  • AETNA — Acop: $3,265
  • AETNA — ALL PRODUCTS: $3,234.75
  • AETNA — Asa_Whirlpool_Peia: $3,810
  • AETNA — International: $4,001
  • AETNA — MEDICARE ADVANTAGE: $858.08
  • AETNA — Qhp/Ipf: $4,313
  • AMERIHEALTH — Managed Medicaid: $740.29
  • Amish Community Aid Plan — ALL PRODUCTS: $1,940.85
  • ANTHEM — HPN: $219.13
  • ANTHEM — Managed Medicaid: $706.64
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $4,313 $2,803.45 $1,219.72 – $4,313
Upper GI endoscopy with biopsy: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $2,156.50
  • ANTHEM — TRADITIONAL: $2,485.58
  • OSCAR — ALL PRODUCTS: $1,556.56
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $4,194 $2,726.10 $292.30 – $4,831
Colonoscopy (diagnostic): 10 of 67 insurance plan rates
  • AETNA — Acop: $3,265
  • AETNA — ALL PRODUCTS: $3,145.50
  • AETNA — Asa_Whirlpool_Peia: $3,810
  • AETNA — International: $4,001
  • AETNA — MEDICARE ADVANTAGE: $879.81
  • AETNA — Qhp/Ipf: $4,194
  • AMERIHEALTH — Managed Medicaid: $844.60
  • Amish Community Aid Plan — ALL PRODUCTS: $1,887.30
  • ANTHEM — HPN: $292.30
  • ANTHEM — Managed Medicaid: $806.21
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $4,194 $2,726.10 $1,186.06 – $4,194
Colonoscopy (diagnostic): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $2,097
  • ANTHEM — TRADITIONAL: $2,417
  • OSCAR — ALL PRODUCTS: $1,513.61
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $5,424 $3,525.60 $316.71 – $4,831
Colonoscopy with biopsy: 10 of 67 insurance plan rates
  • AETNA — Acop: $3,265
  • AETNA — ALL PRODUCTS: $4,068
  • AETNA — Asa_Whirlpool_Peia: $3,810
  • AETNA — International: $4,001
  • AETNA — MEDICARE ADVANTAGE: $1,132.12
  • AETNA — Qhp/Ipf: $5,424
  • AMERIHEALTH — Managed Medicaid: $844.60
  • Amish Community Aid Plan — ALL PRODUCTS: $2,440.80
  • ANTHEM — HPN: $316.71
  • ANTHEM — Managed Medicaid: $806.21
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $5,424 $3,525.60 $1,533.91 – $5,424
Colonoscopy with biopsy: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $2,712
  • ANTHEM — TRADITIONAL: $3,125.85
  • OSCAR — ALL PRODUCTS: $1,957.52
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $5,424 $3,525.60 $400.60 – $4,831
Colonoscopy with removal of polyps (snare): 10 of 67 insurance plan rates
  • AETNA — Acop: $3,265
  • AETNA — ALL PRODUCTS: $4,068
  • AETNA — Asa_Whirlpool_Peia: $3,810
  • AETNA — International: $4,001
  • AETNA — MEDICARE ADVANTAGE: $1,132.12
  • AETNA — Qhp/Ipf: $5,424
  • AMERIHEALTH — Managed Medicaid: $844.60
  • Amish Community Aid Plan — ALL PRODUCTS: $2,440.80
  • ANTHEM — HPN: $400.60
  • ANTHEM — Managed Medicaid: $806.21
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $5,424 $3,525.60 $1,533.91 – $5,424
Colonoscopy with removal of polyps (snare): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $2,712
  • ANTHEM — TRADITIONAL: $3,125.85
  • OSCAR — ALL PRODUCTS: $1,957.52
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US Not listed in the file Not listed in the file $729.43 – $3,265.47
Ultrasound of the lower bowel by endoscope: 10 of 22 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $1,132.12
  • ANTHEM — HPN: $2,775.61
  • ANTHEM — MEDICARE ADVANTAGE: $1,132.12
  • ANTHEM — PPO/HMO: $3,265.47
  • CIGNA — MEDICARE ADVANTAGE: $1,166.08
  • CommuniCare — MEDICARE ADVANTAGE: $1,188.72
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $1,132.12
  • HUMANA — Medicare Advantage HMO: $1,023.77
  • MMO — ALL PRODUCTS: $3,113.32
  • MMO — Medicare Advantage HMO: $1,093.05
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $729.43 – $3,265.47
Ultrasound of the lower bowel by endoscope: rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $844.60
  • ANTHEM — Managed Medicaid: $806.21
  • Buckeye — Managed Medicaid: $806.21
  • CARESOURCE — Managed Medicaid: $821.57
  • MOLINA — Managed Medicaid: $806.21
  • OPTUM — Managed Medicaid Transplant: $729.43
  • Paramount — Managed Medicaid: $790.85
  • UNITED — Managed Medicaid: $821.57
  • United BH — Managed Medicaid: $813.89
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLOSCPY, SCRN; NOT HI RISK $3,647 $2,370.55 $292.56 – $4,001
Screening colonoscopy (not high risk): 10 of 67 insurance plan rates
  • AETNA — Acop: $3,265
  • AETNA — ALL PRODUCTS: $2,735.25
  • AETNA — Asa_Whirlpool_Peia: $3,810
  • AETNA — International: $4,001
  • AETNA — MEDICARE ADVANTAGE: $879.81
  • AETNA — Qhp/Ipf: $3,647
  • AMERIHEALTH — Managed Medicaid: $844.60
  • Amish Community Aid Plan — ALL PRODUCTS: $1,641.15
  • ANTHEM — HPN: $292.56
  • ANTHEM — Managed Medicaid: $806.21
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLOSCPY, SCRN; NOT HI RISK $3,647 $2,370.55 $1,031.37 – $3,647
Screening colonoscopy (not high risk): rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $1,823.50
  • ANTHEM — TRADITIONAL: $2,101.77
  • OSCAR — ALL PRODUCTS: $1,316.20
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPY SURG CHOLECYSTECTOMY $26,838 $17,444.70 $1,058.08 – $16,592.37
Gallbladder removal by laparoscope: 10 of 67 insurance plan rates
  • AETNA — Acop: $8,422
  • AETNA — ALL PRODUCTS: $20,128.50
  • AETNA — Asa_Whirlpool_Peia: $9,828
  • AETNA — International: $10,320
  • AETNA — MEDICARE ADVANTAGE: $5,719.53
  • AETNA — Qhp/Ipf: $26,838
  • AMERIHEALTH — Managed Medicaid: $2,868.07
  • Amish Community Aid Plan — ALL PRODUCTS: $12,077.10
  • ANTHEM — HPN: $1,058.08
  • ANTHEM — Managed Medicaid: $2,737.71
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAPAROSCOPY SURG CHOLECYSTECTOMY $26,838 $17,444.70 $7,589.79 – $26,838
Gallbladder removal by laparoscope: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $13,419
  • ANTHEM — TRADITIONAL: $15,466.74
  • OSCAR — ALL PRODUCTS: $9,685.83
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $16,234 $10,552.10 $4,590.98 – $16,234
Groin (inguinal) hernia repair, age 5 or older: 10 of 67 insurance plan rates
  • AETNA — Acop: $6,075
  • AETNA — ALL PRODUCTS: $12,175.50
  • AETNA — Asa_Whirlpool_Peia: $7,090
  • AETNA — International: $7,445
  • AETNA — MEDICARE ADVANTAGE: $3,387.33
  • AETNA — Qhp/Ipf: $16,234
  • AMERIHEALTH — Managed Medicaid: $2,311.66
  • Amish Community Aid Plan — ALL PRODUCTS: $7,305.30
  • ANTHEM — HPN: $844.91
  • ANTHEM — Managed Medicaid: $2,206.59
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $16,234 $10,552.10 $4,590.98 – $16,234
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $8,117
  • ANTHEM — TRADITIONAL: $9,355.65
  • OSCAR — ALL PRODUCTS: $5,858.85
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate Not listed in the file Not listed in the file $924.19 – $2,050.97
Prostate biopsy: rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,070.11
  • ANTHEM — Managed Medicaid: $1,021.47
  • Buckeye — Managed Medicaid: $1,021.47
  • CARESOURCE — Managed Medicaid: $1,040.93
  • MOLINA — Managed Medicaid: $1,021.47
  • OPTUM — Managed Medicaid Transplant: $924.19
  • Paramount — Managed Medicaid: $1,002.01
  • UNITED — Managed Medicaid: $1,040.93
  • United BH — Managed Medicaid: $1,031.20
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE Not listed in the file Not listed in the file $924.19 – $2,050.97
Prostate biopsy: rates for 8 insurance plans
  • HUMANA — Medicare Advantage HMO: $1,767.05
  • MMO — Medicare Advantage HMO: $1,899.05
  • MMO — Medicare Advantage PPO: $1,956.02
  • OPTUM — All Products VA: $1,899.05
  • OPTUM — Medicare Advantage Transplant: $1,899.05
  • Perennial Health — MEDICARE ADVANTAGE: $2,050.97
  • The Health Plan — MEDICARE ADVANTAGE: $1,899.05
  • UNITED — MEDICARE ADVANTAGE: $1,899.05
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD Not listed in the file Not listed in the file $2,691.42 – $29,007.38
Prostate removal by laparoscope (radical prostatectomy): 10 of 23 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $10,056.64
  • ANTHEM — HPN: $24,655.87
  • ANTHEM — MEDICARE ADVANTAGE: $10,056.64
  • ANTHEM — PPO/HMO: $29,007.38
  • CIGNA — MEDICARE ADVANTAGE: $10,358.34
  • CommuniCare — MEDICARE ADVANTAGE: $10,559.47
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $10,056.64
  • HUMANA — Medicare Advantage HMO: $8,930.36
  • MMO — ALL PRODUCTS: $27,655.77
  • MMO — Medicare Advantage HMO: $9,651.62
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $2,691.42 – $29,007.38
Prostate removal by laparoscope (radical prostatectomy): rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $3,116.38
  • ANTHEM — Managed Medicaid: $2,974.72
  • Buckeye — Managed Medicaid: $2,974.72
  • CARESOURCE — Managed Medicaid: $3,031.38
  • MOLINA — Managed Medicaid: $2,974.72
  • OPTUM — Managed Medicaid Transplant: $2,691.42
  • Paramount — Managed Medicaid: $2,918.06
  • UNITED — Managed Medicaid: $3,031.38
  • United BH — Managed Medicaid: $3,003.05
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C $14,626 $9,506.90 $360.34 – $8,884.52
Hysteroscopy with biopsy of the uterus lining: 10 of 67 insurance plan rates
  • AETNA — Acop: $5,355
  • AETNA — ALL PRODUCTS: $10,969.50
  • AETNA — Asa_Whirlpool_Peia: $6,249
  • AETNA — International: $6,561
  • AETNA — MEDICARE ADVANTAGE: $3,062.57
  • AETNA — Qhp/Ipf: $14,626
  • AMERIHEALTH — Managed Medicaid: $1,616.56
  • Amish Community Aid Plan — ALL PRODUCTS: $6,581.70
  • ANTHEM — HPN: $360.34
  • ANTHEM — Managed Medicaid: $1,543.08
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C $14,626 $9,506.90 $4,136.23 – $14,626
Hysteroscopy with biopsy of the uterus lining: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $7,313
  • ANTHEM — TRADITIONAL: $8,428.96
  • OSCAR — ALL PRODUCTS: $5,278.52
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $4,778 $3,105.70 $1,351.22 – $4,778
Spinal injection, lower back (epidural), with imaging guidance: 10 of 67 insurance plan rates
  • AETNA — Acop: $2,451
  • AETNA — ALL PRODUCTS: $3,583.50
  • AETNA — Asa_Whirlpool_Peia: $2,860
  • AETNA — International: $3,004
  • AETNA — MEDICARE ADVANTAGE: $667.82
  • AETNA — Qhp/Ipf: $4,778
  • AMERIHEALTH — Managed Medicaid: $536.55
  • Amish Community Aid Plan — ALL PRODUCTS: $2,150.10
  • ANTHEM — HPN: $160.27
  • ANTHEM — Managed Medicaid: $512.16
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $4,778 $3,105.70 $1,351.22 – $4,778
Spinal injection, lower back (epidural), with imaging guidance: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $2,389
  • ANTHEM — TRADITIONAL: $2,753.56
  • OSCAR — ALL PRODUCTS: $1,724.38
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $6,143 $3,992.95 $1,737.24 – $6,143
Nerve root injection, lower back, with imaging guidance: 10 of 67 insurance plan rates
  • AETNA — Acop: $2,451
  • AETNA — ALL PRODUCTS: $4,607.25
  • AETNA — Asa_Whirlpool_Peia: $2,860
  • AETNA — International: $3,004
  • AETNA — MEDICARE ADVANTAGE: $836.78
  • AETNA — Qhp/Ipf: $6,143
  • AMERIHEALTH — Managed Medicaid: $536.55
  • Amish Community Aid Plan — ALL PRODUCTS: $2,764.35
  • ANTHEM — HPN: $177.08
  • ANTHEM — Managed Medicaid: $512.16
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $6,143 $3,992.95 $1,737.24 – $6,143
Nerve root injection, lower back, with imaging guidance: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $3,071.50
  • ANTHEM — TRADITIONAL: $3,540.21
  • OSCAR — ALL PRODUCTS: $2,217.01
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE $13,474 $8,758.10 $717.36 – $5,359.39
Carpal tunnel release: 10 of 67 insurance plan rates
  • AETNA — Acop: $3,265
  • AETNA — ALL PRODUCTS: $10,105.50
  • AETNA — Asa_Whirlpool_Peia: $3,810
  • AETNA — International: $4,001
  • AETNA — MEDICARE ADVANTAGE: $1,847.43
  • AETNA — Qhp/Ipf: $13,474
  • AMERIHEALTH — Managed Medicaid: $1,034.32
  • Amish Community Aid Plan — ALL PRODUCTS: $6,063.30
  • ANTHEM — HPN: $717.36
  • ANTHEM — Managed Medicaid: $987.30
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE $13,474 $8,758.10 $3,810.45 – $13,474
Carpal tunnel release: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $6,737
  • ANTHEM — TRADITIONAL: $7,765.07
  • OSCAR — ALL PRODUCTS: $4,862.77
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POST-CATARACT LASER SURGERY $2,524 $1,640.60 $713.79 – $2,524
Laser treatment of clouding after cataract surgery: 10 of 67 insurance plan rates
  • AETNA — Acop: $3,265
  • AETNA — ALL PRODUCTS: $1,893
  • AETNA — Asa_Whirlpool_Peia: $3,810
  • AETNA — International: $4,001
  • AETNA — MEDICARE ADVANTAGE: $520.34
  • AETNA — Qhp/Ipf: $2,524
  • AMERIHEALTH — Managed Medicaid: $302.05
  • Amish Community Aid Plan — ALL PRODUCTS: $1,135.80
  • ANTHEM — HPN: $480.12
  • ANTHEM — Managed Medicaid: $288.32
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POST-CATARACT LASER SURGERY $2,524 $1,640.60 $713.79 – $2,524
Laser treatment of clouding after cataract surgery: rates for 3 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $1,262
  • ANTHEM — TRADITIONAL: $1,454.58
  • OSCAR — ALL PRODUCTS: $910.91
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP Not listed in the file Not listed in the file $1,081.64 – $6,831
Cataract removal with lens implant: 10 of 23 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $2,183.38
  • ANTHEM — HPN: $5,352.99
  • ANTHEM — MEDICARE ADVANTAGE: $2,183.38
  • ANTHEM — PPO/HMO: $6,297.74
  • CIGNA — MEDICARE ADVANTAGE: $2,248.88
  • CommuniCare — MEDICARE ADVANTAGE: $2,292.55
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $2,183.38
  • HUMANA — Medicare Advantage HMO: $2,021.72
  • MMO — ALL PRODUCTS: $6,004.29
  • MMO — Medicare Advantage HMO: $2,114.33
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $1,081.64 – $6,831
Cataract removal with lens implant: rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,252.43
  • ANTHEM — Managed Medicaid: $1,195.50
  • Buckeye — Managed Medicaid: $1,195.50
  • CARESOURCE — Managed Medicaid: $1,218.27
  • MOLINA — Managed Medicaid: $1,195.50
  • OPTUM — Managed Medicaid Transplant: $1,081.64
  • Paramount — Managed Medicaid: $1,172.73
  • UNITED — Managed Medicaid: $1,218.27
  • United BH — Managed Medicaid: $1,206.88

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care Not listed in the file Not listed in the file $1,884.05 – $2,181.53
Vaginal delivery, with care before and after: rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $2,181.53
  • ANTHEM — Managed Medicaid: $2,082.37
  • Buckeye — Managed Medicaid: $2,082.37
  • CARESOURCE — Managed Medicaid: $2,122.03
  • MOLINA — Managed Medicaid: $2,082.37
  • OPTUM — Managed Medicaid Transplant: $1,884.05
  • Paramount — Managed Medicaid: $2,042.71
  • UNITED — Managed Medicaid: $2,122.03
  • United BH — Managed Medicaid: $2,102.20
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $1,308.60 – $1,515.22
Cesarean delivery (C-section), with care before and after: rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,515.22
  • ANTHEM — Managed Medicaid: $1,446.34
  • Buckeye — Managed Medicaid: $1,446.34
  • CARESOURCE — Managed Medicaid: $1,473.89
  • MOLINA — Managed Medicaid: $1,446.34
  • OPTUM — Managed Medicaid Transplant: $1,308.60
  • Paramount — Managed Medicaid: $1,418.79
  • UNITED — Managed Medicaid: $1,473.89
  • United BH — Managed Medicaid: $1,460.12
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery Not listed in the file Not listed in the file $1,884.05 – $2,181.53
Vaginal delivery after a previous C-section, with care before and after: rates for 9 insurance plans
  • AMERIHEALTH — Managed Medicaid: $2,181.53
  • ANTHEM — Managed Medicaid: $2,082.37
  • Buckeye — Managed Medicaid: $2,082.37
  • CARESOURCE — Managed Medicaid: $2,122.03
  • MOLINA — Managed Medicaid: $2,082.37
  • OPTUM — Managed Medicaid Transplant: $1,884.05
  • Paramount — Managed Medicaid: $2,042.71
  • UNITED — Managed Medicaid: $2,122.03
  • United BH — Managed Medicaid: $2,102.20

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $12,225 – $283,600
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 44 insurance plan rates
  • AETNA — Acop: $98,796.50
  • AETNA — Asa_Whirlpool_Peia: $111,093.48
  • AETNA — International: $121,062.15
  • AETNA — MEDICARE ADVANTAGE: $74,596.43
  • ANTHEM — HPN: $12,225
  • ANTHEM — MEDICARE ADVANTAGE: $74,596.43
  • ANTHEM — PPO/HMO: $14,382
  • CIGNA — MEDICARE ADVANTAGE: $76,834.32
  • CommuniCare — MEDICARE ADVANTAGE: $78,326.25
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $74,596.43
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 joint replacement or reattachment of lower extremity w/o MCC Not listed in the file Not listed in the file $12,492 – $60,600
Hip or knee replacement (major joint of the leg), without major complications: 10 of 23 insurance plan rates
  • AETNA — Acop: $30,439
  • AETNA — Asa_Whirlpool_Peia: $35,522
  • AETNA — International: $37,297
  • ANTHEM — HPN: $12,492
  • ANTHEM — PPO/HMO: $14,696
  • Medical Benefit Corp — Transplant SMCP: $60,600
  • MMO — ALL PRODUCTS: $18,856
  • UNITED — ALL PRODUCTS: $22,852
  • AETNA — ALL PRODUCTS: 75% (a percentage in the contract, not a dollar amount)
  • AETNA — NAP: 68.8% (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 REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $12,492 – $60,600
Hip or knee replacement (major joint of the leg), without major complications: 10 of 21 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $15,191.26
  • ANTHEM — MEDICARE ADVANTAGE: $15,191.26
  • CIGNA — MEDICARE ADVANTAGE: $15,647
  • CommuniCare — MEDICARE ADVANTAGE: $15,950.82
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $15,191.26
  • HUMANA — Medicare Advantage HMO: $15,191.26
  • Humana Military — ALL PRODUCTS: $14,119.44
  • MMO — Medicare Advantage HMO: $15,191.26
  • MMO — Medicare Advantage PPO: $15,647
  • OPTUM — All Products VA: $15,191.26
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $12,225 – $83,000
Neck (cervical) spinal fusion, without complications: 10 of 44 insurance plan rates
  • AETNA — Acop: $34,878
  • AETNA — Asa_Whirlpool_Peia: $40,702
  • AETNA — International: $42,736
  • AETNA — MEDICARE ADVANTAGE: $19,066.94
  • ANTHEM — HPN: $12,225
  • ANTHEM — MEDICARE ADVANTAGE: $19,066.94
  • ANTHEM — PPO/HMO: $14,382
  • CIGNA — MEDICARE ADVANTAGE: $19,638.95
  • CommuniCare — MEDICARE ADVANTAGE: $20,020.29
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $19,066.94
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $9,145.51 – $20,692.39
Uterus and ovary surgery (not for cancer), without complications: 10 of 43 insurance plan rates
  • AETNA — Acop: $10,576
  • AETNA — Asa_Whirlpool_Peia: $12,342
  • AETNA — International: $12,959
  • AETNA — MEDICARE ADVANTAGE: $9,985.87
  • ANTHEM — HPN: $10,498
  • ANTHEM — MEDICARE ADVANTAGE: $9,985.87
  • ANTHEM — PPO/HMO: $12,351
  • CIGNA — MEDICARE ADVANTAGE: $10,285.45
  • CommuniCare — MEDICARE ADVANTAGE: $10,485.16
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $9,985.87

Source: Fairview Hospital’s standard charges file (clevelandclinic.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 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
Address18101 Lorain Avenue, Cleveland, OH 44111
CountyCuyahoga County
StateOhio
Phone(216) 476‑7000
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating5 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number360077
Name in Medicare recordsFAIRVIEW HOSPITAL
Profile levelMedicare data + hospital website
Name on the hospital’s websiteCleveland Clinic Fairview Hospital
Official websitemy.clevelandclinic.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Fairview Hospital | Cleveland Clinic — my.clevelandclinic.org
  2. Specialties | Cleveland Clinic Fairview Hospital — my.clevelandclinic.org
  3. Fairview Hospital Visitor Guide | Cleveland Clinic — my.clevelandclinic.org
  4. Guest Services | Cleveland Clinic Fairview Hospital — my.clevelandclinic.org
  5. Imaging & Radiology Services | Fairview Hospital — my.clevelandclinic.org
  6. Rehabilitation & Sports Therapy | Fairview Hospital — my.clevelandclinic.org
  7. Emergency & Trauma | Fairview Hospital — my.clevelandclinic.org
  8. Birthing Services | Fairview Hospital — my.clevelandclinic.org
  9. Neurological Services | Fairview Hospital — my.clevelandclinic.org
  10. Surgical Services | Fairview Hospital — my.clevelandclinic.org
  11. Infant, Child & Adolescent Services | Fairview Hospital — my.clevelandclinic.org
  12. Stroke Center | Fairview Hospital — my.clevelandclinic.org
  13. Heart Center | Fairview Hospital — my.clevelandclinic.org
  14. Bariatric Surgery | Fairview Hospital — my.clevelandclinic.org
  15. Orthopaedics & Total Joint Replacement | Fairview Hospital — my.clevelandclinic.org