Does Flushing Hospital Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Flushing Hospital Medical Center. In a medical emergency, call 911.

Where is Flushing Hospital Medical Center?

45th Avenue and Parsons Boulevard, Flushing, NY 11355, in Queens County, New York.

What is the phone number of Flushing Hospital Medical Center?

(718) 670-5000, as listed by Medicare (CMS).

What is the Medicare star rating of Flushing Hospital Medical Center?

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

Flushing Hospital Medical Center

Quick answers

Does Flushing Hospital Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Flushing Hospital Medical Center. In a medical emergency, call 911.
Where is Flushing Hospital Medical Center?: 45th Avenue and Parsons Boulevard, Flushing, NY 11355, in Queens County, New York.
What is the phone number of Flushing Hospital Medical Center?: (718) 670-5000, as listed by Medicare (CMS).
What is the Medicare star rating of Flushing Hospital Medical Center?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[4][6][7][8][19]}

Addiction Services
Anesthesiology
Cardiology
Dental Services
Internal Medicine
Mental Health Services
Obstetrics & Gynecology
Ophthalmology
Orthopedic
Pain Management
Pediatrics
Pediatric Cardiology
Pediatric Endocrinology
Pediatric Surgery
Physical Medicine and Rehabilitation
Pulmonary Medicine
Radiology
Respiratory Care
Emergency Department
Women's health
Bariatric surgery
Robotic surgery

Conditions treated^{[8][10][13][16][17]}

Heart attack
Chest pain
Arrhythmias
Sudden cardiac events
Congenital heart disease
Stroke
Obesity
Ankle injuries
Ankle instability
Carpal tunnel syndrome
Hip dislocation
Hip arthritis
Knee arthritis
Knee ligament tears
Meniscus tear
Shoulder injury
Wrist fracture
Forearm fracture

Treatments^{[4][5][8][10][15][16][18][19]}

Smoking cessation
Hospice care
Stress testing
Fetal echocardiogram
Mammography
Nuclear medicine
CT scan
MRI
Ultrasound
Vascular laboratory testing
Interventional radiology
Bariatric surgery
Robotic surgery (da Vinci)
Ambulatory (same-day) surgery

Procedures^{[4][5][11][17][19]}

Bariatric surgery
Robotic surgery
Hysterectomy
Gallbladder surgery
Colon resection
Laparoscopic and thoracoscopic pediatric surgery
Robotic-assisted knee, hip, and shoulder surgery

Programs and centers^{[4][5][6][7][14][16]}

Bariatric Surgery Center
Maureen Russo Hospice Unit
Stroke Care
Transitional Care Unit
Neonatal Intensive Care
Ambulatory Surgery Unit
Pediatric emergency division
Coronary care unit and Heart Station
Patient advocacy services
Graduate medical education

Emergency care (hospital website)^[6][7][13]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	NYS-designated Stroke Center

Recognition^[5][6][18]

New York State Designated Stroke Center
MBSAQIP Comprehensive Center (bariatric)
Accredited by the American College of Radiology (ACR) (radiology department)

Doctors and clinicians (198)

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

Main specialties

And 174 more: the button below opens the full list.

Other emergency rooms nearby

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

New York-Presbyterian/Queens0.4 mi · Flushing, NY · Acute Care Hospital
Queens Hospital Center2.5 mi · Jamaica, NY · Acute Care Hospital
Elmhurst Hospital Center3.1 mi · Elmhurst, NY · Acute Care Hospital
Jamaica Hospital Medical Center3.5 mi · Jamaica, NY · Acute Care Hospital
Wyckoff Heights Medical Center6.0 mi · Brooklyn, NY · Acute Care Hospital

Other hospitals nearby

Creedmoor Psychiatric Center4.7 mi · Queens Village, NY · Psychiatric Hospital
New York City Childrens Psych Center4.9 mi · Bellerose, NY · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Franklin Center for Rehabilitation and Nursing0.2 mi · Flushing, NY · 4 of 5 stars
Long Island Care Center Inc0.8 mi · Flushing, NY · 5 of 5 stars
The Pavilion at Queens for Rehabilitation & Nursin0.9 mi · Flushing, NY · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice of New York, LLC6.2 mi · Long Island City, NY · 2 of 5 stars
Calvary Home Health Agency and Hospice Care6.7 mi · Bronx, NY · 2 of 5 stars
Comprehensive Comm Hospice of Parker Jewish Inst7.4 mi · New Hyde Park, NY

All hospice providers in the state →

Home health agencies

Emerest Home Health Care of Long Island1.2 mi · Flushing, NY · 5 of 5 stars
Assured Care Home Health, LLC2.8 mi · East Elmhurst, NY
Emerest Home Health Care of NY6.3 mi · Bronx, NY · 5 of 5 stars

All home health agencies in the state →

Dialysis facilities

The NY Hosp Med Ctr of Queens0.0 mi · Flushing, NY
CRD Associates LLC Cliffside Nursing Home1.2 mi · Flushing, NY
Queens Dialysis at the Pavilion, LLC1.2 mi · Flushing, NY

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Flushing Endoscopy Center, LLC0.0 mi · Flushing, NY
Gsc-Queens0.0 mi · Flushing, NY
Queens Surgical Center LLC1.2 mi · Flushing, NY

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

Charles B. Wang Community Health Center, Inc.0.0 mi · Flushing, NY · Community health center
Charles B. Wang Community Health Center, Inc.0.8 mi · Flushing, NY · Community health center
Charles B. Wang Community Health Center, Inc.0.9 mi · Flushing, NY · Community health center

Clinics and urgent care

City Medical of Upper East Side, PLLC1.2 mi · Flushing, NY · Urgent care center
Q All Care Medical PC1.2 mi · Flushing, NY · Urgent care center
Stat Medical Services of NY PLLC1.2 mi · Flushing, NY · Urgent care center

Pharmacies

143 Pharmacy Inc0.0 mi · Flushing, NY · Community/retail pharmacy
41 Pharmacy Inc0.0 mi · Flushing, NY · Community/retail pharmacy
88 Healthy Pharmacy LLC0.0 mi · Flushing, NY · Community/retail pharmacy

Assisted living nearby

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

Sanford Home0.0 mi · Flushing, NY
Sutton Gardens, LLC1.2 mi · Flushing, NY
Boulevard ALP1.6 mi · Flushing, NY
Castle Senior Living at Forest Hills1.7 mi · Forest Hills, NY

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	2 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	65%National average: 72%
Would definitely recommend the hospital	64%National average: 71%
Nurses “always” communicated well	73%National average: 80%
Doctors “always” communicated well	72%National average: 80%
Staff “always” explained medicines before giving them	56%National average: 62%
Were given information about recovery at home	82%National average: 86%
Room and bathroom “always” clean	73%National average: 74%
Area around the room “always” quiet at night	44%National average: 60%
Completed surveys	1,013Response rate: 22%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.19Better than the national benchmark
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.751No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.743No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	9.2%
Deaths within 30 days: pneumonia patients	16.4%
Deaths within 30 days: COPD patients	9.5%
Deaths within 30 days: stroke patients	10.1%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.02No different from the national rate
Complications after hip or knee replacement	3.7%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.4%
Readmitted within 30 days: heart failure	21.5%
Readmitted within 30 days: pneumonia	18.7%
Readmitted within 30 days: COPD	19.8%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	5.1%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	220 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	88%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Flushing Best hospitals in New York

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 70 common services exactly as Flushing Hospital Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

$ 2 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.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW LOW 30 MIN	$912	$912	$35 – $1,912
New patient office visit (about 30–44 minutes): 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $79.57 Beacon Health Strategies — Medicare: $79.57 Centerlight Healthcare — Centerlight Healthcare: $79.57 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$450	$450	$35 – $1,912
New patient office visit (about 30–44 minutes): 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $79.57 Beacon Health Strategies — Medicare: $79.57 Centerlight Healthcare — Centerlight Healthcare: $79.57 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$450	$450	$67.63 – $1,912
New patient office visit (about 30–44 minutes): 10 of 51 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $79.57 Beacon Health Strategies — Medicare: $79.57 Centerlight Healthcare — Centerlight Healthcare: $79.57 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$520	$520	$35 – $1,912
New patient office visit (about 45–59 minutes): 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $130.02 Beacon Health Strategies — Medicare: $130.02 Centerlight Healthcare — Centerlight Healthcare: $130.02 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW MOD 45 MIN	$977	$977	$35 – $1,912
New patient office visit (about 45–59 minutes): 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $130.02 Beacon Health Strategies — Medicare: $130.02 Centerlight Healthcare — Centerlight Healthcare: $130.02 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$520	$520	$110.52 – $1,912
New patient office visit (about 45–59 minutes): 10 of 51 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $130.02 Beacon Health Strategies — Medicare: $130.02 Centerlight Healthcare — Centerlight Healthcare: $130.02 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60 MIN	$1,040	$1,040	$35 – $1,912
New patient office visit (about 60–74 minutes): 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $178.84 Beacon Health Strategies — Medicare: $178.84 Centerlight Healthcare — Centerlight Healthcare: $178.84 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$590	$590	$35 – $1,912
New patient office visit (about 60–74 minutes): 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $178.84 Beacon Health Strategies — Medicare: $178.84 Centerlight Healthcare — Centerlight Healthcare: $178.84 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$590	$590	$152.01 – $1,912
New patient office visit (about 60–74 minutes): 10 of 51 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $178.84 Beacon Health Strategies — Medicare: $178.84 Centerlight Healthcare — Centerlight Healthcare: $178.84 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$430	$430	$35 – $1,912
Established patient office visit (about 20–29 minutes): 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $63.57 Beacon Health Strategies — Medicare: $63.57 Centerlight Healthcare — Centerlight Healthcare: $63.57 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$430	$430	$54.03 – $1,912
Established patient office visit (about 20–29 minutes): 10 of 51 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $63.57 Beacon Health Strategies — Medicare: $63.57 Centerlight Healthcare — Centerlight Healthcare: $63.57 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_27 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$430	$430	$54.03 – $1,912
Established patient office visit (about 20–29 minutes): 10 of 51 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $63.57 Beacon Health Strategies — Medicare: $63.57 Centerlight Healthcare — Centerlight Healthcare: $63.57 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN	$547	$547	$35 – $1,912
Established patient office visit (about 30–39 minutes): 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $93.53 Beacon Health Strategies — Medicare: $93.53 Centerlight Healthcare — Centerlight Healthcare: $93.53 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$500	$500	$35 – $1,912
Established patient office visit (about 30–39 minutes): 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $93.53 Beacon Health Strategies — Medicare: $93.53 Centerlight Healthcare — Centerlight Healthcare: $93.53 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$500	$500	$79.50 – $1,912
Established patient office visit (about 30–39 minutes): 10 of 51 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Aetna — Government Programs: $93.53 Beacon Health Strategies — Medicare: $93.53 Centerlight Healthcare — Centerlight Healthcare: $93.53 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS)	$400	$400	$66.67 – $1,912
Preventive checkup, new patient, age 18–39: 10 of 25 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $134 Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414 GHI — Commercial PPO/HMO: $75 HIP — Commercial: $610
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS)	$400	$400	$200 – $1,912
Preventive checkup, new patient, age 18–39: 10 of 23 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414 HIP — Commercial: $610 Hotel Trades Council — Dental OR: $1,912 MagnaCare — Preferred/Direct Plus/JIB: $1,485
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_GC In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS)	$400	$400	$200 – $1,912
Preventive checkup, new patient, age 18–39: 10 of 23 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414 HIP — Commercial: $610 Hotel Trades Council — Dental OR: $1,912 MagnaCare — Preferred/Direct Plus/JIB: $1,485
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64	$553	$553	$75 – $1,912
Preventive checkup, new patient, age 40–64: 10 of 25 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $157 Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414 GHI — Commercial PPO/HMO: $75 HIP — Commercial: $610
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS)	$400	$400	$75 – $1,912
Preventive checkup, new patient, age 40–64: 10 of 25 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $157 Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414 GHI — Commercial PPO/HMO: $75 HIP — Commercial: $610
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS)	$400	$400	$200 – $1,912
Preventive checkup, new patient, age 40–64: 10 of 23 insurance plan rates Aetna — Commercial High Performance Network: $278 Aetna — Commercial Product: $278 Aetna — Commercial Whole Health: $264 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289 Create Health Plan — Flex/NYC/Long Island: $1,414 HIP — Commercial: $610 Hotel Trades Council — Dental OR: $1,912 MagnaCare — Preferred/Direct Plus/JIB: $1,485
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM	$940	$940	$35 – $1,961
Emergency room visit (moderate): 10 of 54 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $66 Aetna — Commercial High Performance Network: $1,428 Aetna — Commercial Product: $1,428 Aetna — Commercial Whole Health: $1,357 Aetna — Government Programs: $339.08 Beacon Health Strategies — Medicaid: $300 Beacon Health Strategies — Medicare: $315 Centerlight Healthcare — Centerlight Healthcare: $339.08 Centers Plan for Healthy Living — Medicare: $406.90 Centivo — Centivo: $1,403.83
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$1,880	$1,880	$35 – $1,961
Emergency room visit (moderate): 10 of 54 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $66 Aetna — Commercial High Performance Network: $1,428 Aetna — Commercial Product: $1,428 Aetna — Commercial Whole Health: $1,357 Aetna — Government Programs: $339.08 Beacon Health Strategies — Medicaid: $300 Beacon Health Strategies — Medicare: $315 Centerlight Healthcare — Centerlight Healthcare: $339.08 Centers Plan for Healthy Living — Medicare: $406.90 Centivo — Centivo: $1,403.83
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$940	$940	$66 – $1,961
Emergency room visit (moderate): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $66 Aetna — Commercial High Performance Network: $1,428 Aetna — Commercial Product: $1,428 Aetna — Commercial Whole Health: $1,357 Aetna — Government Programs: $339.08 Beacon Health Strategies — Medicaid: $300 Beacon Health Strategies — Medicare: $315 Centerlight Healthcare — Centerlight Healthcare: $339.08 Centers Plan for Healthy Living — Medicare: $406.90 Centivo — Centivo: $1,403.83
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$975	$975	$35 – $1,961
Emergency room visit (moderately high): 10 of 54 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $104 Aetna — Commercial High Performance Network: $1,428 Aetna — Commercial Product: $1,428 Aetna — Commercial Whole Health: $1,357 Aetna — Government Programs: $518.31 Beacon Health Strategies — Medicaid: $300 Beacon Health Strategies — Medicare: $315 Centerlight Healthcare — Centerlight Healthcare: $518.31 Centers Plan for Healthy Living — Medicare: $621.97 Centivo — Centivo: $1,403.83
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$975	$975	$300 – $1,961
Emergency room visit (moderately high): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $893 Aetna — Commercial High Performance Network: $1,428 Aetna — Commercial Product: $1,428 Aetna — Commercial Whole Health: $1,357 Aetna — Government Programs: $518.31 Beacon Health Strategies — Medicaid: $300 Beacon Health Strategies — Medicare: $315 Centerlight Healthcare — Centerlight Healthcare: $518.31 Centers Plan for Healthy Living — Medicare: $621.97 Centivo — Centivo: $1,403.83
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_27 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$975	$975	$300 – $1,961
Emergency room visit (moderately high): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $893 Aetna — Commercial High Performance Network: $1,428 Aetna — Commercial Product: $1,428 Aetna — Commercial Whole Health: $1,357 Aetna — Government Programs: $518.31 Beacon Health Strategies — Medicaid: $300 Beacon Health Strategies — Medicare: $315 Centerlight Healthcare — Centerlight Healthcare: $518.31 Centers Plan for Healthy Living — Medicare: $621.97 Centivo — Centivo: $1,403.83
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$1,407	$1,407	$35 – $1,961
Emergency room visit (high): 10 of 54 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $161 Aetna — Commercial High Performance Network: $1,428 Aetna — Commercial Product: $1,428 Aetna — Commercial Whole Health: $1,357 Aetna — Government Programs: $739.75 Beacon Health Strategies — Medicaid: $300 Beacon Health Strategies — Medicare: $315 Centerlight Healthcare — Centerlight Healthcare: $739.75 Centers Plan for Healthy Living — Medicare: $887.70 Centivo — Centivo: $1,403.83
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$1,407	$1,407	$300 – $1,961
Emergency room visit (high): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $893 Aetna — Commercial High Performance Network: $1,428 Aetna — Commercial Product: $1,428 Aetna — Commercial Whole Health: $1,357 Aetna — Government Programs: $739.75 Beacon Health Strategies — Medicaid: $300 Beacon Health Strategies — Medicare: $315 Centerlight Healthcare — Centerlight Healthcare: $739.75 Centers Plan for Healthy Living — Medicare: $887.70 Centivo — Centivo: $1,403.83

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$25	$25	$7.19 – $1,912
Basic metabolic panel (blood test): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $9 Aetna — Government Programs: $8.46 Beacon Health Strategies — Medicare: $8.46 Centerlight Healthcare — Centerlight Healthcare: $8.46 Centers Plan for Healthy Living — Medicare: $9.31 Centivo — Centivo: $10.58 Cigna — Managed Care Commercial: $15.40 Elderplan — Elderplan: $8.04 Elderserve Health — FIDA/MMP: $9.73 EmblemHealth — Select Care: $13.20
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$25	$25	$7.19 – $1,912
Basic metabolic panel (blood test): 10 of 50 insurance plan rates Aetna — Government Programs: $8.46 Beacon Health Strategies — Medicare: $8.46 Centerlight Healthcare — Centerlight Healthcare: $8.46 Centers Plan for Healthy Living — Medicare: $9.31 Centivo — Centivo: $10.58 Elderplan — Elderplan: $8.04 Elderserve Health — FIDA/MMP: $9.73 EmblemHealth — Select Care: $13.20 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $15.82 Empire — Indemnity: $15.82
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$25	$25	$7.19 – $1,912
Basic metabolic panel (blood test): 10 of 50 insurance plan rates Aetna — Government Programs: $8.46 Beacon Health Strategies — Medicare: $8.46 Centerlight Healthcare — Centerlight Healthcare: $8.46 Centers Plan for Healthy Living — Medicare: $9.31 Centivo — Centivo: $10.58 Elderplan — Elderplan: $8.04 Elderserve Health — FIDA/MMP: $9.73 EmblemHealth — Select Care: $13.20 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $15.82 Empire — Indemnity: $15.82
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$32	$32	$8.98 – $1,912
Comprehensive metabolic panel (blood test): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $12 Aetna — Government Programs: $10.56 Beacon Health Strategies — Medicare: $10.56 Centerlight Healthcare — Centerlight Healthcare: $10.56 Centers Plan for Healthy Living — Medicare: $11.62 Centivo — Centivo: $13.20 Cigna — Managed Care Commercial: $19.10 Elderplan — Elderplan: $10.03 Elderserve Health — FIDA/MMP: $12.14 EmblemHealth — Select Care: $16.47
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$32	$32	$8.98 – $1,912
Comprehensive metabolic panel (blood test): 10 of 50 insurance plan rates Aetna — Government Programs: $10.56 Beacon Health Strategies — Medicare: $10.56 Centerlight Healthcare — Centerlight Healthcare: $10.56 Centers Plan for Healthy Living — Medicare: $11.62 Centivo — Centivo: $13.20 Elderplan — Elderplan: $10.03 Elderserve Health — FIDA/MMP: $12.14 EmblemHealth — Select Care: $16.47 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $19.75 Empire — Indemnity: $19.75
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$143	$143	$20.10 – $1,912
Obstetric blood test panel: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $43 Aetna — Government Programs: $47.81 Beacon Health Strategies — Medicare: $47.81 Centerlight Healthcare — Centerlight Healthcare: $47.81 Centers Plan for Healthy Living — Medicare: $52.59 Centivo — Centivo: $59.76 Cigna — Managed Care Commercial: $86.86 Elderplan — Elderplan: $45.42 Elderserve Health — FIDA/MMP: $54.98 EmblemHealth — Select Care: $74.58
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$40	$40	$6.04 – $1,912
Cholesterol panel (lipid panel): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $19 Aetna — Government Programs: $13.39 Beacon Health Strategies — Medicare: $13.39 Centerlight Healthcare — Centerlight Healthcare: $13.39 Centers Plan for Healthy Living — Medicare: $14.73 Centivo — Centivo: $16.74 Cigna — Managed Care Commercial: $24.64 Elderplan — Elderplan: $12.72 Elderserve Health — FIDA/MMP: $15.40 EmblemHealth — Select Care: $20.89
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$32	$32	$6.04 – $1,912
Cholesterol panel (lipid panel): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $19 Aetna — Government Programs: $13.39 Beacon Health Strategies — Medicare: $13.39 Centerlight Healthcare — Centerlight Healthcare: $13.39 Centers Plan for Healthy Living — Medicare: $14.73 Centivo — Centivo: $16.74 Cigna — Managed Care Commercial: $24.64 Elderplan — Elderplan: $12.72 Elderserve Health — FIDA/MMP: $15.40 EmblemHealth — Select Care: $20.89
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$40	$40	$11.38 – $1,912
Cholesterol panel (lipid panel): 10 of 50 insurance plan rates Aetna — Government Programs: $13.39 Beacon Health Strategies — Medicare: $13.39 Centerlight Healthcare — Centerlight Healthcare: $13.39 Centers Plan for Healthy Living — Medicare: $14.73 Centivo — Centivo: $16.74 Elderplan — Elderplan: $12.72 Elderserve Health — FIDA/MMP: $15.40 EmblemHealth — Select Care: $20.89 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $25.04 Empire — Indemnity: $25.04
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$26	$26	$7.38 – $1,912
Kidney function panel: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $12 Aetna — Government Programs: $8.68 Beacon Health Strategies — Medicare: $8.68 Centerlight Healthcare — Centerlight Healthcare: $8.68 Centers Plan for Healthy Living — Medicare: $9.55 Centivo — Centivo: $10.85 Cigna — Managed Care Commercial: $16.02 Elderplan — Elderplan: $8.25 Elderserve Health — FIDA/MMP: $9.98 EmblemHealth — Select Care: $13.54
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL	$25	$25	$5 – $1,912
Liver function panel: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $11 Aetna — Government Programs: $8.17 Beacon Health Strategies — Medicare: $8.17 Centerlight Healthcare — Centerlight Healthcare: $8.17 Centers Plan for Healthy Living — Medicare: $8.99 Centivo — Centivo: $10.21 Cigna — Managed Care Commercial: $14.79 Elderplan — Elderplan: $7.76 Elderserve Health — FIDA/MMP: $9.40 EmblemHealth — Select Care: $12.75
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: LIVER FUNCTION BLOOD TEST PANEL	$25	$25	$6.94 – $1,912
Liver function panel: 10 of 50 insurance plan rates Aetna — Government Programs: $8.17 Beacon Health Strategies — Medicare: $8.17 Centerlight Healthcare — Centerlight Healthcare: $8.17 Centers Plan for Healthy Living — Medicare: $8.99 Centivo — Centivo: $10.21 Elderplan — Elderplan: $7.76 Elderserve Health — FIDA/MMP: $9.40 EmblemHealth — Select Care: $12.75 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $15.28 Empire — Indemnity: $15.28
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: LIVER FUNCTION BLOOD TEST PANEL	$25	$25	$6.94 – $1,912
Liver function panel: 10 of 50 insurance plan rates Aetna — Government Programs: $8.17 Beacon Health Strategies — Medicare: $8.17 Centerlight Healthcare — Centerlight Healthcare: $8.17 Centers Plan for Healthy Living — Medicare: $8.99 Centivo — Centivo: $10.21 Elderplan — Elderplan: $7.76 Elderserve Health — FIDA/MMP: $9.40 EmblemHealth — Select Care: $12.75 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $15.28 Empire — Indemnity: $15.28
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$10	$10	$2 – $1,912
Urine test (automated, with microscope): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $5 Aetna — Government Programs: $3.17 Beacon Health Strategies — Medicare: $3.17 Centerlight Healthcare — Centerlight Healthcare: $3.17 Centers Plan for Healthy Living — Medicare: $3.49 Centivo — Centivo: $3.96 Cigna — Managed Care Commercial: $5.55 Elderplan — Elderplan: $3.01 Elderserve Health — FIDA/MMP: $3.65 EmblemHealth — Select Care: $4.95
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$10	$10	$2.69 – $1,912
Urine test (automated, with microscope): 10 of 50 insurance plan rates Aetna — Government Programs: $3.17 Beacon Health Strategies — Medicare: $3.17 Centerlight Healthcare — Centerlight Healthcare: $3.17 Centers Plan for Healthy Living — Medicare: $3.49 Centivo — Centivo: $3.96 Elderplan — Elderplan: $3.01 Elderserve Health — FIDA/MMP: $3.65 EmblemHealth — Select Care: $4.95 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $5.93 Empire — Indemnity: $5.93
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$10	$10	$2.69 – $1,912
Urine test (automated, with microscope): 10 of 50 insurance plan rates Aetna — Government Programs: $3.17 Beacon Health Strategies — Medicare: $3.17 Centerlight Healthcare — Centerlight Healthcare: $3.17 Centers Plan for Healthy Living — Medicare: $3.49 Centivo — Centivo: $3.96 Elderplan — Elderplan: $3.01 Elderserve Health — FIDA/MMP: $3.65 EmblemHealth — Select Care: $4.95 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $5.93 Empire — Indemnity: $5.93
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	$10	$10	$1 – $1,912 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (manual, without microscope): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4 Aetna — Government Programs: $3.48 Beacon Health Strategies — Medicare: $3.48 Centerlight Healthcare — Centerlight Healthcare: $3.48 Centers Plan for Healthy Living — Medicare: $3.83 Centivo — Centivo: $4.35 Cigna — Managed Care Commercial: $6.16 Elderplan — Elderplan: $3.31 Elderserve Health — FIDA/MMP: $4 EmblemHealth — Select Care: $5.43
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST	$7	$7	$1 – $1,912
Urine test (automated, without microscope): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4 Aetna — Government Programs: $2.25 Beacon Health Strategies — Medicare: $2.25 Centerlight Healthcare — Centerlight Healthcare: $2.25 Centers Plan for Healthy Living — Medicare: $2.48 Centivo — Centivo: $2.81 Cigna — Managed Care Commercial: $4.30 Elderplan — Elderplan: $2.14 Elderserve Health — FIDA/MMP: $2.59 EmblemHealth — Select Care: $3.51
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL	$55	$55	$10.10 – $1,912
PSA (prostate specific antigen) blood test: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $26 Aetna — Government Programs: $18.39 Beacon Health Strategies — Medicare: $18.39 Centerlight Healthcare — Centerlight Healthcare: $18.39 Centers Plan for Healthy Living — Medicare: $20.23 Centivo — Centivo: $22.99 Cigna — Managed Care Commercial: $33.27 Elderplan — Elderplan: $17.47 Elderserve Health — FIDA/MMP: $21.15 EmblemHealth — Select Care: $28.69
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$45	$45	$10.10 – $1,912
PSA (prostate specific antigen) blood test: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $26 Aetna — Government Programs: $18.39 Beacon Health Strategies — Medicare: $18.39 Centerlight Healthcare — Centerlight Healthcare: $18.39 Centers Plan for Healthy Living — Medicare: $20.23 Centivo — Centivo: $22.99 Cigna — Managed Care Commercial: $33.27 Elderplan — Elderplan: $17.47 Elderserve Health — FIDA/MMP: $21.15 EmblemHealth — Select Care: $28.69
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$55	$55	$15.63 – $1,912
PSA (prostate specific antigen) blood test: 10 of 50 insurance plan rates Aetna — Government Programs: $18.39 Beacon Health Strategies — Medicare: $18.39 Centerlight Healthcare — Centerlight Healthcare: $18.39 Centers Plan for Healthy Living — Medicare: $20.23 Centivo — Centivo: $22.99 Elderplan — Elderplan: $17.47 Elderserve Health — FIDA/MMP: $21.15 EmblemHealth — Select Care: $28.69 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $34.39 Empire — Indemnity: $34.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$50	$50	$9 – $1,912
Thyroid stimulating hormone (TSH) test: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $24 Aetna — Government Programs: $16.80 Beacon Health Strategies — Medicare: $16.80 Centerlight Healthcare — Centerlight Healthcare: $16.80 Centers Plan for Healthy Living — Medicare: $18.48 Centivo — Centivo: $21 Cigna — Managed Care Commercial: $30.81 Elderplan — Elderplan: $15.96 Elderserve Health — FIDA/MMP: $19.32 EmblemHealth — Select Care: $26.21
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$50	$50	$14.28 – $1,912
Thyroid stimulating hormone (TSH) test: 10 of 50 insurance plan rates Aetna — Government Programs: $16.80 Beacon Health Strategies — Medicare: $16.80 Centerlight Healthcare — Centerlight Healthcare: $16.80 Centers Plan for Healthy Living — Medicare: $18.48 Centivo — Centivo: $21 Elderplan — Elderplan: $15.96 Elderserve Health — FIDA/MMP: $19.32 EmblemHealth — Select Care: $26.21 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $31.42 Empire — Indemnity: $31.42
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$23	$23	$3.17 – $1,912
Complete blood count (CBC) with differential: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $11 Aetna — Government Programs: $7.77 Beacon Health Strategies — Medicare: $7.77 Centerlight Healthcare — Centerlight Healthcare: $7.77 Centers Plan for Healthy Living — Medicare: $8.55 Centivo — Centivo: $9.71 Cigna — Managed Care Commercial: $14.18 Elderplan — Elderplan: $7.38 Elderserve Health — FIDA/MMP: $8.94 EmblemHealth — Select Care: $12.12
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$23	$23	$6.60 – $1,912
Complete blood count (CBC) with differential: 10 of 50 insurance plan rates Aetna — Government Programs: $7.77 Beacon Health Strategies — Medicare: $7.77 Centerlight Healthcare — Centerlight Healthcare: $7.77 Centers Plan for Healthy Living — Medicare: $8.55 Centivo — Centivo: $9.71 Elderplan — Elderplan: $7.38 Elderserve Health — FIDA/MMP: $8.94 EmblemHealth — Select Care: $12.12 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $14.53 Empire — Indemnity: $14.53
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$23	$23	$6.60 – $1,912
Complete blood count (CBC) with differential: 10 of 50 insurance plan rates Aetna — Government Programs: $7.77 Beacon Health Strategies — Medicare: $7.77 Centerlight Healthcare — Centerlight Healthcare: $7.77 Centers Plan for Healthy Living — Medicare: $8.55 Centivo — Centivo: $9.71 Elderplan — Elderplan: $7.38 Elderserve Health — FIDA/MMP: $8.94 EmblemHealth — Select Care: $12.12 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $14.53 Empire — Indemnity: $14.53
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$19	$19	$3.17 – $1,912
Complete blood count (CBC), automated: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $9 Aetna — Government Programs: $6.47 Beacon Health Strategies — Medicare: $6.47 Centerlight Healthcare — Centerlight Healthcare: $6.47 Centers Plan for Healthy Living — Medicare: $7.12 Centivo — Centivo: $8.09 Cigna — Managed Care Commercial: $11.70 Elderplan — Elderplan: $6.15 Elderserve Health — FIDA/MMP: $7.44 EmblemHealth — Select Care: $10.09
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$19	$19	$5.50 – $1,912
Complete blood count (CBC), automated: 10 of 50 insurance plan rates Aetna — Government Programs: $6.47 Beacon Health Strategies — Medicare: $6.47 Centerlight Healthcare — Centerlight Healthcare: $6.47 Centers Plan for Healthy Living — Medicare: $7.12 Centivo — Centivo: $8.09 Elderplan — Elderplan: $6.15 Elderserve Health — FIDA/MMP: $7.44 EmblemHealth — Select Care: $10.09 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $12.10 Empire — Indemnity: $12.10
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME	$13	$13	$2 – $1,912
Blood clotting time test (prothrombin time, PT): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $6 Aetna — Government Programs: $4.29 Beacon Health Strategies — Medicare: $4.29 Centerlight Healthcare — Centerlight Healthcare: $4.29 Centers Plan for Healthy Living — Medicare: $4.72 Centivo — Centivo: $5.36 Cigna — Managed Care Commercial: $8.01 Elderplan — Elderplan: $4.08 Elderserve Health — FIDA/MMP: $4.93 EmblemHealth — Select Care: $6.69
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$9	$9	$2 – $1,912
Blood clotting time test (prothrombin time, PT): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $6 Aetna — Government Programs: $4.29 Beacon Health Strategies — Medicare: $4.29 Centerlight Healthcare — Centerlight Healthcare: $4.29 Centers Plan for Healthy Living — Medicare: $4.72 Centivo — Centivo: $5.36 Cigna — Managed Care Commercial: $8.01 Elderplan — Elderplan: $4.08 Elderserve Health — FIDA/MMP: $4.93 EmblemHealth — Select Care: $6.69
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; CLOTTING TIME	$13	$13	$3.65 – $1,912
Blood clotting time test (prothrombin time, PT): 10 of 50 insurance plan rates Aetna — Government Programs: $4.29 Beacon Health Strategies — Medicare: $4.29 Centerlight Healthcare — Centerlight Healthcare: $4.29 Centers Plan for Healthy Living — Medicare: $4.72 Centivo — Centivo: $5.36 Elderplan — Elderplan: $4.08 Elderserve Health — FIDA/MMP: $4.93 EmblemHealth — Select Care: $6.69 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $8.02 Empire — Indemnity: $8.02
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$18	$18	$3.50 – $1,912
Blood clotting test (partial thromboplastin time, PTT): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $9 Aetna — Government Programs: $6.01 Beacon Health Strategies — Medicare: $6.01 Centerlight Healthcare — Centerlight Healthcare: $6.01 Centers Plan for Healthy Living — Medicare: $6.61 Centivo — Centivo: $7.51 Cigna — Managed Care Commercial: $11.08 Elderplan — Elderplan: $5.71 Elderserve Health — FIDA/MMP: $6.91 EmblemHealth — Select Care: $9.38
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL	$13	$13	$3.50 – $1,912
Blood clotting test (partial thromboplastin time, PTT): 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $9 Aetna — Government Programs: $6.01 Beacon Health Strategies — Medicare: $6.01 Centerlight Healthcare — Centerlight Healthcare: $6.01 Centers Plan for Healthy Living — Medicare: $6.61 Centivo — Centivo: $7.51 Cigna — Managed Care Commercial: $11.08 Elderplan — Elderplan: $5.71 Elderserve Health — FIDA/MMP: $6.91 EmblemHealth — Select Care: $9.38
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$18	$18	$5.11 – $1,912
Blood clotting test (partial thromboplastin time, PTT): 10 of 50 insurance plan rates Aetna — Government Programs: $6.01 Beacon Health Strategies — Medicare: $6.01 Centerlight Healthcare — Centerlight Healthcare: $6.01 Centers Plan for Healthy Living — Medicare: $6.61 Centivo — Centivo: $7.51 Elderplan — Elderplan: $5.71 Elderserve Health — FIDA/MMP: $6.91 EmblemHealth — Select Care: $9.38 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $11.24 Empire — Indemnity: $11.24

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE	$445	$445	$62.87 – $1,912
CT scan of the head or brain, without contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $241 Aetna — Commercial High Performance Network: $1,254 Aetna — Commercial Product: $1,254 Aetna — Commercial Whole Health: $1,191 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Centivo — Centivo: $129.86 Cigna — Managed Care Commercial: $206.90
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_TC In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$445	$445	$116.87 – $1,912
CT scan of the head or brain, without contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $241 Aetna — Commercial High Performance Network: $1,254 Aetna — Commercial Product: $1,254 Aetna — Commercial Whole Health: $148.04 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Centivo — Centivo: $129.86 Cigna — Managed Care Commercial: $1,756
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 76_TC In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$445	$445	$116.87 – $1,912
CT scan of the head or brain, without contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $241 Aetna — Commercial High Performance Network: $1,254 Aetna — Commercial Product: $1,254 Aetna — Commercial Whole Health: $148.04 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Centivo — Centivo: $129.86 Cigna — Managed Care Commercial: $1,756
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	$1,557	$1,557	$202.32 – $1,964
MRI of the brain, before and after contrast: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $1,268 Aetna — Commercial High Performance Network: $1,708 Aetna — Commercial Product: $1,708 Aetna — Commercial Whole Health: $1,623 Aetna — Government Programs: $433.36 Beacon Health Strategies — Medicare: $433.36 Centerlight Healthcare — Centerlight Healthcare: $433.36 Centers Plan for Healthy Living — Medicare: $476.70 Centivo — Centivo: $433.36 Cigna — Managed Care Commercial: $665.95
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$1,557	$1,557	$368.36 – $2,456
MRI of the brain, before and after contrast: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $1,268 Aetna — Commercial High Performance Network: $1,708 Aetna — Commercial Product: $1,708 Aetna — Commercial Whole Health: $494.03 Aetna — Government Programs: $433.36 Beacon Health Strategies — Medicare: $433.36 Centerlight Healthcare — Centerlight Healthcare: $433.36 Centers Plan for Healthy Living — Medicare: $476.70 Centivo — Centivo: $433.36 Cigna — Managed Care Commercial: $2,456
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC_XU In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$1,557	$1,557	$368.36 – $2,456
MRI of the brain, before and after contrast: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $1,268 Aetna — Commercial High Performance Network: $1,708 Aetna — Commercial Product: $1,708 Aetna — Commercial Whole Health: $494.03 Aetna — Government Programs: $433.36 Beacon Health Strategies — Medicare: $433.36 Centerlight Healthcare — Centerlight Healthcare: $433.36 Centers Plan for Healthy Living — Medicare: $476.70 Centivo — Centivo: $433.36 Cigna — Managed Care Commercial: $2,456
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS	$210	$210	$9 – $1,912
Chest X-ray, 2 views: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $24 Aetna — Government Programs: $108.10 Beacon Health Strategies — Medicare: $108.10 Centerlight Healthcare — Centerlight Healthcare: $108.10 Centers Plan for Healthy Living — Medicare: $118.91 Cigna — Managed Care Commercial: $69.89 Elderplan — Elderplan: $110.26 Elderserve Health — FIDA/MMP: $124.31 EmblemHealth — Select Care: $168.64 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $202.15
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 76_TC In the file: X-RAY OF CHEST; 2 VIEWS	$210	$210	$24 – $1,912
Chest X-ray, 2 views: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $24 Aetna — Commercial High Performance Network: $129.72 Aetna — Commercial Product: $129.72 Aetna — Commercial Whole Health: $123.23 Aetna — Government Programs: $108.10 Beacon Health Strategies — Medicare: $108.10 Centerlight Healthcare — Centerlight Healthcare: $108.10 Centers Plan for Healthy Living — Medicare: $118.91 Elderplan — Elderplan: $110.26 Elderserve Health — FIDA/MMP: $124.31
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 77_TC In the file: X-RAY OF CHEST; 2 VIEWS	$210	$210	$24 – $1,912
Chest X-ray, 2 views: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $24 Aetna — Commercial High Performance Network: $129.72 Aetna — Commercial Product: $129.72 Aetna — Commercial Whole Health: $123.23 Aetna — Government Programs: $108.10 Beacon Health Strategies — Medicare: $108.10 Centerlight Healthcare — Centerlight Healthcare: $108.10 Centers Plan for Healthy Living — Medicare: $118.91 Elderplan — Elderplan: $110.26 Elderserve Health — FIDA/MMP: $124.31
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	$304	$304	$18 – $1,912
X-ray of the lower spine, at least 4 views: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $47 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Cigna — Managed Care Commercial: $116.21 Elderplan — Elderplan: $132.46 Elderserve Health — FIDA/MMP: $149.34 EmblemHealth — Select Care: $202.58 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $242.84
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$304	$304	$47 – $1,912
X-ray of the lower spine, at least 4 views: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $47 Aetna — Commercial High Performance Network: $155.83 Aetna — Commercial Product: $155.83 Aetna — Commercial Whole Health: $148.04 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Elderplan — Elderplan: $132.46 Elderserve Health — FIDA/MMP: $149.34
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	$992	$992	$116.15 – $2,507.20
MRI of the lower back (lumbar spine), without contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $634 Aetna — Commercial High Performance Network: $1,708 Aetna — Commercial Product: $1,708 Aetna — Commercial Whole Health: $1,623 Aetna — Government Programs: $296.38 Beacon Health Strategies — Medicare: $296.38 Centerlight Healthcare — Centerlight Healthcare: $296.38 Centers Plan for Healthy Living — Medicare: $326.02 Centivo — Centivo: $296.38 Cigna — Managed Care Commercial: $382.27
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$992	$992	$266.74 – $2,507.20
MRI of the lower back (lumbar spine), without contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $634 Aetna — Commercial High Performance Network: $1,708 Aetna — Commercial Product: $1,708 Aetna — Commercial Whole Health: $337.87 Aetna — Government Programs: $296.38 Beacon Health Strategies — Medicare: $296.38 Centerlight Healthcare — Centerlight Healthcare: $296.38 Centers Plan for Healthy Living — Medicare: $326.02 Centivo — Centivo: $296.38 Cigna — Managed Care Commercial: $2,456
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE	$744	$744	$102 – $1,912
CT scan of the pelvis, with contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $349 Aetna — Commercial High Performance Network: $1,254 Aetna — Commercial Product: $1,254 Aetna — Commercial Whole Health: $1,191 Aetna — Government Programs: $217.88 Beacon Health Strategies — Medicare: $217.88 Centerlight Healthcare — Centerlight Healthcare: $217.88 Centers Plan for Healthy Living — Medicare: $239.67 Centivo — Centivo: $217.88 Cigna — Managed Care Commercial: $548.86
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT SCAN OF PELVIS WITH CONTRAST	$744	$744	$196.09 – $1,912
CT scan of the pelvis, with contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $349 Aetna — Commercial High Performance Network: $1,254 Aetna — Commercial Product: $1,254 Aetna — Commercial Whole Health: $248.38 Aetna — Government Programs: $217.88 Beacon Health Strategies — Medicare: $217.88 Centerlight Healthcare — Centerlight Healthcare: $217.88 Centers Plan for Healthy Living — Medicare: $239.67 Centivo — Centivo: $217.88 Cigna — Managed Care Commercial: $1,756
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC_XU In the file: CT SCAN OF PELVIS WITH CONTRAST	$744	$744	$196.09 – $1,912
CT scan of the pelvis, with contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $349 Aetna — Commercial High Performance Network: $1,254 Aetna — Commercial Product: $1,254 Aetna — Commercial Whole Health: $248.38 Aetna — Government Programs: $217.88 Beacon Health Strategies — Medicare: $217.88 Centerlight Healthcare — Centerlight Healthcare: $217.88 Centers Plan for Healthy Living — Medicare: $239.67 Centivo — Centivo: $217.88 Cigna — Managed Care Commercial: $1,756
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	$1,133	$1,133	$132.04 – $2,507.20
MRI of a leg joint (such as the knee), without contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $571 Aetna — Commercial High Performance Network: $1,708 Aetna — Commercial Product: $1,708 Aetna — Commercial Whole Health: $1,623 Aetna — Government Programs: $296.38 Beacon Health Strategies — Medicare: $296.38 Centerlight Healthcare — Centerlight Healthcare: $296.38 Centers Plan for Healthy Living — Medicare: $326.02 Centivo — Centivo: $296.38 Cigna — Managed Care Commercial: $434.52
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_TC In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,133	$1,133	$571 – $2,507.20
MRI of a leg joint (such as the knee), without contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $571 Aetna — Commercial High Performance Network: $1,708 Aetna — Commercial Product: $1,708 Aetna — Commercial Whole Health: $745.49 Aetna — Government Programs: $653.94 Beacon Health Strategies — Medicare: $653.94 Centerlight Healthcare — Centerlight Healthcare: $653.94 Centers Plan for Healthy Living — Medicare: $719.33 Centivo — Centivo: $653.94 Cigna — Managed Care Commercial: $2,456
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$992	$992	$266.74 – $2,507.20
MRI of a leg joint (such as the knee), without contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $571 Aetna — Commercial High Performance Network: $1,708 Aetna — Commercial Product: $1,708 Aetna — Commercial Whole Health: $337.87 Aetna — Government Programs: $296.38 Beacon Health Strategies — Medicare: $296.38 Centerlight Healthcare — Centerlight Healthcare: $296.38 Centers Plan for Healthy Living — Medicare: $326.02 Centivo — Centivo: $296.38 Cigna — Managed Care Commercial: $2,456
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST	$1,557	$1,557	$64.76 – $1,912
CT scan of the abdomen and pelvis, with contrast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $318 Aetna — Commercial High Performance Network: $1,254 Aetna — Commercial Product: $1,254 Aetna — Commercial Whole Health: $1,191 Aetna — Government Programs: $433.36 Beacon Health Strategies — Medicare: $433.36 Centerlight Healthcare — Centerlight Healthcare: $433.36 Centers Plan for Healthy Living — Medicare: $476.70 Centivo — Centivo: $433.36 Cigna — Managed Care Commercial: $685.87
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$1,557	$1,557	$390.02 – $1,912
CT scan of the abdomen and pelvis, with contrast: 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $1,254 Aetna — Commercial Product: $1,254 Aetna — Commercial Whole Health: $494.03 Aetna — Government Programs: $433.36 Beacon Health Strategies — Medicare: $433.36 Centerlight Healthcare — Centerlight Healthcare: $433.36 Centers Plan for Healthy Living — Medicare: $476.70 Centivo — Centivo: $433.36 Cigna — Managed Care Commercial: $1,756 Elderplan — Elderplan: $442.03
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC_XU In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$1,557	$1,557	$390.02 – $1,912
CT scan of the abdomen and pelvis, with contrast: 10 of 53 insurance plan rates Aetna — Commercial High Performance Network: $1,254 Aetna — Commercial Product: $1,254 Aetna — Commercial Whole Health: $494.03 Aetna — Government Programs: $433.36 Beacon Health Strategies — Medicare: $433.36 Centerlight Healthcare — Centerlight Healthcare: $433.36 Centers Plan for Healthy Living — Medicare: $476.70 Centivo — Centivo: $433.36 Cigna — Managed Care Commercial: $1,756 Elderplan — Elderplan: $442.03
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE	$254	$254	$36 – $1,912
Ultrasound of the abdomen, complete: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $101 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Cigna — Managed Care Commercial: $234.50 Elderplan — Elderplan: $132.46 Elderserve Health — FIDA/MMP: $149.34 EmblemHealth — Select Care: $202.58 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $242.84
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$254	$254	$101 – $1,912
Ultrasound of the abdomen, complete: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $101 Aetna — Commercial High Performance Network: $155.83 Aetna — Commercial Product: $155.83 Aetna — Commercial Whole Health: $148.04 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Elderplan — Elderplan: $132.46 Elderserve Health — FIDA/MMP: $149.34
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >= 14 WKS SNGL FETUS	$254	$254	$33 – $1,912
Pregnancy ultrasound (after the first trimester): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $108 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Cigna — Managed Care Commercial: $264.96 Elderplan — Elderplan: $132.46 Elderserve Health — FIDA/MMP: $149.34 EmblemHealth — Select Care: $202.58 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $242.84
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 76_TC In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$254	$254	$108 – $1,912
Pregnancy ultrasound (after the first trimester): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $108 Aetna — Commercial High Performance Network: $155.83 Aetna — Commercial Product: $155.83 Aetna — Commercial Whole Health: $148.04 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Elderplan — Elderplan: $132.46 Elderserve Health — FIDA/MMP: $149.34
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$254	$254	$108 – $1,912
Pregnancy ultrasound (after the first trimester): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $108 Aetna — Commercial High Performance Network: $155.83 Aetna — Commercial Product: $155.83 Aetna — Commercial Whole Health: $148.04 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Elderplan — Elderplan: $132.46 Elderserve Health — FIDA/MMP: $149.34
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL US NON-OB	$254	$254	$36 – $1,912
Transvaginal ultrasound: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $78 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Cigna — Managed Care Commercial: $259.15 Elderplan — Elderplan: $132.46 Elderserve Health — FIDA/MMP: $149.34 EmblemHealth — Select Care: $202.58 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $242.84
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$254	$254	$78 – $1,912
Transvaginal ultrasound: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $78 Aetna — Commercial High Performance Network: $155.83 Aetna — Commercial Product: $155.83 Aetna — Commercial Whole Health: $148.04 Aetna — Government Programs: $129.86 Beacon Health Strategies — Medicare: $129.86 Centerlight Healthcare — Centerlight Healthcare: $129.86 Centers Plan for Healthy Living — Medicare: $142.85 Elderplan — Elderplan: $132.46 Elderserve Health — FIDA/MMP: $149.34
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI	$224	$224	$37.74 – $1,912
Diagnostic mammogram, one breast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $112 Aetna — Government Programs: $41.93 Beacon Health Strategies — Medicare: $41.93 Centerlight Healthcare — Centerlight Healthcare: $41.93 Centers Plan for Healthy Living — Medicare: $46.12 Cigna — Managed Care Commercial: $259.15 Elderplan — Elderplan: $42.77 Elderserve Health — FIDA/MMP: $48.22 EmblemHealth — Select Care: $65.41 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $78.41
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$224	$224	$37.74 – $1,912
Diagnostic mammogram, one breast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $112 Aetna — Commercial High Performance Network: $50.32 Aetna — Commercial Product: $50.32 Aetna — Commercial Whole Health: $47.80 Aetna — Government Programs: $41.93 Beacon Health Strategies — Medicare: $41.93 Centerlight Healthcare — Centerlight Healthcare: $41.93 Centers Plan for Healthy Living — Medicare: $46.12 Elderplan — Elderplan: $42.77 Elderserve Health — FIDA/MMP: $48.22
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$224	$224	$37.74 – $1,912
Diagnostic mammogram, one breast: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $112 Aetna — Commercial High Performance Network: $50.32 Aetna — Commercial Product: $50.32 Aetna — Commercial Whole Health: $47.80 Aetna — Government Programs: $41.93 Beacon Health Strategies — Medicare: $41.93 Centerlight Healthcare — Centerlight Healthcare: $41.93 Centers Plan for Healthy Living — Medicare: $46.12 Elderplan — Elderplan: $42.77 Elderserve Health — FIDA/MMP: $48.22
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI	$285	$285	$46.38 – $1,912
Diagnostic mammogram, both breasts: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $143 Aetna — Government Programs: $51.53 Beacon Health Strategies — Medicare: $51.53 Centerlight Healthcare — Centerlight Healthcare: $51.53 Centers Plan for Healthy Living — Medicare: $56.68 Cigna — Managed Care Commercial: $330.12 Elderplan — Elderplan: $52.56 Elderserve Health — FIDA/MMP: $59.26 EmblemHealth — Select Care: $80.39 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $96.36
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$285	$285	$46.38 – $1,912
Diagnostic mammogram, both breasts: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $143 Aetna — Commercial High Performance Network: $61.84 Aetna — Commercial Product: $61.84 Aetna — Commercial Whole Health: $58.74 Aetna — Government Programs: $51.53 Beacon Health Strategies — Medicare: $51.53 Centerlight Healthcare — Centerlight Healthcare: $51.53 Centers Plan for Healthy Living — Medicare: $56.68 Elderplan — Elderplan: $52.56 Elderserve Health — FIDA/MMP: $59.26
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD	$178	$178	$34.99 – $1,912
Screening mammogram, both breasts: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $118 Aetna — Government Programs: $38.88 Beacon Health Strategies — Medicare: $38.88 Centerlight Healthcare — Centerlight Healthcare: $38.88 Centers Plan for Healthy Living — Medicare: $42.77 Cigna — Managed Care Commercial: $273.94 Elderplan — Elderplan: $39.66 Elderserve Health — FIDA/MMP: $44.71 EmblemHealth — Select Care: $60.65 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $72.71
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52_LT_TC In the file: SCREENING MAMMOGRAPHY	$178	$178	$34.99 – $1,912
Screening mammogram, both breasts: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $118 Aetna — Commercial High Performance Network: $46.66 Aetna — Commercial Product: $46.66 Aetna — Commercial Whole Health: $44.32 Aetna — Government Programs: $38.88 Beacon Health Strategies — Medicare: $38.88 Centerlight Healthcare — Centerlight Healthcare: $38.88 Centers Plan for Healthy Living — Medicare: $42.77 Elderplan — Elderplan: $39.66 Elderserve Health — FIDA/MMP: $44.71
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: SCREENING MAMMOGRAPHY	$236	$236	$34.99 – $1,912
Screening mammogram, both breasts: 10 of 53 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $118 Aetna — Commercial High Performance Network: $46.66 Aetna — Commercial Product: $46.66 Aetna — Commercial Whole Health: $44.32 Aetna — Government Programs: $38.88 Beacon Health Strategies — Medicare: $38.88 Centerlight Healthcare — Centerlight Healthcare: $38.88 Centers Plan for Healthy Living — Medicare: $42.77 Elderplan — Elderplan: $39.66 Elderserve Health — FIDA/MMP: $44.71

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION	$12,954	$12,954	$307.91 – $19,667.61
Heart rhythm study (electrophysiology evaluation): 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $381 Aetna — Government Programs: $9,688.48 Beacon Health Strategies — Medicare: $9,688.48 Centerlight Healthcare — Centerlight Healthcare: $9,688.48 Centers Plan for Healthy Living — Medicare: $11,626.18 Elderplan — Elderplan: $9,882.25 Elderserve Health — FIDA/MMP: $11,141.75 EmblemHealth — Select Care: $15,114.03 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $6,622 Empire — Indemnity: $6,622

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES	$71	$71	$20.64 – $1,912
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 54 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $50 Aetna — Government Programs: $32.66 Beacon Health Strategies — Medicare: $32.66 Centerlight Healthcare — Centerlight Healthcare: $32.66 Centers Plan for Healthy Living — Medicare: $39.19 Cigna — Managed Care Commercial: $264 Elderplan — Elderplan: $33.31 Elderserve Health — FIDA/MMP: $37.56 EmblemHealth — Select Care: $50.95 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $61.07
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$71	$71	$27.76 – $1,912
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 53 insurance plan rates Aetna — Government Programs: $32.66 Beacon Health Strategies — Medicare: $32.66 Centerlight Healthcare — Centerlight Healthcare: $32.66 Centers Plan for Healthy Living — Medicare: $39.19 Cigna — Managed Care Commercial: $264 Elderplan — Elderplan: $33.31 Elderserve Health — FIDA/MMP: $37.56 EmblemHealth — Select Care: $50.95 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $61.07 Empire — Indemnity: $61.07
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$71	$71	$27.76 – $1,912
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 53 insurance plan rates Aetna — Government Programs: $32.66 Beacon Health Strategies — Medicare: $32.66 Centerlight Healthcare — Centerlight Healthcare: $32.66 Centers Plan for Healthy Living — Medicare: $39.19 Cigna — Managed Care Commercial: $264 Elderplan — Elderplan: $33.31 Elderserve Health — FIDA/MMP: $37.56 EmblemHealth — Select Care: $50.95 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $61.07 Empire — Indemnity: $61.07
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN	$200	$200	$35 – $1,912
Physical therapy evaluation (low complexity): 10 of 54 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $93 Aetna — Government Programs: $109.69 Beacon Health Strategies — Medicare: $109.69 Centerlight Healthcare — Centerlight Healthcare: $109.69 Centers Plan for Healthy Living — Medicare: $131.63 Cigna — Managed Care Commercial: $264 Elderplan — Elderplan: $111.88 Elderserve Health — FIDA/MMP: $126.14 EmblemHealth — Select Care: $171.12 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $205.12
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$200	$200	$93.24 – $1,912
Physical therapy evaluation (low complexity): 10 of 53 insurance plan rates Aetna — Government Programs: $109.69 Beacon Health Strategies — Medicare: $109.69 Centerlight Healthcare — Centerlight Healthcare: $109.69 Centers Plan for Healthy Living — Medicare: $131.63 Cigna — Managed Care Commercial: $264 Elderplan — Elderplan: $111.88 Elderserve Health — FIDA/MMP: $126.14 EmblemHealth — Select Care: $171.12 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $205.12 Empire — Indemnity: $205.12
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_XU In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$200	$200	$93.24 – $1,912
Physical therapy evaluation (low complexity): 10 of 53 insurance plan rates Aetna — Government Programs: $109.69 Beacon Health Strategies — Medicare: $109.69 Centerlight Healthcare — Centerlight Healthcare: $109.69 Centers Plan for Healthy Living — Medicare: $131.63 Cigna — Managed Care Commercial: $264 Elderplan — Elderplan: $111.88 Elderserve Health — FIDA/MMP: $126.14 EmblemHealth — Select Care: $171.12 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $205.12 Empire — Indemnity: $205.12
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN	$275	$275	$35 – $1,912
Physical therapy evaluation (moderate complexity): 10 of 54 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $93 Aetna — Government Programs: $109.69 Beacon Health Strategies — Medicare: $109.69 Centerlight Healthcare — Centerlight Healthcare: $109.69 Centers Plan for Healthy Living — Medicare: $131.63 Cigna — Managed Care Commercial: $264 Elderplan — Elderplan: $111.88 Elderserve Health — FIDA/MMP: $126.14 EmblemHealth — Select Care: $171.12 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $205.12
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$275	$275	$93.24 – $1,912
Physical therapy evaluation (moderate complexity): 10 of 53 insurance plan rates Aetna — Government Programs: $109.69 Beacon Health Strategies — Medicare: $109.69 Centerlight Healthcare — Centerlight Healthcare: $109.69 Centers Plan for Healthy Living — Medicare: $131.63 Cigna — Managed Care Commercial: $264 Elderplan — Elderplan: $111.88 Elderserve Health — FIDA/MMP: $126.14 EmblemHealth — Select Care: $171.12 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $205.12 Empire — Indemnity: $205.12
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	$350	$350	$35 – $1,912
Physical therapy evaluation (high complexity): 10 of 54 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $93 Aetna — Government Programs: $109.69 Beacon Health Strategies — Medicare: $109.69 Centerlight Healthcare — Centerlight Healthcare: $109.69 Centers Plan for Healthy Living — Medicare: $131.63 Cigna — Managed Care Commercial: $264 Elderplan — Elderplan: $111.88 Elderserve Health — FIDA/MMP: $126.14 EmblemHealth — Select Care: $171.12 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $205.12
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$350	$350	$93.24 – $1,912
Physical therapy evaluation (high complexity): 10 of 53 insurance plan rates Aetna — Government Programs: $109.69 Beacon Health Strategies — Medicare: $109.69 Centerlight Healthcare — Centerlight Healthcare: $109.69 Centers Plan for Healthy Living — Medicare: $131.63 Cigna — Managed Care Commercial: $264 Elderplan — Elderplan: $111.88 Elderserve Health — FIDA/MMP: $126.14 EmblemHealth — Select Care: $171.12 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $205.12 Empire — Indemnity: $205.12
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY; 30 MINUTES	$324	$324	$55 – $1,912
Psychotherapy, 30 minutes: 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $71 Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY; 30 MINUTES	$324	$324	$55 – $1,912
Psychotherapy, 30 minutes: 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $71 Aetna — Commercial High Performance Network: $320 Aetna — Commercial Product: $320 Aetna — Commercial Whole Health: $304 Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Elderplan — Elderplan: $224.88
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: PSYCHOTHERAPY; 30 MINUTES	$324	$324	$84 – $1,912
Psychotherapy, 30 minutes: 10 of 46 insurance plan rates Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $144
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY; 45 MINUTES	$276	$276	$90.87 – $1,912
Psychotherapy, 45 minutes: 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $100 Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY; 45 MINUTES	$276	$276	$90.87 – $1,912
Psychotherapy, 45 minutes: 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $100 Aetna — Commercial High Performance Network: $320 Aetna — Commercial Product: $320 Aetna — Commercial Whole Health: $304 Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Elderplan — Elderplan: $224.88
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 93 In the file: PSYCHOTHERAPY; 45 MINUTES	$276	$276	$122 – $1,912
Psychotherapy, 45 minutes: 10 of 46 insurance plan rates Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $144
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES	$276	$276	$90.87 – $1,912
Psychotherapy, 60 minutes: 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $127 Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYTX W/O PT 50 MIN	$277	$277	$75 – $1,912
Family psychotherapy, without the patient: 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $75 Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 93 In the file: FAMILY PSYCHOTHERAPY WITHOUT PATIENT; 50 MINUTES	$277	$277	$90 – $1,912
Family psychotherapy, without the patient: 10 of 46 insurance plan rates Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $144
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: FAMILY PSYCHOTHERAPY WITHOUT PATIENT; 50 MINUTES	$277	$277	$90 – $1,912
Family psychotherapy, without the patient: 10 of 46 insurance plan rates Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $144
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY WITH PATIENT; 50 MINUTES	$276	$276	$30 – $1,912
Family psychotherapy, with the patient: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $75 Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 93 In the file: FAMILY PSYCHOTHERAPY WITH PATIENT; 50 MINUTES	$276	$276	$95 – $1,912
Family psychotherapy, with the patient: 10 of 47 insurance plan rates Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $144
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: FAMILY PSYCHOTHERAPY WITH PATIENT; 50 MINUTES	$276	$276	$95 – $1,912
Family psychotherapy, with the patient: 10 of 47 insurance plan rates Aetna — Government Programs: $220.47 Beacon Health Strategies — Medicare: $220.47 Centerlight Healthcare — Centerlight Healthcare: $220.47 Centers Plan for Healthy Living — Medicare: $264.56 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $224.88 Elderserve Health — FIDA/MMP: $253.54 EmblemHealth — Select Care: $343.93 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $144
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: GROUP PSYCHOTHERAPY	$155	$155	$25 – $1,912
Group psychotherapy: 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $35 Aetna — Government Programs: $126.19 Beacon Health Strategies — Medicare: $126.19 Centerlight Healthcare — Centerlight Healthcare: $126.19 Centers Plan for Healthy Living — Medicare: $151.43 Centivo — Centivo: $456.24 Create Health Plan — Flex/NYC/Long Island: $476 Elderplan — Elderplan: $128.71 Elderserve Health — FIDA/MMP: $145.12 EmblemHealth — Select Care: $196.86
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP PSYCHOTHERAPY	$271	$271	$25 – $1,912
Group psychotherapy: 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $35 Aetna — Commercial High Performance Network: $320 Aetna — Commercial Product: $320 Aetna — Commercial Whole Health: $304 Aetna — Government Programs: $126.19 Beacon Health Strategies — Medicare: $126.19 Centerlight Healthcare — Centerlight Healthcare: $126.19 Centers Plan for Healthy Living — Medicare: $151.43 Centivo — Centivo: $456.24 Elderplan — Elderplan: $128.71

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$2,052	$2,052	$578 – $7,587.25
Removal of breast growth (open surgery): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $578 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $4,863.62 Beacon Health Strategies — Medicare: $4,863.62 Centerlight Healthcare — Centerlight Healthcare: $4,863.62 Centers Plan for Healthy Living — Medicare: $5,836.34 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$1,902	$1,902	$1,912 – $7,587.25
Removal of breast growth (open surgery): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $4,863.62 Beacon Health Strategies — Medicare: $4,863.62 Centerlight Healthcare — Centerlight Healthcare: $4,863.62 Centers Plan for Healthy Living — Medicare: $5,836.34 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_XS In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$1,611	$1,611	$1,912 – $7,587.25
Removal of breast growth (open surgery): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $4,863.62 Beacon Health Strategies — Medicare: $4,863.62 Centerlight Healthcare — Centerlight Healthcare: $4,863.62 Centers Plan for Healthy Living — Medicare: $5,836.34 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$5,180	$5,180	$1,912 – $24,878.55
Total hip replacement: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $17,237 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $15,947.79 Beacon Health Strategies — Medicare: $15,947.79 Centerlight Healthcare — Centerlight Healthcare: $15,947.79 Centers Plan for Healthy Living — Medicare: $19,137.35 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$5,042	$5,042	$1,912 – $24,878.55
Total hip replacement: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $17,237 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $15,947.79 Beacon Health Strategies — Medicare: $15,947.79 Centerlight Healthcare — Centerlight Healthcare: $15,947.79 Centers Plan for Healthy Living — Medicare: $19,137.35 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$5,042	$5,042	$1,912 – $24,878.55
Total knee replacement: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $15,947.79 Beacon Health Strategies — Medicare: $15,947.79 Centerlight Healthcare — Centerlight Healthcare: $15,947.79 Centers Plan for Healthy Living — Medicare: $19,137.35 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$5,318	$5,318	$1,912 – $24,878.55
Total knee replacement: 10 of 52 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $15,947.79 Beacon Health Strategies — Medicare: $15,947.79 Centerlight Healthcare — Centerlight Healthcare: $15,947.79 Centers Plan for Healthy Living — Medicare: $19,137.35 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$1,633.50	$1,633.50	$121.24 – $5,159
Shoulder arthroscopy: shaving of shoulder bone: 10 of 24 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $769 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250 Create Health Plan — Flex/NYC/Long Island: $4,338 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $3,217 Empire — Indemnity: $3,217 Empire Blue Priority — Small Group/Pathway/Blue: $2,734
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$1,755	$1,755	$1,912 – $5,159
Shoulder arthroscopy: shaving of shoulder bone: 10 of 24 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250 Create Health Plan — Flex/NYC/Long Island: $4,338 Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $3,217 Empire — Indemnity: $3,217 Empire Blue Priority — Small Group/Pathway/Blue: $2,734
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$2,382	$2,382	$1,912 – $6,340.43
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $4,064.38 Beacon Health Strategies — Medicare: $4,064.38 Centerlight Healthcare — Centerlight Healthcare: $4,064.38 Centers Plan for Healthy Living — Medicare: $4,877.26 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$1,812	$1,812	$1,912 – $6,340.43
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $4,064.38 Beacon Health Strategies — Medicare: $4,064.38 Centerlight Healthcare — Centerlight Healthcare: $4,064.38 Centers Plan for Healthy Living — Medicare: $4,877.26 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$3,452	$3,452	$363 – $11,471.34
Removal of tonsils and adenoids (under age 12): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $363 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $7,353.42 Beacon Health Strategies — Medicare: $7,353.42 Centerlight Healthcare — Centerlight Healthcare: $7,353.42 Centers Plan for Healthy Living — Medicare: $8,824.10 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,231	$2,231	$174 – $5,159
Upper GI endoscopy with biopsy: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $174 Aetna — Commercial High Performance Network: $2,812 Aetna — Commercial Product: $2,812 Aetna — Commercial Whole Health: $2,671 Aetna — Government Programs: $1,126.63 Beacon Health Strategies — Medicare: $1,126.63 Centerlight Healthcare — Centerlight Healthcare: $1,126.63 Centers Plan for Healthy Living — Medicare: $1,351.96 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,382.50	$2,382.50	$232 – $5,159
Colonoscopy (diagnostic): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $232 Aetna — Commercial High Performance Network: $2,812 Aetna — Commercial Product: $2,812 Aetna — Commercial Whole Health: $2,671 Aetna — Government Programs: $1,155.16 Beacon Health Strategies — Medicare: $1,155.16 Centerlight Healthcare — Centerlight Healthcare: $1,155.16 Centers Plan for Healthy Living — Medicare: $1,386.19 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,601	$1,601	$274 – $5,159
Colonoscopy with biopsy: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $274 Aetna — Commercial High Performance Network: $2,812 Aetna — Commercial Product: $2,812 Aetna — Commercial Whole Health: $2,671 Aetna — Government Programs: $1,486.43 Beacon Health Strategies — Medicare: $1,486.43 Centerlight Healthcare — Centerlight Healthcare: $1,486.43 Centers Plan for Healthy Living — Medicare: $1,783.72 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,394	$1,394	$1,263.47 – $5,159
Colonoscopy with biopsy: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $2,812 Aetna — Commercial Product: $2,812 Aetna — Commercial Whole Health: $2,671 Aetna — Government Programs: $1,486.43 Beacon Health Strategies — Medicare: $1,486.43 Centerlight Healthcare — Centerlight Healthcare: $1,486.43 Centers Plan for Healthy Living — Medicare: $1,783.72 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XS In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$754.50	$754.50	$1,263.47 – $5,159
Colonoscopy with biopsy: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $2,812 Aetna — Commercial Product: $2,812 Aetna — Commercial Whole Health: $2,671 Aetna — Government Programs: $1,486.43 Beacon Health Strategies — Medicare: $1,486.43 Centerlight Healthcare — Centerlight Healthcare: $1,486.43 Centers Plan for Healthy Living — Medicare: $1,783.72 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$754.50	$754.50	$325 – $5,159
Colonoscopy with removal of polyps (snare): 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $325 Aetna — Commercial High Performance Network: $2,812 Aetna — Commercial Product: $2,812 Aetna — Commercial Whole Health: $2,671 Aetna — Government Programs: $1,486.43 Beacon Health Strategies — Medicare: $1,486.43 Centerlight Healthcare — Centerlight Healthcare: $1,486.43 Centers Plan for Healthy Living — Medicare: $1,783.72 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$7,112	$7,112	$719 – $11,714.90
Gallbladder removal by laparoscope: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $719 Aetna — Commercial High Performance Network: $5,613 Aetna — Commercial Product: $5,613 Aetna — Commercial Whole Health: $5,331 Aetna — Government Programs: $7,509.55 Beacon Health Strategies — Medicare: $7,509.55 Centerlight Healthcare — Centerlight Healthcare: $7,509.55 Centers Plan for Healthy Living — Medicare: $9,011.46 Centivo — Centivo: $6,434.22 Cigna — Managed Care Commercial: $7,102
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$2,342	$2,342	$1,912 – $11,714.90
Gallbladder removal by laparoscope: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $5,613 Aetna — Commercial Product: $5,613 Aetna — Commercial Whole Health: $5,331 Aetna — Government Programs: $7,509.55 Beacon Health Strategies — Medicare: $7,509.55 Centerlight Healthcare — Centerlight Healthcare: $7,509.55 Centers Plan for Healthy Living — Medicare: $9,011.46 Centivo — Centivo: $6,434.22 Cigna — Managed Care Commercial: $4,250
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$4,662	$4,662	$1,035 – $11,764.07
Groin (inguinal) hernia repair, age 5 or older: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $1,035 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $7,541.07 Beacon Health Strategies — Medicare: $7,541.07 Centerlight Healthcare — Centerlight Healthcare: $7,541.07 Centers Plan for Healthy Living — Medicare: $9,049.28 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$3,912	$3,912	$1,912 – $6,938.04
Groin (inguinal) hernia repair, age 5 or older: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $4,447.46 Beacon Health Strategies — Medicare: $4,447.46 Centerlight Healthcare — Centerlight Healthcare: $4,447.46 Centers Plan for Healthy Living — Medicare: $5,336.95 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$3,552	$3,552	$1,912 – $6,938.04
Groin (inguinal) hernia repair, age 5 or older: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $4,447.46 Beacon Health Strategies — Medicare: $4,447.46 Centerlight Healthcare — Centerlight Healthcare: $4,447.46 Centers Plan for Healthy Living — Medicare: $5,336.95 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$1,812	$1,812	$525 – $6,272.84
Hysteroscopy with biopsy of the uterus lining: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $1,678.25 Aetna — Commercial High Performance Network: $2,812 Aetna — Commercial Product: $2,812 Aetna — Commercial Whole Health: $2,671 Aetna — Government Programs: $4,021.05 Beacon Health Strategies — Medicare: $4,021.05 Centerlight Healthcare — Centerlight Healthcare: $4,021.05 Centers Plan for Healthy Living — Medicare: $4,825.26 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	$7,231	$7,231	$200 – $7,519.36
Hysteroscopy with biopsy of the uterus lining: 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $1,678.25 Aetna — Commercial High Performance Network: $2,812 Aetna — Commercial Product: $2,812 Aetna — Commercial Whole Health: $2,671 Aetna — Government Programs: $4,021.05 Beacon Health Strategies — Medicare: $4,021.05 Centerlight Healthcare — Centerlight Healthcare: $4,021.05 Centers Plan for Healthy Living — Medicare: $200 Centivo — Centivo: $456.24 Cigna — Managed Care Commercial: $289
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC	$1,639	$1,639	$89.03 – $4,679.44
Spinal injection, lower back (epidural), with imaging guidance: 10 of 50 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $288 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $876.82 Beacon Health Strategies — Medicare: $876.82 Centerlight Healthcare — Centerlight Healthcare: $876.82 Centers Plan for Healthy Living — Medicare: $1,052.18 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$1,812	$1,812	$1,912 – $5,159
Carpal tunnel release: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $2,425.62 Beacon Health Strategies — Medicare: $2,425.62 Centerlight Healthcare — Centerlight Healthcare: $2,425.62 Centers Plan for Healthy Living — Medicare: $2,910.74 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$1,812	$1,812	$1,912 – $5,159
Carpal tunnel release: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $2,425.62 Beacon Health Strategies — Medicare: $2,425.62 Centerlight Healthcare — Centerlight Healthcare: $2,425.62 Centers Plan for Healthy Living — Medicare: $2,910.74 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,082	$2,082	$1,912 – $5,159
Cataract removal with lens implant: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $2,866.70 Beacon Health Strategies — Medicare: $2,866.70 Centerlight Healthcare — Centerlight Healthcare: $2,866.70 Centers Plan for Healthy Living — Medicare: $3,440.04 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$1,872	$1,872	$1,912 – $5,159
Cataract removal with lens implant: 10 of 51 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4,001 Aetna — Commercial High Performance Network: $3,951 Aetna — Commercial Product: $3,951 Aetna — Commercial Whole Health: $3,754 Aetna — Government Programs: $2,866.70 Beacon Health Strategies — Medicare: $2,866.70 Centerlight Healthcare — Centerlight Healthcare: $2,866.70 Centers Plan for Healthy Living — Medicare: $3,440.04 Centivo — Centivo: $4,679.44 Cigna — Managed Care Commercial: $4,250

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$500 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $257,887.04
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 47 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $143,260.93 Aetna — Commercial High Performance Network: $155,122.13 Aetna — Commercial Product: $155,122.13 Aetna — Commercial Whole Health: $147,372.30 Aetna — Government Programs: $118,900.01 Beacon Health Strategies — Medicare: $118,900.01 Centerlight Healthcare — Centerlight Healthcare: $118,900.01 Centers Plan for Healthy Living — Medicare: $133,168.01 Centivo — Centivo: $180,646.68 Cigna — Managed Care Commercial: $171,586.91
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 COMORBITY	Not listed in the file	Not listed in the file	$500 – $50,382.45
Hip or knee replacement (major joint of the leg), without major complications: 10 of 46 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $27,988.36 Aetna — Government Programs: $24,565.24 Beacon Health Strategies — Medicare: $24,565.24 Centerlight Healthcare — Centerlight Healthcare: $24,565.24 Centers Plan for Healthy Living — Medicare: $27,513.07 Centivo — Centivo: $35,292.28 Cigna — Managed Care Commercial: $33,522.30 Create Health Plan — Flex/NYC/Long Island: $50,382.45 Elderplan — Elderplan: $24,565.24 Elderserve Health — FIDA/MMP: $28,250.03
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	$500 – $63,259.30
Neck (cervical) spinal fusion, without complications: 10 of 47 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $35,141.69 Aetna — Commercial High Performance Network: $38,051.22 Aetna — Commercial Product: $38,051.22 Aetna — Commercial Whole Health: $36,150.20 Aetna — Government Programs: $30,719.79 Beacon Health Strategies — Medicare: $30,719.79 Centerlight Healthcare — Centerlight Healthcare: $30,719.79 Centers Plan for Healthy Living — Medicare: $34,406.16 Centivo — Centivo: $44,312.35 Cigna — Managed Care Commercial: $42,090
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY WITHOUT COMPLICATION/COMORBITY	Not listed in the file	Not listed in the file	$500 – $32,030.46
Uterus and ovary surgery (not for cancer), without complications: 10 of 47 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $17,793.50 Aetna — Commercial High Performance Network: $19,266.71 Aetna — Commercial Product: $19,266.71 Aetna — Commercial Whole Health: $18,304.15 Aetna — Government Programs: $16,299.14 Beacon Health Strategies — Medicare: $16,299.14 Centerlight Healthcare — Centerlight Healthcare: $16,299.14 Centers Plan for Healthy Living — Medicare: $18,255.04 Centivo — Centivo: $22,436.94 Cigna — Managed Care Commercial: $21,311.69

Source: Flushing Hospital Medical Center’s standard charges file (apim.services.craneware.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 25, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	45th Avenue and Parsons Boulevard, Flushing, NY 11355
County	Queens County
State	New York
Phone	(718) 670‑5000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	330193
Name in Medicare records	FLUSHING HOSPITAL MEDICAL CENTER
Profile level	Medicare data + hospital website
Official website	flushinghospital.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Flushing Hospital Address & General Information — flushinghospital.org
About Us - Flushing Hospital — flushinghospital.org
Emergency Department - Flushing Hospital — flushinghospital.org
Hospital Queens, New York | Flushing Hospital Medical Center — flushinghospital.org
Bariatric Hospital Care | Queens, NY | Flushing Hospital — flushinghospital.org
Pediatric Cardiology - Flushing Hospital Medical Center — flushinghospital.org
Pediatric Surgery - Flushing Hospital Medical Center — flushinghospital.org
Stroke Unit | Award-Winning Stroke Care | Flushing Hospital — flushinghospital.org
Patient Advocacy Services - Flushing Hospital Medical Center — flushinghospital.org
Ambulatory Surgery Unit - Flushing Hospital Medical Center — flushinghospital.org
Cardiology Department | Flushing Hospital Medical Center | Cardiologists Flushing Hospital, Queens, NY — flushinghospital.org
Orthopedic - Flushing Hospital Medical Center — flushinghospital.org
Diagnostic Imaging Services | Flushing Hospital Medical Center | Radiology Center in Queens | Flushing Hospital Departme — flushinghospital.org
Da Vinci Robotic Surgery in Queens, NY | Flushing Hospital — flushinghospital.org