Does Gettysburg Hospital have an emergency room?

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

Where is Gettysburg Hospital?

147 Gettys Street, Gettysburg, PA 17325, in Adams County, Pennsylvania.

What is the phone number of Gettysburg Hospital?

(717) 334-2121, as listed by Medicare (CMS).

What is the Medicare star rating of Gettysburg Hospital?

4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Does Medicare reduce its payments to Gettysburg Hospital for hospital-acquired conditions?

Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Gettysburg Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.7488; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Gettysburg Hospital — Phone, Address & ER

Quick answers

Does Gettysburg Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Gettysburg Hospital. In a medical emergency, call 911.
Where is Gettysburg Hospital?: 147 Gettys Street, Gettysburg, PA 17325, in Adams County, Pennsylvania.
What is the phone number of Gettysburg Hospital?: (717) 334-2121, as listed by Medicare (CMS).
What is the Medicare star rating of Gettysburg Hospital?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Gettysburg Hospital for hospital-acquired conditions?: Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Gettysburg Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.7488; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas^[4]

Emergency medicine
Maternity care
Cancer care (Adams Cancer Center)
Stroke care

Procedures^[4]

Knee and hip replacement

Programs and centers^[4]

Maternity Center
Adams Cancer Center breast program

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Primary Stroke Center (DNV)

Visiting and practical information

Visiting	Visitors use Main or Emergency entrances, show photo ID, pass weapons screening and wear a visitor badge^[4]
Interpreters and languages	Spanish interpreters on staff weekdays 7-7 and weekends 10-2; phone interpretation for other languages^[4]

Recognition^[4]

DNV accreditation and primary stroke certification
Pathway to Excellence (ANCC)
NAPBC breast center accreditation (Adams Cancer Center)
Keystone 10 facility
Gold Level Safe Sleep facility (Cribs for Kids)

Doctors and clinicians (1,085)

1,085 doctors and other clinicians list Gettysburg Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (1,085)

Aaron B. Heath, DORheumatology
Abdul Akbaryeh, MDInternal Medicine
Abdul H. Cheema, MDHospitalist
Abhinav G. Hoskote, MDHospitalist
Abigail M. Young, NPNurse Practitioner
Abroo T. Nawaz, MDInternal Medicine
Adam I. Wasserman, MDHospitalist
Adam L. Houck, CNACertified Registered Nurse Anesthetist (CRNA)
Adam Musgrove, DOEmergency Medicine
Adam R. Wetzel, MDDiagnostic Radiology
Adil M. Waheed, MDHospitalist
Adnaan S. Moin, MDInterventional Radiology
Adnan S. Malik, MDAdvanced Heart Failure and Transplant Cardiology
Ahmad R. Cheema, MDHematology/Oncology
Ahmed Tarique, MDInternal Medicine
Ahsan Khan, DODiagnostic Radiology
Aisha Parihar, MDEndocrinology
Ajaya T. Moturu, MDPhysical Medicine and Rehabilitation
Akindele J. Aluko, MDFamily Practice
Alan Horn, MDDiagnostic Radiology
Alan Stein, MDUrology
Alang M. Geh, NPNurse Practitioner
Albert J. Folgueras, MDOrthopedic Surgery
Albert W. Heck, MDNeurology

And 1,061 more: the button below opens the full list.

Other emergency rooms nearby

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

UPMC Hanover13 mi · Hanover, PA · Acute Care Hospital
WellSpan Waynesboro Hospital19 mi · Waynesboro, PA · Acute Care Hospital
Carroll Hospital Center23 mi · Westminster, MD · Acute Care Hospital
WellSpan Chambersburg Hospital23 mi · Chambersburg, PA · Acute Care Hospital
UPMC Memorial24 mi · York, PA · Acute Care Hospital

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

Other hospitals near Gettysburg

Brook Lane Health Services22 mi · Hagerstown, MD · Psychiatric Hospital
Roxbury Treatment Center23 mi · Shippensburg, PA · Psychiatric Hospital

Hospitals in Adams County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Transitions Healthcare Gettysburg1.3 mi · Gettysburg, PA · 3 of 5 stars
Gettysburg Center1.6 mi · Gettysburg, PA · 1 of 5 stars
The Gardens at Gettysburg1.8 mi · Gettysburg, PA · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice Program/Vna of Hanover and Spring Grove14 mi · Hanover, PA · 5 of 5 stars
Bridginglife, Inc.23 mi · Westminster, MD · 4 of 5 stars
Franklin Hospice LLC24 mi · Chambersburg, PA

All hospice providers in the state →

Home health agencies

Reliance Healthcare Homehealth14 mi · Hanover, PA
VNA of Hanover and Spring Grove14 mi · Hanover, PA · 2 of 5 stars
Adoration Home Health23 mi · Westminster, MD · 4.5 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Heritage Lake Dialysis0.4 mi · Gettysburg, PA · 3 of 5 stars
DaVita Hanover Dialysis14 mi · Hanover, PA · 2 of 5 stars
FKC Waynesboro18 mi · Waynesboro, PA · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Cherry Tree Surgical, LLC14 mi · Hanover, PA
York Adams Pain Specialists, PC14 mi · Hanover, PA
Carroll County Asc/Yash Kumar23 mi · Westminster, MD

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

Gettysburg Center2.2 mi · Gettysburg, PA · Community health center
Hanover Center12 mi · Hanover, PA · Community health center
Keystone Agricultural Worker Program - Adams Co.13 mi · Gardners, PA · Community health center

Clinics and urgent care

Frederick Health Medical Group LLC11 mi · Emmitsburg, MD · Urgent care center
Medexpress Urgent Care, PC - Pennsylvania14 mi · Hanover, PA · Urgent care center
WellSpan Medical Group14 mi · Hanover, PA · Urgent care center

Pharmacies

The Giant Company, LLC0.4 mi · Gettysburg, PA · Community/retail pharmacy
Wal-Mart Stores East LP0.4 mi · Gettysburg, PA · Community/retail pharmacy
WellSpan Pharmacy, Inc.0.4 mi · Gettysburg, PA · Community/retail pharmacy

Assisted living nearby

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

Concordia at Spiritrust Gettysburg0.4 mi · Gettysburg, PA
Morning Glory Senior Living7.8 mi · Littlestown, PA
Weikert's Care Home7.8 mi · Littlestown, PA
Fairfield Health Management9.0 mi · Fairfield, PA

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Patients got help quickly from staff	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Restfulness of Environment	1 of 5 stars
Care Coordination	3 of 5 stars
Symptoms After Stay	3 of 5 stars
Rated the hospital 9 or 10 out of 10	65%National average: 72%
Would definitely recommend the hospital	65%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	75%National average: 80%
“Always” got help as soon as they wanted	58%National average: 64%
Staff “always” explained medicines before giving them	57%National average: 62%
Were given information about recovery at home	85%National average: 86%
Room and bathroom “always” clean	66%National average: 73%
Completed surveys	333Response rate: 30%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	2.317No different from the national benchmark
Surgical site infections after colon surgery	0.592No different from the national benchmark
MRSA bloodstream infections	0.953No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.773No different from the national benchmark
Not reported to Medicare	Surgical site infections after abdominal hysterectomy

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	12.1%
Deaths within 30 days: heart failure patients	13.5%
Deaths within 30 days: pneumonia patients	14.5%
Deaths within 30 days: COPD patients	8.6%
Deaths within 30 days: stroke patients	11.7%
Serious complications (patient safety indicator PSI-90)	0.88No different from the national rate
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG)
Too few cases to report	Complications after hip or knee replacement

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	15.9%
Readmitted within 30 days: heart attack	14.7%
Readmitted within 30 days: heart failure	20.8%
Readmitted within 30 days: pneumonia	18.4%
Readmitted within 30 days: COPD	18.7%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery
Too few cases to report	Readmitted within 30 days: hip or knee replacement

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	143 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	68%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026	YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score	0.7488Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack	0.9215Fewer readmissions than expected
Heart failure	0.8360Fewer readmissions than expected
Pneumonia	0.9362Fewer readmissions than expected
COPD (chronic lung disease)	0.9694Fewer readmissions than expected
No result published	Hip or knee replacement; Coronary bypass surgery (CABG) (not reported, or too few cases)

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score	21.50 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)	15.00 out of 100
Person and community engagement (patient survey)	19.00 out of 100
Safety (infections and sepsis care)	42.00 out of 100
Efficiency and cost reduction (Medicare spending)	10.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio	0.97Below the national median hospital (1.00): Medicare spent less

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

ER wait times and Medicare ratings nearby

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

ER wait times in Pennsylvania Best hospitals in Pennsylvania

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 63 common services exactly as Gettysburg Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Show the prices of 63 common services

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) In the file: Lc New Patient Visit Level 3	$161	$128.80	$50 – $771.11
New patient office visit (about 30–44 minutes): 10 of 39 insurance plan rates Aetna — All_Plans: $147.32 Aetna_Advantra_Medicare — All_Plans: $135.93 Aetna_Better_Health_Kids — All_Plans: $136 Aetna_Medicare — All_Plans: $135.93 Amerihealth_Caritas_Medicaid — All_Plans: $77.04 Amerihealth_Medicare — All_Plans: $139.23 Blue_Cross_BlueJourney_Medicare — All_Plans: $131.97 Devoted_Medicare — All_Plans: $138.57 First_Health_Network — All_Plans: $147.32 Geisinger — All_Plans: $152.95
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) In the file: Lc New Patient Visit Level 3	$161	$128.80	$90.34 – $152.95
New patient office visit (about 30–44 minutes): 10 of 11 insurance plan rates Aetna — All_Plans: $145.54 Blue_Cross — All_Other_Plans: $129.11 Blue_Cross — Capital_Blue_Performance_PPO: $90.34 Blue_Cross — Capital_Cares_4_kids: $90.37 Cigna — All_Plans: $144.82 First_Health_Network — All_Plans: $147.15 Geisinger — All_Plans: $152.95 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $149.73 PHC — All_Plans: $128.80 UPMC — Employees_And_Dependents: $128.80
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: New Outpatient Visit Level 4 or Over 45 Minutes	$334	$267.20	$50 – $771.11
New patient office visit (about 45–59 minutes): 10 of 39 insurance plan rates Aetna — All_Plans: $305.61 Aetna_Advantra_Medicare — All_Plans: $135.93 Aetna_Better_Health_Kids — All_Plans: $136 Aetna_Medicare — All_Plans: $135.93 Amerihealth_Caritas_Medicaid — All_Plans: $128.33 Amerihealth_Medicare — All_Plans: $139.23 Blue_Cross_BlueJourney_Medicare — All_Plans: $131.97 Devoted_Medicare — All_Plans: $138.57 First_Health_Network — All_Plans: $305.61 Geisinger — All_Plans: $317.30
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) In the file: New Outpatient Visit Level 4 or Over 45 Minutes	$334	$267.20	$187.41 – $317.30
New patient office visit (about 45–59 minutes): 10 of 11 insurance plan rates Aetna — All_Plans: $301.94 Blue_Cross — All_Other_Plans: $267.83 Blue_Cross — Capital_Blue_Performance_PPO: $187.41 Blue_Cross — Capital_Cares_4_kids: $187.47 Cigna — All_Plans: $300.43 First_Health_Network — All_Plans: $305.28 Geisinger — All_Plans: $317.30 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $310.62 PHC — All_Plans: $267.20 UPMC — Employees_And_Dependents: $267.20
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: New Outpatient Visit Level 5 or Over 60 Minutes	$398	$318.40	$50 – $771.11
New patient office visit (about 60–74 minutes): 10 of 38 insurance plan rates Aetna — All_Plans: $364.17 Aetna_Advantra_Medicare — All_Plans: $135.93 Aetna_Better_Health_Kids — All_Plans: $136 Aetna_Medicare — All_Plans: $135.93 Amerihealth_Medicare — All_Plans: $139.23 Blue_Cross_BlueJourney_Medicare — All_Plans: $131.97 Devoted_Medicare — All_Plans: $138.57 First_Health_Network — All_Plans: $364.17 Geisinger — All_Plans: $378.10 Geisinger_Gold_Medicare — All_Plans: $138.57
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) In the file: New Outpatient Visit Level 5 or Over 60 Minutes	$398	$318.40	$223.32 – $378.10
New patient office visit (about 60–74 minutes): 10 of 11 insurance plan rates Aetna — All_Plans: $359.79 Blue_Cross — All_Other_Plans: $319.16 Blue_Cross — Capital_Blue_Performance_PPO: $223.32 Blue_Cross — Capital_Cares_4_kids: $223.40 Cigna — All_Plans: $358 First_Health_Network — All_Plans: $363.77 Geisinger — All_Plans: $378.10 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $370.14 PHC — All_Plans: $318.40 UPMC — Employees_And_Dependents: $318.40
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Est Outpatient Visit Level 3 or Over 20 Minutes	$142	$113.60	$50 – $771.11
Established patient office visit (about 20–29 minutes): 10 of 39 insurance plan rates Aetna — All_Plans: $129.93 Aetna_Advantra_Medicare — All_Plans: $135.93 Aetna_Better_Health_Kids — All_Plans: $136 Aetna_Medicare — All_Plans: $135.93 Amerihealth_Caritas_Medicaid — All_Plans: $56.80 Amerihealth_Medicare — All_Plans: $139.23 Blue_Cross_BlueJourney_Medicare — All_Plans: $131.97 Devoted_Medicare — All_Plans: $138.57 First_Health_Network — All_Plans: $129.93 Geisinger — All_Plans: $134.90
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Maternity Triage 3-5 Hrs	$841	$672.80	$50 – $798.95
Established patient office visit (about 20–29 minutes): 10 of 39 insurance plan rates Aetna — All_Plans: $769.52 Aetna_Advantra_Medicare — All_Plans: $135.93 Aetna_Better_Health_Kids — All_Plans: $136 Aetna_Medicare — All_Plans: $135.93 Amerihealth_Caritas_Medicaid — All_Plans: $56.80 Amerihealth_Medicare — All_Plans: $139.23 Blue_Cross_BlueJourney_Medicare — All_Plans: $131.97 Devoted_Medicare — All_Plans: $138.57 First_Health_Network — All_Plans: $769.52 Geisinger — All_Plans: $798.95
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Lc Est Patient Visit Level 3	$153	$122.40	$50 – $771.11
Established patient office visit (about 20–29 minutes): 10 of 39 insurance plan rates Aetna — All_Plans: $140 Aetna_Advantra_Medicare — All_Plans: $135.93 Aetna_Better_Health_Kids — All_Plans: $136 Aetna_Medicare — All_Plans: $135.93 Amerihealth_Caritas_Medicaid — All_Plans: $56.80 Amerihealth_Medicare — All_Plans: $139.23 Blue_Cross_BlueJourney_Medicare — All_Plans: $131.97 Devoted_Medicare — All_Plans: $138.57 First_Health_Network — All_Plans: $140 Geisinger — All_Plans: $145.35
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Est Outpatient Visit Level 4 or Over 30 Minutes	$210	$168	$50 – $771.11
Established patient office visit (about 30–39 minutes): 10 of 39 insurance plan rates Aetna — All_Plans: $192.15 Aetna_Advantra_Medicare — All_Plans: $135.93 Aetna_Better_Health_Kids — All_Plans: $136 Aetna_Medicare — All_Plans: $135.93 Amerihealth_Caritas_Medicaid — All_Plans: $77.28 Amerihealth_Medicare — All_Plans: $139.23 Blue_Cross_BlueJourney_Medicare — All_Plans: $131.97 Devoted_Medicare — All_Plans: $138.57 First_Health_Network — All_Plans: $192.15 Geisinger — All_Plans: $199.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Maternity Triage 5-7 Hrs	$962	$769.60	$50 – $913.90
Established patient office visit (about 30–39 minutes): 10 of 39 insurance plan rates Aetna — All_Plans: $880.23 Aetna_Advantra_Medicare — All_Plans: $135.93 Aetna_Better_Health_Kids — All_Plans: $136 Aetna_Medicare — All_Plans: $135.93 Amerihealth_Caritas_Medicaid — All_Plans: $77.28 Amerihealth_Medicare — All_Plans: $139.23 Blue_Cross_BlueJourney_Medicare — All_Plans: $131.97 Devoted_Medicare — All_Plans: $138.57 First_Health_Network — All_Plans: $880.23 Geisinger — All_Plans: $913.90
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Lc Est Patient Visit Level 4	$230	$184	$50 – $771.11
Established patient office visit (about 30–39 minutes): 10 of 39 insurance plan rates Aetna — All_Plans: $210.45 Aetna_Advantra_Medicare — All_Plans: $135.93 Aetna_Better_Health_Kids — All_Plans: $136 Aetna_Medicare — All_Plans: $135.93 Amerihealth_Caritas_Medicaid — All_Plans: $77.28 Amerihealth_Medicare — All_Plans: $139.23 Blue_Cross_BlueJourney_Medicare — All_Plans: $131.97 Devoted_Medicare — All_Plans: $138.57 First_Health_Network — All_Plans: $210.45 Geisinger — All_Plans: $218.50
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency Department Visit for Problem of Moderate Severity	$2,176	$1,740.80	$98.75 – $3,100
Emergency room visit (moderate): 10 of 43 insurance plan rates Aetna — All_Plans: $1,991.04 Aetna_Advantra_Medicare — All_Plans: $292.06 Aetna_Better_Health_Kids — All_Plans: $268.60 Aetna_Medicare — All_Plans: $292.06 Amerihealth_Caritas_Medicaid — All_Plans: $200 Amerihealth_Medicare — All_Plans: $299.15 Blue_Cross — All_Other_Plans: $1,881.59 Blue_Cross — Capital_Blue_Performance_PPO: $1,471.63 Blue_Cross — Capital_Cares_4_kids: $1,317.11 Blue_Cross_BlueJourney_Medicare — All_Plans: $283.55
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) In the file: Emergency Department Visit for Problem of Moderate Severity	$2,176	$1,740.80	$1,220.95 – $2,067.20
Emergency room visit (moderate): 10 of 11 insurance plan rates Aetna — All_Plans: $1,967.10 Blue_Cross — All_Other_Plans: $1,744.93 Blue_Cross — Capital_Blue_Performance_PPO: $1,220.95 Blue_Cross — Capital_Cares_4_kids: $1,221.39 Cigna — All_Plans: $1,957.31 First_Health_Network — All_Plans: $1,988.86 Geisinger — All_Plans: $2,067.20 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $2,023.68 PHC — All_Plans: $1,740.80 UPMC — Employees_And_Dependents: $1,740.80
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency Department Visit for Problem of High Severity	$3,348	$2,678.40	$153.75 – $3,180.60
Emergency room visit (moderately high): 10 of 43 insurance plan rates Aetna — All_Plans: $3,063.42 Aetna_Advantra_Medicare — All_Plans: $449.15 Aetna_Better_Health_Kids — All_Plans: $418.20 Aetna_Medicare — All_Plans: $449.15 Amerihealth_Caritas_Medicaid — All_Plans: $200 Amerihealth_Medicare — All_Plans: $460.05 Blue_Cross — All_Other_Plans: $2,895.02 Blue_Cross — Capital_Blue_Performance_PPO: $2,264.25 Blue_Cross — Capital_Cares_4_kids: $2,026.51 Blue_Cross_BlueJourney_Medicare — All_Plans: $436.07
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) In the file: Emergency Department Visit for Problem of High Severity	$3,348	$2,678.40	$1,878.56 – $3,180.60
Emergency room visit (moderately high): 10 of 11 insurance plan rates Aetna — All_Plans: $3,026.59 Blue_Cross — All_Other_Plans: $2,684.76 Blue_Cross — Capital_Blue_Performance_PPO: $1,878.56 Blue_Cross — Capital_Cares_4_kids: $1,879.23 Cigna — All_Plans: $3,011.53 First_Health_Network — All_Plans: $3,060.07 Geisinger — All_Plans: $3,180.60 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $3,113.64 PHC — All_Plans: $2,678.40 UPMC — Employees_And_Dependents: $2,678.40
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency Department Visit for Life Threatening or Functioning Severity	$3,727	$2,981.60	$200 – $3,668.59
Emergency room visit (high): 10 of 43 insurance plan rates Aetna — All_Plans: $3,410.21 Aetna_Advantra_Medicare — All_Plans: $646.69 Aetna_Better_Health_Kids — All_Plans: $656.20 Aetna_Medicare — All_Plans: $646.69 Amerihealth_Caritas_Medicaid — All_Plans: $200 Amerihealth_Medicare — All_Plans: $662.38 Blue_Cross — All_Other_Plans: $3,222.74 Blue_Cross — Capital_Blue_Performance_PPO: $2,520.57 Blue_Cross — Capital_Cares_4_kids: $2,255.92 Blue_Cross_BlueJourney_Medicare — All_Plans: $627.85
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) In the file: Emergency Department Visit for Life Threatening or Functioning Severity	$3,727	$2,981.60	$2,091.22 – $3,540.65
Emergency room visit (high): 10 of 11 insurance plan rates Aetna — All_Plans: $3,369.21 Blue_Cross — All_Other_Plans: $2,988.68 Blue_Cross — Capital_Blue_Performance_PPO: $2,091.22 Blue_Cross — Capital_Cares_4_kids: $2,091.97 Cigna — All_Plans: $3,352.44 First_Health_Network — All_Plans: $3,406.48 Geisinger — All_Plans: $3,540.65 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $3,466.11 PHC — All_Plans: $2,981.60 UPMC — Employees_And_Dependents: $2,981.60

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Blood Test, Basic Group of Blood Chemicals (Calcium, Total)	$69	$20	$8.46 – $65.55
Basic metabolic panel (blood test): 10 of 43 insurance plan rates Aetna — All_Plans: $34.94 Aetna_Advantra_Medicare — All_Plans: $8.71 Aetna_Better_Health_Kids — All_Plans: $31.82 Aetna_Medicare — All_Plans: $8.71 Amerihealth_Caritas_Medicaid — All_Plans: $9.36 Amerihealth_Medicare — All_Plans: $8.93 Blue_Cross — All_Other_Plans: $59.66 Blue_Cross — Capital_Blue_Performance_PPO: $32.91 Blue_Cross — Capital_Cares_4_kids: $41.77 Blue_Cross_BlueJourney_Medicare — All_Plans: $8.46
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) In the file: Blood Test, Basic Group of Blood Chemicals (Calcium, Total)	$69	$20	$38.72 – $65.55
Basic metabolic panel (blood test): 10 of 11 insurance plan rates Aetna — All_Plans: $62.38 Blue_Cross — All_Other_Plans: $55.33 Blue_Cross — Capital_Blue_Performance_PPO: $38.72 Blue_Cross — Capital_Cares_4_kids: $38.73 Cigna — All_Plans: $62.07 First_Health_Network — All_Plans: $63.07 Geisinger — All_Plans: $65.55 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $64.17 PHC — All_Plans: $55.20 UPMC — Employees_And_Dependents: $55.20
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Blood Test, Comprehensive Group of Blood Chemicals	$88	$25	$10.56 – $83.60
Comprehensive metabolic panel (blood test): 10 of 43 insurance plan rates Aetna — All_Plans: $43.61 Aetna_Advantra_Medicare — All_Plans: $10.88 Aetna_Better_Health_Kids — All_Plans: $39.75 Aetna_Medicare — All_Plans: $10.88 Amerihealth_Caritas_Medicaid — All_Plans: $11.69 Amerihealth_Medicare — All_Plans: $11.14 Blue_Cross — All_Other_Plans: $76.09 Blue_Cross — Capital_Blue_Performance_PPO: $41.97 Blue_Cross — Capital_Cares_4_kids: $53.27 Blue_Cross_BlueJourney_Medicare — All_Plans: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) In the file: Blood Test, Comprehensive Group of Blood Chemicals	$88	$25	$49.38 – $83.60
Comprehensive metabolic panel (blood test): 10 of 11 insurance plan rates Aetna — All_Plans: $79.55 Blue_Cross — All_Other_Plans: $70.57 Blue_Cross — Capital_Blue_Performance_PPO: $49.38 Blue_Cross — Capital_Cares_4_kids: $49.39 Cigna — All_Plans: $79.16 First_Health_Network — All_Plans: $80.43 Geisinger — All_Plans: $83.60 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $81.84 PHC — All_Plans: $70.40 UPMC — Employees_And_Dependents: $70.40
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric Blood Test Panel	$249	$190	$12 – $279.36
Obstetric blood test panel: 10 of 43 insurance plan rates Aetna — All_Plans: $197.46 Aetna_Advantra_Medicare — All_Plans: $49.24 Aetna_Better_Health_Kids — All_Plans: $40.80 Aetna_Medicare — All_Plans: $49.24 Amerihealth_Caritas_Medicaid — All_Plans: $12 Amerihealth_Medicare — All_Plans: $50.44 Blue_Cross — All_Other_Plans: $215.31 Blue_Cross — Capital_Blue_Performance_PPO: $118.75 Blue_Cross — Capital_Cares_4_kids: $150.72 Blue_Cross_BlueJourney_Medicare — All_Plans: $47.81
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) In the file: Obstetric Blood Test Panel	$249	$190	$139.71 – $236.55
Obstetric blood test panel: 10 of 11 insurance plan rates Aetna — All_Plans: $225.10 Blue_Cross — All_Other_Plans: $199.67 Blue_Cross — Capital_Blue_Performance_PPO: $139.71 Blue_Cross — Capital_Cares_4_kids: $139.76 Cigna — All_Plans: $223.98 First_Health_Network — All_Plans: $227.59 Geisinger — All_Plans: $236.55 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $231.57 PHC — All_Plans: $199.20 UPMC — Employees_And_Dependents: $199.20
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Blood Test, Lipids (Cholesterol and Triglycerides)	$100	$40	$13.39 – $95
Cholesterol panel (lipid panel): 10 of 43 insurance plan rates Aetna — All_Plans: $55.30 Aetna_Advantra_Medicare — All_Plans: $13.79 Aetna_Better_Health_Kids — All_Plans: $47.60 Aetna_Medicare — All_Plans: $13.79 Amerihealth_Caritas_Medicaid — All_Plans: $14 Amerihealth_Medicare — All_Plans: $14.13 Blue_Cross — All_Other_Plans: $86.47 Blue_Cross — Capital_Blue_Performance_PPO: $47.69 Blue_Cross — Capital_Cares_4_kids: $60.53 Blue_Cross_BlueJourney_Medicare — All_Plans: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: Blood Test, Lipids (Cholesterol and Triglycerides)	$100	$40	$56.11 – $95
Cholesterol panel (lipid panel): 10 of 11 insurance plan rates Aetna — All_Plans: $90.40 Blue_Cross — All_Other_Plans: $80.19 Blue_Cross — Capital_Blue_Performance_PPO: $56.11 Blue_Cross — Capital_Cares_4_kids: $56.13 Cigna — All_Plans: $89.95 First_Health_Network — All_Plans: $91.40 Geisinger — All_Plans: $95 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $93 PHC — All_Plans: $80 UPMC — Employees_And_Dependents: $80
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Kidney Function Blood Test Panel	$45	$36	$8.68 – $50.72
Kidney function panel: 10 of 43 insurance plan rates Aetna — All_Plans: $35.85 Aetna_Advantra_Medicare — All_Plans: $8.94 Aetna_Better_Health_Kids — All_Plans: $32.64 Aetna_Medicare — All_Plans: $8.94 Amerihealth_Caritas_Medicaid — All_Plans: $9.60 Amerihealth_Medicare — All_Plans: $9.16 Blue_Cross — All_Other_Plans: $38.91 Blue_Cross — Capital_Blue_Performance_PPO: $21.46 Blue_Cross — Capital_Cares_4_kids: $27.24 Blue_Cross_BlueJourney_Medicare — All_Plans: $8.68
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: Kidney Function Blood Test Panel	$45	$36	$25.25 – $42.75
Kidney function panel: 10 of 11 insurance plan rates Aetna — All_Plans: $40.68 Blue_Cross — All_Other_Plans: $36.09 Blue_Cross — Capital_Blue_Performance_PPO: $25.25 Blue_Cross — Capital_Cares_4_kids: $25.26 Cigna — All_Plans: $40.48 First_Health_Network — All_Plans: $41.13 Geisinger — All_Plans: $42.75 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $41.85 PHC — All_Plans: $36 UPMC — Employees_And_Dependents: $36
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Liver Function Blood Test Panel	$42	$25	$8.17 – $47.74
Liver function panel: 10 of 43 insurance plan rates Aetna — All_Plans: $33.74 Aetna_Advantra_Medicare — All_Plans: $8.42 Aetna_Better_Health_Kids — All_Plans: $30.70 Aetna_Medicare — All_Plans: $8.42 Amerihealth_Caritas_Medicaid — All_Plans: $9.03 Amerihealth_Medicare — All_Plans: $8.62 Blue_Cross — All_Other_Plans: $36.32 Blue_Cross — Capital_Blue_Performance_PPO: $20.03 Blue_Cross — Capital_Cares_4_kids: $25.42 Blue_Cross_BlueJourney_Medicare — All_Plans: $8.17
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: Liver Function Blood Test Panel	$42	$25	$23.57 – $39.90
Liver function panel: 10 of 11 insurance plan rates Aetna — All_Plans: $37.97 Blue_Cross — All_Other_Plans: $33.68 Blue_Cross — Capital_Blue_Performance_PPO: $23.57 Blue_Cross — Capital_Cares_4_kids: $23.57 Cigna — All_Plans: $37.78 First_Health_Network — All_Plans: $38.39 Geisinger — All_Plans: $39.90 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $39.06 PHC — All_Plans: $33.60 UPMC — Employees_And_Dependents: $33.60
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Manual Urinalysis Test With Examination Using Microscope, Automated	$20	$10	$3 – $19
Urine test (automated, with microscope): 10 of 43 insurance plan rates Aetna — All_Plans: $13.09 Aetna_Advantra_Medicare — All_Plans: $3.27 Aetna_Better_Health_Kids — All_Plans: $10.20 Aetna_Medicare — All_Plans: $3.27 Amerihealth_Caritas_Medicaid — All_Plans: $3 Amerihealth_Medicare — All_Plans: $3.34 Blue_Cross — All_Other_Plans: $17.29 Blue_Cross — Capital_Blue_Performance_PPO: $9.54 Blue_Cross — Capital_Cares_4_kids: $12.11 Blue_Cross_BlueJourney_Medicare — All_Plans: $3.17
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) In the file: Manual Urinalysis Test With Examination Using Microscope, Automated	$20	$10	$11.22 – $19
Urine test (automated, with microscope): 10 of 11 insurance plan rates Aetna — All_Plans: $18.08 Blue_Cross — All_Other_Plans: $16.04 Blue_Cross — Capital_Blue_Performance_PPO: $11.22 Blue_Cross — Capital_Cares_4_kids: $11.23 Cigna — All_Plans: $17.99 First_Health_Network — All_Plans: $18.28 Geisinger — All_Plans: $19 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $18.60 PHC — All_Plans: $16 UPMC — Employees_And_Dependents: $16
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis, Manual Test	$17	$13.60	$3.48 – $20.33
Urine test (manual, without microscope): 10 of 43 insurance plan rates Aetna — All_Plans: $14.37 Aetna_Advantra_Medicare — All_Plans: $3.58 Aetna_Better_Health_Kids — All_Plans: $12.14 Aetna_Medicare — All_Plans: $3.58 Amerihealth_Caritas_Medicaid — All_Plans: $3.57 Amerihealth_Medicare — All_Plans: $3.67 Blue_Cross — All_Other_Plans: $14.70 Blue_Cross — Capital_Blue_Performance_PPO: $8.11 Blue_Cross — Capital_Cares_4_kids: $10.29 Blue_Cross_BlueJourney_Medicare — All_Plans: $3.48
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) In the file: Urinalysis, Manual Test	$17	$13.60	$9.54 – $16.15
Urine test (manual, without microscope): 10 of 11 insurance plan rates Aetna — All_Plans: $15.37 Blue_Cross — All_Other_Plans: $13.63 Blue_Cross — Capital_Blue_Performance_PPO: $9.54 Blue_Cross — Capital_Cares_4_kids: $9.54 Cigna — All_Plans: $15.29 First_Health_Network — All_Plans: $15.54 Geisinger — All_Plans: $16.15 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $15.81 PHC — All_Plans: $13.60 UPMC — Employees_And_Dependents: $13.60
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Automated Urinalysis Test	$11	$10	$2.25 – $13.15
Urine test (automated, without microscope): 10 of 43 insurance plan rates Aetna — All_Plans: $9.29 Aetna_Advantra_Medicare — All_Plans: $2.32 Aetna_Better_Health_Kids — All_Plans: $10.54 Aetna_Medicare — All_Plans: $2.32 Amerihealth_Caritas_Medicaid — All_Plans: $3.10 Amerihealth_Medicare — All_Plans: $2.37 Blue_Cross — All_Other_Plans: $9.51 Blue_Cross — Capital_Blue_Performance_PPO: $5.25 Blue_Cross — Capital_Cares_4_kids: $6.66 Blue_Cross_BlueJourney_Medicare — All_Plans: $2.25
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) In the file: Automated Urinalysis Test	$11	$10	$6.17 – $10.45
Urine test (automated, without microscope): 10 of 11 insurance plan rates Aetna — All_Plans: $9.94 Blue_Cross — All_Other_Plans: $8.82 Blue_Cross — Capital_Blue_Performance_PPO: $6.17 Blue_Cross — Capital_Cares_4_kids: $6.17 Cigna — All_Plans: $9.89 First_Health_Network — All_Plans: $10.05 Geisinger — All_Plans: $10.45 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $10.23 PHC — All_Plans: $8.80 UPMC — Employees_And_Dependents: $8.80
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Psa (Prostate Specific Antigen) Measurement, Total	$96	$45	$18.39 – $107.45
PSA (prostate specific antigen) blood test: 10 of 43 insurance plan rates Aetna — All_Plans: $75.95 Aetna_Advantra_Medicare — All_Plans: $18.94 Aetna_Better_Health_Kids — All_Plans: $82.82 Aetna_Medicare — All_Plans: $18.94 Amerihealth_Caritas_Medicaid — All_Plans: $24.36 Amerihealth_Medicare — All_Plans: $19.40 Blue_Cross — All_Other_Plans: $83.01 Blue_Cross — Capital_Blue_Performance_PPO: $45.78 Blue_Cross — Capital_Cares_4_kids: $58.11 Blue_Cross_BlueJourney_Medicare — All_Plans: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) In the file: Psa (Prostate Specific Antigen) Measurement, Total	$96	$45	$53.87 – $91.20
PSA (prostate specific antigen) blood test: 10 of 11 insurance plan rates Aetna — All_Plans: $86.78 Blue_Cross — All_Other_Plans: $76.98 Blue_Cross — Capital_Blue_Performance_PPO: $53.87 Blue_Cross — Capital_Cares_4_kids: $53.88 Cigna — All_Plans: $86.35 First_Health_Network — All_Plans: $87.74 Geisinger — All_Plans: $91.20 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $89.28 PHC — All_Plans: $76.80 UPMC — Employees_And_Dependents: $76.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Blood Test, Thyroid Stimulating Hormone (Tsh)	$112	$40	$16.80 – $106.40
Thyroid stimulating hormone (TSH) test: 10 of 43 insurance plan rates Aetna — All_Plans: $69.38 Aetna_Advantra_Medicare — All_Plans: $17.30 Aetna_Better_Health_Kids — All_Plans: $78.91 Aetna_Medicare — All_Plans: $17.30 Amerihealth_Caritas_Medicaid — All_Plans: $23.21 Amerihealth_Medicare — All_Plans: $17.72 Blue_Cross — All_Other_Plans: $96.85 Blue_Cross — Capital_Blue_Performance_PPO: $53.41 Blue_Cross — Capital_Cares_4_kids: $67.79 Blue_Cross_BlueJourney_Medicare — All_Plans: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) In the file: Blood Test, Thyroid Stimulating Hormone (Tsh)	$112	$40	$62.84 – $106.40
Thyroid stimulating hormone (TSH) test: 10 of 11 insurance plan rates Aetna — All_Plans: $101.25 Blue_Cross — All_Other_Plans: $89.81 Blue_Cross — Capital_Blue_Performance_PPO: $62.84 Blue_Cross — Capital_Cares_4_kids: $62.87 Cigna — All_Plans: $100.74 First_Health_Network — All_Plans: $102.37 Geisinger — All_Plans: $106.40 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $104.16 PHC — All_Plans: $89.60 UPMC — Employees_And_Dependents: $89.60
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Complete Blood Cell Count, With Diff	$55	$15	$6 – $52.25
Complete blood count (CBC) with differential: 10 of 43 insurance plan rates Aetna — All_Plans: $32.09 Aetna_Advantra_Medicare — All_Plans: $8 Aetna_Better_Health_Kids — All_Plans: $20.40 Aetna_Medicare — All_Plans: $8 Amerihealth_Caritas_Medicaid — All_Plans: $6 Amerihealth_Medicare — All_Plans: $8.20 Blue_Cross — All_Other_Plans: $47.56 Blue_Cross — Capital_Blue_Performance_PPO: $26.23 Blue_Cross — Capital_Cares_4_kids: $33.29 Blue_Cross_BlueJourney_Medicare — All_Plans: $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) In the file: Complete Blood Cell Count, With Diff	$55	$15	$30.86 – $52.25
Complete blood count (CBC) with differential: 10 of 11 insurance plan rates Aetna — All_Plans: $49.72 Blue_Cross — All_Other_Plans: $44.10 Blue_Cross — Capital_Blue_Performance_PPO: $30.86 Blue_Cross — Capital_Cares_4_kids: $30.87 Cigna — All_Plans: $49.47 First_Health_Network — All_Plans: $50.27 Geisinger — All_Plans: $52.25 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $51.15 PHC — All_Plans: $44 UPMC — Employees_And_Dependents: $44
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Complete Blood Cell Count, W/O Diff	$45	$15	$6.47 – $42.75
Complete blood count (CBC), automated: 10 of 43 insurance plan rates Aetna — All_Plans: $26.72 Aetna_Advantra_Medicare — All_Plans: $6.66 Aetna_Better_Health_Kids — All_Plans: $25.57 Aetna_Medicare — All_Plans: $6.66 Amerihealth_Caritas_Medicaid — All_Plans: $7.52 Amerihealth_Medicare — All_Plans: $6.83 Blue_Cross — All_Other_Plans: $38.91 Blue_Cross — Capital_Blue_Performance_PPO: $21.46 Blue_Cross — Capital_Cares_4_kids: $27.24 Blue_Cross_BlueJourney_Medicare — All_Plans: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) In the file: Complete Blood Cell Count, W/O Diff	$45	$15	$25.25 – $42.75
Complete blood count (CBC), automated: 10 of 11 insurance plan rates Aetna — All_Plans: $40.68 Blue_Cross — All_Other_Plans: $36.09 Blue_Cross — Capital_Blue_Performance_PPO: $25.25 Blue_Cross — Capital_Cares_4_kids: $25.26 Cigna — All_Plans: $40.48 First_Health_Network — All_Plans: $41.13 Geisinger — All_Plans: $42.75 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $41.85 PHC — All_Plans: $36 UPMC — Employees_And_Dependents: $36
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Blood Test, Clotting Time	$34	$15	$4 – $32.30
Blood clotting time test (prothrombin time, PT): 10 of 43 insurance plan rates Aetna — All_Plans: $17.72 Aetna_Advantra_Medicare — All_Plans: $4.42 Aetna_Better_Health_Kids — All_Plans: $13.60 Aetna_Medicare — All_Plans: $4.42 Amerihealth_Caritas_Medicaid — All_Plans: $4 Amerihealth_Medicare — All_Plans: $4.53 Blue_Cross — All_Other_Plans: $29.40 Blue_Cross — Capital_Blue_Performance_PPO: $16.21 Blue_Cross — Capital_Cares_4_kids: $20.58 Blue_Cross_BlueJourney_Medicare — All_Plans: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) In the file: Blood Test, Clotting Time	$34	$15	$19.08 – $32.30
Blood clotting time test (prothrombin time, PT): 10 of 11 insurance plan rates Aetna — All_Plans: $30.74 Blue_Cross — All_Other_Plans: $27.26 Blue_Cross — Capital_Blue_Performance_PPO: $19.08 Blue_Cross — Capital_Cares_4_kids: $19.08 Cigna — All_Plans: $30.58 First_Health_Network — All_Plans: $31.08 Geisinger — All_Plans: $32.30 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $31.62 PHC — All_Plans: $27.20 UPMC — Employees_And_Dependents: $27.20
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Coagulation Assessment Blood Test, Plasma or Whole Blood	$40	$30	$6.01 – $38
Blood clotting test (partial thromboplastin time, PTT): 10 of 43 insurance plan rates Aetna — All_Plans: $24.82 Aetna_Advantra_Medicare — All_Plans: $6.19 Aetna_Better_Health_Kids — All_Plans: $25.50 Aetna_Medicare — All_Plans: $6.19 Amerihealth_Caritas_Medicaid — All_Plans: $7.50 Amerihealth_Medicare — All_Plans: $6.34 Blue_Cross — All_Other_Plans: $34.59 Blue_Cross — Capital_Blue_Performance_PPO: $19.08 Blue_Cross — Capital_Cares_4_kids: $24.21 Blue_Cross_BlueJourney_Medicare — All_Plans: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) In the file: Coagulation Assessment Blood Test, Plasma or Whole Blood	$40	$30	$22.44 – $38
Blood clotting test (partial thromboplastin time, PTT): 10 of 11 insurance plan rates Aetna — All_Plans: $36.16 Blue_Cross — All_Other_Plans: $32.08 Blue_Cross — Capital_Blue_Performance_PPO: $22.44 Blue_Cross — Capital_Cares_4_kids: $22.45 Cigna — All_Plans: $35.98 First_Health_Network — All_Plans: $36.56 Geisinger — All_Plans: $38 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $37.20 PHC — All_Plans: $32 UPMC — Employees_And_Dependents: $32

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) In the file: CT Scan Head or Brain Without Contrast	$1,462	$296	$96.88 – $1,388.90
CT scan of the head or brain, without contrast: 10 of 43 insurance plan rates Aetna — All_Plans: $1,337.73 Aetna_Advantra_Medicare — All_Plans: $112.17 Aetna_Better_Health_Kids — All_Plans: $396.95 Aetna_Medicare — All_Plans: $112.17 Amerihealth_Caritas_Medicaid — All_Plans: $165.79 Amerihealth_Medicare — All_Plans: $114.89 Blue_Cross — All_Other_Plans: $1,264.19 Blue_Cross — Capital_Blue_Performance_PPO: $230 Blue_Cross — Capital_Cares_4_kids: $884.93 Blue_Cross_BlueJourney_Medicare — All_Plans: $108.90
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) In the file: CT Scan Head or Brain Without Contrast	$1,462	$296	$820.33 – $1,388.90
CT scan of the head or brain, without contrast: 10 of 11 insurance plan rates Aetna — All_Plans: $1,321.65 Blue_Cross — All_Other_Plans: $1,172.38 Blue_Cross — Capital_Blue_Performance_PPO: $820.33 Blue_Cross — Capital_Cares_4_kids: $820.62 Cigna — All_Plans: $1,315.07 First_Health_Network — All_Plans: $1,336.27 Geisinger — All_Plans: $1,388.90 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $1,359.66 PHC — All_Plans: $1,169.60 UPMC — Employees_And_Dependents: $1,169.60
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI Scan of Brain Before and After Contrast	$2,646	$701.50	$336.25 – $2,513.70
MRI of the brain, before and after contrast: 10 of 43 insurance plan rates Aetna — All_Plans: $2,421.09 Aetna_Advantra_Medicare — All_Plans: $376.69 Aetna_Better_Health_Kids — All_Plans: $1,152.60 Aetna_Medicare — All_Plans: $376.69 Amerihealth_Caritas_Medicaid — All_Plans: $481.38 Amerihealth_Medicare — All_Plans: $385.83 Blue_Cross — All_Other_Plans: $2,288 Blue_Cross — Capital_Blue_Performance_PPO: $718 Blue_Cross — Capital_Cares_4_kids: $1,601.60 Blue_Cross_BlueJourney_Medicare — All_Plans: $365.72
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) In the file: MRI Scan of Brain Before and After Contrast	$2,646	$701.50	$1,484.67 – $2,513.70
MRI of the brain, before and after contrast: 10 of 11 insurance plan rates Aetna — All_Plans: $2,391.98 Blue_Cross — All_Other_Plans: $2,121.83 Blue_Cross — Capital_Blue_Performance_PPO: $1,484.67 Blue_Cross — Capital_Cares_4_kids: $1,485.20 Cigna — All_Plans: $2,380.08 First_Health_Network — All_Plans: $2,418.44 Geisinger — All_Plans: $2,513.70 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $2,460.78 PHC — All_Plans: $2,116.80 UPMC — Employees_And_Dependents: $2,116.80
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: X-Ray of Chest, 2 Views	$403	$322.40	$18.57 – $526.87
Chest X-ray, 2 views: 10 of 43 insurance plan rates Aetna — All_Plans: $368.75 Aetna_Advantra_Medicare — All_Plans: $92.88 Aetna_Better_Health_Kids — All_Plans: $80.38 Aetna_Medicare — All_Plans: $92.88 Amerihealth_Caritas_Medicaid — All_Plans: $33.57 Amerihealth_Medicare — All_Plans: $95.13 Blue_Cross — All_Other_Plans: $348.47 Blue_Cross — Capital_Blue_Performance_PPO: $192.19 Blue_Cross — Capital_Cares_4_kids: $243.93 Blue_Cross_BlueJourney_Medicare — All_Plans: $90.17
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) In the file: X-Ray of Chest, 2 Views	$403	$322.40	$226.12 – $382.85
Chest X-ray, 2 views: 10 of 11 insurance plan rates Aetna — All_Plans: $364.31 Blue_Cross — All_Other_Plans: $323.17 Blue_Cross — Capital_Blue_Performance_PPO: $226.12 Blue_Cross — Capital_Cares_4_kids: $226.20 Cigna — All_Plans: $362.50 First_Health_Network — All_Plans: $368.34 Geisinger — All_Plans: $382.85 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $374.79 PHC — All_Plans: $322.40 UPMC — Employees_And_Dependents: $322.40
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: X-Ray of Lower and Sacral Spine, Minimum of 4 Views	$658	$526.40	$28.13 – $636.31
X-ray of the lower spine, at least 4 views: 10 of 43 insurance plan rates Aetna — All_Plans: $602.07 Aetna_Advantra_Medicare — All_Plans: $112.17 Aetna_Better_Health_Kids — All_Plans: $124.51 Aetna_Medicare — All_Plans: $112.17 Amerihealth_Caritas_Medicaid — All_Plans: $52 Amerihealth_Medicare — All_Plans: $114.89 Blue_Cross — All_Other_Plans: $568.97 Blue_Cross — Capital_Blue_Performance_PPO: $313.80 Blue_Cross — Capital_Cares_4_kids: $398.28 Blue_Cross_BlueJourney_Medicare — All_Plans: $108.90
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) In the file: X-Ray of Lower and Sacral Spine, Minimum of 4 Views	$658	$526.40	$369.20 – $625.10
X-ray of the lower spine, at least 4 views: 10 of 11 insurance plan rates Aetna — All_Plans: $594.83 Blue_Cross — All_Other_Plans: $527.65 Blue_Cross — Capital_Blue_Performance_PPO: $369.20 Blue_Cross — Capital_Cares_4_kids: $369.34 Cigna — All_Plans: $591.87 First_Health_Network — All_Plans: $601.41 Geisinger — All_Plans: $625.10 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $611.94 PHC — All_Plans: $526.40 UPMC — Employees_And_Dependents: $526.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI Scan of Lower Spinal Canal Without Contrast	$2,225	$454	$234 – $2,113.75
MRI of the lower back (lumbar spine), without contrast: 10 of 43 insurance plan rates Aetna — All_Plans: $2,035.88 Aetna_Advantra_Medicare — All_Plans: $254.97 Aetna_Better_Health_Kids — All_Plans: $870.91 Aetna_Medicare — All_Plans: $254.97 Amerihealth_Caritas_Medicaid — All_Plans: $363.73 Amerihealth_Medicare — All_Plans: $261.15 Blue_Cross — All_Other_Plans: $1,923.96 Blue_Cross — Capital_Blue_Performance_PPO: $468 Blue_Cross — Capital_Cares_4_kids: $1,346.77 Blue_Cross_BlueJourney_Medicare — All_Plans: $247.54
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) In the file: MRI Scan of Lower Spinal Canal Without Contrast	$2,225	$454	$1,248.45 – $2,113.75
MRI of the lower back (lumbar spine), without contrast: 10 of 11 insurance plan rates Aetna — All_Plans: $2,011.40 Blue_Cross — All_Other_Plans: $1,784.23 Blue_Cross — Capital_Blue_Performance_PPO: $1,248.45 Blue_Cross — Capital_Cares_4_kids: $1,248.89 Cigna — All_Plans: $2,001.39 First_Health_Network — All_Plans: $2,033.65 Geisinger — All_Plans: $2,113.75 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $2,069.25 PHC — All_Plans: $1,780 UPMC — Employees_And_Dependents: $1,780
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT Scan of Pelvis With Contrast	$2,362	$475.50	$108.13 – $2,243.90
CT scan of the pelvis, with contrast: 10 of 43 insurance plan rates Aetna — All_Plans: $2,161.23 Aetna_Advantra_Medicare — All_Plans: $187.77 Aetna_Better_Health_Kids — All_Plans: $476.31 Aetna_Medicare — All_Plans: $187.77 Amerihealth_Caritas_Medicaid — All_Plans: $198.93 Amerihealth_Medicare — All_Plans: $192.33 Blue_Cross — All_Other_Plans: $2,042.42 Blue_Cross — Capital_Blue_Performance_PPO: $407 Blue_Cross — Capital_Cares_4_kids: $1,429.69 Blue_Cross_BlueJourney_Medicare — All_Plans: $182.30
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) In the file: CT Scan of Pelvis With Contrast	$2,362	$475.50	$1,325.32 – $2,243.90
CT scan of the pelvis, with contrast: 10 of 11 insurance plan rates Aetna — All_Plans: $2,135.25 Blue_Cross — All_Other_Plans: $1,894.09 Blue_Cross — Capital_Blue_Performance_PPO: $1,325.32 Blue_Cross — Capital_Cares_4_kids: $1,325.79 Cigna — All_Plans: $2,124.62 First_Health_Network — All_Plans: $2,158.87 Geisinger — All_Plans: $2,243.90 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $2,196.66 PHC — All_Plans: $1,889.60 UPMC — Employees_And_Dependents: $1,889.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI Scan of Leg Joint Without Contrast	$2,225	$462	$247.54 – $2,113.75
MRI of a leg joint (such as the knee), without contrast: 10 of 43 insurance plan rates Aetna — All_Plans: $2,035.88 Aetna_Advantra_Medicare — All_Plans: $254.97 Aetna_Better_Health_Kids — All_Plans: $1,126.73 Aetna_Medicare — All_Plans: $254.97 Amerihealth_Caritas_Medicaid — All_Plans: $470.57 Amerihealth_Medicare — All_Plans: $261.15 Blue_Cross — All_Other_Plans: $1,923.96 Blue_Cross — Capital_Blue_Performance_PPO: $468 Blue_Cross — Capital_Cares_4_kids: $1,346.77 Blue_Cross_BlueJourney_Medicare — All_Plans: $247.54
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) In the file: MRI Scan of Leg Joint Without Contrast	$2,225	$462	$1,248.45 – $2,113.75
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates Aetna — All_Plans: $2,011.40 Blue_Cross — All_Other_Plans: $1,784.23 Blue_Cross — Capital_Blue_Performance_PPO: $1,248.45 Blue_Cross — Capital_Cares_4_kids: $1,248.89 Cigna — All_Plans: $2,001.39 First_Health_Network — All_Plans: $2,033.65 Geisinger — All_Plans: $2,113.75 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $2,069.25 PHC — All_Plans: $1,780 UPMC — Employees_And_Dependents: $1,780
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT Scan of Abdomen and Pelvis With Contrast	$2,896	$437.50	$240.91 – $2,751.20
CT scan of the abdomen and pelvis, with contrast: 10 of 43 insurance plan rates Aetna — All_Plans: $2,649.84 Aetna_Advantra_Medicare — All_Plans: $376.69 Aetna_Better_Health_Kids — All_Plans: $894.74 Aetna_Medicare — All_Plans: $376.69 Amerihealth_Caritas_Medicaid — All_Plans: $373.69 Amerihealth_Medicare — All_Plans: $385.83 Blue_Cross — All_Other_Plans: $2,504.17 Blue_Cross — Capital_Blue_Performance_PPO: $407 Blue_Cross — Capital_Cares_4_kids: $1,752.92 Blue_Cross_BlueJourney_Medicare — All_Plans: $365.72
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) In the file: CT Scan of Abdomen and Pelvis With Contrast	$2,896	$437.50	$1,624.95 – $2,751.20
CT scan of the abdomen and pelvis, with contrast: 10 of 11 insurance plan rates Aetna — All_Plans: $2,617.98 Blue_Cross — All_Other_Plans: $2,322.30 Blue_Cross — Capital_Blue_Performance_PPO: $1,624.95 Blue_Cross — Capital_Cares_4_kids: $1,625.52 Cigna — All_Plans: $2,604.95 First_Health_Network — All_Plans: $2,646.94 Geisinger — All_Plans: $2,751.20 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $2,693.28 PHC — All_Plans: $2,316.80 UPMC — Employees_And_Dependents: $2,316.80
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Complete Ultrasound Scan of Abdomen	$1,590	$1,272	$71.88 – $1,510.50
Ultrasound of the abdomen, complete: 10 of 43 insurance plan rates Aetna — All_Plans: $1,454.85 Aetna_Advantra_Medicare — All_Plans: $112.17 Aetna_Better_Health_Kids — All_Plans: $323.92 Aetna_Medicare — All_Plans: $112.17 Amerihealth_Caritas_Medicaid — All_Plans: $135.28 Amerihealth_Medicare — All_Plans: $114.89 Blue_Cross — All_Other_Plans: $1,374.87 Blue_Cross — Capital_Blue_Performance_PPO: $758.27 Blue_Cross — Capital_Cares_4_kids: $962.41 Blue_Cross_BlueJourney_Medicare — All_Plans: $108.90
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) In the file: Complete Ultrasound Scan of Abdomen	$1,590	$1,272	$892.15 – $1,510.50
Ultrasound of the abdomen, complete: 10 of 11 insurance plan rates Aetna — All_Plans: $1,437.36 Blue_Cross — All_Other_Plans: $1,275.02 Blue_Cross — Capital_Blue_Performance_PPO: $892.15 Blue_Cross — Capital_Cares_4_kids: $892.47 Cigna — All_Plans: $1,430.21 First_Health_Network — All_Plans: $1,453.26 Geisinger — All_Plans: $1,510.50 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $1,478.70 PHC — All_Plans: $1,272 UPMC — Employees_And_Dependents: $1,272
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ultrasound Scan of Pregnant Uterus (14 Weeks or More), Single or 1st Fetus	$1,111	$888.80	$58.13 – $1,055.45
Pregnancy ultrasound (after the first trimester): 10 of 43 insurance plan rates Aetna — All_Plans: $1,016.57 Aetna_Advantra_Medicare — All_Plans: $112.17 Aetna_Better_Health_Kids — All_Plans: $263.50 Aetna_Medicare — All_Plans: $112.17 Amerihealth_Caritas_Medicaid — All_Plans: $110.05 Amerihealth_Medicare — All_Plans: $114.89 Blue_Cross — All_Other_Plans: $960.68 Blue_Cross — Capital_Blue_Performance_PPO: $529.84 Blue_Cross — Capital_Cares_4_kids: $672.48 Blue_Cross_BlueJourney_Medicare — All_Plans: $108.90
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) In the file: Ultrasound Scan of Pregnant Uterus (14 Weeks or More), Single or 1st Fetus	$1,111	$888.80	$623.38 – $1,055.45
Pregnancy ultrasound (after the first trimester): 10 of 11 insurance plan rates Aetna — All_Plans: $1,004.34 Blue_Cross — All_Other_Plans: $890.91 Blue_Cross — Capital_Blue_Performance_PPO: $623.38 Blue_Cross — Capital_Cares_4_kids: $623.60 Cigna — All_Plans: $999.34 First_Health_Network — All_Plans: $1,015.45 Geisinger — All_Plans: $1,055.45 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $1,033.23 PHC — All_Plans: $888.80 UPMC — Employees_And_Dependents: $888.80
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound of Uterus, Ovaries, Tubes, Cervix and Pelvic Area Through Vagina	$740	$592	$58.13 – $703
Transvaginal ultrasound: 10 of 42 insurance plan rates Aetna — All_Plans: $677.10 Aetna_Advantra_Medicare — All_Plans: $112.17 Aetna_Better_Health_Kids — All_Plans: $260.10 Aetna_Medicare — All_Plans: $112.17 Amerihealth_Medicare — All_Plans: $114.89 Blue_Cross — All_Other_Plans: $639.88 Blue_Cross — Capital_Blue_Performance_PPO: $352.91 Blue_Cross — Capital_Cares_4_kids: $447.91 Blue_Cross_BlueJourney_Medicare — All_Plans: $108.90 Cigna — All_Plans: $636.40
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) In the file: Ultrasound of Uterus, Ovaries, Tubes, Cervix and Pelvic Area Through Vagina	$740	$592	$415.21 – $703
Transvaginal ultrasound: 10 of 11 insurance plan rates Aetna — All_Plans: $668.96 Blue_Cross — All_Other_Plans: $593.41 Blue_Cross — Capital_Blue_Performance_PPO: $415.21 Blue_Cross — Capital_Cares_4_kids: $415.36 Cigna — All_Plans: $665.63 First_Health_Network — All_Plans: $676.36 Geisinger — All_Plans: $703 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $688.20 PHC — All_Plans: $592 UPMC — Employees_And_Dependents: $592
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: Diagnostic Mammography of 1 Breast	$449	$222	$78.86 – $493.29
Diagnostic mammogram, one breast: 10 of 43 insurance plan rates Aetna — All_Plans: $410.84 Aetna_Advantra_Medicare — All_Plans: $81.23 Aetna_Better_Health_Kids — All_Plans: $348.19 Aetna_Medicare — All_Plans: $81.23 Amerihealth_Caritas_Medicaid — All_Plans: $145.42 Amerihealth_Medicare — All_Plans: $83.20 Blue_Cross — All_Other_Plans: $388.25 Blue_Cross — Capital_Blue_Performance_PPO: $194 Blue_Cross — Capital_Cares_4_kids: $271.78 Blue_Cross_BlueJourney_Medicare — All_Plans: $78.86
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) In the file: Diagnostic Mammography of 1 Breast	$449	$222	$251.93 – $426.55
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates Aetna — All_Plans: $405.90 Blue_Cross — All_Other_Plans: $360.05 Blue_Cross — Capital_Blue_Performance_PPO: $251.93 Blue_Cross — Capital_Cares_4_kids: $252.02 Cigna — All_Plans: $403.88 First_Health_Network — All_Plans: $410.39 Geisinger — All_Plans: $426.55 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $417.57 PHC — All_Plans: $359.20 UPMC — Employees_And_Dependents: $359.20
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic Mammography of Both Breasts	$449	$208	$100.45 – $632.62
Diagnostic mammogram, both breasts: 10 of 43 insurance plan rates Aetna — All_Plans: $410.84 Aetna_Advantra_Medicare — All_Plans: $103.46 Aetna_Better_Health_Kids — All_Plans: $441.49 Aetna_Medicare — All_Plans: $103.46 Amerihealth_Caritas_Medicaid — All_Plans: $184.39 Amerihealth_Medicare — All_Plans: $105.97 Blue_Cross — All_Other_Plans: $388.25 Blue_Cross — Capital_Blue_Performance_PPO: $194 Blue_Cross — Capital_Cares_4_kids: $271.78 Blue_Cross_BlueJourney_Medicare — All_Plans: $100.45
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) In the file: Diagnostic Mammography of Both Breasts	$449	$208	$251.93 – $426.55
Diagnostic mammogram, both breasts: 10 of 11 insurance plan rates Aetna — All_Plans: $405.90 Blue_Cross — All_Other_Plans: $360.05 Blue_Cross — Capital_Blue_Performance_PPO: $251.93 Blue_Cross — Capital_Cares_4_kids: $252.02 Cigna — All_Plans: $403.88 First_Health_Network — All_Plans: $410.39 Geisinger — All_Plans: $426.55 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $417.57 PHC — All_Plans: $359.20 UPMC — Employees_And_Dependents: $359.20
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Screening Mammography	$427	$225	$83.06 – $521.53
Screening mammogram, both breasts: 10 of 43 insurance plan rates Aetna — All_Plans: $390.71 Aetna_Advantra_Medicare — All_Plans: $85.55 Aetna_Better_Health_Kids — All_Plans: $355.98 Aetna_Medicare — All_Plans: $85.55 Amerihealth_Caritas_Medicaid — All_Plans: $148.67 Amerihealth_Medicare — All_Plans: $87.63 Blue_Cross — All_Other_Plans: $369.23 Blue_Cross — Capital_Blue_Performance_PPO: $194 Blue_Cross — Capital_Cares_4_kids: $258.46 Blue_Cross_BlueJourney_Medicare — All_Plans: $83.06
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) In the file: Screening Mammography	$427	$225	$239.59 – $405.65
Screening mammogram, both breasts: 10 of 11 insurance plan rates Aetna — All_Plans: $386.01 Blue_Cross — All_Other_Plans: $342.41 Blue_Cross — Capital_Blue_Performance_PPO: $239.59 Blue_Cross — Capital_Cares_4_kids: $239.68 Cigna — All_Plans: $384.09 First_Health_Network — All_Plans: $390.28 Geisinger — All_Plans: $405.65 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $397.11 PHC — All_Plans: $341.60 UPMC — Employees_And_Dependents: $341.60

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Sleep Study in Sleep Lab (6 Years or Older)	$4,919	$3,935.20	$433.20 – $6,087.75
Sleep study (overnight, in a sleep lab): 10 of 43 insurance plan rates Aetna — All_Plans: $4,500.89 Aetna_Advantra_Medicare — All_Plans: $1,073.13 Aetna_Better_Health_Kids — All_Plans: $1,178.30 Aetna_Medicare — All_Plans: $1,073.13 Amerihealth_Caritas_Medicaid — All_Plans: $492.12 Amerihealth_Medicare — All_Plans: $1,099.17 Blue_Cross — All_Other_Plans: $4,253.46 Blue_Cross — Capital_Blue_Performance_PPO: $3,326.72 Blue_Cross — Capital_Cares_4_kids: $2,977.42 Blue_Cross_BlueJourney_Medicare — All_Plans: $1,041.87
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) In the file: Sleep Study in Sleep Lab (6 Years or Older)	$4,919	$3,935.20	$2,760.05 – $4,673.05
Sleep study (overnight, in a sleep lab): 10 of 11 insurance plan rates Aetna — All_Plans: $4,446.78 Blue_Cross — All_Other_Plans: $3,944.55 Blue_Cross — Capital_Blue_Performance_PPO: $2,760.05 Blue_Cross — Capital_Cares_4_kids: $2,761.03 Cigna — All_Plans: $4,424.64 First_Health_Network — All_Plans: $4,495.97 Geisinger — All_Plans: $4,673.05 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $4,574.67 PHC — All_Plans: $3,935.20 UPMC — Employees_And_Dependents: $3,935.20

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) In the file: Physical Therapy, Each 15 Minutes	$148	$118.40	$27.75 – $162.15
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 43 insurance plan rates Aetna — All_Plans: $135.42 Aetna_Advantra_Medicare — All_Plans: $28.58 Aetna_Better_Health_Kids — All_Plans: $28.49 Aetna_Medicare — All_Plans: $28.58 Amerihealth_Caritas_Medicaid — All_Plans: $56.80 Amerihealth_Medicare — All_Plans: $29.28 Blue_Cross — All_Other_Plans: $127.98 Blue_Cross — Capital_Blue_Performance_PPO: $100.09 Blue_Cross — Capital_Cares_4_kids: $89.58 Blue_Cross_BlueJourney_Medicare — All_Plans: $27.75
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: Occupational Therapy, Each 15 Minutes	$148	$118.40	$27.75 – $162.15
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 43 insurance plan rates Aetna — All_Plans: $135.42 Aetna_Advantra_Medicare — All_Plans: $28.58 Aetna_Better_Health_Kids — All_Plans: $28.49 Aetna_Medicare — All_Plans: $28.58 Amerihealth_Caritas_Medicaid — All_Plans: $56.80 Amerihealth_Medicare — All_Plans: $29.28 Blue_Cross — All_Other_Plans: $127.98 Blue_Cross — Capital_Blue_Performance_PPO: $100.09 Blue_Cross — Capital_Cares_4_kids: $89.58 Blue_Cross_BlueJourney_Medicare — All_Plans: $27.75
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) In the file: Physical Therapy, Each 15 Minutes	$148	$118.40	$83.04 – $140.60
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates Aetna — All_Plans: $133.79 Blue_Cross — All_Other_Plans: $118.68 Blue_Cross — Capital_Blue_Performance_PPO: $83.04 Blue_Cross — Capital_Cares_4_kids: $83.07 Cigna — All_Plans: $133.13 First_Health_Network — All_Plans: $135.27 Geisinger — All_Plans: $140.60 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $137.64 PHC — All_Plans: $118.40 UPMC — Employees_And_Dependents: $118.40
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Evaluation for Physical Therapy, Typically 20 Minutes	$366	$292.80	$56.80 – $552.11
Physical therapy evaluation (low complexity): 10 of 43 insurance plan rates Aetna — All_Plans: $334.89 Aetna_Advantra_Medicare — All_Plans: $97.32 Aetna_Better_Health_Kids — All_Plans: $216.27 Aetna_Medicare — All_Plans: $97.32 Amerihealth_Caritas_Medicaid — All_Plans: $56.80 Amerihealth_Medicare — All_Plans: $99.69 Blue_Cross — All_Other_Plans: $316.48 Blue_Cross — Capital_Blue_Performance_PPO: $247.53 Blue_Cross — Capital_Cares_4_kids: $221.54 Blue_Cross_BlueJourney_Medicare — All_Plans: $94.49
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) In the file: Evaluation for Physical Therapy, Typically 20 Minutes	$366	$292.80	$205.36 – $347.70
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates Aetna — All_Plans: $330.86 Blue_Cross — All_Other_Plans: $293.50 Blue_Cross — Capital_Blue_Performance_PPO: $205.36 Blue_Cross — Capital_Cares_4_kids: $205.44 Cigna — All_Plans: $329.22 First_Health_Network — All_Plans: $334.52 Geisinger — All_Plans: $347.70 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $340.38 PHC — All_Plans: $292.80 UPMC — Employees_And_Dependents: $292.80
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Evaluation for Physical Therapy, Typically 30 Minutes	$391	$312.80	$56.80 – $552.11
Physical therapy evaluation (moderate complexity): 10 of 43 insurance plan rates Aetna — All_Plans: $357.77 Aetna_Advantra_Medicare — All_Plans: $97.32 Aetna_Better_Health_Kids — All_Plans: $216.27 Aetna_Medicare — All_Plans: $97.32 Amerihealth_Caritas_Medicaid — All_Plans: $56.80 Amerihealth_Medicare — All_Plans: $99.69 Blue_Cross — All_Other_Plans: $338.10 Blue_Cross — Capital_Blue_Performance_PPO: $264.43 Blue_Cross — Capital_Cares_4_kids: $236.67 Blue_Cross_BlueJourney_Medicare — All_Plans: $94.49
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) In the file: Evaluation for Physical Therapy, Typically 30 Minutes	$391	$312.80	$219.39 – $371.45
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates Aetna — All_Plans: $353.46 Blue_Cross — All_Other_Plans: $313.54 Blue_Cross — Capital_Blue_Performance_PPO: $219.39 Blue_Cross — Capital_Cares_4_kids: $219.47 Cigna — All_Plans: $351.70 First_Health_Network — All_Plans: $357.37 Geisinger — All_Plans: $371.45 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $363.63 PHC — All_Plans: $312.80 UPMC — Employees_And_Dependents: $312.80
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Evaluation for Physical Therapy, Typically 45 Minutes	$417	$333.60	$56.80 – $552.11
Physical therapy evaluation (high complexity): 10 of 43 insurance plan rates Aetna — All_Plans: $381.56 Aetna_Advantra_Medicare — All_Plans: $97.32 Aetna_Better_Health_Kids — All_Plans: $216.27 Aetna_Medicare — All_Plans: $97.32 Amerihealth_Caritas_Medicaid — All_Plans: $56.80 Amerihealth_Medicare — All_Plans: $99.69 Blue_Cross — All_Other_Plans: $360.58 Blue_Cross — Capital_Blue_Performance_PPO: $282.02 Blue_Cross — Capital_Cares_4_kids: $252.41 Blue_Cross_BlueJourney_Medicare — All_Plans: $94.49
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) In the file: Evaluation for Physical Therapy, Typically 45 Minutes	$417	$333.60	$233.98 – $396.15
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates Aetna — All_Plans: $376.97 Blue_Cross — All_Other_Plans: $334.39 Blue_Cross — Capital_Blue_Performance_PPO: $233.98 Blue_Cross — Capital_Cares_4_kids: $234.06 Cigna — All_Plans: $375.09 First_Health_Network — All_Plans: $381.14 Geisinger — All_Plans: $396.15 Johns_Hopkins_HealthCare_Plan — All_Other_Plans: $387.81 PHC — All_Plans: $333.60 UPMC — Employees_And_Dependents: $333.60

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Removal of growth and tissue of breast, duct, or nipple	Not listed in the file	Not listed in the file	$970 – $22,913.19
Removal of breast growth (open surgery): 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $4,039.05 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $4,039.05 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $4,137.09 Blue_Cross_BlueJourney_Medicare — All_Plans: $4,023.37 Devoted_Medicare — All_Plans: $4,117.48 Geisinger_Gold_Medicare — All_Plans: $4,117.48 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Replacement of thigh bone and hip joint with prosthesis	Not listed in the file	Not listed in the file	$970 – $76,991.02
Total hip replacement: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $13,571.69 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $13,571.69 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $13,901.10 Blue_Cross_BlueJourney_Medicare — All_Plans: $13,518.99 Devoted_Medicare — All_Plans: $13,835.22 Geisinger_Gold_Medicare — All_Plans: $13,835.22 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Replacement of knee joint, both sides of knee	Not listed in the file	Not listed in the file	$970 – $76,991.02
Total knee replacement: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $13,571.69 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $13,571.69 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $13,901.10 Blue_Cross_BlueJourney_Medicare — All_Plans: $13,518.99 Devoted_Medicare — All_Plans: $13,835.22 Geisinger_Gold_Medicare — All_Plans: $13,835.22 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) rele	Not listed in the file	Not listed in the file	$970 – $42,745.84
Shoulder arthroscopy: shaving of shoulder bone: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $7,535.08 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $7,535.08 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $7,717.97 Blue_Cross_BlueJourney_Medicare — All_Plans: $7,505.82 Devoted_Medicare — All_Plans: $7,681.39 Geisinger_Gold_Medicare — All_Plans: $7,681.39 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Removal of knee cartilage using an endoscope	Not listed in the file	Not listed in the file	$970 – $19,414.75
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $3,422.36 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $3,422.36 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $3,505.43 Blue_Cross_BlueJourney_Medicare — All_Plans: $3,409.07 Devoted_Medicare — All_Plans: $3,488.81 Geisinger_Gold_Medicare — All_Plans: $3,488.81 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Removal of tonsils and adenoid glands (younger than 12 years)	Not listed in the file	Not listed in the file	$867.50 – $35,397.44
Removal of tonsils and adenoids (under age 12): 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $6,239.73 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $6,239.73 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $6,391.18 Blue_Cross_BlueJourney_Medicare — All_Plans: $6,215.50 Devoted_Medicare — All_Plans: $6,360.89 Geisinger_Gold_Medicare — All_Plans: $6,360.89 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	Not listed in the file	Not listed in the file	$357.50 – $6,420
Upper GI endoscopy (diagnostic): 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $988.92 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $988.92 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $1,012.93 Blue_Cross_BlueJourney_Medicare — All_Plans: $985.08 Devoted_Medicare — All_Plans: $1,008.13 Geisinger_Gold_Medicare — All_Plans: $1,008.13 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	Not listed in the file	Not listed in the file	$351.25 – $6,420
Upper GI endoscopy with biopsy: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $988.92 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $988.92 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $1,012.93 Blue_Cross_BlueJourney_Medicare — All_Plans: $985.08 Devoted_Medicare — All_Plans: $1,008.13 Geisinger_Gold_Medicare — All_Plans: $1,008.13 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Diagnostic exam of large bowel using a flexible endoscope	Not listed in the file	Not listed in the file	$553.75 – $6,420
Colonoscopy (diagnostic): 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $961.66 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $961.66 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $985 Blue_Cross_BlueJourney_Medicare — All_Plans: $957.92 Devoted_Medicare — All_Plans: $980.33 Geisinger_Gold_Medicare — All_Plans: $980.33 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Biopsy of large bowel using a flexible endoscope	Not listed in the file	Not listed in the file	$475 – $7,055.25
Colonoscopy with biopsy: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $1,243.67 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $1,243.67 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $1,273.86 Blue_Cross_BlueJourney_Medicare — All_Plans: $1,238.84 Devoted_Medicare — All_Plans: $1,267.82 Geisinger_Gold_Medicare — All_Plans: $1,267.82 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Removal of polyps or growths of large bowel using an endoscope with mechanical snare	Not listed in the file	Not listed in the file	$475 – $7,055.25
Colonoscopy with removal of polyps (snare): 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $1,243.67 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $1,243.67 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $1,273.86 Blue_Cross_BlueJourney_Medicare — All_Plans: $1,238.84 Devoted_Medicare — All_Plans: $1,267.82 Geisinger_Gold_Medicare — All_Plans: $1,267.82 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Removal of gallbladder using an endoscope	Not listed in the file	Not listed in the file	$970 – $34,910.94
Gallbladder removal by laparoscope: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $6,153.97 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $6,153.97 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $6,303.34 Blue_Cross_BlueJourney_Medicare — All_Plans: $6,130.07 Devoted_Medicare — All_Plans: $6,273.47 Geisinger_Gold_Medicare — All_Plans: $6,273.47 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair of groin hernia (5 years or older)	Not listed in the file	Not listed in the file	$970 – $21,116.79
Groin (inguinal) hernia repair, age 5 or older: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $3,722.39 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $3,722.39 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $3,812.74 Blue_Cross_BlueJourney_Medicare — All_Plans: $3,707.93 Devoted_Medicare — All_Plans: $3,794.67 Geisinger_Gold_Medicare — All_Plans: $3,794.67 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy of Prostate Gland	Not listed in the file	Not listed in the file	$970 – $12,257.66
Prostate biopsy: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $2,160.73 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $2,160.73 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $2,213.18 Blue_Cross_BlueJourney_Medicare — All_Plans: $2,152.34 Devoted_Medicare — All_Plans: $2,202.69 Geisinger_Gold_Medicare — All_Plans: $2,202.69 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed	Not listed in the file	Not listed in the file	$970 – $62,297.44
Prostate removal by laparoscope (radical prostatectomy): 10 of 42 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $10,981.56 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $10,981.56 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $11,248.10 Blue_Cross_BlueJourney_Medicare — All_Plans: $10,938.91 Devoted_Medicare — All_Plans: $11,194.80 Geisinger_Gold_Medicare — All_Plans: $11,194.80 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Biopsy of Lining of Uterus and/or Removal of Polyp Using an Endoscope	Not listed in the file	Not listed in the file	$970 – $19,025.31
Hysteroscopy with biopsy of the uterus lining: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $3,353.71 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $3,353.71 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $3,435.11 Blue_Cross_BlueJourney_Medicare — All_Plans: $3,340.69 Devoted_Medicare — All_Plans: $3,418.83 Geisinger_Gold_Medicare — All_Plans: $3,418.83 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Injection of Substance Into Lower Spine Canal Using Imaging Guidance	Not listed in the file	Not listed in the file	$709.18 – $6,420
Spinal injection, lower back (epidural), with imaging guidance: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $730.46 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $730.46 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $748.18 Blue_Cross_BlueJourney_Medicare — All_Plans: $727.62 Devoted_Medicare — All_Plans: $744.64 Geisinger_Gold_Medicare — All_Plans: $744.64 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Inject Anesthetic/Steroid Sacral Spine Nerve W Image Guide, Single Level	Not listed in the file	Not listed in the file	$118.80 – $6,420
Nerve root injection, lower back, with imaging guidance: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $939.06 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $939.06 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $961.85 Blue_Cross_BlueJourney_Medicare — All_Plans: $935.41 Devoted_Medicare — All_Plans: $957.30 Geisinger_Gold_Medicare — All_Plans: $957.30 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Release and/or relocation of hand nerve	Not listed in the file	Not listed in the file	$830 – $11,684.74
Carpal tunnel release: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $2,059.74 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $2,059.74 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $2,109.74 Blue_Cross_BlueJourney_Medicare — All_Plans: $2,051.74 Devoted_Medicare — All_Plans: $2,099.74 Geisinger_Gold_Medicare — All_Plans: $2,099.74 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Removal of cataract with insertion of prosthetic lens	Not listed in the file	Not listed in the file	$970 – $13,647.14
Cataract removal with lens implant: 10 of 43 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $2,405.67 Aetna_Better_Health_Kids — All_Plans: $6,420 Aetna_Medicare — All_Plans: $2,405.67 Amerihealth_Caritas_Medicaid — All_Plans: $1,101.92 Amerihealth_Medicare — All_Plans: $2,464.06 Blue_Cross_BlueJourney_Medicare — All_Plans: $2,396.33 Devoted_Medicare — All_Plans: $2,452.38 Geisinger_Gold_Medicare — All_Plans: $2,452.38 Geisinger_Medicaid — All_Plans: $970 Health_Partners_Medicaid — All_Other_Plans: $970

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: Major joint replacement or reattachment of lower extremity	Not listed in the file	Not listed in the file	$13,570.99 – $74,073.62
Hip or knee replacement (major joint of the leg), without major complications: 10 of 36 insurance plan rates Aetna_Advantra_Medicare — All_Plans: $13,978.12 Aetna_Medicare — All_Plans: $13,978.12 Amerihealth_Medicare — All_Plans: $14,317.39 Blue_Cross — Capital_Blue_Performance_PPO: $20,845 Blue_Cross_BlueJourney_Medicare — All_Plans: $13,923.84 Devoted_Medicare — All_Plans: $14,249.54 Geisinger_Gold_Medicare — All_Plans: $14,249.54 Health_Partners_Medicaid — Kidz_Partners: $14,928.09 Highmark — All_Other_Plans: $54,413.46 Highmark — Blue_Cross_High_Performance_Network: $43,530.77

Source: Gettysburg Hospital’s standard charges file (edge.sitecorecloud.io, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 1, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	147 Gettys Street, Gettysburg, PA 17325
County	Adams County
State	Pennsylvania
Phone	(717) 334‑2121
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	390065
Name in Medicare records	GETTYSBURG HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	WellSpan Gettysburg Hospital
Official website	wellspan.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

WellSpan Gettysburg Hospital - WellSpan Health — wellspan.org

Gettysburg Hospital

Summary

Profile from official sources

At a glance