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Acute Care Hospital

Good Samaritan Hospital of Suffern

Suffern, New York · Rockland County · Emergency services listed

Summary

Good Samaritan Hospital of Suffern is an acute care hospital in Suffern, New York. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 43 services, specialties and programs. Medicare lists 550 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

Call(914) 368‑5000 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
286Beds (hospital website)
550Doctors and clinicians
43Services listed

Quick answers

Does Good Samaritan Hospital of Suffern have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Good Samaritan Hospital of Suffern. In a medical emergency, call 911.
Where is Good Samaritan Hospital of Suffern?
255 Lafayette Avenue, Suffern, NY 10901, in Rockland County, New York.
What is the phone number of Good Samaritan Hospital of Suffern?
(914) 368-5000, as listed by Medicare (CMS).
What is the Medicare star rating of Good Samaritan Hospital of Suffern?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][6][7]

Conditions treated[6][7]

Treatments[6]

Procedures[6]

Programs and centers[6][7][8][9]

  • Cardiovascular program
  • Primary Stroke Center program
  • Chest Pain Center
  • Robotic surgery program
  • Wound and Hyperbaric Institute
  • Surgical Weight Loss Institute bariatric program
  • Center for Breast Health
  • Level II special care nursery
  • Children's Diagnostic Center
  • Certified Home Care Agency
  • Caregiver Center
  • Garden of Hope therapeutic garden

Emergency care (hospital website)[4]

Emergency roomYes

Visiting and practical information

ParkingFree self-parking in the visitor lot in front of the hospital; valet available for $2[9]
Interpreters and languagesFree interpreters 24/7 by phone or video in 200+ languages, plus 24/7 ASL video interpreting; ask your nurse[9]
Patient portalmyCare Patient Portal

Recognition[6][7]

  • Level III Trauma Center
  • Chest Pain Center
  • Primary Stroke Center
  • Accredited Breast Center (Center for Breast Health)

Doctors and clinicians (550)

550 doctors and other clinicians list Good Samaritan Hospital of Suffern 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 (550)

And 526 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 2 of 5 stars
Overall rating of the hospital2 of 5 stars
Would recommend the hospital2 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines1 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean4 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1057%National average: 72%
Would definitely recommend the hospital56%National average: 71%
Nurses “always” communicated well71%National average: 80%
Doctors “always” communicated well72%National average: 80%
Staff “always” explained medicines before giving them52%National average: 62%
Were given information about recovery at home81%National average: 86%
Room and bathroom “always” clean71%National average: 74%
Area around the room “always” quiet at night43%National average: 60%
Completed surveys1,797Response rate: 21%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.742No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0Better than the national benchmark
Surgical site infections after colon surgery0No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.174Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients11.1%
Deaths within 30 days: heart failure patients9.9%
Deaths within 30 days: pneumonia patients16%
Deaths within 30 days: COPD patients8.7%
Deaths within 30 days: stroke patients14.3%
Deaths within 30 days: coronary bypass surgery (CABG)2.4%
Serious complications (patient safety indicator PSI-90)0.88No different from the national rate
Complications after hip or knee replacement2.9%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack14.8%
Readmitted within 30 days: heart failure23.9%
Readmitted within 30 days: pneumonia16.8%
Readmitted within 30 days: COPD19.4%
Readmitted within 30 days: coronary bypass surgery10.9%
Readmitted within 30 days: hip or knee replacement5.8%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)215 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)43%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in New YorkBest hospitals in New York

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 80 common services exactly as Good Samaritan Hospital of Suffern 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 →

$ 21 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT VISIT, NEW Not listed in the file Not listed in the file $50,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
New patient office visit (about 30–44 minutes): 10 of 19 insurance plan rates
  • Tricare — Tricare: $50,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — Aetna: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna Employee — Aetna Employee: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna HP Network — Aetna HP Network: 4,500% (a percentage in the contract, not a dollar amount)
  • CDPHP — CDPHP: 5,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: 8,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM GHI/HIP PPO — EMBLEM GHI/HIP PPO: 8,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM SELECT CARE (EXCHANGE) — EMBLEM SELECT CARE (EXCHANGE): 6,800% (a percentage in the contract, not a dollar amount)
  • First Health — First Health: 8,500% (a percentage in the contract, not a dollar amount)
  • MAGNACARE STANDARD — MAGNACARE STANDARD: 7,000% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier G0 In the file: HYPERBARIC NEW PT INTERMEDIATE 99203 $673 $673 $201.90 – $673
New patient office visit (about 30–44 minutes): 10 of 27 insurance plan rates
  • Aetna — Aetna: $336.50
  • Aetna Employee — Aetna Employee: $336.50
  • Aetna HP Network — Aetna HP Network: $302.85
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $269.20
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $255.74
  • BLUE CROSS HMO — BLUE CROSS HMO: $336.50
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $518.21
  • CDPHP — CDPHP: $336.50
  • CIGNA PPO — CIGNA PPO: $471.10
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: $538.40
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier G0 In the file: CLINIC NEW PT DETAILED 99203 $673 $673 $201.90 – $673
New patient office visit (about 30–44 minutes): 10 of 27 insurance plan rates
  • Aetna — Aetna: $336.50
  • Aetna Employee — Aetna Employee: $336.50
  • Aetna HP Network — Aetna HP Network: $302.85
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $269.20
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $255.74
  • BLUE CROSS HMO — BLUE CROSS HMO: $336.50
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $518.21
  • CDPHP — CDPHP: $336.50
  • CIGNA PPO — CIGNA PPO: $471.10
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: $538.40
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT VISIT, NEW Not listed in the file Not listed in the file $50,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
New patient office visit (about 45–59 minutes): 10 of 19 insurance plan rates
  • Tricare — Tricare: $50,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — Aetna: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna Employee — Aetna Employee: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna HP Network — Aetna HP Network: 4,500% (a percentage in the contract, not a dollar amount)
  • CDPHP — CDPHP: 5,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: 8,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM GHI/HIP PPO — EMBLEM GHI/HIP PPO: 8,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM SELECT CARE (EXCHANGE) — EMBLEM SELECT CARE (EXCHANGE): 6,800% (a percentage in the contract, not a dollar amount)
  • First Health — First Health: 8,500% (a percentage in the contract, not a dollar amount)
  • MAGNACARE STANDARD — MAGNACARE STANDARD: 7,000% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier G0 In the file: CLINIC NEW PT COMPREHENSIVE 99204 $923 $923 $276.90 – $1,086.28
New patient office visit (about 45–59 minutes): 10 of 27 insurance plan rates
  • Aetna — Aetna: $461.50
  • Aetna Employee — Aetna Employee: $461.50
  • Aetna HP Network — Aetna HP Network: $415.35
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $369.20
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $350.74
  • BLUE CROSS HMO — BLUE CROSS HMO: $461.50
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $710.71
  • CDPHP — CDPHP: $461.50
  • CIGNA PPO — CIGNA PPO: $646.10
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: $738.40
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: HC NEW PT LEVEL IV 99204 $923 $923 $276.90 – $1,086.28
New patient office visit (about 45–59 minutes): 10 of 27 insurance plan rates
  • Aetna — Aetna: $461.50
  • Aetna Employee — Aetna Employee: $461.50
  • Aetna HP Network — Aetna HP Network: $415.35
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $369.20
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $350.74
  • BLUE CROSS HMO — BLUE CROSS HMO: $461.50
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $710.71
  • CDPHP — CDPHP: $461.50
  • CIGNA PPO — CIGNA PPO: $646.10
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: $738.40
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT VISIT, NEW Not listed in the file Not listed in the file $50,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
New patient office visit (about 60–74 minutes): 10 of 19 insurance plan rates
  • Tricare — Tricare: $50,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — Aetna: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna Employee — Aetna Employee: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna HP Network — Aetna HP Network: 4,500% (a percentage in the contract, not a dollar amount)
  • CDPHP — CDPHP: 5,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: 8,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM GHI/HIP PPO — EMBLEM GHI/HIP PPO: 8,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM SELECT CARE (EXCHANGE) — EMBLEM SELECT CARE (EXCHANGE): 6,800% (a percentage in the contract, not a dollar amount)
  • First Health — First Health: 8,500% (a percentage in the contract, not a dollar amount)
  • MAGNACARE STANDARD — MAGNACARE STANDARD: 7,000% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier G0 In the file: CLINIC NEW PT COMPLEX 99205 $1,105 $1,105 $331.50 – $1,478.32
New patient office visit (about 60–74 minutes): 10 of 27 insurance plan rates
  • Aetna — Aetna: $552.50
  • Aetna Employee — Aetna Employee: $552.50
  • Aetna HP Network — Aetna HP Network: $497.25
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $442
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $419.90
  • BLUE CROSS HMO — BLUE CROSS HMO: $552.50
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $850.85
  • CDPHP — CDPHP: $552.50
  • CIGNA PPO — CIGNA PPO: $773.50
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: $884
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: HC NEW PT LEVEL V 99205 $1,105 $1,105 $331.50 – $1,478.32
New patient office visit (about 60–74 minutes): 10 of 27 insurance plan rates
  • Aetna — Aetna: $552.50
  • Aetna Employee — Aetna Employee: $552.50
  • Aetna HP Network — Aetna HP Network: $497.25
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $442
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $419.90
  • BLUE CROSS HMO — BLUE CROSS HMO: $552.50
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $850.85
  • CDPHP — CDPHP: $552.50
  • CIGNA PPO — CIGNA PPO: $773.50
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: $884
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT VISIT, EST Not listed in the file Not listed in the file $25 – $50,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $269
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $25
  • Tricare — Tricare: $50,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • VALUE OPTIONS (Non-HMO) — VALUE OPTIONS (Non-HMO): $52.44
  • VALUE OPTIONS COMM (CHCS) — VALUE OPTIONS COMM (CHCS): $60.73
  • VALUE OPTIONS GHI BMP — VALUE OPTIONS GHI BMP: $51.67
  • VALUE OPTIONS MEDICARE (CHCS) — VALUE OPTIONS MEDICARE (CHCS): $35.87
  • Aetna — Aetna: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna Employee — Aetna Employee: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna HP Network — Aetna HP Network: 4,500% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier G0 In the file: ADOLESCENT SUBSQT EXPAND 99213 $394 $394 $25 – $536.33
Established patient office visit (about 20–29 minutes): 10 of 32 insurance plan rates
  • Aetna — Aetna: $197
  • Aetna Employee — Aetna Employee: $197
  • Aetna HP Network — Aetna HP Network: $177.30
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $269
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $157.60
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $149.72
  • BLUE CROSS HMO — BLUE CROSS HMO: $197
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $303.38
  • CDPHP — CDPHP: $197
  • CIGNA PPO — CIGNA PPO: $275.80
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: HC ESTAB PT LEVEL III W PROC 99213 $394 $394 $25 – $536.33
Established patient office visit (about 20–29 minutes): 10 of 32 insurance plan rates
  • Aetna — Aetna: $197
  • Aetna Employee — Aetna Employee: $197
  • Aetna HP Network — Aetna HP Network: $177.30
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $269
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $157.60
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $149.72
  • BLUE CROSS HMO — BLUE CROSS HMO: $197
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $303.38
  • CDPHP — CDPHP: $197
  • CIGNA PPO — CIGNA PPO: $275.80
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT VISIT, EST Not listed in the file Not listed in the file $25 – $50,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $302
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $25
  • Tricare — Tricare: $50,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • VALUE OPTIONS (Non-HMO) — VALUE OPTIONS (Non-HMO): $57.96
  • VALUE OPTIONS COMM (CHCS) — VALUE OPTIONS COMM (CHCS): $68.99
  • VALUE OPTIONS GHI BMP — VALUE OPTIONS GHI BMP: $57.41
  • VALUE OPTIONS MEDICARE (CHCS) — VALUE OPTIONS MEDICARE (CHCS): $35.87
  • Aetna — Aetna: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna Employee — Aetna Employee: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna HP Network — Aetna HP Network: 4,500% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier G0 In the file: CLINIC ESTAB PT COMPREHENS 99214 $616 $616 $25 – $789.53
Established patient office visit (about 30–39 minutes): 10 of 32 insurance plan rates
  • Aetna — Aetna: $308
  • Aetna Employee — Aetna Employee: $308
  • Aetna HP Network — Aetna HP Network: $277.20
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $302
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $246.40
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $234.08
  • BLUE CROSS HMO — BLUE CROSS HMO: $308
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $474.32
  • CDPHP — CDPHP: $308
  • CIGNA PPO — CIGNA PPO: $431.20
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: HC ESTAB PT LEVEL IV 99214 $616 $616 $25 – $789.53
Established patient office visit (about 30–39 minutes): 10 of 32 insurance plan rates
  • Aetna — Aetna: $308
  • Aetna Employee — Aetna Employee: $308
  • Aetna HP Network — Aetna HP Network: $277.20
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $302
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $246.40
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $234.08
  • BLUE CROSS HMO — BLUE CROSS HMO: $308
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $474.32
  • CDPHP — CDPHP: $308
  • CIGNA PPO — CIGNA PPO: $431.20
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT, NEW, AGE 18-39 Not listed in the file Not listed in the file $92.36 – $25,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Preventive checkup, new patient, age 18–39: 10 of 22 insurance plan rates
  • HAMASPIK (MCR) — HAMASPIK (MCR): $25,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • HEALTH FIRST MEDICARE — HEALTH FIRST MEDICARE: $25,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Tricare — Tricare: $92.36
  • Aetna — Aetna: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna Employee — Aetna Employee: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna HP Network — Aetna HP Network: 4,500% (a percentage in the contract, not a dollar amount)
  • CDPHP — CDPHP: 5,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: 8,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM GHI/HIP PPO — EMBLEM GHI/HIP PPO: 8,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM SELECT CARE (EXCHANGE) — EMBLEM SELECT CARE (EXCHANGE): 6,800% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT, NEW, AGE 40-64 Not listed in the file Not listed in the file $112.36 – $25,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Preventive checkup, new patient, age 40–64: 10 of 22 insurance plan rates
  • HAMASPIK (MCR) — HAMASPIK (MCR): $25,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • HEALTH FIRST MEDICARE — HEALTH FIRST MEDICARE: $25,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Tricare — Tricare: $112.36
  • Aetna — Aetna: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna Employee — Aetna Employee: 5,000% (a percentage in the contract, not a dollar amount)
  • Aetna HP Network — Aetna HP Network: 4,500% (a percentage in the contract, not a dollar amount)
  • CDPHP — CDPHP: 5,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: 8,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM GHI/HIP PPO — EMBLEM GHI/HIP PPO: 8,000% (a percentage in the contract, not a dollar amount)
  • EMBLEM SELECT CARE (EXCHANGE) — EMBLEM SELECT CARE (EXCHANGE): 6,800% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99283 - Level 3 FCT $5,842 $5,842 $193 – $4,965.70
Emergency room visit (moderate): 10 of 41 insurance plan rates
  • Aetna — Aetna: $2,973
  • Aetna Employee — Aetna Employee: $2,973
  • Aetna HP Network — Aetna HP Network: $2,676
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $356.03
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $193
  • BEACON EXCHANGE — BEACON EXCHANGE: $406.90
  • BEACON MEDICARE — BEACON MEDICARE: $339.08
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $2,142
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $2,009
  • BLUE CROSS HMO — BLUE CROSS HMO: $2,350
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99283 - Level 3 FCT $5,842 $5,842 $1,752.60 – $4,089.40
Emergency room visit (moderate): rates for 4 insurance plans
  • CDPHP — CDPHP: $2,921
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $4,089.40
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $1,752.60
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $2,921
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT Not listed in the file Not listed in the file $193 – $6,117.59
Emergency room visit (moderate): 10 of 41 insurance plan rates
  • Aetna — Aetna: $2,973
  • Aetna Employee — Aetna Employee: $2,973
  • Aetna HP Network — Aetna HP Network: $2,676
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $3,667.01
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $193
  • BEACON EXCHANGE — BEACON EXCHANGE: $4,190.87
  • BEACON MEDICARE — BEACON MEDICARE: $3,492.39
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $2,142
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $2,009
  • BLUE CROSS HMO — BLUE CROSS HMO: $2,350
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99284 - Level 4 FCT $7,011 $7,011 $193 – $7,158.84
Emergency room visit (moderately high): 10 of 41 insurance plan rates
  • Aetna — Aetna: $2,973
  • Aetna Employee — Aetna Employee: $2,973
  • Aetna HP Network — Aetna HP Network: $2,676
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $544.23
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $193
  • BEACON EXCHANGE — BEACON EXCHANGE: $621.97
  • BEACON MEDICARE — BEACON MEDICARE: $518.31
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $5,506
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $5,162
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,923
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99284 - Level 4 FCT $7,011 $7,011 $2,103.30 – $4,907.70
Emergency room visit (moderately high): rates for 4 insurance plans
  • CDPHP — CDPHP: $3,505.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $4,907.70
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $2,103.30
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $3,505.50
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT Not listed in the file Not listed in the file $193 – $7,158.84
Emergency room visit (moderately high): 10 of 41 insurance plan rates
  • Aetna — Aetna: $2,973
  • Aetna Employee — Aetna Employee: $2,973
  • Aetna HP Network — Aetna HP Network: $2,676
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $3,690.53
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $193
  • BEACON EXCHANGE — BEACON EXCHANGE: $4,217.75
  • BEACON MEDICARE — BEACON MEDICARE: $3,514.79
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $5,506
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $5,162
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,923
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99285 - Level 5 FCT $10,709 $10,709 $193 – $9,102.65
Emergency room visit (high): 10 of 41 insurance plan rates
  • Aetna — Aetna: $2,973
  • Aetna Employee — Aetna Employee: $2,973
  • Aetna HP Network — Aetna HP Network: $2,676
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $776.74
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $193
  • BEACON EXCHANGE — BEACON EXCHANGE: $887.70
  • BEACON MEDICARE — BEACON MEDICARE: $739.75
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $5,506
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $5,162
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,923
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 99285 - Level 5 FCT $10,709 $10,709 $3,212.70 – $7,496.30
Emergency room visit (high): rates for 4 insurance plans
  • CDPHP — CDPHP: $5,354.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $7,496.30
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $3,212.70
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $5,354.50
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT Not listed in the file Not listed in the file $193 – $7,158.84
Emergency room visit (high): 10 of 41 insurance plan rates
  • Aetna — Aetna: $2,973
  • Aetna Employee — Aetna Employee: $2,973
  • Aetna HP Network — Aetna HP Network: $2,676
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $776.74
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $193
  • BEACON EXCHANGE — BEACON EXCHANGE: $887.70
  • BEACON MEDICARE — BEACON MEDICARE: $739.75
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $5,506
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $5,162
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,923

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic Metabolic Panel $135 $135 $8.46 – $301.37
Basic metabolic panel (blood test): 10 of 39 insurance plan rates
  • Aetna — Aetna: $16.33
  • Aetna Employee — Aetna Employee: $16.33
  • Aetna HP Network — Aetna HP Network: $14.72
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $8.88
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $11
  • BEACON EXCHANGE — BEACON EXCHANGE: $10.15
  • BEACON MEDICARE — BEACON MEDICARE: $8.46
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $301.37
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $48.82
  • BLUE CROSS HMO — BLUE CROSS HMO: $60.23
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Basic Metabolic Panel $135 $135 $40.50 – $94.50
Basic metabolic panel (blood test): rates for 4 insurance plans
  • CDPHP — CDPHP: $67.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $94.50
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $40.50
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $67.50
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIALP $168 $168 $10.56 – $450.93
Comprehensive metabolic panel (blood test): 10 of 38 insurance plan rates
  • Aetna — Aetna: $20.38
  • Aetna Employee — Aetna Employee: $20.38
  • Aetna HP Network — Aetna HP Network: $18.37
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $11.09
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $13.73
  • BEACON EXCHANGE — BEACON EXCHANGE: $12.67
  • BEACON MEDICARE — BEACON MEDICARE: $10.56
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $450.93
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $73.03
  • BLUE CROSS HMO — BLUE CROSS HMO: $90.12
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DIALP $168 $168 $50.40 – $117.60
Comprehensive metabolic panel (blood test): rates for 4 insurance plans
  • CDPHP — CDPHP: $84
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $117.60
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $50.40
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $84
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 80061 - Lipid panel, Cholesterol serum total, Lipoprotein direct measurement $214 $214 $13.39 – $631.92
Cholesterol panel (lipid panel): 10 of 39 insurance plan rates
  • Aetna — Aetna: $25.84
  • Aetna Employee — Aetna Employee: $25.84
  • Aetna HP Network — Aetna HP Network: $23.30
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $14.06
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $17.41
  • BEACON EXCHANGE — BEACON EXCHANGE: $16.07
  • BEACON MEDICARE — BEACON MEDICARE: $13.39
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $631.92
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $102.36
  • BLUE CROSS HMO — BLUE CROSS HMO: $126.30
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Panel SACH/BSCH $214 $214 $13.39 – $631.92
Cholesterol panel (lipid panel): 10 of 39 insurance plan rates
  • Aetna — Aetna: $25.84
  • Aetna Employee — Aetna Employee: $25.84
  • Aetna HP Network — Aetna HP Network: $23.30
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $14.06
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $17.41
  • BEACON EXCHANGE — BEACON EXCHANGE: $16.07
  • BEACON MEDICARE — BEACON MEDICARE: $13.39
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $631.92
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $102.36
  • BLUE CROSS HMO — BLUE CROSS HMO: $126.30
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 80061 - Lipid panel, Cholesterol serum total, Lipoprotein direct measurement $214 $214 $64.20 – $149.80
Cholesterol panel (lipid panel): rates for 4 insurance plans
  • CDPHP — CDPHP: $107
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $149.80
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $64.20
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $107
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Function Panel $138 $138 $8.68 – $378.14
Kidney function panel: 10 of 39 insurance plan rates
  • Aetna — Aetna: $16.75
  • Aetna Employee — Aetna Employee: $16.75
  • Aetna HP Network — Aetna HP Network: $15.10
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $9.11
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $11.28
  • BEACON EXCHANGE — BEACON EXCHANGE: $10.42
  • BEACON MEDICARE — BEACON MEDICARE: $8.68
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $378.14
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $61.25
  • BLUE CROSS HMO — BLUE CROSS HMO: $75.58
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Renal Function Panel $138 $138 $41.40 – $96.60
Kidney function panel: rates for 4 insurance plans
  • CDPHP — CDPHP: $69
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $96.60
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $41.40
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $69
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic Function Panel $131 $131 $8.17 – $301.37
Liver function panel: 10 of 39 insurance plan rates
  • Aetna — Aetna: $15.77
  • Aetna Employee — Aetna Employee: $15.77
  • Aetna HP Network — Aetna HP Network: $14.22
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $8.58
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $10.62
  • BEACON EXCHANGE — BEACON EXCHANGE: $9.80
  • BEACON MEDICARE — BEACON MEDICARE: $8.17
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $301.37
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $48.82
  • BLUE CROSS HMO — BLUE CROSS HMO: $60.23
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Hepatic Function Panel $131 $131 $39.30 – $91.70
Liver function panel: rates for 4 insurance plans
  • CDPHP — CDPHP: $65.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $91.70
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $39.30
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $65.50
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis with Microscopic $51 $51 $3.17 – $149.21
Urine test (automated, with microscope): 10 of 39 insurance plan rates
  • Aetna — Aetna: $6.12
  • Aetna Employee — Aetna Employee: $6.12
  • Aetna HP Network — Aetna HP Network: $5.52
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $3.33
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $4.12
  • BEACON EXCHANGE — BEACON EXCHANGE: $3.80
  • BEACON MEDICARE — BEACON MEDICARE: $3.17
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $149.21
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $24.16
  • BLUE CROSS HMO — BLUE CROSS HMO: $29.82
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis with Microscopic $51 $51 $15.30 – $35.70
Urine test (automated, with microscope): rates for 4 insurance plans
  • CDPHP — CDPHP: $25.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $35.70
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $15.30
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $25.50
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis $37 $37 $2.25 – $105.96
Urine test (automated, without microscope): 10 of 39 insurance plan rates
  • Aetna — Aetna: $4.34
  • Aetna Employee — Aetna Employee: $4.34
  • Aetna HP Network — Aetna HP Network: $3.92
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $2.36
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $2.93
  • BEACON EXCHANGE — BEACON EXCHANGE: $2.70
  • BEACON MEDICARE — BEACON MEDICARE: $2.25
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $105.96
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $17.16
  • BLUE CROSS HMO — BLUE CROSS HMO: $21.17
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Urinalysis $37 $37 $11.10 – $25.90
Urine test (automated, without microscope): rates for 4 insurance plans
  • CDPHP — CDPHP: $18.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $25.90
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $11.10
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $18.50
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA, Ultrasensitive W/O Serial LC $293 $293 $18.39 – $867.92
PSA (prostate specific antigen) blood test: 10 of 39 insurance plan rates
  • Aetna — Aetna: $35.49
  • Aetna Employee — Aetna Employee: $35.49
  • Aetna HP Network — Aetna HP Network: $32
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $19.31
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $23.91
  • BEACON EXCHANGE — BEACON EXCHANGE: $22.07
  • BEACON MEDICARE — BEACON MEDICARE: $18.39
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $867.92
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $140.58
  • BLUE CROSS HMO — BLUE CROSS HMO: $173.46
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA, Ultrasensitive W/O Serial LC $293 $293 $87.90 – $205.10
PSA (prostate specific antigen) blood test: rates for 4 insurance plans
  • CDPHP — CDPHP: $146.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $205.10
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $87.90
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $146.50
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier G0 In the file: Pros. Spec. Ag, Screen $293 $293 $18.39 – $867.92
PSA (prostate specific antigen) blood test: 10 of 39 insurance plan rates
  • Aetna — Aetna: $35.49
  • Aetna Employee — Aetna Employee: $35.49
  • Aetna HP Network — Aetna HP Network: $32
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $19.31
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $23.91
  • BEACON EXCHANGE — BEACON EXCHANGE: $22.07
  • BEACON MEDICARE — BEACON MEDICARE: $18.39
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $867.92
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $140.58
  • BLUE CROSS HMO — BLUE CROSS HMO: $173.46
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH w Free Thyroid if Abnormal $268 $268 $16.80 – $792.54
Thyroid stimulating hormone (TSH) test: 10 of 38 insurance plan rates
  • Aetna — Aetna: $32.42
  • Aetna Employee — Aetna Employee: $32.42
  • Aetna HP Network — Aetna HP Network: $29.23
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $17.64
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $21.84
  • BEACON EXCHANGE — BEACON EXCHANGE: $20.16
  • BEACON MEDICARE — BEACON MEDICARE: $16.80
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $792.54
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $128.37
  • BLUE CROSS HMO — BLUE CROSS HMO: $158.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TSH w Free Thyroid if Abnormal $268 $268 $80.40 – $187.60
Thyroid stimulating hormone (TSH) test: rates for 4 insurance plans
  • CDPHP — CDPHP: $134
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $187.60
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $80.40
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $134
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete Blood Count w/ Automated Differential $125 $125 $7.77 – $366.74
Complete blood count (CBC) with differential: 10 of 38 insurance plan rates
  • Aetna — Aetna: $15
  • Aetna Employee — Aetna Employee: $15
  • Aetna HP Network — Aetna HP Network: $13.52
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $8.16
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $10.10
  • BEACON EXCHANGE — BEACON EXCHANGE: $9.32
  • BEACON MEDICARE — BEACON MEDICARE: $7.77
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $366.74
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $59.40
  • BLUE CROSS HMO — BLUE CROSS HMO: $73.30
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Complete Blood Count w/ Automated Differential $125 $125 $37.50 – $87.50
Complete blood count (CBC) with differential: rates for 4 insurance plans
  • CDPHP — CDPHP: $62.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $87.50
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $37.50
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $62.50
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBCMD $103 $103 $6.47 – $274.21
Complete blood count (CBC), automated: 10 of 39 insurance plan rates
  • Aetna — Aetna: $12.49
  • Aetna Employee — Aetna Employee: $12.49
  • Aetna HP Network — Aetna HP Network: $11.26
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $6.79
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $8.41
  • BEACON EXCHANGE — BEACON EXCHANGE: $7.76
  • BEACON MEDICARE — BEACON MEDICARE: $6.47
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $274.21
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $44.42
  • BLUE CROSS HMO — BLUE CROSS HMO: $54.81
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBCMD $103 $103 $30.90 – $72.10
Complete blood count (CBC), automated: rates for 4 insurance plans
  • CDPHP — CDPHP: $51.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $72.10
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $30.90
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $51.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Mixing Study LC $68 $68 $4.29 – $185.40
Blood clotting time test (prothrombin time, PT): 10 of 39 insurance plan rates
  • Aetna — Aetna: $8.28
  • Aetna Employee — Aetna Employee: $8.28
  • Aetna HP Network — Aetna HP Network: $7.46
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $4.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $5.58
  • BEACON EXCHANGE — BEACON EXCHANGE: $5.15
  • BEACON MEDICARE — BEACON MEDICARE: $4.29
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $185.40
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $30.03
  • BLUE CROSS HMO — BLUE CROSS HMO: $37.05
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT Mixing Study LC $68 $68 $20.40 – $47.60
Blood clotting time test (prothrombin time, PT): rates for 4 insurance plans
  • CDPHP — CDPHP: $34
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $47.60
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $20.40
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $34
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 85730 -PTT $96 $96 $6.01 – $283.30
Blood clotting test (partial thromboplastin time, PTT): 10 of 39 insurance plan rates
  • Aetna — Aetna: $11.60
  • Aetna Employee — Aetna Employee: $11.60
  • Aetna HP Network — Aetna HP Network: $10.46
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $6.31
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $7.81
  • BEACON EXCHANGE — BEACON EXCHANGE: $7.21
  • BEACON MEDICARE — BEACON MEDICARE: $6.01
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $283.30
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $45.88
  • BLUE CROSS HMO — BLUE CROSS HMO: $56.62
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: aPTT Mixing Studies LC $96 $96 $6.01 – $283.30
Blood clotting test (partial thromboplastin time, PTT): 10 of 39 insurance plan rates
  • Aetna — Aetna: $11.60
  • Aetna Employee — Aetna Employee: $11.60
  • Aetna HP Network — Aetna HP Network: $10.46
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $6.31
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $7.81
  • BEACON EXCHANGE — BEACON EXCHANGE: $7.21
  • BEACON MEDICARE — BEACON MEDICARE: $6.01
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $283.30
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $45.88
  • BLUE CROSS HMO — BLUE CROSS HMO: $56.62
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 85730 -PTT $96 $96 $28.80 – $67.20
Blood clotting test (partial thromboplastin time, PTT): rates for 4 insurance plans
  • CDPHP — CDPHP: $48
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $67.20
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $28.80
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $48

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT Brain Stroke/TPA Protocol $2,089 $2,089 $130.50 – $6,653.17
CT scan of the head or brain, without contrast: 10 of 39 insurance plan rates
  • Aetna — Aetna: $252.17
  • Aetna Employee — Aetna Employee: $231.91
  • Aetna HP Network — Aetna HP Network: $226.63
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $136.35
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $168.82
  • BEACON EXCHANGE — BEACON EXCHANGE: $155.83
  • BEACON MEDICARE — BEACON MEDICARE: $129.86
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $6,653.17
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $1,077.64
  • BLUE CROSS HMO — BLUE CROSS HMO: $1,329.68
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: CT Brain Stroke/TPA Protocol $2,089 $2,089 $626.70 – $1,462.30
CT scan of the head or brain, without contrast: rates for 4 insurance plans
  • CDPHP — CDPHP: $1,044.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $1,462.30
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $626.70
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $1,044.50
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI IAC w/ & w/o Contrast $7,115 $7,115 $435.49 – $22,869.46
MRI of the brain, before and after contrast: 10 of 39 insurance plan rates
  • Aetna — Aetna: $795.78
  • Aetna Employee — Aetna Employee: $731.92
  • Aetna HP Network — Aetna HP Network: $715.20
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $455.03
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $563.37
  • BEACON EXCHANGE — BEACON EXCHANGE: $520.03
  • BEACON MEDICARE — BEACON MEDICARE: $433.36
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $22,869.46
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $3,704.24
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,570.61
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: MRI IAC w/ & w/o Contrast $7,115 $7,115 $2,134.50 – $4,980.50
MRI of the brain, before and after contrast: rates for 4 insurance plans
  • CDPHP — CDPHP: $3,557.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $4,980.50
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $2,134.50
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $3,557.50
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: 71046 CHEST PA AND LATERAL $1,488 $1,488 $18.62 – $1,589
Chest X-ray, 2 views: 10 of 38 insurance plan rates
  • Aetna — Aetna: $86.58
  • Aetna Employee — Aetna Employee: $79.32
  • Aetna HP Network — Aetna HP Network: $77.82
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $113.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $140.53
  • BEACON EXCHANGE — BEACON EXCHANGE: $129.72
  • BEACON MEDICARE — BEACON MEDICARE: $108.10
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $595.20
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $18.62
  • BLUE CROSS HMO — BLUE CROSS HMO: $18.62
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: XR Chest 2 Views w/ Fluoroscopy $1,488 $1,488 $18.62 – $1,589
Chest X-ray, 2 views: 10 of 38 insurance plan rates
  • Aetna — Aetna: $86.58
  • Aetna Employee — Aetna Employee: $79.32
  • Aetna HP Network — Aetna HP Network: $77.82
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $113.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $140.53
  • BEACON EXCHANGE — BEACON EXCHANGE: $129.72
  • BEACON MEDICARE — BEACON MEDICARE: $108.10
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $595.20
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $18.62
  • BLUE CROSS HMO — BLUE CROSS HMO: $18.62
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: 71046 CHEST PA AND LATERAL $1,488 $1,488 $744 – $1,041.60
Chest X-ray, 2 views: rates for 3 insurance plans
  • CDPHP — CDPHP: $744
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $1,041.60
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $744
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: XR Spine Lumbosacral 4+ Views $2,089 $2,089 $130.50 – $1,880.10
X-ray of the lower spine, at least 4 views: 10 of 38 insurance plan rates
  • Aetna — Aetna: $145.45
  • Aetna Employee — Aetna Employee: $133.57
  • Aetna HP Network — Aetna HP Network: $130.73
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $136.35
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $168.82
  • BEACON EXCHANGE — BEACON EXCHANGE: $155.83
  • BEACON MEDICARE — BEACON MEDICARE: $129.86
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $1,718.47
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $278.34
  • BLUE CROSS HMO — BLUE CROSS HMO: $343.44
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: XR Spine Lumbosacral 4+ Views $2,089 $2,089 $1,044.50 – $1,462.30
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • CDPHP — CDPHP: $1,044.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $1,462.30
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $1,044.50
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI Spine Lumbar w/o Contrast $4,342 $4,342 $297.84 – $14,688.59
MRI of the lower back (lumbar spine), without contrast: 10 of 39 insurance plan rates
  • Aetna — Aetna: $458.96
  • Aetna Employee — Aetna Employee: $422.02
  • Aetna HP Network — Aetna HP Network: $412.48
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $311.20
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $385.29
  • BEACON EXCHANGE — BEACON EXCHANGE: $355.66
  • BEACON MEDICARE — BEACON MEDICARE: $296.38
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $14,688.59
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $2,379.15
  • BLUE CROSS HMO — BLUE CROSS HMO: $2,935.61
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: MRI Spine Lumbar w/o Contrast $4,342 $4,342 $1,302.60 – $3,039.40
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans
  • CDPHP — CDPHP: $2,171
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $3,039.40
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $1,302.60
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $2,171
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: 72193 CT PELVIS C+ $3,396 $3,396 $218.95 – $10,175.92
CT scan of the pelvis, with contrast: 10 of 39 insurance plan rates
  • Aetna — Aetna: $647.86
  • Aetna Employee — Aetna Employee: $596.10
  • Aetna HP Network — Aetna HP Network: $582.26
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $228.77
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $283.24
  • BEACON EXCHANGE — BEACON EXCHANGE: $261.46
  • BEACON MEDICARE — BEACON MEDICARE: $217.88
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $10,175.92
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $1,648.22
  • BLUE CROSS HMO — BLUE CROSS HMO: $2,033.72
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT Pelvis w/ Contrast $3,396 $3,396 $218.95 – $10,175.92
CT scan of the pelvis, with contrast: 10 of 39 insurance plan rates
  • Aetna — Aetna: $647.86
  • Aetna Employee — Aetna Employee: $596.10
  • Aetna HP Network — Aetna HP Network: $582.26
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $228.77
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $283.24
  • BEACON EXCHANGE — BEACON EXCHANGE: $261.46
  • BEACON MEDICARE — BEACON MEDICARE: $217.88
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $10,175.92
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $1,648.22
  • BLUE CROSS HMO — BLUE CROSS HMO: $2,033.72
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: 72193 CT PELVIS C+ $3,396 $3,396 $1,018.80 – $2,377.20
CT scan of the pelvis, with contrast: rates for 4 insurance plans
  • CDPHP — CDPHP: $1,698
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $2,377.20
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $1,018.80
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $1,698
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: MRI Toe Joint w/o Contrast Right $4,342 $4,342 $297.84 – $14,703.01
MRI of a leg joint (such as the knee), without contrast: 10 of 39 insurance plan rates
  • Aetna — Aetna: $2,171
  • Aetna Employee — Aetna Employee: $2,171
  • Aetna HP Network — Aetna HP Network: $2,171
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $311.20
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $385.29
  • BEACON EXCHANGE — BEACON EXCHANGE: $355.66
  • BEACON MEDICARE — BEACON MEDICARE: $296.38
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $14,703.01
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $2,381.49
  • BLUE CROSS HMO — BLUE CROSS HMO: $2,938.49
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI Toe Joint w/o Contrast Left $4,342 $4,342 $297.84 – $14,703.01
MRI of a leg joint (such as the knee), without contrast: 10 of 39 insurance plan rates
  • Aetna — Aetna: $2,171
  • Aetna Employee — Aetna Employee: $2,171
  • Aetna HP Network — Aetna HP Network: $2,171
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $311.20
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $385.29
  • BEACON EXCHANGE — BEACON EXCHANGE: $355.66
  • BEACON MEDICARE — BEACON MEDICARE: $296.38
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $14,703.01
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $2,381.49
  • BLUE CROSS HMO — BLUE CROSS HMO: $2,938.49
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee · modifier RT In the file: MRI Toe Joint w/o Contrast Right $4,342 $4,342 $1,302.60 – $3,039.40
MRI of a leg joint (such as the knee), without contrast: rates for 4 insurance plans
  • CDPHP — CDPHP: $2,171
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $3,039.40
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $1,302.60
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $2,171
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: CT ABDOMEN/PELVIS C+ $7,115 $7,115 $267.20 – $10,772.64
CT scan of the abdomen and pelvis, with contrast: 10 of 39 insurance plan rates
  • Aetna — Aetna: $3,557.50
  • Aetna Employee — Aetna Employee: $3,557.50
  • Aetna HP Network — Aetna HP Network: $3,557.50
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $455.03
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $563.37
  • BEACON EXCHANGE — BEACON EXCHANGE: $520.03
  • BEACON MEDICARE — BEACON MEDICARE: $433.36
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $10,772.64
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $1,744.88
  • BLUE CROSS HMO — BLUE CROSS HMO: $2,152.98
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT Abdomen and Pelvis w/ Con w/ Oral $7,115 $7,115 $435.49 – $10,772.64
CT scan of the abdomen and pelvis, with contrast: 10 of 39 insurance plan rates
  • Aetna — Aetna: $812.21
  • Aetna Employee — Aetna Employee: $747.59
  • Aetna HP Network — Aetna HP Network: $729.97
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $455.03
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $563.37
  • BEACON EXCHANGE — BEACON EXCHANGE: $520.03
  • BEACON MEDICARE — BEACON MEDICARE: $433.36
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $10,772.64
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $1,744.88
  • BLUE CROSS HMO — BLUE CROSS HMO: $2,152.98
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee · modifier 26 In the file: CT ABDOMEN/PELVIS C+ $7,115 $7,115 $2,134.50 – $4,980.50
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans
  • CDPHP — CDPHP: $3,557.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $4,980.50
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $2,134.50
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $3,557.50
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: US Abdomen Doppler Complete $2,089 $2,089 $130.50 – $4,120.11
Ultrasound of the abdomen, complete: 10 of 39 insurance plan rates
  • Aetna — Aetna: $1,044.50
  • Aetna Employee — Aetna Employee: $1,044.50
  • Aetna HP Network — Aetna HP Network: $940.05
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $136.35
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $168.82
  • BEACON EXCHANGE — BEACON EXCHANGE: $155.83
  • BEACON MEDICARE — BEACON MEDICARE: $129.86
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $4,120.11
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $667.35
  • BLUE CROSS HMO — BLUE CROSS HMO: $823.43
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: US Abdomen Doppler Complete $2,089 $2,089 $626.70 – $1,462.30
Ultrasound of the abdomen, complete: rates for 4 insurance plans
  • CDPHP — CDPHP: $1,044.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $1,462.30
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $626.70
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $1,044.50
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: US OB Greater Than 14 Weeks $2,089 $2,089 $130.50 – $4,120.11
Pregnancy ultrasound (after the first trimester): 10 of 39 insurance plan rates
  • Aetna — Aetna: $1,044.50
  • Aetna Employee — Aetna Employee: $1,044.50
  • Aetna HP Network — Aetna HP Network: $940.05
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $136.35
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $168.82
  • BEACON EXCHANGE — BEACON EXCHANGE: $155.83
  • BEACON MEDICARE — BEACON MEDICARE: $129.86
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $4,120.11
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $667.35
  • BLUE CROSS HMO — BLUE CROSS HMO: $823.43
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: US OB Greater Than 14 Weeks $2,089 $2,089 $626.70 – $1,462.30
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans
  • CDPHP — CDPHP: $1,044.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $1,462.30
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $626.70
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $1,044.50
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: 76830 US INTRALUMINAL-TRANSVAG $2,089 $2,089 $130.50 – $3,916.30
Transvaginal ultrasound: 10 of 39 insurance plan rates
  • Aetna — Aetna: $1,044.50
  • Aetna Employee — Aetna Employee: $1,044.50
  • Aetna HP Network — Aetna HP Network: $940.05
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $136.35
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $168.82
  • BEACON EXCHANGE — BEACON EXCHANGE: $155.83
  • BEACON MEDICARE — BEACON MEDICARE: $129.86
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $3,916.30
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $634.33
  • BLUE CROSS HMO — BLUE CROSS HMO: $782.69
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: US Transvaginal w/ Duplex $2,089 $2,089 $130.50 – $3,916.30
Transvaginal ultrasound: 10 of 39 insurance plan rates
  • Aetna — Aetna: $1,044.50
  • Aetna Employee — Aetna Employee: $1,044.50
  • Aetna HP Network — Aetna HP Network: $940.05
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $136.35
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $168.82
  • BEACON EXCHANGE — BEACON EXCHANGE: $155.83
  • BEACON MEDICARE — BEACON MEDICARE: $129.86
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $3,916.30
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $634.33
  • BLUE CROSS HMO — BLUE CROSS HMO: $782.69
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: 76830 US INTRALUMINAL-TRANSVAG $2,089 $2,089 $626.70 – $1,462.30
Transvaginal ultrasound: rates for 4 insurance plans
  • CDPHP — CDPHP: $1,044.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $1,462.30
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $626.70
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $1,044.50
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MG Mammogram Diagnostic w/ CAD/3D Right $727 $727 $72.65 – $951
Diagnostic mammogram, one breast: 10 of 38 insurance plan rates
  • Aetna — Aetna: $363.50
  • Aetna Employee — Aetna Employee: $363.50
  • Aetna HP Network — Aetna HP Network: $327.15
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $107.81
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $133.48
  • BEACON EXCHANGE — BEACON EXCHANGE: $123.22
  • BEACON MEDICARE — BEACON MEDICARE: $102.68
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $290.80
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $72.65
  • BLUE CROSS HMO — BLUE CROSS HMO: $72.65
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MG Mammogram Diagnostic w/ CAD/3D Left $727 $727 $72.65 – $951
Diagnostic mammogram, one breast: 10 of 38 insurance plan rates
  • Aetna — Aetna: $363.50
  • Aetna Employee — Aetna Employee: $363.50
  • Aetna HP Network — Aetna HP Network: $327.15
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $107.81
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $133.48
  • BEACON EXCHANGE — BEACON EXCHANGE: $123.22
  • BEACON MEDICARE — BEACON MEDICARE: $102.68
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $290.80
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $72.65
  • BLUE CROSS HMO — BLUE CROSS HMO: $72.65
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee · modifier TC In the file: MG Mammogram Diagnostic w/ CAD/3D Right $727 $727 $363.50 – $508.90
Diagnostic mammogram, one breast: rates for 3 insurance plans
  • CDPHP — CDPHP: $363.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $508.90
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $363.50
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: MG Post BX Imaging Bilat $915 $915 $92.79 – $951
Diagnostic mammogram, both breasts: 10 of 38 insurance plan rates
  • Aetna — Aetna: $457.50
  • Aetna Employee — Aetna Employee: $457.50
  • Aetna HP Network — Aetna HP Network: $411.75
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $138.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $171.47
  • BEACON EXCHANGE — BEACON EXCHANGE: $158.28
  • BEACON MEDICARE — BEACON MEDICARE: $131.90
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $366
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $92.79
  • BLUE CROSS HMO — BLUE CROSS HMO: $92.79
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: MG Mammogram Screening/Diag Bilat/CAD/3D $915 $915 $92.79 – $951
Diagnostic mammogram, both breasts: 10 of 38 insurance plan rates
  • Aetna — Aetna: $457.50
  • Aetna Employee — Aetna Employee: $457.50
  • Aetna HP Network — Aetna HP Network: $411.75
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $138.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $171.47
  • BEACON EXCHANGE — BEACON EXCHANGE: $158.28
  • BEACON MEDICARE — BEACON MEDICARE: $131.90
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $366
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $92.79
  • BLUE CROSS HMO — BLUE CROSS HMO: $92.79
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee · modifier 50 In the file: MG Post BX Imaging Bilat $915 $915 $457.50 – $640.50
Diagnostic mammogram, both breasts: rates for 3 insurance plans
  • CDPHP — CDPHP: $457.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $640.50
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $457.50
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: MG Mammogram Screening w/ CAD Bilat $771 $771 $76.73 – $951
Screening mammogram, both breasts: 10 of 38 insurance plan rates
  • Aetna — Aetna: $385.50
  • Aetna Employee — Aetna Employee: $385.50
  • Aetna HP Network — Aetna HP Network: $346.95
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $114.07
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $141.23
  • BEACON EXCHANGE — BEACON EXCHANGE: $130.37
  • BEACON MEDICARE — BEACON MEDICARE: $108.64
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $308.40
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $76.73
  • BLUE CROSS HMO — BLUE CROSS HMO: $76.73
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee · modifier 50 In the file: MG Mammogram Screening w/ CAD Bilat $771 $771 $385.50 – $539.70
Screening mammogram, both breasts: rates for 3 insurance plans
  • CDPHP — CDPHP: $385.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $539.70
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $385.50

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY Not listed in the file Not listed in the file $193 – $26,350
Left heart catheterization (diagnostic): 10 of 40 insurance plan rates
  • Aetna — Aetna: $2,973
  • Aetna Employee — Aetna Employee: $2,973
  • Aetna HP Network — Aetna HP Network: $2,676
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $4,228.37
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $193
  • BEACON EXCHANGE — BEACON EXCHANGE: $4,832.42
  • BEACON MEDICARE — BEACON MEDICARE: $4,027.02
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $21,381
  • BLUE CROSS HMO — BLUE CROSS HMO: $26,350
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $25,657
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROPHYSIOLOGY EVALUATION Not listed in the file Not listed in the file $8,760 – $50,000
Heart rhythm study (electrophysiology evaluation): 10 of 38 insurance plan rates
  • Aetna — Aetna: $16,995
  • Aetna Employee — Aetna Employee: $16,995
  • Aetna HP Network — Aetna HP Network: $15,296
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $10,172.91
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $12,595.04
  • BEACON EXCHANGE — BEACON EXCHANGE: $11,626.19
  • BEACON MEDICARE — BEACON MEDICARE: $9,688.49
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $9,833
  • BLUE CROSS HMO — BLUE CROSS HMO: $11,609
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $11,799
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB Not listed in the file Not listed in the file $193 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $50,000
Heart rhythm study with ablation for atrial fibrillation: 10 of 40 insurance plan rates
  • Aetna — Aetna: $2,973
  • Aetna Employee — Aetna Employee: $2,973
  • Aetna HP Network — Aetna HP Network: $2,676
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $34,090.97
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $193 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • BEACON EXCHANGE — BEACON EXCHANGE: $38,961.11
  • BEACON MEDICARE — BEACON MEDICARE: $32,467.59
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $9,833
  • BLUE CROSS HMO — BLUE CROSS HMO: $11,609
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $11,799
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPHY, 4 OR MORE Not listed in the file Not listed in the file $1,999.57 – $6,208.99
Sleep study (overnight, in a sleep lab): 10 of 30 insurance plan rates
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $1,120.04
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $1,386.71
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,280.04
  • BEACON MEDICARE — BEACON MEDICARE: $1,066.70
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $3,948.10
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,871.50
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $4,740.63
  • EMBLEM GHI/HIP MEDICARE — EMBLEM GHI/HIP MEDICARE: $1,088.03
  • EMBLEM GHI/HIP PPO — EMBLEM GHI/HIP PPO: $2,350.09
  • EMBLEM SELECT CARE (EXCHANGE) — EMBLEM SELECT CARE (EXCHANGE): $1,999.57

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT Therapeutic Exercise Units $632 $632 $32.90 – $1,150.18
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 39 insurance plan rates
  • Aetna — Aetna: $377
  • Aetna Employee — Aetna Employee: $377
  • Aetna HP Network — Aetna HP Network: $339
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $34.55
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $42.77
  • BEACON EXCHANGE — BEACON EXCHANGE: $39.48
  • BEACON MEDICARE — BEACON MEDICARE: $32.90
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $1,150.18
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $186.30
  • BLUE CROSS HMO — BLUE CROSS HMO: $229.88
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: 97110 PT Therapeutic Exercise Assistant Units Hidden $632 $632 $32.90 – $1,150.18
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 39 insurance plan rates
  • Aetna — Aetna: $377
  • Aetna Employee — Aetna Employee: $377
  • Aetna HP Network — Aetna HP Network: $339
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $34.55
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $42.77
  • BEACON EXCHANGE — BEACON EXCHANGE: $39.48
  • BEACON MEDICARE — BEACON MEDICARE: $32.90
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $1,150.18
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $186.30
  • BLUE CROSS HMO — BLUE CROSS HMO: $229.88
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: 97110 OT Therapeutic Exercise Assistant Units Hidden $632 $632 $32.90 – $1,150.18
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 39 insurance plan rates
  • Aetna — Aetna: $377
  • Aetna Employee — Aetna Employee: $377
  • Aetna HP Network — Aetna HP Network: $339
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $34.55
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $42.77
  • BEACON EXCHANGE — BEACON EXCHANGE: $39.48
  • BEACON MEDICARE — BEACON MEDICARE: $32.90
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $1,150.18
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $186.30
  • BLUE CROSS HMO — BLUE CROSS HMO: $229.88
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT Evaluation Units, Low Complexity $1,164 $1,164 $76.19 – $989.40
Physical therapy evaluation (low complexity): 10 of 39 insurance plan rates
  • Aetna — Aetna: $377
  • Aetna Employee — Aetna Employee: $377
  • Aetna HP Network — Aetna HP Network: $339
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $115.66
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $143.20
  • BEACON EXCHANGE — BEACON EXCHANGE: $132.18
  • BEACON MEDICARE — BEACON MEDICARE: $110.15
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $465.60
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $76.19
  • BLUE CROSS HMO — BLUE CROSS HMO: $76.19
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT Evaluation Units, Low Complexity $1,164 $1,164 $349.20 – $814.80
Physical therapy evaluation (low complexity): rates for 4 insurance plans
  • CDPHP — CDPHP: $582
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $814.80
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $349.20
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $582
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT Evaluation Units, Moderate Complexity $1,164 $1,164 $76.19 – $989.40
Physical therapy evaluation (moderate complexity): 10 of 39 insurance plan rates
  • Aetna — Aetna: $377
  • Aetna Employee — Aetna Employee: $377
  • Aetna HP Network — Aetna HP Network: $339
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $115.66
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $143.20
  • BEACON EXCHANGE — BEACON EXCHANGE: $132.18
  • BEACON MEDICARE — BEACON MEDICARE: $110.15
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $465.60
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $76.19
  • BLUE CROSS HMO — BLUE CROSS HMO: $76.19
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT Evaluation Units, Moderate Complexity $1,164 $1,164 $349.20 – $814.80
Physical therapy evaluation (moderate complexity): rates for 4 insurance plans
  • CDPHP — CDPHP: $582
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $814.80
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $349.20
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $582
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT Evaluation Units, High Complexity $1,164 $1,164 $76.19 – $989.40
Physical therapy evaluation (high complexity): 10 of 39 insurance plan rates
  • Aetna — Aetna: $377
  • Aetna Employee — Aetna Employee: $377
  • Aetna HP Network — Aetna HP Network: $339
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $115.66
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $143.20
  • BEACON EXCHANGE — BEACON EXCHANGE: $132.18
  • BEACON MEDICARE — BEACON MEDICARE: $110.15
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $465.60
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $76.19
  • BLUE CROSS HMO — BLUE CROSS HMO: $76.19
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT Evaluation Units, High Complexity $1,164 $1,164 $349.20 – $814.80
Physical therapy evaluation (high complexity): rates for 4 insurance plans
  • CDPHP — CDPHP: $582
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $814.80
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $349.20
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $582
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy, 30 Mins 90832 CHILD $571 $571 $45.92 – $579.89
Psychotherapy, 30 minutes: 10 of 41 insurance plan rates
  • Aetna — Aetna: $371.15
  • Aetna Employee — Aetna Employee: $371.15
  • Aetna HP Network — Aetna HP Network: $336.89
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $231.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $286.62
  • BEACON EXCHANGE — BEACON EXCHANGE: $264.58
  • BEACON MEDICARE — BEACON MEDICARE: $220.48
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $207
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $194
  • BLUE CROSS HMO — BLUE CROSS HMO: $251
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Psychotherapy, 30 Mins 90832 CHILD $571 $571 $171.30 – $399.70
Psychotherapy, 30 minutes: rates for 4 insurance plans
  • CDPHP — CDPHP: $285.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $399.70
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $171.30
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $285.50
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy, 45 Mins 90834 ADULT $682 $682 $91.85 – $765.02
Psychotherapy, 45 minutes: 10 of 41 insurance plan rates
  • Aetna — Aetna: $443.30
  • Aetna Employee — Aetna Employee: $443.30
  • Aetna HP Network — Aetna HP Network: $402.38
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $231.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $286.62
  • BEACON EXCHANGE — BEACON EXCHANGE: $264.58
  • BEACON MEDICARE — BEACON MEDICARE: $220.48
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $375
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $352
  • BLUE CROSS HMO — BLUE CROSS HMO: $434
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy, 45 Mins 90834 CHILD $682 $682 $91.85 – $765.02
Psychotherapy, 45 minutes: 10 of 41 insurance plan rates
  • Aetna — Aetna: $443.30
  • Aetna Employee — Aetna Employee: $443.30
  • Aetna HP Network — Aetna HP Network: $402.38
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $231.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $286.62
  • BEACON EXCHANGE — BEACON EXCHANGE: $264.58
  • BEACON MEDICARE — BEACON MEDICARE: $220.48
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $375
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $352
  • BLUE CROSS HMO — BLUE CROSS HMO: $434
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Psychotherapy, 45 Mins 90834 ADULT $682 $682 $204.60 – $477.40
Psychotherapy, 45 minutes: rates for 4 insurance plans
  • CDPHP — CDPHP: $341
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $477.40
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $204.60
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $341
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy 60 Minutes 90837 $579 $579 $91.85 – $1,132.56
Psychotherapy, 60 minutes: 10 of 41 insurance plan rates
  • Aetna — Aetna: $376.35
  • Aetna Employee — Aetna Employee: $376.35
  • Aetna HP Network — Aetna HP Network: $341.61
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $231.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $286.62
  • BEACON EXCHANGE — BEACON EXCHANGE: $264.58
  • BEACON MEDICARE — BEACON MEDICARE: $220.48
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $375
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $352
  • BLUE CROSS HMO — BLUE CROSS HMO: $434
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Psychotherapy 60 Minutes 90837 $579 $579 $173.70 – $405.30
Psychotherapy, 60 minutes: rates for 4 insurance plans
  • CDPHP — CDPHP: $289.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $405.30
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $173.70
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $289.50
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family Therapy 30 minutes W/O Patient 90846 ADULT $682 $682 $91.85 – $827.64
Family psychotherapy, without the patient: 10 of 41 insurance plan rates
  • Aetna — Aetna: $443.30
  • Aetna Employee — Aetna Employee: $443.30
  • Aetna HP Network — Aetna HP Network: $402.38
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $231.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $286.62
  • BEACON EXCHANGE — BEACON EXCHANGE: $264.58
  • BEACON MEDICARE — BEACON MEDICARE: $220.48
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $297
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $278
  • BLUE CROSS HMO — BLUE CROSS HMO: $354
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Family Therapy 30 minutes W/O Patient 90846 ADULT $682 $682 $204.60 – $477.40
Family psychotherapy, without the patient: rates for 4 insurance plans
  • CDPHP — CDPHP: $341
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $477.40
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $204.60
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $341
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family, Couples Psychotherapy 60 minutes With Patient 90847 ADULT $682 $682 $91.85 – $863.03
Family psychotherapy, with the patient: 10 of 41 insurance plan rates
  • Aetna — Aetna: $443.30
  • Aetna Employee — Aetna Employee: $443.30
  • Aetna HP Network — Aetna HP Network: $402.38
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $231.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $286.62
  • BEACON EXCHANGE — BEACON EXCHANGE: $264.58
  • BEACON MEDICARE — BEACON MEDICARE: $220.48
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $272.80
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $259.16
  • BLUE CROSS HMO — BLUE CROSS HMO: $341
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family, Couples Psychotherapy 60 minutes With Patient 90847 CHILD $682 $682 $91.85 – $863.03
Family psychotherapy, with the patient: 10 of 41 insurance plan rates
  • Aetna — Aetna: $443.30
  • Aetna Employee — Aetna Employee: $443.30
  • Aetna HP Network — Aetna HP Network: $402.38
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $231.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $286.62
  • BEACON EXCHANGE — BEACON EXCHANGE: $264.58
  • BEACON MEDICARE — BEACON MEDICARE: $220.48
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $272.80
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $259.16
  • BLUE CROSS HMO — BLUE CROSS HMO: $341
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Family, Couples Psychotherapy 60 minutes With Patient 90847 ADULT $682 $682 $204.60 – $477.40
Family psychotherapy, with the patient: rates for 4 insurance plans
  • CDPHP — CDPHP: $341
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $477.40
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $204.60
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $341
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group Therapy 90853 ADULT $1,120 $1,120 $55.97 – $1,008
Group psychotherapy: 10 of 41 insurance plan rates
  • Aetna — Aetna: $728
  • Aetna Employee — Aetna Employee: $728
  • Aetna HP Network — Aetna HP Network: $660.80
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $132.50
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $164.05
  • BEACON EXCHANGE — BEACON EXCHANGE: $151.43
  • BEACON MEDICARE — BEACON MEDICARE: $126.19
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $448
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $425.60
  • BLUE CROSS HMO — BLUE CROSS HMO: $560
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Group Therapy 90853 ADULT $1,120 $1,120 $336 – $784
Group psychotherapy: rates for 4 insurance plans
  • CDPHP — CDPHP: $560
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $784
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $336
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $560

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION Not listed in the file Not listed in the file $6,073 – $14,440.46
Removal of breast growth (open surgery): 10 of 41 insurance plan rates
  • Aetna — Aetna: $7,858
  • Aetna Employee — Aetna Employee: $7,858
  • Aetna HP Network — Aetna HP Network: $7,072
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $5,106.80
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $6,322.71
  • BEACON EXCHANGE — BEACON EXCHANGE: $5,836.34
  • BEACON MEDICARE — BEACON MEDICARE: $4,863.62
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $10,414
  • BLUE CROSS HMO — BLUE CROSS HMO: $12,827
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $12,497
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP REPLACEMENT Not listed in the file Not listed in the file $5,853 – $50,000
Total hip replacement: 10 of 41 insurance plan rates
  • Aetna — Aetna: $12,793
  • Aetna Employee — Aetna Employee: $12,793
  • Aetna HP Network — Aetna HP Network: $11,514
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $16,745.18
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $20,732.13
  • BEACON EXCHANGE — BEACON EXCHANGE: $19,137.35
  • BEACON MEDICARE — BEACON MEDICARE: $15,947.79
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $12,560
  • BLUE CROSS HMO — BLUE CROSS HMO: $15,481
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $15,072
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE REPLACEMENT Not listed in the file Not listed in the file $5,853 – $50,000
Total knee replacement: 10 of 41 insurance plan rates
  • Aetna — Aetna: $12,793
  • Aetna Employee — Aetna Employee: $12,793
  • Aetna HP Network — Aetna HP Network: $11,514
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $16,745.18
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $20,732.13
  • BEACON EXCHANGE — BEACON EXCHANGE: $19,137.35
  • BEACON MEDICARE — BEACON MEDICARE: $15,947.79
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $12,974
  • BLUE CROSS HMO — BLUE CROSS HMO: $15,992
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $15,569
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHOULDER ARTHROSCOPY/SURGERY Not listed in the file Not listed in the file $2,470 – $50,000
Shoulder arthroscopy: shaving of shoulder bone: 10 of 28 insurance plan rates
  • Aetna — Aetna: $7,858
  • Aetna Employee — Aetna Employee: $7,858
  • Aetna HP Network — Aetna HP Network: $7,072
  • CIGNA PPO — CIGNA PPO: $6,274
  • MAGNACARE PREFERRED — MAGNACARE PREFERRED: $8,760
  • MVP EXCHANGE — MVP EXCHANGE: $12,212
  • MVP HMO/PPO — MVP HMO/PPO: $14,367
  • OXFORD COMMERCIAL — OXFORD COMMERCIAL: $2,470
  • OXFORD EXCHANGE — OXFORD EXCHANGE: $2,500
  • Tricare — Tricare: $50,000
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KNEE ARTHROSCOPY/SURGERY Not listed in the file Not listed in the file $6,585.55 – $14,440.46
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 41 insurance plan rates
  • Aetna — Aetna: $10,965
  • Aetna Employee — Aetna Employee: $10,965
  • Aetna HP Network — Aetna HP Network: $9,869
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $4,267.59
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $5,283.68
  • BEACON EXCHANGE — BEACON EXCHANGE: $4,877.24
  • BEACON MEDICARE — BEACON MEDICARE: $4,064.37
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $10,414
  • BLUE CROSS HMO — BLUE CROSS HMO: $12,827
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $12,497
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS Not listed in the file Not listed in the file $6,073 – $15,054.39
Removal of tonsils and adenoids (under age 12): 10 of 41 insurance plan rates
  • Aetna — Aetna: $7,858
  • Aetna Employee — Aetna Employee: $7,858
  • Aetna HP Network — Aetna HP Network: $7,072
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $7,721.09
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $9,559.45
  • BEACON EXCHANGE — BEACON EXCHANGE: $8,824.10
  • BEACON MEDICARE — BEACON MEDICARE: $7,353.42
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $10,857
  • BLUE CROSS HMO — BLUE CROSS HMO: $13,384
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $13,028
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 43235 - EGD DIAGNOSTIC BRUSH WASH $3,827 $3,827 $193 – $7,657
Upper GI endoscopy (diagnostic): 10 of 38 insurance plan rates
  • Aetna — Aetna: $2,973
  • Aetna Employee — Aetna Employee: $2,973
  • Aetna HP Network — Aetna HP Network: $2,676
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $1,182.96
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $193
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,351.96
  • BEACON MEDICARE — BEACON MEDICARE: $1,126.63
  • BLUE CROSS HMO — BLUE CROSS HMO: $1,913.50
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $1,722.15
  • CDPHP — CDPHP: $2,687
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 43235 - EGD DIAGNOSTIC BRUSH WASH $3,827 $3,827 $1,148.10 – $2,678.90
Upper GI endoscopy (diagnostic): rates for 4 insurance plans
  • CDPHP — CDPHP: $1,913.50
  • MAGNACARE STANDARD — MAGNACARE STANDARD: $2,678.90
  • SELF-PAY - CC 30% — SELF-PAY - CC 30 PerCent: $1,148.10
  • SELF-PAY - CC 50% — SELF-PAY - CC 50: $1,913.50
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UPPR GI ENDOSCOPY, DIAGNOSIS Not listed in the file Not listed in the file $3,947 – $14,367
Upper GI endoscopy (diagnostic): 10 of 41 insurance plan rates
  • Aetna — Aetna: $4,386
  • Aetna Employee — Aetna Employee: $4,386
  • Aetna HP Network — Aetna HP Network: $3,947
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $1,182.96
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $1,464.62
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,351.96
  • BEACON MEDICARE — BEACON MEDICARE: $1,126.63
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $3,966
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,886
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $4,759
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UPPER GI ENDOSCOPY, BIOPSY Not listed in the file Not listed in the file $3,966 – $14,367
Upper GI endoscopy with biopsy: 10 of 41 insurance plan rates
  • Aetna — Aetna: $6,944
  • Aetna Employee — Aetna Employee: $6,944
  • Aetna HP Network — Aetna HP Network: $6,250
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $1,182.96
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $1,464.62
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,351.96
  • BEACON MEDICARE — BEACON MEDICARE: $1,126.63
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $3,966
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,886
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $4,759
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY Not listed in the file Not listed in the file $3,966 – $14,367
Colonoscopy (diagnostic): 10 of 41 insurance plan rates
  • Aetna — Aetna: $6,944
  • Aetna Employee — Aetna Employee: $6,944
  • Aetna HP Network — Aetna HP Network: $6,250
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $1,212.92
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $1,501.71
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,386.19
  • BEACON MEDICARE — BEACON MEDICARE: $1,155.16
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $3,966
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,886
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $4,759
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY Not listed in the file Not listed in the file $4,135 – $14,367
Colonoscopy with biopsy: 10 of 41 insurance plan rates
  • Aetna — Aetna: $6,944
  • Aetna Employee — Aetna Employee: $6,944
  • Aetna HP Network — Aetna HP Network: $6,250
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $1,560.75
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $1,932.36
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,783.72
  • BEACON MEDICARE — BEACON MEDICARE: $1,486.43
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $4,607
  • BLUE CROSS HMO — BLUE CROSS HMO: $5,681
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $5,528
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LESION REMOVAL COLONOSCOPY Not listed in the file Not listed in the file $4,135 – $14,367
Colonoscopy with removal of polyps (snare): 10 of 41 insurance plan rates
  • Aetna — Aetna: $6,944
  • Aetna Employee — Aetna Employee: $6,944
  • Aetna HP Network — Aetna HP Network: $6,250
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $1,560.75
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $1,932.36
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,783.72
  • BEACON MEDICARE — BEACON MEDICARE: $1,486.43
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $4,607
  • BLUE CROSS HMO — BLUE CROSS HMO: $5,681
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $5,528
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US Not listed in the file Not listed in the file $4,135 – $14,367
Ultrasound of the lower bowel by endoscope: 10 of 41 insurance plan rates
  • Aetna — Aetna: $6,944
  • Aetna Employee — Aetna Employee: $6,944
  • Aetna HP Network — Aetna HP Network: $6,250
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $1,560.75
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $1,932.36
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,783.72
  • BEACON MEDICARE — BEACON MEDICARE: $1,486.43
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $4,607
  • BLUE CROSS HMO — BLUE CROSS HMO: $5,681
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $5,528
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLON CA SCRN NOT HI RSK IND Not listed in the file Not listed in the file $3,431 – $14,367
Screening colonoscopy (not high risk): 10 of 41 insurance plan rates
  • Aetna — Aetna: $6,944
  • Aetna Employee — Aetna Employee: $6,944
  • Aetna HP Network — Aetna HP Network: $6,250
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $1,212.92
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $1,501.71
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,386.19
  • BEACON MEDICARE — BEACON MEDICARE: $1,155.16
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $3,966
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,886
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $4,759
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY Not listed in the file Not listed in the file $5,853 – $16,501.51
Gallbladder removal by laparoscope: 10 of 41 insurance plan rates
  • Aetna — Aetna: $11,880
  • Aetna Employee — Aetna Employee: $11,880
  • Aetna HP Network — Aetna HP Network: $10,692
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $7,885.04
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $9,762.43
  • BEACON EXCHANGE — BEACON EXCHANGE: $9,011.47
  • BEACON MEDICARE — BEACON MEDICARE: $7,509.56
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $11,900
  • BLUE CROSS HMO — BLUE CROSS HMO: $14,666
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $14,279
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPAIR INGUINAL HERNIA Not listed in the file Not listed in the file $6,633.67 – $14,440.46
Groin (inguinal) hernia repair, age 5 or older: 10 of 41 insurance plan rates
  • Aetna — Aetna: $10,965
  • Aetna Employee — Aetna Employee: $10,965
  • Aetna HP Network — Aetna HP Network: $9,869
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $4,669.83
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $5,781.70
  • BEACON EXCHANGE — BEACON EXCHANGE: $5,336.95
  • BEACON MEDICARE — BEACON MEDICARE: $4,447.46
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $10,414
  • BLUE CROSS HMO — BLUE CROSS HMO: $12,827
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $12,497
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE Not listed in the file Not listed in the file $4,143 – $50,000
Prostate biopsy: 10 of 30 insurance plan rates
  • Aetna — Aetna: $6,944
  • Aetna Employee — Aetna Employee: $6,944
  • Aetna HP Network — Aetna HP Network: $6,250
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $4,607
  • BLUE CROSS HMO — BLUE CROSS HMO: $5,681
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $5,528
  • CIGNA PPO — CIGNA PPO: $5,738
  • HAMASPIK (MCR) — HAMASPIK (MCR): $25,000
  • HEALTH FIRST MEDICARE — HEALTH FIRST MEDICARE: $25,000
  • MAGNACARE PREFERRED — MAGNACARE PREFERRED: $8,760
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD Not listed in the file Not listed in the file $5,853 – $17,991.38
Prostate removal by laparoscope (radical prostatectomy): 10 of 41 insurance plan rates
  • Aetna — Aetna: $11,880
  • Aetna Employee — Aetna Employee: $11,880
  • Aetna HP Network — Aetna HP Network: $10,692
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $13,864.23
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $17,165.24
  • BEACON EXCHANGE — BEACON EXCHANGE: $15,844.84
  • BEACON MEDICARE — BEACON MEDICARE: $13,204.03
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $12,974
  • BLUE CROSS HMO — BLUE CROSS HMO: $15,992
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $15,569
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY, BIOPSY Not listed in the file Not listed in the file $4,135 – $14,367
Hysteroscopy with biopsy of the uterus lining: 10 of 41 insurance plan rates
  • Aetna — Aetna: $7,858
  • Aetna Employee — Aetna Employee: $7,858
  • Aetna HP Network — Aetna HP Network: $7,072
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $4,222.10
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $5,227.37
  • BEACON EXCHANGE — BEACON EXCHANGE: $4,825.26
  • BEACON MEDICARE — BEACON MEDICARE: $4,021.05
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $4,607
  • BLUE CROSS HMO — BLUE CROSS HMO: $5,681
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $5,528
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC Not listed in the file Not listed in the file $3,431 – $14,367
Spinal injection, lower back (epidural), with imaging guidance: 10 of 41 insurance plan rates
  • Aetna — Aetna: $4,386
  • Aetna Employee — Aetna Employee: $4,386
  • Aetna HP Network — Aetna HP Network: $3,947
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $920.66
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $1,139.87
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,052.18
  • BEACON MEDICARE — BEACON MEDICARE: $876.82
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $3,966
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,886
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $4,759
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJ FORAMEN EPIDURAL L/S Not listed in the file Not listed in the file $3,431 – $14,367
Nerve root injection, lower back, with imaging guidance: 10 of 41 insurance plan rates
  • Aetna — Aetna: $4,386
  • Aetna Employee — Aetna Employee: $4,386
  • Aetna HP Network — Aetna HP Network: $3,947
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $1,153.59
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $1,428.26
  • BEACON EXCHANGE — BEACON EXCHANGE: $1,318.39
  • BEACON MEDICARE — BEACON MEDICARE: $1,098.66
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $3,966
  • BLUE CROSS HMO — BLUE CROSS HMO: $4,886
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $4,759
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY Not listed in the file Not listed in the file $4,607 – $14,367
Carpal tunnel release: 10 of 41 insurance plan rates
  • Aetna — Aetna: $6,944
  • Aetna Employee — Aetna Employee: $6,944
  • Aetna HP Network — Aetna HP Network: $6,250
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $2,546.89
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $3,153.29
  • BEACON EXCHANGE — BEACON EXCHANGE: $2,910.73
  • BEACON MEDICARE — BEACON MEDICARE: $2,425.61
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $4,607
  • BLUE CROSS HMO — BLUE CROSS HMO: $5,681
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $5,528
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY Not listed in the file Not listed in the file $6,160.82
Laser treatment of clouding after cataract surgery: 10 of 31 insurance plan rates
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $717.35
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $888.15
  • BEACON EXCHANGE — BEACON EXCHANGE: $819.83
  • BEACON MEDICARE — BEACON MEDICARE: $683.19
  • EMBLEM GHI/HIP MEDICARE — EMBLEM GHI/HIP MEDICARE: $696.85
  • GEISINGER HEALTH COMMERCIAL/EXCHANGE — GEISINGER HEALTH COMMERCIAL/EXCHANGE: $2,254.53
  • HAMASPIK (MCR) — HAMASPIK (MCR): $683.19
  • HEALTH FIRST MEDICARE — HEALTH FIRST MEDICARE: $731.01
  • Medicare — Medicare: $686.55
  • MEDICARE MANAGED — MEDICARE MANAGED: $683.19
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE CATARACT/INSERT LENS Not listed in the file Not listed in the file $4,607 – $17,361
Cataract removal with lens implant: 10 of 41 insurance plan rates
  • Aetna — Aetna: $17,361
  • Aetna Employee — Aetna Employee: $17,361
  • Aetna HP Network — Aetna HP Network: $15,625
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $3,010.03
  • BEACON COMMERCIAL — BEACON COMMERCIAL: $3,726.71
  • BEACON EXCHANGE — BEACON EXCHANGE: $3,440.04
  • BEACON MEDICARE — BEACON MEDICARE: $2,866.70
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $4,607
  • BLUE CROSS HMO — BLUE CROSS HMO: $5,681
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $5,528

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY Not listed in the file Not listed in the file $5,853 – $50,000
Vaginal delivery after a previous C-section, with care before and after: 10 of 24 insurance plan rates
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $10,414
  • BLUE CROSS HMO — BLUE CROSS HMO: $12,827
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $12,497
  • CIGNA PPO — CIGNA PPO: $5,853
  • MAGNACARE PREFERRED — MAGNACARE PREFERRED: $8,760
  • MVP EXCHANGE — MVP EXCHANGE: $12,212
  • MVP HMO/PPO — MVP HMO/PPO: $14,367
  • SELF-PAY — SELF-PAY: $14,440.46
  • Tricare — Tricare: $50,000
  • Aetna — Aetna: 5,000% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $1,664 – $521,572.53
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 37 insurance plan rates
  • Aetna — Aetna: $282,801.18
  • Aetna Employee — Aetna Employee: $282,801.18
  • Aetna HP Network — Aetna HP Network: $254,519.11
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $96,324.70
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $401,202.41
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $376,129.09
  • BLUE CROSS HMO — BLUE CROSS HMO: $501,505.46
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $451,358.83
  • CIGNA PPO — CIGNA PPO: $303,139.62
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: $324,965.06
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Not listed in the file Not listed in the file $1,664 – $78,285.42
Spinal fusion (not neck), without major complications: 10 of 16 insurance plan rates
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $36,211.32
  • EMBLEM GHI/HIP MEDICARE — EMBLEM GHI/HIP MEDICARE: $34,781.39
  • First Health — First Health: $1,664
  • GEISINGER HEALTH COMMERCIAL/EXCHANGE — GEISINGER HEALTH COMMERCIAL/EXCHANGE: $78,285.42
  • HAMASPIK (MCR) — HAMASPIK (MCR): $34,486.97
  • HEALTH FIRST MEDICARE — HEALTH FIRST MEDICARE: $36,901.06
  • Medicare — Medicare: $34,486.97
  • MEDICARE MANAGED — MEDICARE MANAGED: $34,486.97
  • MVP GOLD (MCR) — MVP GOLD (MCR): $34,486.97
  • WORLD TRADE CENTER FDNY — WORLD TRADE CENTER FDNY: $47,389.48
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $1,664 – $102,839.81
Hip or knee replacement (major joint of the leg), without major complications: 10 of 36 insurance plan rates
  • Aetna — Aetna: $55,760.64
  • Aetna Employee — Aetna Employee: $55,760.64
  • Aetna HP Network — Aetna HP Network: $50,184.19
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $19,241.90
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $79,106.12
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $74,162.35
  • BLUE CROSS HMO — BLUE CROSS HMO: $98,883.13
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $88,995.59
  • CIGNA PPO — CIGNA PPO: $59,770.82
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: $64,074.20
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $1,664 – $130,158.54
Neck (cervical) spinal fusion, without complications: 10 of 36 insurance plan rates
  • Aetna — Aetna: $70,573.10
  • Aetna Employee — Aetna Employee: $70,573.10
  • Aetna HP Network — Aetna HP Network: $63,515.30
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $24,270.89
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $100,120.15
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $93,863.10
  • BLUE CROSS HMO — BLUE CROSS HMO: $125,150.80
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $112,636.70
  • CIGNA PPO — CIGNA PPO: $75,648.56
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: $81,095.10
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $1,664 – $66,148.24
Uterus and ovary surgery (not for cancer), without complications: 10 of 36 insurance plan rates
  • Aetna — Aetna: $35,866.16
  • Aetna Employee — Aetna Employee: $35,866.16
  • Aetna HP Network — Aetna HP Network: $32,279.29
  • AFFINITY BY MOLINA MCR — AFFINITY BY MOLINA MCR: $12,487.49
  • BLUE CROSS ACCESS — BLUE CROSS ACCESS: $50,882.35
  • BLUE CROSS CONNECTION/EXCHANGE — BLUE CROSS CONNECTION/EXCHANGE: $47,702.43
  • BLUE CROSS HMO — BLUE CROSS HMO: $63,603.24
  • BLUE CROSS SMALL GROUP — BLUE CROSS SMALL GROUP: $57,243.42
  • CIGNA PPO — CIGNA PPO: $38,445.57
  • EMBLEM GHI/HIP HMO/EPO/POS — EMBLEM GHI/HIP HMO/EPO/POS: $41,213.57

Source: Good Samaritan Hospital of Suffern’s standard charges file (wmchealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 29, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address255 Lafayette Avenue, Suffern, NY 10901
CountyRockland County
StateNew York
Phone(914) 368‑5000
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number330158
Name in Medicare recordsGOOD SAMARITAN HOSPITAL OF SUFFERN
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(845) 368‑5000[9][10]
Name on the hospital’s websiteGood Samaritan Hospital
Official websitewmchealth.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Good Samaritan Hospital — wmchealth.org
  2. Good Samaritan Hospital Community Health Needs Assessment and Community Service Plan 2025-2027 — wmchealth.org
  3. Good Samaritan Hospital Emergency Department — providers.wmchealth.org
  4. Visitor Information - Westchester Medical Center Health Network — wmchealth.org
  5. Patient Guide - Good Samaritan Hospital — wmchealth.org
  6. Contact Us - Westchester Medical Center Health Network — wmchealth.org