Does Hackensack Meridian Mountainside Medical have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Hackensack Meridian Mountainside Medical. In a medical emergency, call 911.

Where is Hackensack Meridian Mountainside Medical?

1 Bay Avenue, Montclair, NJ 07042, in Essex County, New Jersey.

What is the phone number of Hackensack Meridian Mountainside Medical?

(973) 429-6000, as listed by Medicare (CMS).

What is the Medicare star rating of Hackensack Meridian Mountainside Medical?

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

Does Medicare reduce its payments to Hackensack Meridian Mountainside Medical for hospital-acquired conditions?

No. For fiscal year 2026, CMS lists no Medicare payment reduction for Hackensack Meridian Mountainside Medical under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.0621; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Hackensack Meridian Mountainside Medical

Quick answers

Does Hackensack Meridian Mountainside Medical have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Hackensack Meridian Mountainside Medical. In a medical emergency, call 911.
Where is Hackensack Meridian Mountainside Medical?: 1 Bay Avenue, Montclair, NJ 07042, in Essex County, New Jersey.
What is the phone number of Hackensack Meridian Mountainside Medical?: (973) 429-6000, as listed by Medicare (CMS).
What is the Medicare star rating of Hackensack Meridian Mountainside Medical?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Hackensack Meridian Mountainside Medical for hospital-acquired conditions?: No. For fiscal year 2026, CMS lists no Medicare payment reduction for Hackensack Meridian Mountainside Medical under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.0621; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas^{[5][9][10][13][15][16][17][19]}

Conditions treated^{[5][9][10][13][18][19]}

Treatments^{[9][10][13][14][17][19]}

Cardiac rehabilitation
Joint replacement
Sleeve gastrectomy
Roux-en-Y gastric bypass
Leadless pacemaker implantation
Stroke thrombectomy
Uterine fibroid embolization
Radiofrequency ablation
Yttrium-90 radioembolization

Procedures^{[5][7][9][13][15][16][18][19]}

Cardiac catheterization
Emergency angioplasty
CT calcium scoring
CCTA with Heartflow analysis
Spinal fusion
Spine surgery
Hip replacement
Knee replacement
Shoulder replacement
Arthroscopic surgery
MRI
PET/CT scans
Mammography
Low-dose CT lung screening
EBUS
Robotic-assisted lung biopsy (Ion)
Breast reconstruction
Gender-affirming surgery

Programs and centers^{[9][10][11][13][14][18][19]}

Orthopedic Institute
Hip Preservation Program
Structural Heart Program
Heart Failure Center
Montclair Neuroscience Institute
Lung Cancer Screening Program
Cardiac Rehabilitation
Weight loss surgery program

Emergency care (hospital website)^[5][6]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Primary Stroke Center (NJ Department of Health); Joint Commission stroke certification

Visiting and practical information

Parking	Visitors use the 24/7 garage off Walnut Crescent and Highland Ave at hourly rates (max $24/day); outpatient parking is free with validation; valet is available^[8]
Interpreters and languages	The ER has a sign language computer and a language interpretation phone system^[5]

Recognition^{[5][14][18][19]}

Joint Commission Chest Pain certification
Joint Commission Stroke certification
Joint Commission Sepsis certification
Joint Commission Wound Care certification
Cardiac rehabilitation certification (AACVPR)
Commission on Cancer accreditation with commendation

Doctors and clinicians (466)

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

Main specialties

And 442 more: the button below opens the full list.

Other emergency rooms nearby

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

Clara Maass Medical Center3.0 mi · Belleville, NJ · Acute Care Hospital
VA New Jersey Health Care System4.0 mi · East Orange, NJ · Federal/VA Acute Care Hospital
Carewell Health Medical Center4.0 mi · East Orange, NJ · Acute Care Hospital
The University Hospital5.2 mi · Newark, NJ · Acute Care Hospital
St Mary's General Hospital5.3 mi · Passaic, NJ · Acute Care Hospital

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

Other hospitals near Montclair

Essex County Hospital Center3.1 mi · Cedar Grove, NJ · Psychiatric Hospital
Silver Lake Hospital LTACH3.3 mi · Newark, NJ · Long-Term Acute Care Hospital
Kessler Rehab Center3.4 mi · West Orange, NJ · Inpatient Rehabilitation Hospital

Hospitals in Essex County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Montclair Care Center0.5 mi · Montclair, NJ · 4 of 5 stars
Family of Caring Healthcare at Montclair0.6 mi · Montclair, NJ · 5 of 5 stars
Green Hill1.8 mi · West Orange, NJ · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Compassionate Care Hospice of Clifton, LLC1.7 mi · Bloomfield, NJ · 3 of 5 stars
Hospice of New Jersey, LLC1.7 mi · Bloomfield, NJ · 2 of 5 stars
Barnabas Health Home Care and Hospice3.1 mi · West Orange, NJ · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Barnabas Health Home Care and Hospice3.1 mi · West Orange, NJ · 3.5 of 5 stars
Patient Care3.1 mi · West Orange, NJ · 3.5 of 5 stars
Adoration Home Health3.8 mi · Clifton, NJ · 3.5 of 5 stars

All home health agencies in the state →

Dialysis facilities

FMC North Montclair0.0 mi · Montclair, NJ · 5 of 5 stars
Mountainside Hospital0.0 mi · Montclair, NJ · 3 of 5 stars
FMC Bloomfield1.7 mi · Bloomfield, NJ · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

North Fullerton Surgery Center0.0 mi · Montclair, NJ
Pilgrim Medical Center0.0 mi · Montclair, NJ
Ambulatory Center for Excellence in Surgery1.7 mi · Bloomfield, NJ

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

Zufall Health Center West Orange2.6 mi · West Orange, NJ · Community health center
Orange Community Health Center2.8 mi · Orange, NJ · Community health center
East Orange Primary Care Center3.3 mi · East Orange, NJ · Community health center

Clinics and urgent care

Citywide Urgent Care NJ LLC1.7 mi · Bloomfield, NJ · Urgent care center
Medexpress Urgent Care - Northern New Jersey, PC1.7 mi · Bloomfield, NJ · Urgent care center
Summit Medical Group PA1.7 mi · Bloomfield, NJ · Urgent care center

Pharmacies

Grove Pharmacy Limited Liability Company0.0 mi · Montclair, NJ · Community/retail pharmacy
Montclair Hospital, LLC0.0 mi · Montclair, NJ · Community/retail pharmacy
Serket Pharmacy LLC0.0 mi · Montclair, NJ · Community/retail pharmacy

Assisted living nearby

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

Coterie Hudson Yards12 mi · New York, NY
Frederic Fleming Residence12 mi · New York, NY
VillageCare at 46 and Ten13 mi · New York, NY
NY Found-Sr Citizens EHP#5 Clinton Gardens13 mi · New York, NY

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	2 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	3 of 5 stars
Patients got help quickly from staff	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Restfulness of Environment	2 of 5 stars
Care Coordination	2 of 5 stars
Symptoms After Stay	2 of 5 stars
Rated the hospital 9 or 10 out of 10	62%National average: 72%
Would definitely recommend the hospital	63%National average: 71%
Nurses “always” communicated well	74%National average: 80%
Doctors “always” communicated well	75%National average: 80%
“Always” got help as soon as they wanted	54%National average: 64%
Staff “always” explained medicines before giving them	58%National average: 62%
Were given information about recovery at home	82%National average: 86%
Room and bathroom “always” clean	76%National average: 73%
Completed surveys	807Response rate: 20%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0.446No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	1.71No different from the national benchmark
Surgical site infections after colon surgery	0No different from the national benchmark
MRSA bloodstream infections	0.933No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.379No different from the national benchmark
Not reported to Medicare	Surgical site infections after abdominal hysterectomy

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	12.5%
Deaths within 30 days: heart failure patients	9.5%
Deaths within 30 days: pneumonia patients	15.3%
Deaths within 30 days: COPD patients	7.6%
Deaths within 30 days: stroke patients	11.6%
Serious complications (patient safety indicator PSI-90)	0.95No different from the national rate
Complications after hip or knee replacement	5%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG)

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	17.4%
Readmitted within 30 days: heart attack	13.7%
Readmitted within 30 days: heart failure	22%
Readmitted within 30 days: pneumonia	18.1%
Readmitted within 30 days: COPD	20.6%
Readmitted within 30 days: hip or knee replacement	5.7%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	229 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	83%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026	NoCMS lists no payment reduction for this hospital.
Total HAC Score	0.0621Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack	0.9972Fewer readmissions than expected
Heart failure	1.0311More readmissions than expected
Pneumonia	1.0417More readmissions than expected
COPD (chronic lung disease)	0.9988Fewer readmissions than expected
Hip or knee replacement	0.8881Fewer readmissions than expected
No result published	Coronary bypass surgery (CABG) (not reported, or too few cases)

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score	18.83 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)	20.00 out of 100
Person and community engagement (patient survey)	17.00 out of 100
Safety (infections and sepsis care)	38.33 out of 100
Efficiency and cost reduction (Medicare spending)	0.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio	1.08Above the national median hospital (1.00): Medicare spent more

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

ER wait times and Medicare ratings nearby

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

ER wait times in New Jersey Best hospitals in New Jersey

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 53 common services exactly as Hackensack Meridian Mountainside Medical lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Show the prices of 53 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: Emergency department visit with low level of medical decision making	$2,869	$2,869	$165 – $3,208
Emergency room visit (moderate): 10 of 40 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,438.65 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $438.96 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,438.65 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,004.15 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,295.20 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,004.15 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,151.75 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,438.65 GILSBAR [1425] — GILSBAR [142500]: $2,438.65 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,004.15
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: Emergency department visit with moderate level of medical decision making	$3,119	$549.39	$165 – $3,208
Emergency room visit (moderately high): 10 of 40 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,651.15 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $477.21 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,651.15 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,091.65 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,495.20 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,091.65 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,339.25 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,651.15 GILSBAR [1425] — GILSBAR [142500]: $2,651.15 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,091.65
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: Emergency department visit with high level of medical decision making	$3,938	$3,938	$165 – $3,938
Emergency room visit (high): 10 of 40 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $3,347.30 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $602.51 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $3,347.30 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,378.30 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $3,150.40 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,378.30 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,953.50 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $3,347.30 GILSBAR [1425] — GILSBAR [142500]: $3,347.30 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,378.30

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: Blood test, basic group of blood chemicals (Calcium, total)	$142	$9.73	$8.46 – $142
Basic metabolic panel (blood test): 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $120.70 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $21.73 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $120.70 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $142 BCBS [1155] — EMPIRE BCBS PPO [115559]: $139.70 BLACK LUNG [6055] — BLACK LUNG [605500]: $58.22 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $58.22 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $106.50 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $120.70 GILSBAR [1425] — GILSBAR [142500]: $120.70
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: Blood test, comprehensive group of blood chemicals	$305	$12.14	$10.56 – $305
Comprehensive metabolic panel (blood test): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $259.25 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $46.67 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $259.25 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $305 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $300.06 BCBS [1155] — EMPIRE BCBS PPO [115559]: $300.06 BLACK LUNG [6055] — BLACK LUNG [605500]: $125.05 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $244 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $125.05 EMBLEM HEALTH [2430] — GHI [243003]: $283.35
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Blood test, lipids (cholesterol and triglycerides)	$324	$15.40	$13.39 – $324
Cholesterol panel (lipid panel): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $275.40 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $49.57 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $275.40 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $324 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $318.75 BCBS [1155] — EMPIRE BCBS PPO [115559]: $318.75 BLACK LUNG [6055] — BLACK LUNG [605500]: $132.84 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $259.20 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $132.84 EMBLEM HEALTH [2430] — GHI [243003]: $301
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: Kidney function blood test panel	$241.50	$9.98	$8.68 – $241.50
Kidney function panel: 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $205.28 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $36.95 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $205.28 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $241.50 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $237.59 BCBS [1155] — EMPIRE BCBS PPO [115559]: $237.59 BLACK LUNG [6055] — BLACK LUNG [605500]: $99.02 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $193.20 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $99.02 EMBLEM HEALTH [2430] — GHI [243003]: $224.35
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: Liver function blood test panel	$187	$9.40	$8.17 – $187
Liver function panel: 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $158.95 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $28.61 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $158.95 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $187 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $183.97 BCBS [1155] — EMPIRE BCBS PPO [115559]: $183.97 BLACK LUNG [6055] — BLACK LUNG [605500]: $76.67 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $149.60 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $76.67 EMBLEM HEALTH [2430] — GHI [243003]: $173.72
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: Manual urinalysis test with examination using microscope, automated	$145	$3.65	$3.17 – $145
Urine test (automated, with microscope): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $123.25 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $22.19 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $123.25 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $145 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $142.65 BCBS [1155] — EMPIRE BCBS PPO [115559]: $142.65 BLACK LUNG [6055] — BLACK LUNG [605500]: $59.45 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $116 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $59.45 EMBLEM HEALTH [2430] — GHI [243003]: $134.71
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: Urinalysis, manual test	$39.90	$4	$3.48 – $39.90
Urine test (manual, without microscope): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $33.92 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $6.10 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $33.92 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $39.90 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $39.25 BCBS [1155] — EMPIRE BCBS PPO [115559]: $39.25 BLACK LUNG [6055] — BLACK LUNG [605500]: $16.36 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $31.92 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $16.36 EMBLEM HEALTH [2430] — GHI [243003]: $37.07
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Automated urinalysis test	$72	$2.59	$2.25 – $72
Urine test (automated, without microscope): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $61.20 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $11.02 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $61.20 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $72 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $70.83 BCBS [1155] — EMPIRE BCBS PPO [115559]: $70.83 BLACK LUNG [6055] — BLACK LUNG [605500]: $29.52 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $57.60 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $29.52 EMBLEM HEALTH [2430] — GHI [243003]: $66.89
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: PSA (prostate specific antigen) measurement, total	$519.75	$21.15	$18.39 – $519.75
PSA (prostate specific antigen) blood test: 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $441.79 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $79.52 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $441.79 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $519.75 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $511.33 BCBS [1155] — EMPIRE BCBS PPO [115559]: $511.33 BLACK LUNG [6055] — BLACK LUNG [605500]: $213.10 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $415.80 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $213.10 EMBLEM HEALTH [2430] — GHI [243003]: $482.85
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Blood test, thyroid stimulating hormone (TSH)	$232	$19.32	$16.80 – $232
Thyroid stimulating hormone (TSH) test: 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $197.20 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $35.50 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $197.20 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $232 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $228.24 BCBS [1155] — EMPIRE BCBS PPO [115559]: $228.24 BLACK LUNG [6055] — BLACK LUNG [605500]: $95.12 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $185.60 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $95.12 EMBLEM HEALTH [2430] — GHI [243003]: $215.53
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	$117	$8.94	$7.77 – $117
Complete blood count (CBC) with differential: 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $99.45 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $17.90 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $99.45 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $117 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $115.10 BCBS [1155] — EMPIRE BCBS PPO [115559]: $115.10 BLACK LUNG [6055] — BLACK LUNG [605500]: $47.97 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $93.60 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $47.97 EMBLEM HEALTH [2430] — GHI [243003]: $108.69
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: Complete blood cell count (red cells, white blood cell, platelets), automated test	$87	$7.44	$6.47 – $87
Complete blood count (CBC), automated: 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $73.95 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $13.31 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $73.95 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $87 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $85.59 BCBS [1155] — EMPIRE BCBS PPO [115559]: $85.59 BLACK LUNG [6055] — BLACK LUNG [605500]: $35.67 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $69.60 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $35.67 EMBLEM HEALTH [2430] — GHI [243003]: $80.82
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Blood test, clotting time	$96	$4.93	$4.29 – $96
Blood clotting time test (prothrombin time, PT): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $81.60 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $14.69 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $81.60 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $96 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $94.44 BCBS [1155] — EMPIRE BCBS PPO [115559]: $94.44 BLACK LUNG [6055] — BLACK LUNG [605500]: $39.36 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $76.80 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $39.36 EMBLEM HEALTH [2430] — GHI [243003]: $89.18
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Coagulation assessment blood test, plasma or whole blood	$103	$6.91	$6.01 – $103
Blood clotting test (partial thromboplastin time, PTT): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $87.55 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $15.76 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $87.55 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $103 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $101.33 BCBS [1155] — EMPIRE BCBS PPO [115559]: $101.33 BLACK LUNG [6055] — BLACK LUNG [605500]: $42.23 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $82.40 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $42.23 EMBLEM HEALTH [2430] — GHI [243003]: $95.69

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: CT scan head or brain without contrast	$3,145	$137.20	$119.31 – $3,145
CT scan of the head or brain, without contrast: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,673.25 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $481.19 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,673.25 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,289.45 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,516 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,289.45 EMBLEM HEALTH [2430] — GHI [243003]: $2,921.71 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,358.75 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,673.25 GILSBAR [1425] — GILSBAR [142500]: $2,673.25
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI scan of brain before and after contrast	$5,953	$460.77	$400.67 – $8,270.48
MRI of the brain, before and after contrast: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $5,060.05 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $910.81 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $5,060.05 BLACK LUNG [6055] — BLACK LUNG [605500]: $2,440.73 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $4,762.40 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $2,440.73 EMBLEM HEALTH [2430] — GHI [243003]: $5,530.34 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $4,464.75 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $5,060.05 GILSBAR [1425] — GILSBAR [142500]: $5,060.05
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Chest 2 Views	$390	$113.60	$40.95 – $390
Chest X-ray, 2 views: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $331.50 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $59.67 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $331.50 BLACK LUNG [6055] — BLACK LUNG [605500]: $159.90 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $312 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $159.90 EMBLEM HEALTH [2430] — GHI [243003]: $362.31 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $292.50 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $331.50 GILSBAR [1425] — GILSBAR [142500]: $331.50
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: X-ray of lower and sacral spine, minimum of 4 views	$692	$137.20	$72.66 – $692
X-ray of the lower spine, at least 4 views: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $588.20 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $105.88 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $588.20 BLACK LUNG [6055] — BLACK LUNG [605500]: $283.72 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $553.60 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $283.72 EMBLEM HEALTH [2430] — GHI [243003]: $642.87 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $519 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $588.20 GILSBAR [1425] — GILSBAR [142500]: $588.20
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI scan of lower spinal canal without contrast	$4,302	$311.87	$271.19 – $5,101.92
MRI of the lower back (lumbar spine), without contrast: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $3,656.70 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $658.21 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $3,656.70 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,763.82 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $3,441.60 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,763.82 EMBLEM HEALTH [2430] — GHI [243003]: $3,996.56 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $3,226.50 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $3,656.70 GILSBAR [1425] — GILSBAR [142500]: $3,656.70
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: CT scan of pelvis with contrast	$3,399.90	$229.68	$199.72 – $3,399.90
CT scan of the pelvis, with contrast: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,889.92 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $520.18 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,889.92 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,393.96 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,719.92 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,393.96 EMBLEM HEALTH [2430] — GHI [243003]: $3,158.51 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,549.93 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,889.92 GILSBAR [1425] — GILSBAR [142500]: $2,889.92
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI scan of leg joint without contrast	$4,019	$311.87	$271.19 – $7,652.88
MRI of a leg joint (such as the knee), without contrast: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $3,416.15 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $614.91 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $3,416.15 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,647.79 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $3,215.20 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,647.79 EMBLEM HEALTH [2430] — GHI [243003]: $3,733.65 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $3,014.25 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $3,416.15 GILSBAR [1425] — GILSBAR [142500]: $3,416.15
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee · modifier TC\|50 In the file: MRI scan of leg joint without contrast\|TECHNICAL COMPONENT\|BILATERAL PROCEDURE	$6,028.50	$697.06	$271.19 – $7,652.88
MRI of a leg joint (such as the knee), without contrast: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $5,124.23 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $922.36 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $5,124.23 BLACK LUNG [6055] — BLACK LUNG [605500]: $2,471.69 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $4,822.80 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $2,471.69 EMBLEM HEALTH [2430] — GHI [243003]: $5,600.48 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $4,521.38 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $5,124.23 GILSBAR [1425] — GILSBAR [142500]: $5,124.23
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: CT scan of abdomen and pelvis with contrast	$3,145	$460.77	$330.23 – $3,404.86
CT scan of the abdomen and pelvis, with contrast: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,673.25 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $481.19 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,673.25 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,289.45 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,516 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,289.45 EMBLEM HEALTH [2430] — GHI [243003]: $2,921.71 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,358.75 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,673.25 GILSBAR [1425] — GILSBAR [142500]: $2,673.25
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: Complete ultrasound scan of abdomen	$1,230	$137.20	$119.31 – $1,230
Ultrasound of the abdomen, complete: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $1,045.50 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $188.19 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $1,045.50 BLACK LUNG [6055] — BLACK LUNG [605500]: $504.30 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $984 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $504.30 EMBLEM HEALTH [2430] — GHI [243003]: $1,142.67 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $922.50 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $1,045.50 GILSBAR [1425] — GILSBAR [142500]: $1,045.50
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus	$3,234	$137.20	$119.31 – $3,234
Pregnancy ultrasound (after the first trimester): 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,748.90 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $494.80 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,748.90 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,325.94 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,587.20 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,325.94 EMBLEM HEALTH [2430] — GHI [243003]: $3,004.39 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,425.50 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,748.90 GILSBAR [1425] — GILSBAR [142500]: $2,748.90
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina	$1,065	$137.20	$111.83 – $1,065
Transvaginal ultrasound: 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $905.25 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $162.95 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $905.25 BLACK LUNG [6055] — BLACK LUNG [605500]: $436.65 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $852 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $436.65 EMBLEM HEALTH [2430] — GHI [243003]: $989.39 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $798.75 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $905.25 GILSBAR [1425] — GILSBAR [142500]: $905.25
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Diag Mammo W/ Cad Unilat	$604.80	$114.55	$63.50 – $984.97
Diagnostic mammogram, one breast: 10 of 45 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $514.08 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $92.53 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $514.08 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $595 BCBS [1155] — EMPIRE BCBS PPO [115559]: $595 BLACK LUNG [6055] — BLACK LUNG [605500]: $247.97 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $483.84 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $247.97 EMBLEM HEALTH [2430] — GHI [243003]: $561.86 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $453.60
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: Diagnostic mammography of both breasts	$800	$145.95	$84 – $1,260.12
Diagnostic mammogram, both breasts: 10 of 45 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $680 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $122.40 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $680 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $787.04 BCBS [1155] — EMPIRE BCBS PPO [115559]: $787.04 BLACK LUNG [6055] — BLACK LUNG [605500]: $328 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $640 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $328 EMBLEM HEALTH [2430] — GHI [243003]: $743.20 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $600
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Screening Mammo Bilat W/Cad if Performed	$950	$120.72	$99.75 – $1,040.77
Screening mammogram, both breasts: 10 of 45 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $807.50 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $145.35 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $807.50 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $934.61 BCBS [1155] — EMPIRE BCBS PPO [115559]: $934.61 BLACK LUNG [6055] — BLACK LUNG [605500]: $389.50 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $760 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $389.50 EMBLEM HEALTH [2430] — GHI [243003]: $882.55 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $712.50

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: Sleep study in sleep lab (6 years or older)	$6,580.35	$1,312.65	$690.94 – $6,580.35
Sleep study (overnight, in a sleep lab): 10 of 49 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $5,593.30 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $1,006.79 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $5,593.30 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $6,580.35 BLACK LUNG [6055] — BLACK LUNG [605500]: $2,697.94 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $5,264.28 CIGNA [1260] — CIGNA HMO POS OPEN ACCESS [126018]: $6,399.39 CIGNA [1260] — CIGNA INDEMNITY [126019]: $6,399.39 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $2,697.94 EMBLEM HEALTH [2430] — GHI [243003]: $6,113.15

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	$338	$39.76	$32.12 – $355
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $287.30 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $51.71 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $287.30 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $338 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $332.52 BCBS [1155] — EMPIRE BCBS PPO [115559]: $332.52 BLACK LUNG [6055] — BLACK LUNG [605500]: $138.58 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $270.40 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $138.58 EMBLEM HEALTH [2430] — GHI [243003]: $314
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: Evaluation for physical therapy, typically 20 minutes	$455	$109.96	$47.78 – $643.57
Physical therapy evaluation (low complexity): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $386.75 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $69.62 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $386.75 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $455 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $447.63 BCBS [1155] — EMPIRE BCBS PPO [115559]: $447.63 BLACK LUNG [6055] — BLACK LUNG [605500]: $186.55 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $364 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $186.55 EMBLEM HEALTH [2430] — GHI [243003]: $422.70
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity	$862	$109.96	$90.51 – $862
Physical therapy evaluation (moderate complexity): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $732.70 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $131.89 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $732.70 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $862 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $848.04 BCBS [1155] — EMPIRE BCBS PPO [115559]: $848.04 BLACK LUNG [6055] — BLACK LUNG [605500]: $353.42 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $689.60 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $353.42 EMBLEM HEALTH [2430] — GHI [243003]: $800.80
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: Evaluation for physical therapy, typically 45 minutes	$541.80	$109.96	$56.89 – $643.57
Physical therapy evaluation (high complexity): 10 of 46 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $460.53 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $82.90 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $460.53 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $541.80 BCBS [1155] — EMPIRE BCBS HMO POS EPO [115558]: $533.02 BCBS [1155] — EMPIRE BCBS PPO [115559]: $533.02 BLACK LUNG [6055] — BLACK LUNG [605500]: $222.14 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $433.44 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $222.14 EMBLEM HEALTH [2430] — GHI [243003]: $503.33
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: Psychotherapy, 30 minutes	$543.90	$207.30	$49.25 – $543.90
Psychotherapy, 30 minutes: 10 of 51 insurance plan rates 1199 SEIU BENEFIT FUND [3505] — 1199 SEIU BENEFIT FUND [350500]: $477.54 ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $462.32 AETNA [1015] — AETNA LIBERTY [101531]: $407.93 AETNA [1015] — AETNA PPO [101526]: $477.54 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $83.22 ALLIED BENEFIT SYSTEMS INC [1030] — ALLIED BENEFIT SYSTEMS [103000]: $477.54 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $462.32 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $543.90 BLACK LUNG [6055] — BLACK LUNG [605500]: $223 CIGNA [1260] — CIGNA HMO POS OPEN ACCESS [126018]: $528.94
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: Psychotherapy, 45 minutes	$576	$207.30	$60.48 – $576
Psychotherapy, 45 minutes: 10 of 51 insurance plan rates 1199 SEIU BENEFIT FUND [3505] — 1199 SEIU BENEFIT FUND [350500]: $505.73 ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $489.60 AETNA [1015] — AETNA LIBERTY [101531]: $432 AETNA [1015] — AETNA PPO [101526]: $505.73 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $88.13 ALLIED BENEFIT SYSTEMS INC [1030] — ALLIED BENEFIT SYSTEMS [103000]: $505.73 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $489.60 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $576 BLACK LUNG [6055] — BLACK LUNG [605500]: $236.16 CIGNA [1260] — CIGNA HMO POS OPEN ACCESS [126018]: $560.16
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: Psychotherapy, 1 hour	$487.20	$207.30	$51.16 – $487.20
Psychotherapy, 60 minutes: 10 of 51 insurance plan rates 1199 SEIU BENEFIT FUND [3505] — 1199 SEIU BENEFIT FUND [350500]: $427.76 ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $414.12 AETNA [1015] — AETNA LIBERTY [101531]: $365.40 AETNA [1015] — AETNA PPO [101526]: $427.76 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $74.54 ALLIED BENEFIT SYSTEMS INC [1030] — ALLIED BENEFIT SYSTEMS [103000]: $427.76 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $414.12 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $487.20 BLACK LUNG [6055] — BLACK LUNG [605500]: $199.75 CIGNA [1260] — CIGNA HMO POS OPEN ACCESS [126018]: $473.80
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: Family psychotherapy without patient, 50 minutes	$801.15	$207.30	$65.75 – $801.15
Family psychotherapy, without the patient: 10 of 54 insurance plan rates 1199 SEIU BENEFIT FUND [3505] — 1199 SEIU BENEFIT FUND [350500]: $703.41 ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $680.98 AETNA [1015] — AETNA LIBERTY [101531]: $600.86 AETNA [1015] — AETNA PPO [101526]: $703.41 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $122.58 ALLIED BENEFIT SYSTEMS INC [1030] — ALLIED BENEFIT SYSTEMS [103000]: $703.41 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $680.98 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $801.15 BLACK LUNG [6055] — BLACK LUNG [605500]: $328.47 CIGNA [1260] — CIGNA HMO POS OPEN ACCESS [126018]: $779.12
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: Family psychotherapy with patient, 50 minutes	$801.15	$207.30	$65.75 – $801.15
Family psychotherapy, with the patient: 10 of 54 insurance plan rates 1199 SEIU BENEFIT FUND [3505] — 1199 SEIU BENEFIT FUND [350500]: $703.41 ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $680.98 AETNA [1015] — AETNA LIBERTY [101531]: $600.86 AETNA [1015] — AETNA PPO [101526]: $703.41 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $122.58 ALLIED BENEFIT SYSTEMS INC [1030] — ALLIED BENEFIT SYSTEMS [103000]: $703.41 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $680.98 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $801.15 BLACK LUNG [6055] — BLACK LUNG [605500]: $328.47 CIGNA [1260] — CIGNA HMO POS OPEN ACCESS [126018]: $779.12
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: Group psychotherapy	$1,142.40	$119.35	$40 – $1,142.40
Group psychotherapy: 10 of 51 insurance plan rates 1199 SEIU BENEFIT FUND [3505] — 1199 SEIU BENEFIT FUND [350500]: $1,003.03 ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $971.04 AETNA [1015] — AETNA LIBERTY [101531]: $856.80 AETNA [1015] — AETNA PPO [101526]: $1,003.03 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $174.79 ALLIED BENEFIT SYSTEMS INC [1030] — ALLIED BENEFIT SYSTEMS [103000]: $1,003.03 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $971.04 AMERIHEALTH [3520] — AMERIHEALTH PREFERRED HMO/POS [352007]: $1,142.40 BLACK LUNG [6055] — BLACK LUNG [605500]: $468.38 CIGNA [1260] — CIGNA HMO POS OPEN ACCESS [126018]: $1,110.98

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	$2,750	$1,209.65	$288.75 – $13,478.79
Upper GI endoscopy (diagnostic): 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,337.50 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $420.75 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,337.50 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,127.50 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,200 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,127.50 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,062.50 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,337.50 GILSBAR [1425] — GILSBAR [142500]: $2,337.50 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,127.50
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Egd Biopsy Single/Multiple	$2,753.85	$1,209.65	$289.15 – $13,478.79
Upper GI endoscopy with biopsy: 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,340.77 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $421.34 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,340.77 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,129.08 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,203.08 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,129.08 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,065.39 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,340.77 GILSBAR [1425] — GILSBAR [142500]: $2,340.77 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,129.08
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Hospital (facility) fee In the file: Diagnostic exam of large bowel using a flexible endoscope	$2,750	$1,176.29	$288.75 – $13,478.79
Colonoscopy (diagnostic): 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,337.50 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $420.75 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,337.50 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,127.50 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,200 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,127.50 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,062.50 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,337.50 GILSBAR [1425] — GILSBAR [142500]: $2,337.50 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,127.50
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Hospital (facility) fee In the file: Biopsy of large bowel using a flexible endoscope	$3,195	$1,521.26	$335.48 – $13,478.79
Colonoscopy with biopsy: 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,715.75 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $488.84 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,715.75 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,309.95 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,556 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,309.95 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,396.25 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,715.75 GILSBAR [1425] — GILSBAR [142500]: $2,715.75 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,309.95
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Hospital (facility) fee In the file: Removal of polyps or growths of large bowel using an endoscope with mechanical snare	$3,000	$1,521.26	$315 – $13,478.79
Colonoscopy with removal of polyps (snare): 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,550 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $459 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,550 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,230 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,400 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,230 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,250 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,550 GILSBAR [1425] — GILSBAR [142500]: $2,550 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,230
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Hospital (facility) fee In the file: Ultrasound exam of large bowel using a flexible endoscope	$3,500	$1,521.26	$367.50 – $13,478.79
Ultrasound of the lower bowel by endoscope: 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,975 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $535.50 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,975 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,435 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,800 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,435 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,625 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,975 GILSBAR [1425] — GILSBAR [142500]: $2,975 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,435
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Colonoscopy Screen Not High Risk	$3,740	$1,176.29	$392.70 – $22,900
Screening colonoscopy (not high risk): 10 of 43 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $3,179 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $572.22 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $3,179 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,533.40 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,992 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,533.40 EMBLEM HEALTH [2430] — GHI [243003]: $3,474.46 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,805 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $3,179 GILSBAR [1425] — GILSBAR [142500]: $3,179
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: Biopsy of prostate gland	$4,246.68	$2,643	$445.90 – $22,900
Prostate biopsy: 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $3,609.68 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $649.74 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $3,609.68 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,741.14 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $3,397.34 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,741.14 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $3,185.01 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $3,609.68 GILSBAR [1425] — GILSBAR [142500]: $3,609.68 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,741.14
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Inj Epidural Lumb/Caud W/Imaging	$2,935	$893.50	$308.18 – $22,900
Spinal injection, lower back (epidural), with imaging guidance: 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $2,494.75 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $449.06 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $2,494.75 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,203.35 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $2,348 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,203.35 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $2,201.25 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $2,494.75 GILSBAR [1425] — GILSBAR [142500]: $2,494.75 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,203.35
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Bilat Inj Anes/Steroid Trnsf Lumbr/Sac Sngl	$5,799	$1,148.66	$480.07 – $22,900
Nerve root injection, lower back, with imaging guidance: 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $4,929.15 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $887.25 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $4,929.15 BLACK LUNG [6055] — BLACK LUNG [605500]: $2,377.59 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $4,639.20 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $2,377.59 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $4,349.25 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $4,929.15 GILSBAR [1425] — GILSBAR [142500]: $4,929.15 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $2,377.59
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level	$4,572.13	$1,148.66	$480.07 – $22,900
Nerve root injection, lower back, with imaging guidance: 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $3,886.31 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $699.54 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $3,886.31 BLACK LUNG [6055] — BLACK LUNG [605500]: $1,874.57 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $3,657.70 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $1,874.57 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $3,429.10 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $3,886.31 GILSBAR [1425] — GILSBAR [142500]: $3,886.31 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $1,874.57
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee · modifier 50 In the file: HC Bilat Inj Anes/Steroid Trnsf Lumbr/Sac Sngl\|BILATERAL PROCEDURE	$8,698.50	$1,722.99	$480.07 – $22,900
Nerve root injection, lower back, with imaging guidance: 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $7,393.73 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $1,330.87 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $7,393.73 BLACK LUNG [6055] — BLACK LUNG [605500]: $3,566.39 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $6,958.80 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $3,566.39 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $6,523.88 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $7,393.73 GILSBAR [1425] — GILSBAR [142500]: $7,393.73 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $3,566.39
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: Removal of recurring cataract in lens capsule using a laser	$1,733.88	$707.81	$182.06 – $22,900
Laser treatment of clouding after cataract surgery: 10 of 41 insurance plan rates ADMINISTRATIVE CONCEPTS [1005] — ADMINISTRATIVE CONCEPTS [100502]: $1,473.80 AETNA MEDICAID REPLACEMENT [3510] — AETNA BETTER HEALTH [351001]: $265.28 ALLIED NATIONAL GLOBAL CARE [1035] — ALLIED NATIONAL [103500]: $1,473.80 BLACK LUNG [6055] — BLACK LUNG [605500]: $710.89 CIGNA [1260] — CIGNA BEHAVIORAL HEALTH [126013]: $1,387.10 CREATE FLEX / SELECT [3580] — CREATE FLEX CARE [358000]: $710.89 FIRST HEALTH [1375] — FIRST HEALTH NETWORK [137501]: $1,300.41 FIRST HEALTH [1375] — TALL TREE ADMINISTRATORS [137508]: $1,473.80 GILSBAR [1425] — GILSBAR [142500]: $1,473.80 HEALTHCARE HIGHWAYS [2210] — HCH 90 DEGREE BENEFITS [221013]: $710.89

Source: Hackensack Meridian Mountainside Medical’s standard charges file (cdn.ardenthealthservices.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on February 12, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	1 Bay Avenue, Montclair, NJ 07042
County	Essex County
State	New Jersey
Phone	(973) 429‑6000
Emergency services	Yes
Ownership	Proprietary
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	310054
Name in Medicare records	HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	Hackensack Meridian Mountainside Medical Center
Official website	mountainsidemedicalcenter.com
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-31.

Emergency care in New Jersey - Hackensack Meridian Mountainside Medical Center — mountainsidemedicalcenter.com
Mountainside Medical Center - Emergency Department — mountainsidemedicalcenter.com
Heart Screening Services in NJ | Mountainside Medical Center — mountainsidemedicalcenter.com
Parking - Hackensack Meridian Mountainside Medical Center — mountainsidemedicalcenter.com
Orthopedic Care in Montclair, NJ | Mountainside Medical Center — mountainsidemedicalcenter.com
Weight Loss Surgery in New Jersey | Mountainside Medical Center — mountainsidemedicalcenter.com
About Us - Hackensack Meridian Mountainside Medical Center — mountainsidemedicalcenter.com
Cardiologists in New Jersey - Mountainside Medical Center — mountainsidemedicalcenter.com
Cardiac Rehabilitation in New Jersey | Mountainside Medical Center — mountainsidemedicalcenter.com
Plastic surgeons in New Jersey - Hackensack Meridian Mountainside Medical Center — mountainsidemedicalcenter.com
Imaging Services in New Jersey - Hackensack Meridian Mountainside Medical Center — mountainsidemedicalcenter.com
Interventional Radiology in New Jersey - Hackensack Meridian Mountainside Medical Center — mountainsidemedicalcenter.com
Lung cancer screening in NJ - Hackensack Meridian Mountainside Medical Center — mountainsidemedicalcenter.com
Neurologists in New Jersey | Mountainside Medical Center — mountainsidemedicalcenter.com