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Acute Care Hospital

Hospital for Special Surgery

New York, New York · New York County

Summary

Hospital for Special Surgery is an acute care hospital in New York, New York. Medicare data does not list emergency services. CMS overall star rating: 5 of 5 stars. Its official website lists 54 services, specialties and programs. Medicare lists 906 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

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Exterior of Hospital for Special Surgery
Photo: Ajay Suresh from New York, NY, USA, CC BY 2.0, via Wikimedia Commons · source · licence

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

Not listedEmergency services
5 of 5 stars5 of 5 stars · Medicare rating
54Services listed

Quick answers

Does Hospital for Special Surgery have an emergency room?
Medicare (CMS) data does not list emergency services at Hospital for Special Surgery. The closest hospitals that do: New York-Presbyterian Hospital (0.1 mi), Lenox Hill Hospital (0.7 mi) and Metropolitan Hospital Center (1.4 mi). In a medical emergency, call 911.
Where is Hospital for Special Surgery?
535 East 70th Street, New York, NY 10021, in New York County, New York.
What is the phone number of Hospital for Special Surgery?
(212) 606-1000, as listed by Medicare (CMS).
What is the Medicare star rating of Hospital for Special Surgery?
5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][7][10][12]

Conditions treated[7][8][9][11][12]

  • Hip fractures
  • Ankle fractures
  • Wrist fractures
  • Pelvic fracture
  • Open fractures
  • Stress fractures
  • Tibia fractures
  • Polytrauma
  • Lupus
  • Inflammatory arthritis
  • Scleroderma
  • Vasculitis
  • Myositis
  • Osteoporosis
  • Heel pain
  • Achilles tendon pain
  • Ankle sprains
  • Shin splints

Treatments[4][5][8][10][11][12]

  • Hip replacement
  • Knee replacement
  • Spinal fusion surgery
  • Regional anesthesia
  • Custom foot orthotics
  • Limb lengthening

Procedures[4][7]

  • Total knee replacement
  • MRI
  • CT scan
  • Ultrasound
  • DEXA bone density testing
  • EOS imaging
  • Image-guided joint injection
  • Nerve block
  • Radiofrequency ablation
  • Biopsy

Programs and centers[5][7][9][10][11][12]

  • Complex Joint Reconstruction Center
  • Complex Spine and Scoliosis Center
  • Lerner Children's Pavilion
  • Non-surgical Foot and Ankle Service
  • Heel Pain Center
  • Orthopedic Trauma Service
  • Sports Medicine Institute
  • Osteoporosis Center

Visiting and practical information

Interpreters and languagesFree skilled medical interpreters and communication assistance; Language Assistance 212.606.1760[14][13]

Recognition[4][5][6]

  • Magnet Recognition (ANCC), redesignated five consecutive times
  • U.S. News & World Report No. 1 in orthopedics (2026-2027)
  • Accredited by The Joint Commission
  • U.S. News & World Report #1 in orthopedics 2027
  • U.S. News & World Report #3 in rheumatology 2027
  • Healthgrades America's 100 Best Hospitals for Joint Replacement Award 2027

Doctors and clinicians (906)

906 doctors and other clinicians list Hospital for Special Surgery 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 (906)

And 882 more: the button below opens the full list.

Nearest emergency rooms

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

  • Duane Reade0.3 mi · Roosevelt Island, NY · Pharmacy
  • Barmed Drugs Inc0.4 mi · New York, NY · Community/retail pharmacy
  • BBRX1LLC0.4 mi · New York, NY · Community/retail pharmacy

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 Hospital for Special Surgery 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) 4 of 5 stars
Overall rating of the hospital4 of 5 stars
Would recommend the hospital5 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well4 of 5 stars
Staff explained medicines3 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean4 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1083%National average: 72%
Would definitely recommend the hospital87%National average: 71%
Nurses “always” communicated well82%National average: 80%
Doctors “always” communicated well83%National average: 80%
Staff “always” explained medicines before giving them65%National average: 62%
Were given information about recovery at home89%National average: 86%
Room and bathroom “always” clean77%National average: 74%
Area around the room “always” quiet at night51%National average: 60%
Completed surveys897Response rate: 42%

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)Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)Not reported to Medicare
Surgical site infections after colon surgeryNot reported to Medicare
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infectionsNot reported to Medicare
Clostridioides difficile (C. diff) intestinal infections0.165Better 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 patientsNot reported to Medicare
Deaths within 30 days: heart failure patientsNot reported to Medicare
Deaths within 30 days: pneumonia patientsNot reported to Medicare
Deaths within 30 days: COPD patientsNot reported to Medicare
Deaths within 30 days: stroke patientsNot reported to Medicare
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)0.62Better than 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 2024.

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 attackNot reported to Medicare
Readmitted within 30 days: heart failureNot reported to Medicare
Readmitted within 30 days: pneumoniaNot reported to Medicare
Readmitted within 30 days: COPDNot reported to Medicare
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacement3.8%

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.

Average (median) time patients spent in the emergency room before leaving (OP-18b)Not reported to Medicare
Patients who left the emergency room before being seen (OP-22)Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)Too few cases to report

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026.

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.

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 51 common services exactly as Hospital for Special Surgery lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

$ 2 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: Hosp OP Visit New Lvl 3 $440 $440 $127.78 – $440
New patient office visit (about 30–44 minutes): 10 of 85 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $325.60
  • AETNA [1003] — AETNA EPO [100305]: $325.60
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $325.60
  • AETNA [1003] — AETNA HMO [100306]: $325.60
  • AETNA [1003] — AETNA INDEMNITY [100302]: $325.60
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $325.60
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $325.60
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $325.60
  • AETNA [1003] — AETNA POS [100308]: $325.60
  • AETNA [1003] — AETNA PPO [100309]: $325.60
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30 MIN,Facility Rate $550 $550 $40.84 – $263.56
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: $170.82
  • Anthem NY — Commercial: $218.75
  • Anthem NY — Exchange: $185.94
  • CIGNA — Commercial: $158.59
  • Emblem — City of NY Plans: $140.95
  • Emblem — Commercial: $140.95
  • Emblem — Medicare Managed Care: $80.08
  • Fidelis — Essential Plans 1,2: $72.08
  • Fidelis — Essential Plans 3,4: $60.06
  • Fidelis — Medicaid Managed Care: $60.06
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30 MIN,Office Rate $550 $550 $40.84 – $263.56
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: $242.93
  • Anthem NY — Commercial: $218.75
  • Anthem NY — Exchange: $185.94
  • CIGNA — Commercial: $219.51
  • Emblem — City of NY Plans: $235.21
  • Emblem — Commercial: $235.21
  • Emblem — Medicare Managed Care: $133.64
  • Fidelis — Essential Plans 1,2: $120.28
  • Fidelis — Essential Plans 3,4: $100.23
  • Fidelis — Medicaid Managed Care: $100.23
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: Hosp OP Visit New Lvl 4 $440 $440 $127.78 – $440
New patient office visit (about 45–59 minutes): 10 of 85 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $325.60
  • AETNA [1003] — AETNA EPO [100305]: $325.60
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $325.60
  • AETNA [1003] — AETNA HMO [100306]: $325.60
  • AETNA [1003] — AETNA INDEMNITY [100302]: $325.60
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $325.60
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $325.60
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $325.60
  • AETNA [1003] — AETNA POS [100308]: $325.60
  • AETNA [1003] — AETNA PPO [100309]: $325.60
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45 MIN,Facility Rate $900 $900 $67.88 – $401.02
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: $277.74
  • Anthem NY — Commercial: $331.63
  • Anthem NY — Exchange: $281.89
  • CIGNA — Commercial: $257.48
  • Emblem — City of NY Plans: $230.08
  • Emblem — Commercial: $230.08
  • Emblem — Medicare Managed Care: $130.73
  • Fidelis — Essential Plans 1,2: $117.65
  • Fidelis — Essential Plans 3,4: $98.04
  • Fidelis — Medicaid Managed Care: $98.04
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45 MIN,Office Rate $900 $900 $67.88 – $401.02
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: $364.03
  • Anthem NY — Commercial: $331.63
  • Anthem NY — Exchange: $281.89
  • CIGNA — Commercial: $327.78
  • Emblem — City of NY Plans: $353.71
  • Emblem — Commercial: $353.71
  • Emblem — Medicare Managed Care: $200.97
  • Fidelis — Essential Plans 1,2: $180.88
  • Fidelis — Essential Plans 3,4: $150.73
  • Fidelis — Medicaid Managed Care: $150.73
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: Hosp OP Visit New Lvl 5 $440 $440 $127.78 – $440
New patient office visit (about 60–74 minutes): 10 of 85 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $325.60
  • AETNA [1003] — AETNA EPO [100305]: $325.60
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $325.60
  • AETNA [1003] — AETNA HMO [100306]: $325.60
  • AETNA [1003] — AETNA INDEMNITY [100302]: $325.60
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $325.60
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $325.60
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $325.60
  • AETNA [1003] — AETNA POS [100308]: $325.60
  • AETNA [1003] — AETNA PPO [100309]: $325.60
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60 MIN,Office Rate $1,000 $1,000 $88.31 – $505.76
New patient office visit (about 60–74 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: $454.72
  • Anthem NY — Commercial: $415.61
  • Anthem NY — Exchange: $353.27
  • CIGNA — Commercial: $432.21
  • Emblem — City of NY Plans: $473.11
  • Emblem — Commercial: $473.11
  • Emblem — Medicare Managed Care: $268.81
  • Fidelis — Essential Plans 1,2: $241.93
  • Fidelis — Essential Plans 3,4: $201.61
  • Fidelis — Medicaid Managed Care: $201.61
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60 MIN,Facility Rate $1,000 $1,000 $88.31 – $505.76
New patient office visit (about 60–74 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: $364.06
  • Anthem NY — Commercial: $415.61
  • Anthem NY — Exchange: $353.27
  • CIGNA — Commercial: $350.53
  • Emblem — City of NY Plans: $316.68
  • Emblem — Commercial: $316.68
  • Emblem — Medicare Managed Care: $179.93
  • Fidelis — Essential Plans 1,2: $161.94
  • Fidelis — Essential Plans 3,4: $134.95
  • Fidelis — Medicaid Managed Care: $134.95
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Hosp OP Visit Est Lvl 3 $225 $225 $65.34 – $225
Established patient office visit (about 20–29 minutes): 10 of 85 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $166.50
  • AETNA [1003] — AETNA EPO [100305]: $166.50
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $166.50
  • AETNA [1003] — AETNA HMO [100306]: $166.50
  • AETNA [1003] — AETNA INDEMNITY [100302]: $166.50
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $166.50
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $166.50
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $166.50
  • AETNA [1003] — AETNA POS [100308]: $166.50
  • AETNA [1003] — AETNA PPO [100309]: $166.50
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P EST LOW 20 MIN,Facility Rate $375 $375 $26.11 – $189.43
Established patient office visit (about 20–29 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: $105.32
  • Anthem NY — Commercial: $146.25
  • Anthem NY — Exchange: $124.31
  • CIGNA — Commercial: $126.50
  • Emblem — City of NY Plans: $112.24
  • Emblem — Commercial: $112.24
  • Emblem — Medicare Managed Care: $63.77
  • Fidelis — Essential Plans 1,2: $57.40
  • Fidelis — Essential Plans 3,4: $47.83
  • Fidelis — Medicaid Managed Care: $47.83
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P EST LOW 20 MIN,Office Rate $375 $375 $26.11 – $189.43
Established patient office visit (about 20–29 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: $155.56
  • Anthem NY — Commercial: $146.25
  • Anthem NY — Exchange: $124.31
  • CIGNA — Commercial: $178.06
  • Emblem — City of NY Plans: $189.43
  • Emblem — Commercial: $189.43
  • Emblem — Medicare Managed Care: $107.63
  • Fidelis — Essential Plans 1,2: $96.87
  • Fidelis — Essential Plans 3,4: $80.72
  • Fidelis — Medicaid Managed Care: $80.72
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: Hosp OP Visit Est Lvl 4 $225 $225 $65.34 – $225
Established patient office visit (about 30–39 minutes): 10 of 85 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $166.50
  • AETNA [1003] — AETNA EPO [100305]: $166.50
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $166.50
  • AETNA [1003] — AETNA HMO [100306]: $166.50
  • AETNA [1003] — AETNA INDEMNITY [100302]: $166.50
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $166.50
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $166.50
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $166.50
  • AETNA [1003] — AETNA POS [100308]: $166.50
  • AETNA [1003] — AETNA PPO [100309]: $166.50
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P EST MOD 30 MIN,Facility Rate $500 $500 $40.83 – $269.76
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: $166.65
  • Anthem NY — Commercial: $214.83
  • Anthem NY — Exchange: $182.61
  • CIGNA — Commercial: $186.30
  • Emblem — City of NY Plans: $165.25
  • Emblem — Commercial: $165.25
  • Emblem — Medicare Managed Care: $93.89
  • Fidelis — Essential Plans 1,2: $84.50
  • Fidelis — Essential Plans 3,4: $70.42
  • Fidelis — Medicaid Managed Care: $70.42
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: OFFICE O/P EST MOD 30 MIN,Office Rate $500 $500 $40.83 – $269.76
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates
  • Aetna — Commercial: $235.48
  • Anthem NY — Commercial: $214.83
  • Anthem NY — Exchange: $182.61
  • CIGNA — Commercial: $250.57
  • Emblem — City of NY Plans: $269.76
  • Emblem — Commercial: $269.76
  • Emblem — Medicare Managed Care: $153.27
  • Fidelis — Essential Plans 1,2: $137.94
  • Fidelis — Essential Plans 3,4: $114.95
  • Fidelis — Medicaid Managed Care: $114.95
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30,Facility Rate $760 $760 $57.96 – $321.44
Office consultation with a specialist (moderate): 10 of 17 insurance plan rates
  • Aetna — Commercial: $237.32
  • Anthem NY — Commercial: $303.04
  • Anthem NY — Exchange: $257.58
  • CIGNA — Commercial: $168.07
  • Emblem — City of NY Plans: $171.34
  • Emblem — Commercial: $171.34
  • Emblem — Medicare Managed Care: $97.35
  • Fidelis — Essential Plans 1,2: $87.62
  • Fidelis — Essential Plans 3,4: $73.01
  • Fidelis — Medicaid Managed Care: $73.01
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30,Office Rate $760 $760 $57.96 – $321.44
Office consultation with a specialist (moderate): 10 of 14 insurance plan rates
  • Aetna — Commercial: $321.44
  • Anthem NY — Commercial: $303.04
  • Anthem NY — Exchange: $257.58
  • CIGNA — Commercial: $218.29
  • Emblem — City of NY Plans: $222.57
  • Emblem — Commercial: $222.57
  • Emblem — Medicare Managed Care: $126.46
  • Fidelis — Essential Plans 1,2: $113.81
  • Fidelis — Essential Plans 3,4: $94.84
  • Fidelis — Medicaid Managed Care: $94.84
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40,Facility Rate $800 $800 $90.74 – $466.49
Office consultation with a specialist (moderate to high): 10 of 17 insurance plan rates
  • Aetna — Commercial: $369.27
  • Anthem NY — Commercial: $452.08
  • Anthem NY — Exchange: $384.27
  • CIGNA — Commercial: $256.04
  • Emblem — City of NY Plans: $261.97
  • Emblem — Commercial: $261.97
  • Emblem — Medicare Managed Care: $148.85
  • Fidelis — Essential Plans 1,2: $133.96
  • Fidelis — Essential Plans 3,4: $111.63
  • Fidelis — Medicaid Managed Care: $111.63
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40,Office Rate $800 $800 $90.74 – $466.49
Office consultation with a specialist (moderate to high): 10 of 14 insurance plan rates
  • Aetna — Commercial: $466.49
  • Anthem NY — Commercial: $452.08
  • Anthem NY — Exchange: $384.27
  • CIGNA — Commercial: $310.94
  • Emblem — City of NY Plans: $317.98
  • Emblem — Commercial: $317.98
  • Emblem — Medicare Managed Care: $180.67
  • Fidelis — Essential Plans 1,2: $162.60
  • Fidelis — Essential Plans 3,4: $135.50
  • Fidelis — Medicaid Managed Care: $135.50
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 18-39,Facility Rate $500 $500 $44.64 – $324.59
Preventive checkup, new patient, age 18–39: 10 of 17 insurance plan rates
  • Aetna — Commercial: $188.85
  • Anthem NY — Commercial: $324.59
  • Anthem NY — Exchange: $275.90
  • CIGNA — Commercial: $178.37
  • Emblem — City of NY Plans: $159.97
  • Emblem — Commercial: $159.97
  • Emblem — Medicare Managed Care: $90.89
  • Fidelis — Essential Plans 1,2: $81.80
  • Fidelis — Essential Plans 3,4: $68.17
  • Fidelis — Medicaid Managed Care: $68.17
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 18-39,Office Rate $500 $500 $44.64 – $324.59
Preventive checkup, new patient, age 18–39: 10 of 17 insurance plan rates
  • Aetna — Commercial: $287.16
  • Anthem NY — Commercial: $324.59
  • Anthem NY — Exchange: $275.90
  • CIGNA — Commercial: $251.35
  • Emblem — City of NY Plans: $267.89
  • Emblem — Commercial: $267.89
  • Emblem — Medicare Managed Care: $152.21
  • Fidelis — Essential Plans 1,2: $136.99
  • Fidelis — Essential Plans 3,4: $114.16
  • Fidelis — Medicaid Managed Care: $114.16
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 40-64,Facility Rate $650 $650 $54.86 – $377.05
Preventive checkup, new patient, age 40–64: 10 of 17 insurance plan rates
  • Aetna — Commercial: $230.95
  • Anthem NY — Commercial: $377.05
  • Anthem NY — Exchange: $320.49
  • CIGNA — Commercial: $216.06
  • Emblem — City of NY Plans: $194.55
  • Emblem — Commercial: $194.55
  • Emblem — Medicare Managed Care: $110.54
  • Fidelis — Essential Plans 1,2: $99.49
  • Fidelis — Essential Plans 3,4: $82.91
  • Fidelis — Medicaid Managed Care: $82.91
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 40-64,Office Rate $650 $650 $54.86 – $377.05
Preventive checkup, new patient, age 40–64: 10 of 17 insurance plan rates
  • Aetna — Commercial: $333.63
  • Anthem NY — Commercial: $377.05
  • Anthem NY — Exchange: $320.49
  • CIGNA — Commercial: $289.04
  • Emblem — City of NY Plans: $308.63
  • Emblem — Commercial: $308.63
  • Emblem — Medicare Managed Care: $175.36
  • Fidelis — Essential Plans 1,2: $157.82
  • Fidelis — Essential Plans 3,4: $131.52
  • Fidelis — Medicaid Managed Care: $131.52
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT LOW MDM,Facility Rate $320 $320 $29.29 – $156.66
Emergency room visit (moderate): 10 of 17 insurance plan rates
  • Aetna — Commercial: $152.24
  • Anthem NY — Commercial: $153.20
  • Anthem NY — Exchange: $130.22
  • CIGNA — Commercial: $136.77
  • Emblem — City of NY Plans: $137.85
  • Emblem — Commercial: $137.85
  • Emblem — Medicare Managed Care: $78.32
  • Fidelis — Essential Plans 1,2: $70.49
  • Fidelis — Essential Plans 3,4: $58.74
  • Fidelis — Medicaid Managed Care: $58.74
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT LOW MDM,Office Rate $320 $320 $29.29 – $156.66
Emergency room visit (moderate): 10 of 14 insurance plan rates
  • Aetna — Commercial: $152.24
  • Anthem NY — Commercial: $153.20
  • Anthem NY — Exchange: $130.22
  • CIGNA — Commercial: $136.77
  • Emblem — City of NY Plans: $137.85
  • Emblem — Commercial: $137.85
  • Emblem — Medicare Managed Care: $78.32
  • Fidelis — Essential Plans 1,2: $70.49
  • Fidelis — Essential Plans 3,4: $58.74
  • Fidelis — Medicaid Managed Care: $58.74
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT MOD MDM,Facility Rate $806 $806 $54.02 – $296.17
Emergency room visit (moderately high): 10 of 17 insurance plan rates
  • Aetna — Commercial: $274.59
  • Anthem NY — Commercial: $290.60
  • Anthem NY — Exchange: $247.01
  • CIGNA — Commercial: $232.63
  • Emblem — City of NY Plans: $234.75
  • Emblem — Commercial: $234.75
  • Emblem — Medicare Managed Care: $133.38
  • Fidelis — Essential Plans 1,2: $120.04
  • Fidelis — Essential Plans 3,4: $100.03
  • Fidelis — Medicaid Managed Care: $100.03
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT MOD MDM,Office Rate $806 $806 $54.02 – $296.17
Emergency room visit (moderately high): 10 of 14 insurance plan rates
  • Aetna — Commercial: $274.59
  • Anthem NY — Commercial: $290.60
  • Anthem NY — Exchange: $247.01
  • CIGNA — Commercial: $232.63
  • Emblem — City of NY Plans: $234.75
  • Emblem — Commercial: $234.75
  • Emblem — Medicare Managed Care: $133.38
  • Fidelis — Essential Plans 1,2: $120.04
  • Fidelis — Essential Plans 3,4: $100.03
  • Fidelis — Medicaid Managed Care: $100.03
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT HI MDM,Facility Rate $1,211 $1,211 $80.62 – $437.41
Emergency room visit (high): 10 of 17 insurance plan rates
  • Aetna — Commercial: $412.21
  • Anthem NY — Commercial: $429.18
  • Anthem NY — Exchange: $364.80
  • CIGNA — Commercial: $336.77
  • Emblem — City of NY Plans: $339.34
  • Emblem — Commercial: $339.34
  • Emblem — Medicare Managed Care: $192.80
  • Fidelis — Essential Plans 1,2: $173.52
  • Fidelis — Essential Plans 3,4: $144.60
  • Fidelis — Medicaid Managed Care: $144.60
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT HI MDM,Office Rate $1,211 $1,211 $80.62 – $437.41
Emergency room visit (high): 10 of 14 insurance plan rates
  • Aetna — Commercial: $412.21
  • Anthem NY — Commercial: $429.18
  • Anthem NY — Exchange: $364.80
  • CIGNA — Commercial: $336.77
  • Emblem — City of NY Plans: $339.34
  • Emblem — Commercial: $339.34
  • Emblem — Medicare Managed Care: $192.80
  • Fidelis — Essential Plans 1,2: $173.52
  • Fidelis — Essential Plans 3,4: $144.60
  • Fidelis — Medicaid Managed Care: $144.60

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: Metabolic Panel Total Ca $265 $197.30 $9.89 – $191
Basic metabolic panel (blood test): 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $132.50
  • AETNA [1003] — AETNA EPO [100305]: $132.50
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $132.50
  • AETNA [1003] — AETNA HMO [100306]: $132.50
  • AETNA [1003] — AETNA INDEMNITY [100302]: $132.50
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $132.50
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $132.50
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $132.50
  • AETNA [1003] — AETNA POS [100308]: $132.50
  • AETNA [1003] — AETNA PPO [100309]: $132.50
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: Comprehen Metabolic Panel $379 $270.14 $13.64 – $261.51
Comprehensive metabolic panel (blood test): 10 of 116 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $189.50
  • AETNA [1003] — AETNA EPO [100305]: $189.50
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $189.50
  • AETNA [1003] — AETNA HMO [100306]: $189.50
  • AETNA [1003] — AETNA INDEMNITY [100302]: $189.50
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $189.50
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $189.50
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $189.50
  • AETNA [1003] — AETNA POS [100308]: $189.50
  • AETNA [1003] — AETNA PPO [100309]: $189.50
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Lipid Panel $331 $235.93 $8.24 – $228.39
Cholesterol panel (lipid panel): 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $165.50
  • AETNA [1003] — AETNA EPO [100305]: $165.50
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $165.50
  • AETNA [1003] — AETNA HMO [100306]: $165.50
  • AETNA [1003] — AETNA INDEMNITY [100302]: $165.50
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $165.50
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $165.50
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $165.50
  • AETNA [1003] — AETNA POS [100308]: $165.50
  • AETNA [1003] — AETNA PPO [100309]: $165.50
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: Hepatic Function Panel $280 $199.58 $9.89 – $193.20
Liver function panel: 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $140
  • AETNA [1003] — AETNA EPO [100305]: $140
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $140
  • AETNA [1003] — AETNA HMO [100306]: $140
  • AETNA [1003] — AETNA INDEMNITY [100302]: $140
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $140
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $140
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $140
  • AETNA [1003] — AETNA POS [100308]: $140
  • AETNA [1003] — AETNA PPO [100309]: $140
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: Autom Urine Dip W Micro $132 $132 $3.17 – $191
Urine test (automated, with microscope): 10 of 116 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $66
  • AETNA [1003] — AETNA EPO [100305]: $66
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $66
  • AETNA [1003] — AETNA HMO [100306]: $66
  • AETNA [1003] — AETNA INDEMNITY [100302]: $66
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $66
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $66
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $66
  • AETNA [1003] — AETNA POS [100308]: $66
  • AETNA [1003] — AETNA PPO [100309]: $66
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Autom Urinalysis WO Micro $98 $98 $2 – $191
Urine test (automated, without microscope): 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $49
  • AETNA [1003] — AETNA EPO [100305]: $49
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $49
  • AETNA [1003] — AETNA HMO [100306]: $49
  • AETNA [1003] — AETNA INDEMNITY [100302]: $49
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $49
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $49
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $49
  • AETNA [1003] — AETNA POS [100308]: $49
  • AETNA [1003] — AETNA PPO [100309]: $49
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Psa,Total $394 $280.83 $18.39 – $271.86
PSA (prostate specific antigen) blood test: 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $197
  • AETNA [1003] — AETNA EPO [100305]: $197
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $197
  • AETNA [1003] — AETNA HMO [100306]: $197
  • AETNA [1003] — AETNA INDEMNITY [100302]: $197
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $197
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $197
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $197
  • AETNA [1003] — AETNA POS [100308]: $197
  • AETNA [1003] — AETNA PPO [100309]: $197
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Psatotal $394 $280.83 $18.39 – $271.86
PSA (prostate specific antigen) blood test: 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $197
  • AETNA [1003] — AETNA EPO [100305]: $197
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $197
  • AETNA [1003] — AETNA HMO [100306]: $197
  • AETNA [1003] — AETNA INDEMNITY [100302]: $197
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $197
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $197
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $197
  • AETNA [1003] — AETNA POS [100308]: $197
  • AETNA [1003] — AETNA PPO [100309]: $197
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Thyroid Stimulating Hormone $349 $248.76 $9 – $240.81
Thyroid stimulating hormone (TSH) test: 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $174.50
  • AETNA [1003] — AETNA EPO [100305]: $174.50
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $174.50
  • AETNA [1003] — AETNA HMO [100306]: $174.50
  • AETNA [1003] — AETNA INDEMNITY [100302]: $174.50
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $174.50
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $174.50
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $174.50
  • AETNA [1003] — AETNA POS [100308]: $174.50
  • AETNA [1003] — AETNA PPO [100309]: $174.50
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Compl Cbc W Plt W Autom Dif $175 $175 $3.17 – $191
Complete blood count (CBC) with differential: 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $87.50
  • AETNA [1003] — AETNA EPO [100305]: $87.50
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $87.50
  • AETNA [1003] — AETNA HMO [100306]: $87.50
  • AETNA [1003] — AETNA INDEMNITY [100302]: $87.50
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $87.50
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $87.50
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $87.50
  • AETNA [1003] — AETNA POS [100308]: $87.50
  • AETNA [1003] — AETNA PPO [100309]: $87.50
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: Compl Autom Cbc W Plt $169 $169 $3.17 – $191
Complete blood count (CBC), automated: 10 of 116 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $84.50
  • AETNA [1003] — AETNA EPO [100305]: $84.50
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $84.50
  • AETNA [1003] — AETNA HMO [100306]: $84.50
  • AETNA [1003] — AETNA INDEMNITY [100302]: $84.50
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $84.50
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $84.50
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $84.50
  • AETNA [1003] — AETNA POS [100308]: $84.50
  • AETNA [1003] — AETNA PPO [100309]: $84.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Prothrombin Time $124 $124 $5.33 – $191
Blood clotting time test (prothrombin time, PT): 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $62
  • AETNA [1003] — AETNA EPO [100305]: $62
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $62
  • AETNA [1003] — AETNA HMO [100306]: $62
  • AETNA [1003] — AETNA INDEMNITY [100302]: $62
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $62
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $62
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $62
  • AETNA [1003] — AETNA POS [100308]: $62
  • AETNA [1003] — AETNA PPO [100309]: $62
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Thromboplastin Time Partial $177 $177 $8.11 – $191
Blood clotting test (partial thromboplastin time, PTT): 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $88.50
  • AETNA [1003] — AETNA EPO [100305]: $88.50
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $88.50
  • AETNA [1003] — AETNA HMO [100306]: $88.50
  • AETNA [1003] — AETNA INDEMNITY [100302]: $88.50
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $88.50
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $88.50
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $88.50
  • AETNA [1003] — AETNA POS [100308]: $88.50
  • AETNA [1003] — AETNA PPO [100309]: $88.50

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: CT - Head/Brain WO Contrast $2,456 $2,131.08 $121.20 – $2,063
CT scan of the head or brain, without contrast: 10 of 87 insurance plan rates
  • AFFINITY BY MOLINA HEALTH PLAN [1005] — AFFINITY ESSENTIAL EXCHANGE [100500]: $1,124
  • ALLIED BENEFIT SYSTEM - CIGNA NETWORK [1337] — ALLIED BENEFIT SYSTEM - CIGNA NETWORK [133700]: $856.98
  • APWU [1016] — APWU [101600]: $856.98
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ [102301]: $2,063
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ PPO [102302]: $2,063
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS INDIVIDUAL NETWORK [102218]: $333.30
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS NY EXCHANGE [102200]: $121.20
  • CIGNA [1035] — CIGNA [103500]: $856.98
  • CIGNA [1035] — CIGNA EPO [103502]: $856.98
  • CIGNA [1035] — CIGNA GREAT WEST [103506]: $856.98
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: CT HEAD/BRAIN W/O DYE,Facility Rate $247 $247 $30.65 – $102.48
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: $102.48
  • Anthem NY — Commercial: $69.61
  • Anthem NY — Exchange: $59.17
  • CIGNA — Commercial: $88.89
  • Emblem — City of NY Plans: $57.80
  • Emblem — Commercial: $57.80
  • Emblem — Medicare Managed Care: $43.79
  • Fidelis — Essential Plans 1,2: $33.41
  • Fidelis — Essential Plans 3,4: $33.41
  • Fidelis — Medicaid Managed Care: $31.65
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: CT HEAD/BRAIN W/O DYE,Office Rate $247 $247 $30.65 – $102.48
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: $102.48
  • Anthem NY — Commercial: $69.61
  • Anthem NY — Exchange: $59.17
  • CIGNA — Commercial: $88.89
  • Emblem — City of NY Plans: $57.80
  • Emblem — Commercial: $57.80
  • Emblem — Medicare Managed Care: $43.79
  • Fidelis — Essential Plans 1,2: $33.41
  • Fidelis — Essential Plans 3,4: $33.41
  • Fidelis — Medicaid Managed Care: $31.65
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI Brain W & WO Contrast $5,343 $2,262.92 $505 – $2,190.63
MRI of the brain, before and after contrast: 10 of 87 insurance plan rates
  • AFFINITY BY MOLINA HEALTH PLAN [1005] — AFFINITY ESSENTIAL EXCHANGE [100500]: $2,115
  • ALLIED BENEFIT SYSTEM - CIGNA NETWORK [1337] — ALLIED BENEFIT SYSTEM - CIGNA NETWORK [133700]: $1,071.22
  • APWU [1016] — APWU [101600]: $1,071.22
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ [102301]: $1,872
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ PPO [102302]: $1,872
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS INDIVIDUAL NETWORK [102218]: $1,388.75
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS NY EXCHANGE [102200]: $505
  • CIGNA [1035] — CIGNA [103500]: $1,071.22
  • CIGNA [1035] — CIGNA EPO [103502]: $1,071.22
  • CIGNA [1035] — CIGNA GREAT WEST [103506]: $1,071.22
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: MRI BRAIN STEM W/O & W/DYE,Facility Rate $600 $600 $81.76 – $284.08
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: $284.08
  • Anthem NY — Commercial: $193.35
  • Anthem NY — Exchange: $164.35
  • CIGNA — Commercial: $240.19
  • Emblem — City of NY Plans: $154.17
  • Emblem — Commercial: $154.17
  • Emblem — Medicare Managed Care: $116.80
  • Fidelis — Essential Plans 1,2: $90.45
  • Fidelis — Essential Plans 3,4: $90.45
  • Fidelis — Medicaid Managed Care: $85.69
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: MRI BRAIN STEM W/O & W/DYE,Office Rate $600 $600 $81.76 – $284.08
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: $284.08
  • Anthem NY — Commercial: $193.35
  • Anthem NY — Exchange: $164.35
  • CIGNA — Commercial: $240.19
  • Emblem — City of NY Plans: $154.17
  • Emblem — Commercial: $154.17
  • Emblem — Medicare Managed Care: $116.80
  • Fidelis — Essential Plans 1,2: $90.45
  • Fidelis — Essential Plans 3,4: $90.45
  • Fidelis — Medicaid Managed Care: $85.69
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: Xray Exam Chest 2 Views $588 $530.96 $15.15 – $514
Chest X-ray, 2 views: 10 of 116 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $238
  • AETNA [1003] — AETNA EPO [100305]: $238
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $238
  • AETNA [1003] — AETNA HMO [100306]: $238
  • AETNA [1003] — AETNA INDEMNITY [100302]: $238
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $238
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $238
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $238
  • AETNA [1003] — AETNA POS [100308]: $238
  • AETNA [1003] — AETNA PPO [100309]: $238
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: X-RAY EXAM CHEST 2 VIEWS,Facility Rate $59 $59 Not listed in the file
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: X-RAY EXAM CHEST 2 VIEWS,Office Rate $59 $59 Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: X-Ray Lwr Spine 4+ Views $973 $573.91 $30.30 – $555.58
X-ray of the lower spine, at least 4 views: 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $238
  • AETNA [1003] — AETNA EPO [100305]: $238
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $238
  • AETNA [1003] — AETNA HMO [100306]: $238
  • AETNA [1003] — AETNA INDEMNITY [100302]: $238
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $238
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $238
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $238
  • AETNA [1003] — AETNA POS [100308]: $238
  • AETNA [1003] — AETNA PPO [100309]: $238
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: X-RAY EXAM L-2 SPINE 4/>VWS,Facility Rate $85 $85 $9.81 – $37.23
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates
  • Aetna — Commercial: $37.23
  • Anthem NY — Commercial: $24.88
  • Anthem NY — Exchange: $21.15
  • CIGNA — Commercial: $27.59
  • Emblem — City of NY Plans: $18.76
  • Emblem — Commercial: $18.76
  • Emblem — Medicare Managed Care: $14.21
  • Fidelis — Essential Plans 1,2: $10.36
  • Fidelis — Essential Plans 3,4: $10.36
  • Fidelis — Medicaid Managed Care: $9.81
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: X-RAY EXAM L-2 SPINE 4/>VWS,Office Rate $85 $85 $9.81 – $37.23
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates
  • Aetna — Commercial: $37.23
  • Anthem NY — Commercial: $24.88
  • Anthem NY — Exchange: $21.15
  • CIGNA — Commercial: $27.59
  • Emblem — City of NY Plans: $18.76
  • Emblem — Commercial: $18.76
  • Emblem — Medicare Managed Care: $14.21
  • Fidelis — Essential Plans 1,2: $10.36
  • Fidelis — Essential Plans 3,4: $10.36
  • Fidelis — Medicaid Managed Care: $9.81
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI Spine Lumbar WO Contr $5,532 $2,342.97 $505 – $2,268.12
MRI of the lower back (lumbar spine), without contrast: 10 of 87 insurance plan rates
  • AFFINITY BY MOLINA HEALTH PLAN [1005] — AFFINITY ESSENTIAL EXCHANGE [100500]: $2,115
  • ALLIED BENEFIT SYSTEM - CIGNA NETWORK [1337] — ALLIED BENEFIT SYSTEM - CIGNA NETWORK [133700]: $1,071.22
  • APWU [1016] — APWU [101600]: $1,071.22
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ [102301]: $1,872
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ PPO [102302]: $1,872
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS INDIVIDUAL NETWORK [102218]: $1,388.75
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS NY EXCHANGE [102200]: $505
  • CIGNA [1035] — CIGNA [103500]: $1,071.22
  • CIGNA [1035] — CIGNA EPO [103502]: $1,071.22
  • CIGNA [1035] — CIGNA GREAT WEST [103506]: $1,071.22
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee · modifier 52 In the file: MRI Spine Lumbar WO Contr,REDUCED SERVICES $4,702.20 $2,184.80 $505 – $2,115
MRI of the lower back (lumbar spine), without contrast: 10 of 87 insurance plan rates
  • AFFINITY BY MOLINA HEALTH PLAN [1005] — AFFINITY ESSENTIAL EXCHANGE [100500]: $2,115
  • ALLIED BENEFIT SYSTEM - CIGNA NETWORK [1337] — ALLIED BENEFIT SYSTEM - CIGNA NETWORK [133700]: $1,071.22
  • APWU [1016] — APWU [101600]: $1,071.22
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ [102301]: $1,872
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ PPO [102302]: $1,872
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS INDIVIDUAL NETWORK [102218]: $1,388.75
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS NY EXCHANGE [102200]: $505
  • CIGNA [1035] — CIGNA [103500]: $1,071.22
  • CIGNA [1035] — CIGNA EPO [103502]: $1,071.22
  • CIGNA [1035] — CIGNA GREAT WEST [103506]: $1,071.22
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee · modifier R2 In the file: MRI Spine Lumbar WO Contr,R2 $2,489.40 $2,184.80 $505 – $2,115
MRI of the lower back (lumbar spine), without contrast: 10 of 87 insurance plan rates
  • AFFINITY BY MOLINA HEALTH PLAN [1005] — AFFINITY ESSENTIAL EXCHANGE [100500]: $2,115
  • ALLIED BENEFIT SYSTEM - CIGNA NETWORK [1337] — ALLIED BENEFIT SYSTEM - CIGNA NETWORK [133700]: $1,071.22
  • APWU [1016] — APWU [101600]: $1,071.22
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ [102301]: $1,872
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ PPO [102302]: $1,872
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS INDIVIDUAL NETWORK [102218]: $1,388.75
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS NY EXCHANGE [102200]: $505
  • CIGNA [1035] — CIGNA [103500]: $1,071.22
  • CIGNA [1035] — CIGNA EPO [103502]: $1,071.22
  • CIGNA [1035] — CIGNA GREAT WEST [103506]: $1,071.22
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: CT Pelvis; W Contr $2,579 $2,131.08 $171.70 – $2,063
CT scan of the pelvis, with contrast: 10 of 85 insurance plan rates
  • AFFINITY BY MOLINA HEALTH PLAN [1005] — AFFINITY ESSENTIAL EXCHANGE [100500]: $1,124
  • ALLIED BENEFIT SYSTEM - CIGNA NETWORK [1337] — ALLIED BENEFIT SYSTEM - CIGNA NETWORK [133700]: $856.98
  • APWU [1016] — APWU [101600]: $856.98
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ [102301]: $2,063
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ PPO [102302]: $2,063
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS INDIVIDUAL NETWORK [102218]: $472.18
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS NY EXCHANGE [102200]: $171.70
  • CIGNA [1035] — CIGNA [103500]: $856.98
  • CIGNA [1035] — CIGNA EPO [103502]: $856.98
  • CIGNA [1035] — CIGNA GREAT WEST [103506]: $856.98
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: CT PELVIS W/DYE,Facility Rate $316 $316 $41.57 – $139.71
CT scan of the pelvis, with contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: $139.71
  • Anthem NY — Commercial: $94.49
  • Anthem NY — Exchange: $80.32
  • CIGNA — Commercial: $121.96
  • Emblem — City of NY Plans: $78.39
  • Emblem — Commercial: $78.39
  • Emblem — Medicare Managed Care: $59.39
  • Fidelis — Essential Plans 1,2: $45.70
  • Fidelis — Essential Plans 3,4: $45.70
  • Fidelis — Medicaid Managed Care: $43.30
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: CT PELVIS W/DYE,Office Rate $316 $316 $41.57 – $139.71
CT scan of the pelvis, with contrast: 10 of 17 insurance plan rates
  • Aetna — Commercial: $139.71
  • Anthem NY — Commercial: $94.49
  • Anthem NY — Exchange: $80.32
  • CIGNA — Commercial: $121.96
  • Emblem — City of NY Plans: $78.39
  • Emblem — Commercial: $78.39
  • Emblem — Medicare Managed Care: $59.39
  • Fidelis — Essential Plans 1,2: $45.70
  • Fidelis — Essential Plans 3,4: $45.70
  • Fidelis — Medicaid Managed Care: $43.30
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI - Le Jnt WO Contr $4,765 $2,184.80 $505 – $2,115
MRI of a leg joint (such as the knee), without contrast: 10 of 87 insurance plan rates
  • AFFINITY BY MOLINA HEALTH PLAN [1005] — AFFINITY ESSENTIAL EXCHANGE [100500]: $2,115
  • ALLIED BENEFIT SYSTEM - CIGNA NETWORK [1337] — ALLIED BENEFIT SYSTEM - CIGNA NETWORK [133700]: $1,071.22
  • APWU [1016] — APWU [101600]: $1,071.22
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ [102301]: $1,872
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ PPO [102302]: $1,872
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS INDIVIDUAL NETWORK [102218]: $1,388.75
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS NY EXCHANGE [102200]: $505
  • CIGNA [1035] — CIGNA [103500]: $1,071.22
  • CIGNA [1035] — CIGNA EPO [103502]: $1,071.22
  • CIGNA [1035] — CIGNA GREAT WEST [103506]: $1,071.22
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee · modifier R1 In the file: MRI - Le Jnt WO Contr,R1 $3,097.25 $2,184.80 $505 – $2,115
MRI of a leg joint (such as the knee), without contrast: 10 of 87 insurance plan rates
  • AFFINITY BY MOLINA HEALTH PLAN [1005] — AFFINITY ESSENTIAL EXCHANGE [100500]: $2,115
  • ALLIED BENEFIT SYSTEM - CIGNA NETWORK [1337] — ALLIED BENEFIT SYSTEM - CIGNA NETWORK [133700]: $1,071.22
  • APWU [1016] — APWU [101600]: $1,071.22
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ [102301]: $1,872
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ PPO [102302]: $1,872
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS INDIVIDUAL NETWORK [102218]: $1,388.75
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS NY EXCHANGE [102200]: $505
  • CIGNA [1035] — CIGNA [103500]: $1,071.22
  • CIGNA [1035] — CIGNA EPO [103502]: $1,071.22
  • CIGNA [1035] — CIGNA GREAT WEST [103506]: $1,071.22
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee · modifier R2 In the file: MRI - Le Jnt WO Contr,R2 $2,144.25 $2,144.25 $505 – $2,115
MRI of a leg joint (such as the knee), without contrast: 10 of 87 insurance plan rates
  • AFFINITY BY MOLINA HEALTH PLAN [1005] — AFFINITY ESSENTIAL EXCHANGE [100500]: $2,115
  • ALLIED BENEFIT SYSTEM - CIGNA NETWORK [1337] — ALLIED BENEFIT SYSTEM - CIGNA NETWORK [133700]: $1,071.22
  • APWU [1016] — APWU [101600]: $1,071.22
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ [102301]: $1,872
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ PPO [102302]: $1,872
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS INDIVIDUAL NETWORK [102218]: $1,388.75
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS NY EXCHANGE [102200]: $505
  • CIGNA [1035] — CIGNA [103500]: $1,071.22
  • CIGNA [1035] — CIGNA EPO [103502]: $1,071.22
  • CIGNA [1035] — CIGNA GREAT WEST [103506]: $1,071.22
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: CT Abd & Pelv W/Contrast $3,224 $2,364.58 $92.66 – $2,289.04
CT scan of the abdomen and pelvis, with contrast: 10 of 87 insurance plan rates
  • AFFINITY BY MOLINA HEALTH PLAN [1005] — AFFINITY ESSENTIAL EXCHANGE [100500]: $1,124
  • ALLIED BENEFIT SYSTEM - CIGNA NETWORK [1337] — ALLIED BENEFIT SYSTEM - CIGNA NETWORK [133700]: $856.98
  • APWU [1016] — APWU [101600]: $856.98
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ [102301]: $2,063
  • BLUE CROSS BLUE SHIELD NJ [1023] — BCBS NJ PPO [102302]: $2,063
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS INDIVIDUAL NETWORK [102218]: $299.78
  • BLUE CROSS BLUE SHIELD NY [1022] — BCBS NY EXCHANGE [102200]: $109.01
  • CIGNA [1035] — CIGNA [103500]: $856.98
  • CIGNA [1035] — CIGNA EPO [103502]: $856.98
  • CIGNA [1035] — CIGNA GREAT WEST [103506]: $856.98
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: CT ABD & PELVIS W/CONTRAST,Facility Rate $615 $615 Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: CT ABD & PELVIS W/CONTRAST,Office Rate $615 $615 Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: US Exam Abdom Complete $1,131 $876.24 $60.60 – $848.25
Ultrasound of the abdomen, complete: 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $836.94
  • AETNA [1003] — AETNA EPO [100305]: $836.94
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $836.94
  • AETNA [1003] — AETNA HMO [100306]: $836.94
  • AETNA [1003] — AETNA INDEMNITY [100302]: $836.94
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $836.94
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $836.94
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $836.94
  • AETNA [1003] — AETNA POS [100308]: $836.94
  • AETNA [1003] — AETNA PPO [100309]: $836.94
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: US EXAM ABDOM COMPLETE,Facility Rate $218 $218 $29.01 – $98.71
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates
  • Aetna — Commercial: $98.71
  • Anthem NY — Commercial: $66.69
  • Anthem NY — Exchange: $56.69
  • CIGNA — Commercial: $84.45
  • Emblem — City of NY Plans: $54.71
  • Emblem — Commercial: $54.71
  • Emblem — Medicare Managed Care: $41.45
  • Fidelis — Essential Plans 1,2: $32.04
  • Fidelis — Essential Plans 3,4: $32.04
  • Fidelis — Medicaid Managed Care: $30.36
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: US EXAM ABDOM COMPLETE,Office Rate $218 $218 $29.01 – $98.71
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates
  • Aetna — Commercial: $98.71
  • Anthem NY — Commercial: $66.69
  • Anthem NY — Exchange: $56.69
  • CIGNA — Commercial: $84.45
  • Emblem — City of NY Plans: $54.71
  • Emblem — Commercial: $54.71
  • Emblem — Medicare Managed Care: $41.45
  • Fidelis — Essential Plans 1,2: $32.04
  • Fidelis — Essential Plans 3,4: $32.04
  • Fidelis — Medicaid Managed Care: $30.36

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: Therapeutic Exer Ea 15 Mins $221 $221 $10 – $275
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 99 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $204
  • AETNA [1003] — AETNA EPO [100305]: $204
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $204
  • AETNA [1003] — AETNA HMO [100306]: $204
  • AETNA [1003] — AETNA INDEMNITY [100302]: $204
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $204
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $204
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $204
  • AETNA [1003] — AETNA POS [100308]: $204
  • AETNA [1003] — AETNA PPO [100309]: $204
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee · modifier KX In the file: Therapeutic Exer Ea 15 Mins,DOCUMENTATION ON FILE $221 $221 $221
Physical therapy: therapeutic exercise (each 15 minutes): rates for 1 insurance plan
  • FIDELIS ESSENTIAL [1323] — FIDELIS ESSENTIAL [132300]: $221
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: Pt Eval Basic $236 $236 $10 – $323
Physical therapy evaluation (low complexity): 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $316
  • AETNA [1003] — AETNA EPO [100305]: $316
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $316
  • AETNA [1003] — AETNA HMO [100306]: $316
  • AETNA [1003] — AETNA INDEMNITY [100302]: $316
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $316
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $316
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $316
  • AETNA [1003] — AETNA POS [100308]: $316
  • AETNA [1003] — AETNA PPO [100309]: $316
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL LOW COMPLEX 20 MIN,Facility Rate $236 $236 $78.75 – $227.75
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: $205.45
  • Anthem NY — Commercial: $93.50
  • Anthem NY — Exchange: $79.47
  • CIGNA — Commercial: $227.75
  • Emblem — City of NY Plans: $191.11
  • Emblem — Commercial: $191.11
  • Emblem — Medicare Managed Care: $109.20
  • Fidelis — Essential Plans 1,2: $98.28
  • Fidelis — Essential Plans 3,4: $81.90
  • Fidelis — Medicaid Managed Care: $81.90
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL LOW COMPLEX 20 MIN,Office Rate $236 $236 $78.75 – $227.75
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates
  • Aetna — Commercial: $205.45
  • Anthem NY — Commercial: $93.50
  • Anthem NY — Exchange: $79.47
  • CIGNA — Commercial: $227.75
  • Emblem — City of NY Plans: $191.11
  • Emblem — Commercial: $191.11
  • Emblem — Medicare Managed Care: $109.20
  • Fidelis — Essential Plans 1,2: $98.28
  • Fidelis — Essential Plans 3,4: $81.90
  • Fidelis — Medicaid Managed Care: $81.90
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: Pt Eval Standard $551 $551 $10 – $551
Physical therapy evaluation (moderate complexity): 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $316
  • AETNA [1003] — AETNA EPO [100305]: $316
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $316
  • AETNA [1003] — AETNA HMO [100306]: $316
  • AETNA [1003] — AETNA INDEMNITY [100302]: $316
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $316
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $316
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $316
  • AETNA [1003] — AETNA POS [100308]: $316
  • AETNA [1003] — AETNA PPO [100309]: $316
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL MOD COMPLEX 30 MIN,Facility Rate $551 $551 $81.90 – $227.75
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates
  • Aetna — Commercial: $205.45
  • CIGNA — Commercial: $227.75
  • Emblem — City of NY Plans: $191.11
  • Emblem — Commercial: $191.11
  • Emblem — Medicare Managed Care: $109.20
  • Fidelis — Essential Plans 1,2: $98.28
  • Fidelis — Essential Plans 3,4: $81.90
  • Fidelis — Medicaid Managed Care: $81.90
  • Horizon — Commercial: $204.04
  • Metro Plus — Essential Plans 1,2: $183.75
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL MOD COMPLEX 30 MIN,Office Rate $551 $551 $81.90 – $227.75
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates
  • Aetna — Commercial: $205.45
  • CIGNA — Commercial: $227.75
  • Emblem — City of NY Plans: $191.11
  • Emblem — Commercial: $191.11
  • Emblem — Medicare Managed Care: $109.20
  • Fidelis — Essential Plans 1,2: $98.28
  • Fidelis — Essential Plans 3,4: $81.90
  • Fidelis — Medicaid Managed Care: $81.90
  • Horizon — Commercial: $204.04
  • Metro Plus — Essential Plans 1,2: $183.75
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: Pt Eval Cmplx $740 $740 $10 – $740
Physical therapy evaluation (high complexity): 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $316
  • AETNA [1003] — AETNA EPO [100305]: $316
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $316
  • AETNA [1003] — AETNA HMO [100306]: $316
  • AETNA [1003] — AETNA INDEMNITY [100302]: $316
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $316
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $316
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $316
  • AETNA [1003] — AETNA POS [100308]: $316
  • AETNA [1003] — AETNA PPO [100309]: $316
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: Pt Eval Cmplx+Seating/Mobility $740 $740 $10 – $740
Physical therapy evaluation (high complexity): 10 of 115 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $316
  • AETNA [1003] — AETNA EPO [100305]: $316
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $316
  • AETNA [1003] — AETNA HMO [100306]: $316
  • AETNA [1003] — AETNA INDEMNITY [100302]: $316
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $316
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $316
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $316
  • AETNA [1003] — AETNA POS [100308]: $316
  • AETNA [1003] — AETNA PPO [100309]: $316
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL HIGH COMPLEX 45 MIN,Facility Rate $740 $740 $81.90 – $246.75
Physical therapy evaluation (high complexity): 10 of 15 insurance plan rates
  • Aetna — Commercial: $205.45
  • CIGNA — Commercial: $227.75
  • Emblem — City of NY Plans: $191.11
  • Emblem — Commercial: $191.11
  • Emblem — Medicare Managed Care: $109.20
  • Fidelis — Essential Plans 1,2: $98.28
  • Fidelis — Essential Plans 3,4: $81.90
  • Fidelis — Medicaid Managed Care: $81.90
  • Horizon — Commercial: $204.04
  • Metro Plus — Essential Plans 1,2: $246.75
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES,Facility Rate $150 $150 $55.89 – $205.45
Psychotherapy, 30 minutes: 10 of 17 insurance plan rates
  • Aetna — Commercial: $117.21
  • Anthem NY — Commercial: $152.13
  • Anthem NY — Exchange: $129.31
  • CIGNA — Commercial: $150.88
  • Emblem — City of NY Plans: $130.41
  • Emblem — Commercial: $130.41
  • Emblem — Medicare Managed Care: $74.52
  • Fidelis — Essential Plans 1,2: $67.07
  • Fidelis — Essential Plans 3,4: $55.89
  • Fidelis — Medicaid Managed Care: $55.89
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES,Office Rate $150 $150 $55.89 – $205.45
Psychotherapy, 30 minutes: 10 of 17 insurance plan rates
  • Aetna — Commercial: $152.28
  • Anthem NY — Commercial: $152.13
  • Anthem NY — Exchange: $129.31
  • CIGNA — Commercial: $174.49
  • Emblem — City of NY Plans: $163.69
  • Emblem — Commercial: $163.69
  • Emblem — Medicare Managed Care: $93.54
  • Fidelis — Essential Plans 1,2: $84.18
  • Fidelis — Essential Plans 3,4: $70.15
  • Fidelis — Medicaid Managed Care: $70.15
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES,Facility Rate $180 $180 $73.98 – $272.26
Psychotherapy, 45 minutes: 10 of 17 insurance plan rates
  • Aetna — Commercial: $175.65
  • Anthem NY — Commercial: $202.41
  • Anthem NY — Exchange: $172.05
  • CIGNA — Commercial: $199.27
  • Emblem — City of NY Plans: $172.61
  • Emblem — Commercial: $172.61
  • Emblem — Medicare Managed Care: $98.63
  • Fidelis — Essential Plans 1,2: $88.77
  • Fidelis — Essential Plans 3,4: $73.98
  • Fidelis — Medicaid Managed Care: $73.98
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES,Office Rate $180 $180 $73.98 – $272.26
Psychotherapy, 45 minutes: 10 of 17 insurance plan rates
  • Aetna — Commercial: $194.08
  • Anthem NY — Commercial: $202.41
  • Anthem NY — Exchange: $172.05
  • CIGNA — Commercial: $229.97
  • Emblem — City of NY Plans: $217.44
  • Emblem — Commercial: $217.44
  • Emblem — Medicare Managed Care: $124.25
  • Fidelis — Essential Plans 1,2: $111.82
  • Fidelis — Essential Plans 3,4: $93.19
  • Fidelis — Medicaid Managed Care: $93.19
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES,Facility Rate $200 $200 $108.82 – $399.95
Psychotherapy, 60 minutes: 10 of 17 insurance plan rates
  • Aetna — Commercial: $265.32
  • Anthem NY — Commercial: $304.75
  • Anthem NY — Exchange: $259.04
  • CIGNA — Commercial: $294.17
  • Emblem — City of NY Plans: $253.91
  • Emblem — Commercial: $253.91
  • Emblem — Medicare Managed Care: $145.09
  • Fidelis — Essential Plans 1,2: $130.58
  • Fidelis — Essential Plans 3,4: $108.82
  • Fidelis — Medicaid Managed Care: $108.82
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES,Office Rate $200 $200 $108.82 – $399.95
Psychotherapy, 60 minutes: 10 of 17 insurance plan rates
  • Aetna — Commercial: $283.72
  • Anthem NY — Commercial: $304.75
  • Anthem NY — Exchange: $259.04
  • CIGNA — Commercial: $339.04
  • Emblem — City of NY Plans: $318.44
  • Emblem — Commercial: $318.44
  • Emblem — Medicare Managed Care: $181.96
  • Fidelis — Essential Plans 1,2: $163.77
  • Fidelis — Essential Plans 3,4: $136.47
  • Fidelis — Medicaid Managed Care: $136.47

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion Not listed in the file $12,750.32 $18.72 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,343
Removal of breast growth (open surgery): 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $12,267
  • AETNA [1003] — AETNA EPO [100305]: $12,267
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $12,267
  • AETNA [1003] — AETNA HMO [100306]: $12,267
  • AETNA [1003] — AETNA INDEMNITY [100302]: $12,267
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $12,267
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $12,267
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $12,267
  • AETNA [1003] — AETNA POS [100308]: $12,267
  • AETNA [1003] — AETNA PPO [100309]: $12,267
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL HIP ARTHROPLASTY,Facility Rate $25,575 $25,575 $836.73 – $6,993.82
Total hip replacement: 10 of 17 insurance plan rates
  • Aetna — Commercial: $5,768.23
  • Anthem NY — Commercial: $6,841.78
  • Anthem NY — Exchange: $5,815.51
  • CIGNA — Commercial: $6,060
  • Emblem — City of NY Plans: $5,256.45
  • Emblem — Commercial: $5,291.63
  • Emblem — Medicare Managed Care: $1,344.50
  • Fidelis — Essential Plans 1,2: $1,210.05
  • Fidelis — Essential Plans 3,4: $1,008.38
  • Fidelis — Medicaid Managed Care: $1,008.38
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL HIP ARTHROPLASTY,Office Rate $25,575 $25,575 $836.73 – $6,993.82
Total hip replacement: 10 of 17 insurance plan rates
  • Aetna — Commercial: $5,768.23
  • Anthem NY — Commercial: $6,841.78
  • Anthem NY — Exchange: $5,815.51
  • CIGNA — Commercial: $6,060
  • Emblem — City of NY Plans: $5,256.45
  • Emblem — Commercial: $5,291.63
  • Emblem — Medicare Managed Care: $1,344.50
  • Fidelis — Essential Plans 1,2: $1,210.05
  • Fidelis — Essential Plans 3,4: $1,008.38
  • Fidelis — Medicaid Managed Care: $1,008.38
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft Not listed in the file $85,336.13 $119.96 – $82,610
Total hip replacement: 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $60,632
  • AETNA [1003] — AETNA EPO [100305]: $60,632
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $60,632
  • AETNA [1003] — AETNA HMO [100306]: $60,632
  • AETNA [1003] — AETNA INDEMNITY [100302]: $60,632
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $60,632
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $60,632
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $60,632
  • AETNA [1003] — AETNA POS [100308]: $60,632
  • AETNA [1003] — AETNA PPO [100309]: $60,632
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL KNEE ARTHROPLASTY,Facility Rate $26,351 $26,351 $898.90 – $8,742.25
Total knee replacement: 10 of 17 insurance plan rates
  • Aetna — Commercial: $6,865.60
  • Anthem NY — Commercial: $7,304.36
  • Anthem NY — Exchange: $6,208.71
  • CIGNA — Commercial: $7,575
  • Emblem — City of NY Plans: $6,372.11
  • Emblem — Commercial: $6,414.75
  • Emblem — Medicare Managed Care: $1,341.89
  • Fidelis — Essential Plans 1,2: $1,207.70
  • Fidelis — Essential Plans 3,4: $1,006.42
  • Fidelis — Medicaid Managed Care: $1,006.42
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL KNEE ARTHROPLASTY,Office Rate $26,351 $26,351 $898.90 – $8,742.25
Total knee replacement: 10 of 17 insurance plan rates
  • Aetna — Commercial: $6,865.60
  • Anthem NY — Commercial: $7,304.36
  • Anthem NY — Exchange: $6,208.71
  • CIGNA — Commercial: $7,575
  • Emblem — City of NY Plans: $6,372.11
  • Emblem — Commercial: $6,414.75
  • Emblem — Medicare Managed Care: $1,341.89
  • Fidelis — Essential Plans 1,2: $1,207.70
  • Fidelis — Essential Plans 3,4: $1,006.42
  • Fidelis — Medicaid Managed Care: $1,006.42
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments Not listed in the file $79,504.85 $119.96 – $76,965
Total knee replacement: 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $60,632
  • AETNA [1003] — AETNA EPO [100305]: $60,632
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $60,632
  • AETNA [1003] — AETNA HMO [100306]: $60,632
  • AETNA [1003] — AETNA INDEMNITY [100302]: $60,632
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $60,632
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $60,632
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $60,632
  • AETNA [1003] — AETNA POS [100308]: $60,632
  • AETNA [1003] — AETNA PPO [100309]: $60,632
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: SHO ARTHRS SRG DECOMPRESSION,Facility Rate $12,060 $12,060 $127.63 – $4,577
Shoulder arthroscopy: shaving of shoulder bone: 10 of 17 insurance plan rates
  • Aetna — Commercial: $3,207.70
  • Anthem NY — Commercial: $867.92
  • Anthem NY — Exchange: $737.73
  • CIGNA — Commercial: $4,030
  • Emblem — City of NY Plans: $3,183.84
  • Emblem — Commercial: $3,183.84
  • Emblem — Medicare Managed Care: $170.17
  • Fidelis — Essential Plans 1,2: $153.15
  • Fidelis — Essential Plans 3,4: $127.63
  • Fidelis — Medicaid Managed Care: $127.63
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: SHO ARTHRS SRG DECOMPRESSION,Office Rate $12,060 $12,060 $127.63 – $4,577
Shoulder arthroscopy: shaving of shoulder bone: 10 of 17 insurance plan rates
  • Aetna — Commercial: $3,207.70
  • Anthem NY — Commercial: $867.92
  • Anthem NY — Exchange: $737.73
  • CIGNA — Commercial: $4,030
  • Emblem — City of NY Plans: $3,183.84
  • Emblem — Commercial: $3,183.84
  • Emblem — Medicare Managed Care: $170.17
  • Fidelis — Essential Plans 1,2: $153.15
  • Fidelis — Essential Plans 3,4: $127.63
  • Fidelis — Medicaid Managed Care: $127.63
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls Not listed in the file $17,034.17 $119.96 – $16,490
Shoulder arthroscopy: shaving of shoulder bone: 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $12,267
  • AETNA [1003] — AETNA EPO [100305]: $12,267
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $12,267
  • AETNA [1003] — AETNA HMO [100306]: $12,267
  • AETNA [1003] — AETNA INDEMNITY [100302]: $12,267
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $12,267
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $12,267
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $12,267
  • AETNA [1003] — AETNA POS [100308]: $12,267
  • AETNA [1003] — AETNA PPO [100309]: $12,267
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: KNEE ARTHROSCOPY/SURGERY,Facility Rate $12,000 $12,000 $369.68 – $4,577
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 17 insurance plan rates
  • Aetna — Commercial: $3,489.30
  • Anthem NY — Commercial: $2,738.02
  • Anthem NY — Exchange: $2,327.32
  • CIGNA — Commercial: $4,030
  • Emblem — City of NY Plans: $3,199.68
  • Emblem — Commercial: $3,199.68
  • Emblem — Medicare Managed Care: $597.03
  • Fidelis — Essential Plans 1,2: $537.33
  • Fidelis — Essential Plans 3,4: $447.77
  • Fidelis — Medicaid Managed Care: $447.77
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: KNEE ARTHROSCOPY/SURGERY,Office Rate $12,000 $12,000 $369.68 – $4,577
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 17 insurance plan rates
  • Aetna — Commercial: $3,489.30
  • Anthem NY — Commercial: $2,738.02
  • Anthem NY — Exchange: $2,327.32
  • CIGNA — Commercial: $4,030
  • Emblem — City of NY Plans: $3,199.68
  • Emblem — Commercial: $3,199.68
  • Emblem — Medicare Managed Care: $597.03
  • Fidelis — Essential Plans 1,2: $537.33
  • Fidelis — Essential Plans 3,4: $447.77
  • Fidelis — Medicaid Managed Care: $447.77
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg Not listed in the file $15,246.05 $70.35 – $14,759
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $12,511
  • AETNA [1003] — AETNA EPO [100305]: $12,511
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $12,511
  • AETNA [1003] — AETNA HMO [100306]: $12,511
  • AETNA [1003] — AETNA INDEMNITY [100302]: $12,511
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $12,511
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $12,511
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $12,511
  • AETNA [1003] — AETNA POS [100308]: $12,511
  • AETNA [1003] — AETNA PPO [100309]: $12,511
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: PRP I/HERN INIT REDUC >5 YR,Facility Rate $8,000 $8,000 $641.14 – $1,391.18
Groin (inguinal) hernia repair, age 5 or older: rates for 9 insurance plans
  • Aetna — Commercial: $1,175.51
  • Anthem NY — Commercial: $1,391.18
  • Anthem NY — Exchange: $1,182.50
  • CIGNA — Commercial: $1,127.87
  • Emblem — City of NY Plans: $1,038.47
  • Emblem — Commercial: $1,038.47
  • Horizon — Commercial: $1,390.68
  • NYSHIP — Commercial: $641.14
  • UHC — Commercial: $1,039.53
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: PRP I/HERN INIT REDUC >5 YR,Office Rate $8,000 $8,000 $641.14 – $1,391.18
Groin (inguinal) hernia repair, age 5 or older: rates for 9 insurance plans
  • Aetna — Commercial: $1,175.51
  • Anthem NY — Commercial: $1,391.18
  • Anthem NY — Exchange: $1,182.50
  • CIGNA — Commercial: $1,127.87
  • Emblem — City of NY Plans: $1,038.47
  • Emblem — Commercial: $1,038.47
  • Horizon — Commercial: $1,390.68
  • NYSHIP — Commercial: $641.14
  • UHC — Commercial: $1,039.53
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible Not listed in the file $15,246.05 $70.35 – $14,759
Groin (inguinal) hernia repair, age 5 or older: 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $12,511
  • AETNA [1003] — AETNA EPO [100305]: $12,511
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $12,511
  • AETNA [1003] — AETNA HMO [100306]: $12,511
  • AETNA [1003] — AETNA INDEMNITY [100302]: $12,511
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $12,511
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $12,511
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $12,511
  • AETNA [1003] — AETNA POS [100308]: $12,511
  • AETNA [1003] — AETNA PPO [100309]: $12,511
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX INTERLAMINAR LMBR/SAC,Facility Rate $2,750 $2,750 $66.49 – $720.36
Spinal injection, lower back (epidural), with imaging guidance: 10 of 15 insurance plan rates
  • Aetna — Commercial: $260.73
  • CIGNA — Commercial: $203.31
  • Emblem — City of NY Plans: $175.48
  • Emblem — Commercial: $175.48
  • Emblem — Medicare Managed Care: $100.27
  • Fidelis — Essential Plans 1,2: $90.24
  • Fidelis — Essential Plans 3,4: $75.20
  • Fidelis — Medicaid Managed Care: $75.20
  • Horizon — Commercial: $256.61
  • Metro Plus — Essential Plans 1,2: $69.26
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX INTERLAMINAR LMBR/SAC,Office Rate $2,750 $2,750 $66.49 – $720.36
Spinal injection, lower back (epidural), with imaging guidance: 10 of 15 insurance plan rates
  • Aetna — Commercial: $638.16
  • CIGNA — Commercial: $542.20
  • Emblem — City of NY Plans: $549.71
  • Emblem — Commercial: $549.71
  • Emblem — Medicare Managed Care: $314.12
  • Fidelis — Essential Plans 1,2: $282.71
  • Fidelis — Essential Plans 3,4: $235.59
  • Fidelis — Medicaid Managed Care: $235.59
  • Horizon — Commercial: $628.06
  • Metro Plus — Essential Plans 1,2: $297.35
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn Not listed in the file $8,431.35 $1,883 – $8,162
Spinal injection, lower back (epidural), with imaging guidance: 10 of 116 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $2,974
  • AETNA [1003] — AETNA EPO [100305]: $2,974
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $2,974
  • AETNA [1003] — AETNA HMO [100306]: $2,974
  • AETNA [1003] — AETNA INDEMNITY [100302]: $2,974
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $2,974
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $2,974
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $2,974
  • AETNA [1003] — AETNA POS [100308]: $2,974
  • AETNA [1003] — AETNA PPO [100309]: $2,974
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX AA&/STRD TFRM EPI L/S 1,Facility Rate $3,090 $3,090 $61.22 – $1,119.84
Nerve root injection, lower back, with imaging guidance: 10 of 17 insurance plan rates
  • Aetna — Commercial: $799.11
  • Anthem NY — Commercial: $1,112.47
  • Anthem NY — Exchange: $945.60
  • CIGNA — Commercial: $859
  • Emblem — City of NY Plans: $679.73
  • Emblem — Commercial: $679.73
  • Emblem — Medicare Managed Care: $112.01
  • Fidelis — Essential Plans 1,2: $100.81
  • Fidelis — Essential Plans 3,4: $84.01
  • Fidelis — Medicaid Managed Care: $84.01
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: NJX AA&/STRD TFRM EPI L/S 1,Office Rate $3,090 $3,090 $61.22 – $1,119.84
Nerve root injection, lower back, with imaging guidance: 10 of 17 insurance plan rates
  • Aetna — Commercial: $799.11
  • Anthem NY — Commercial: $1,112.47
  • Anthem NY — Exchange: $945.60
  • CIGNA — Commercial: $859
  • Emblem — City of NY Plans: $679.73
  • Emblem — Commercial: $679.73
  • Emblem — Medicare Managed Care: $304.12
  • Fidelis — Essential Plans 1,2: $273.71
  • Fidelis — Essential Plans 3,4: $228.09
  • Fidelis — Medicaid Managed Care: $228.09
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level Not listed in the file $5,014.18 $1,883 – $4,854
Nerve root injection, lower back, with imaging guidance: 10 of 116 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $2,974
  • AETNA [1003] — AETNA EPO [100305]: $2,974
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $2,974
  • AETNA [1003] — AETNA HMO [100306]: $2,974
  • AETNA [1003] — AETNA INDEMNITY [100302]: $2,974
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $2,974
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $2,974
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $2,974
  • AETNA [1003] — AETNA POS [100308]: $2,974
  • AETNA [1003] — AETNA PPO [100309]: $2,974
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: CARPAL TUNNEL SURGERY,Facility Rate $8,500 $8,500 $240.80 – $2,183.66
Carpal tunnel release: 10 of 17 insurance plan rates
  • Aetna — Commercial: $2,025.92
  • Anthem NY — Commercial: $2,172.56
  • Anthem NY — Exchange: $1,846.68
  • CIGNA — Commercial: $1,833
  • Emblem — City of NY Plans: $2,173.09
  • Emblem — Commercial: $2,183.66
  • Emblem — Medicare Managed Care: $489.88
  • Fidelis — Essential Plans 1,2: $440.89
  • Fidelis — Essential Plans 3,4: $367.41
  • Fidelis — Medicaid Managed Care: $367.41
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: CARPAL TUNNEL SURGERY,Office Rate $8,500 $8,500 $240.80 – $2,183.66
Carpal tunnel release: 10 of 17 insurance plan rates
  • Aetna — Commercial: $2,025.92
  • Anthem NY — Commercial: $2,172.56
  • Anthem NY — Exchange: $1,846.68
  • CIGNA — Commercial: $1,833
  • Emblem — City of NY Plans: $2,173.09
  • Emblem — Commercial: $2,183.66
  • Emblem — Medicare Managed Care: $558.96
  • Fidelis — Essential Plans 1,2: $503.06
  • Fidelis — Essential Plans 3,4: $419.22
  • Fidelis — Medicaid Managed Care: $419.22
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne Not listed in the file $12,043.75 $10.81 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $11,659
Carpal tunnel release: 10 of 117 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $7,773
  • AETNA [1003] — AETNA EPO [100305]: $7,773
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $7,773
  • AETNA [1003] — AETNA HMO [100306]: $7,773
  • AETNA [1003] — AETNA INDEMNITY [100302]: $7,773
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $7,773
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $7,773
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $7,773
  • AETNA [1003] — AETNA POS [100308]: $7,773
  • AETNA [1003] — AETNA PPO [100309]: $7,773

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
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 $79,243.50 $17,974.27 – $76,712
Hip or knee replacement (major joint of the leg), without major complications: 10 of 90 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $69,635
  • AETNA [1003] — AETNA EPO [100305]: $69,635
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $69,635
  • AETNA [1003] — AETNA HMO [100306]: $69,635
  • AETNA [1003] — AETNA INDEMNITY [100302]: $69,635
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $69,635
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $69,635
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $69,635
  • AETNA [1003] — AETNA POS [100308]: $69,635
  • AETNA [1003] — AETNA PPO [100309]: $69,635
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 $88,857.84 $22,749.02 – $86,019.21
Neck (cervical) spinal fusion, without complications: 10 of 90 insurance plan rates
  • AETNA [1003] — AETNA [100300]: $62,317
  • AETNA [1003] — AETNA EPO [100305]: $62,317
  • AETNA [1003] — AETNA GEHA-ASA [100311]: $62,317
  • AETNA [1003] — AETNA HMO [100306]: $62,317
  • AETNA [1003] — AETNA INDEMNITY [100302]: $62,317
  • AETNA [1003] — AETNA INTERNATIONAL [100301]: $62,317
  • AETNA [1003] — AETNA MANAGED CHOICE [100307]: $62,317
  • AETNA [1003] — AETNA OPEN CHOICE [100303]: $62,317
  • AETNA [1003] — AETNA POS [100308]: $62,317
  • AETNA [1003] — AETNA PPO [100309]: $62,317

Source: Hospital for Special Surgery’s standard charges file (d2cg6hcwj0g0z0.cloudfront.net, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address535 East 70th Street, New York, NY 10021
CountyNew York County
StateNew York
Phone(212) 606‑1000
Emergency servicesNot listed
OwnershipVoluntary non-profit - Private
Medicare overall rating5 of 5 stars
CMS Certification Number330270
Name in Medicare recordsHOSPITAL FOR SPECIAL SURGERY
Profile levelMedicare data + hospital website
Official websitehss.edu
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. About HSS | Hospital for Special Surgery | US #1 for Orthopedics — hss.edu
  2. Rankings, Ratings & Recognition — hss.edu
  3. Accreditations and Affiliations — hss.edu
  4. Radiology and Imaging | HSS — hss.edu
  5. Reasons to Choose HSS | #1 in Orthopedics #3 in Rheumatology — hss.edu
  6. Leadership Councils: Dedicated to Advancing the HSS Mission — hss.edu
  7. For Medical Professionals | HSS — hss.edu
  8. Orthopedic Trauma Service | Hospital for Special Surgery — hss.edu
  9. Non-surgical Foot and Ankle Service | HSS Orthopedics — hss.edu
  10. Contact HSS | Key Phone Numbers for Patients & Visitors — hss.edu
  11. Patient Language Assistance and Translation Services | HSS — hss.edu