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Acute Care Hospital

Jamaica Hospital Medical Center

Jamaica, New York · Queens County · Emergency services listed

Summary

Jamaica Hospital Medical Center is an acute care hospital in Jamaica, New York. Medicare data lists emergency services. CMS overall star rating: 1 of 5 stars. Its official website lists 103 services, specialties and programs. Medicare lists 380 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

Call(718) 262‑6000 Directions Website Medicare profile
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Exterior of Jamaica Hospital Medical Center
Photo: Bjoertvedt, CC BY-SA 3.0, 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

YesEmergency services
1 of 5 stars1 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
380Doctors and clinicians
103Services listed

Quick answers

Does Jamaica Hospital Medical Center have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Jamaica Hospital Medical Center. In a medical emergency, call 911.
Where is Jamaica Hospital Medical Center?
89th Avenue and Van Wyck Expressway, Jamaica, NY 11418, in Queens County, New York.
What is the phone number of Jamaica Hospital Medical Center?
(718) 262-6000, as listed by Medicare (CMS).
What is the Medicare star rating of Jamaica Hospital Medical Center?
1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][16][17]

Conditions treated[7][8][9][10][11][13][16][18]

Treatments[8][10][11][12][13][16]

Procedures[4][10][13][16][18]

Programs and centers[4][7][8][11][12][16][17]

  • Stroke Care
  • Trauma Center
  • Lupus Center
  • Sleep Center
  • Traumatic Brain Injury Services
  • Transitional Care Unit
  • Chest Pain Center
  • Geriatric Emergency Department
  • Pediatric Emergency Department
  • Fast Track Center (urgent care)
  • Psychiatric emergency department
  • Thomas Santucci Cardiovascular Interventional Suite
  • Non-Invasive Cardiology Laboratory
  • Hypertension Center
  • Pediatric Heart Clinic
  • Ferrara Family Center for Hospice Care
  • Care Management (Care Transitions, Co-Managed Care, EMPOWER, Complex Case Management)
  • Palomino Rehabilitation Center

Emergency care (hospital website)[4][6][8][18]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel I
Stroke designationComprehensive Stroke Center (Joint Commission)

Visiting and practical information

VisitingVisiting hours vary by department and are subject to change; check with the unit[16]
Interpreters and languagesQualified interpreters and language support are provided for patients who speak different languages[16]
Patient portalMediSys Connect

Recognition[6][8][11][18]

  • NYS-designated Level 1 Trauma Center; ACS verified
  • Comprehensive Stroke Center certification (Joint Commission)
  • Level 1 Trauma Center (American College of Surgeons; New York State)
  • Primary Heart Attack Center (Joint Commission)
  • Geriatric emergency department accreditation (American College of Emergency Physicians)

Doctors and clinicians (380)

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

Main specialties

Doctors with a page on this site (380)

And 356 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 2 of 5 stars
Overall rating of the hospital2 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean4 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1058%National average: 72%
Would definitely recommend the hospital63%National average: 71%
Nurses “always” communicated well72%National average: 80%
Doctors “always” communicated well73%National average: 80%
Staff “always” explained medicines before giving them54%National average: 62%
Were given information about recovery at home79%National average: 86%
Room and bathroom “always” clean72%National average: 74%
Area around the room “always” quiet at night51%National average: 60%
Completed surveys1,975Response rate: 21%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.249Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.522No different from the national benchmark
Surgical site infections after colon surgery0No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0.537No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.542Better 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 patients13.6%
Deaths within 30 days: heart failure patients11.3%
Deaths within 30 days: pneumonia patients16.4%
Deaths within 30 days: COPD patients8.5%
Deaths within 30 days: stroke patients8.5%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)1.48Worse than the national rate
Complications after hip or knee replacement4.3%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack14.7%
Readmitted within 30 days: heart failure23.6%
Readmitted within 30 days: pneumonia17.9%
Readmitted within 30 days: COPD22.4%
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacement5.1%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)227 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)87%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in JamaicaBest hospitals in New York

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 75 common services exactly as Jamaica Hospital Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

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

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW LOW 30 MIN $506 $506 $35 – $1,912
New patient office visit (about 30–44 minutes): 10 of 54 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $79.57
  • Beacon Health Strategies — Medicare: $79.57
  • Centerlight Healthcare — Centerlight Healthcare: $79.57
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES $390 $390 $35 – $1,912
New patient office visit (about 30–44 minutes): 10 of 54 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $79.57
  • Beacon Health Strategies — Medicare: $79.57
  • Centerlight Healthcare — Centerlight Healthcare: $79.57
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES $390 $390 $67.63 – $1,912
New patient office visit (about 30–44 minutes): 10 of 52 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $79.57
  • Beacon Health Strategies — Medicare: $79.57
  • Centerlight Healthcare — Centerlight Healthcare: $79.57
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW MOD 45 MIN $315 $315 $35 – $1,912
New patient office visit (about 45–59 minutes): 10 of 54 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $130.02
  • Beacon Health Strategies — Medicare: $130.02
  • Centerlight Healthcare — Centerlight Healthcare: $130.02
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES $420 $420 $35 – $1,912
New patient office visit (about 45–59 minutes): 10 of 54 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $130.02
  • Beacon Health Strategies — Medicare: $130.02
  • Centerlight Healthcare — Centerlight Healthcare: $130.02
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES $420 $420 $110.52 – $1,912
New patient office visit (about 45–59 minutes): 10 of 52 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $130.02
  • Beacon Health Strategies — Medicare: $130.02
  • Centerlight Healthcare — Centerlight Healthcare: $130.02
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60 MIN $336 $336 $35 – $1,912
New patient office visit (about 60–74 minutes): 10 of 54 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $178.84
  • Beacon Health Strategies — Medicare: $178.84
  • Centerlight Healthcare — Centerlight Healthcare: $178.84
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES $450 $450 $35 – $1,912
New patient office visit (about 60–74 minutes): 10 of 54 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $178.84
  • Beacon Health Strategies — Medicare: $178.84
  • Centerlight Healthcare — Centerlight Healthcare: $178.84
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES $450 $450 $152.01 – $1,912
New patient office visit (about 60–74 minutes): 10 of 52 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $178.84
  • Beacon Health Strategies — Medicare: $178.84
  • Centerlight Healthcare — Centerlight Healthcare: $178.84
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN $300 $300 $35 – $1,912
Established patient office visit (about 20–29 minutes): 10 of 54 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $63.57
  • Beacon Health Strategies — Medicare: $63.57
  • Centerlight Healthcare — Centerlight Healthcare: $63.57
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES $720 $720 $35 – $1,912
Established patient office visit (about 20–29 minutes): 10 of 54 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $63.57
  • Beacon Health Strategies — Medicare: $63.57
  • Centerlight Healthcare — Centerlight Healthcare: $63.57
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 24 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES $360 $360 $54.03 – $1,912
Established patient office visit (about 20–29 minutes): 10 of 52 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $63.57
  • Beacon Health Strategies — Medicare: $63.57
  • Centerlight Healthcare — Centerlight Healthcare: $63.57
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN $323 $323 $35 – $1,912
Established patient office visit (about 30–39 minutes): 10 of 54 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $93.53
  • Beacon Health Strategies — Medicare: $93.53
  • Centerlight Healthcare — Centerlight Healthcare: $93.53
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES $390 $390 $35 – $1,912
Established patient office visit (about 30–39 minutes): 10 of 54 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $93.53
  • Beacon Health Strategies — Medicare: $93.53
  • Centerlight Healthcare — Centerlight Healthcare: $93.53
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES $390 $390 $79.50 – $1,912
Established patient office visit (about 30–39 minutes): 10 of 52 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Aetna — Government Programs: $93.53
  • Beacon Health Strategies — Medicare: $93.53
  • Centerlight Healthcare — Centerlight Healthcare: $93.53
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39 $593 $593 $75 – $1,912
Preventive checkup, new patient, age 18–39: 10 of 25 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $134
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
  • GHI — Commercial PPO/HMO: $75
  • HIP — Commercial: $610
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS) $345 $345 $75 – $1,912
Preventive checkup, new patient, age 18–39: 10 of 25 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $134
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
  • GHI — Commercial PPO/HMO: $75
  • HIP — Commercial: $610
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS) $345 $345 $200 – $1,912
Preventive checkup, new patient, age 18–39: 10 of 23 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
  • HIP — Commercial: $610
  • Hotel Trades Council — Dental OR: $1,912
  • MagnaCare — Preferred/Direct Plus/JIB: $1,485
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS) $354 $354 $75 – $1,912
Preventive checkup, new patient, age 40–64: 10 of 28 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $157
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
  • GHI — Commercial PPO/HMO: $75
  • HIP — Commercial: $610
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64 $608 $608 $75 – $1,912
Preventive checkup, new patient, age 40–64: 10 of 25 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $157
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
  • GHI — Commercial PPO/HMO: $75
  • HIP — Commercial: $610
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS) $354 $354 $200 – $1,912
Preventive checkup, new patient, age 40–64: 10 of 23 insurance plan rates
  • Aetna — Commercial High Performance Network: $238
  • Aetna — Commercial Product: $238
  • Aetna — Commercial Whole Health: $226
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
  • Create Health Plan — Flex/NYC/Long Island: $1,414
  • HIP — Commercial: $610
  • Hotel Trades Council — Dental OR: $1,912
  • MagnaCare — Preferred/Direct Plus/JIB: $1,485
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $944 $944 $35 – $1,961
Emergency room visit (moderate): 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $66
  • Aetna — Commercial High Performance Network: $1,871
  • Aetna — Commercial Product: $1,871
  • Aetna — Commercial Whole Health: $1,779
  • Aetna — Government Programs: $339.08
  • Beacon Health Strategies — Medicaid: $300
  • Beacon Health Strategies — Medicare: $315
  • Centerlight Healthcare — Centerlight Healthcare: $339.08
  • Centers Plan for Healthy Living — Medicare: $423.85
  • Centivo — Centivo: $1,403.83
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $944 $944 $66 – $1,961
Emergency room visit (moderate): 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $66
  • Aetna — Commercial High Performance Network: $1,871
  • Aetna — Commercial Product: $1,871
  • Aetna — Commercial Whole Health: $1,779
  • Aetna — Government Programs: $339.08
  • Beacon Health Strategies — Medicaid: $300
  • Beacon Health Strategies — Medicare: $315
  • Centerlight Healthcare — Centerlight Healthcare: $339.08
  • Centers Plan for Healthy Living — Medicare: $423.85
  • Centivo — Centivo: $1,403.83
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_27 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $944 $944 $66 – $1,961
Emergency room visit (moderate): 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $66
  • Aetna — Commercial High Performance Network: $1,871
  • Aetna — Commercial Product: $1,871
  • Aetna — Commercial Whole Health: $1,779
  • Aetna — Government Programs: $339.08
  • Beacon Health Strategies — Medicaid: $300
  • Beacon Health Strategies — Medicare: $315
  • Centerlight Healthcare — Centerlight Healthcare: $339.08
  • Centers Plan for Healthy Living — Medicare: $423.85
  • Centivo — Centivo: $1,403.83
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM $768 $768 $35 – $1,961
Emergency room visit (moderately high): 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $104
  • Aetna — Commercial High Performance Network: $1,871
  • Aetna — Commercial Product: $1,871
  • Aetna — Commercial Whole Health: $1,779
  • Aetna — Government Programs: $518.31
  • Beacon Health Strategies — Medicaid: $300
  • Beacon Health Strategies — Medicare: $315
  • Centerlight Healthcare — Centerlight Healthcare: $518.31
  • Centers Plan for Healthy Living — Medicare: $647.89
  • Centivo — Centivo: $1,403.83
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $975 $975 $35 – $1,961
Emergency room visit (moderately high): 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $104
  • Aetna — Commercial High Performance Network: $1,871
  • Aetna — Commercial Product: $1,871
  • Aetna — Commercial Whole Health: $1,779
  • Aetna — Government Programs: $518.31
  • Beacon Health Strategies — Medicaid: $300
  • Beacon Health Strategies — Medicare: $315
  • Centerlight Healthcare — Centerlight Healthcare: $518.31
  • Centers Plan for Healthy Living — Medicare: $647.89
  • Centivo — Centivo: $1,403.83
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $975 $975 $225 – $1,961
Emergency room visit (moderately high): 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $918
  • Aetna — Commercial High Performance Network: $1,871
  • Aetna — Commercial Product: $1,871
  • Aetna — Commercial Whole Health: $1,779
  • Aetna — Government Programs: $518.31
  • Beacon Health Strategies — Medicaid: $300
  • Beacon Health Strategies — Medicare: $315
  • Centerlight Healthcare — Centerlight Healthcare: $518.31
  • Centers Plan for Healthy Living — Medicare: $647.89
  • Centivo — Centivo: $1,403.83
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM $10,114 $10,114 $35 – $1,961
Emergency room visit (high): 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $161
  • Aetna — Commercial High Performance Network: $1,871
  • Aetna — Commercial Product: $1,871
  • Aetna — Commercial Whole Health: $1,779
  • Aetna — Government Programs: $739.75
  • Beacon Health Strategies — Medicaid: $300
  • Beacon Health Strategies — Medicare: $315
  • Centerlight Healthcare — Centerlight Healthcare: $739.75
  • Centers Plan for Healthy Living — Medicare: $924.69
  • Centivo — Centivo: $1,403.83
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $1,008 $1,008 $35 – $1,961
Emergency room visit (high): 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $161
  • Aetna — Commercial High Performance Network: $1,871
  • Aetna — Commercial Product: $1,871
  • Aetna — Commercial Whole Health: $1,779
  • Aetna — Government Programs: $739.75
  • Beacon Health Strategies — Medicaid: $300
  • Beacon Health Strategies — Medicare: $315
  • Centerlight Healthcare — Centerlight Healthcare: $739.75
  • Centers Plan for Healthy Living — Medicare: $924.69
  • Centivo — Centivo: $1,403.83
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $756 $756 $35 – $1,912
Emergency room visit (high): 10 of 48 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $161
  • Aetna — Commercial High Performance Network: $1,560
  • Aetna — Commercial Product: $1,560
  • Aetna — Commercial Whole Health: $1,482
  • Aetna — Government Programs: $739.75
  • Beacon Health Strategies — Medicare: $739.75
  • Centerlight Healthcare — Centerlight Healthcare: $739.75
  • Centers Plan for Healthy Living — Medicare: $924.69
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $25 $25 $7.19 – $1,912
Basic metabolic panel (blood test): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $9
  • Aetna — Government Programs: $8.46
  • Beacon Health Strategies — Medicare: $8.46
  • Centerlight Healthcare — Centerlight Healthcare: $8.46
  • Centers Plan for Healthy Living — Medicare: $9.31
  • Centivo — Centivo: $10.58
  • Cigna — Managed Care Commercial: $15.40
  • Elderplan — Elderplan: $8.04
  • EmblemHealth — Select Care: $13.96
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $19.20
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91_XU In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $25 $25 $7.19 – $1,912
Basic metabolic panel (blood test): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $8.46
  • Beacon Health Strategies — Medicare: $8.46
  • Centerlight Healthcare — Centerlight Healthcare: $8.46
  • Centers Plan for Healthy Living — Medicare: $9.31
  • Centivo — Centivo: $10.58
  • Elderplan — Elderplan: $8.04
  • EmblemHealth — Select Care: $13.96
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $19.20
  • Empire — Indemnity: $19.20
  • Empire — Medicare: $8.46
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $25 $25 $7.19 – $1,912
Basic metabolic panel (blood test): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $8.46
  • Beacon Health Strategies — Medicare: $8.46
  • Centerlight Healthcare — Centerlight Healthcare: $8.46
  • Centers Plan for Healthy Living — Medicare: $9.31
  • Centivo — Centivo: $10.58
  • Elderplan — Elderplan: $8.04
  • EmblemHealth — Select Care: $13.96
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $19.20
  • Empire — Indemnity: $19.20
  • Empire — Medicare: $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $32 $32 $8.98 – $1,912
Comprehensive metabolic panel (blood test): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $12
  • Aetna — Government Programs: $10.56
  • Beacon Health Strategies — Medicare: $10.56
  • Centerlight Healthcare — Centerlight Healthcare: $10.56
  • Centers Plan for Healthy Living — Medicare: $11.62
  • Centivo — Centivo: $13.20
  • Cigna — Managed Care Commercial: $19.10
  • Elderplan — Elderplan: $10.03
  • EmblemHealth — Select Care: $17.42
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $23.97
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $32 $32 $8.98 – $1,912
Comprehensive metabolic panel (blood test): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $10.56
  • Beacon Health Strategies — Medicare: $10.56
  • Centerlight Healthcare — Centerlight Healthcare: $10.56
  • Centers Plan for Healthy Living — Medicare: $11.62
  • Centivo — Centivo: $13.20
  • Elderplan — Elderplan: $10.03
  • EmblemHealth — Select Care: $17.42
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $23.97
  • Empire — Indemnity: $23.97
  • Empire — Medicare: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $32 $32 $8.98 – $1,912
Comprehensive metabolic panel (blood test): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $10.56
  • Beacon Health Strategies — Medicare: $10.56
  • Centerlight Healthcare — Centerlight Healthcare: $10.56
  • Centers Plan for Healthy Living — Medicare: $11.62
  • Centivo — Centivo: $13.20
  • Elderplan — Elderplan: $10.03
  • EmblemHealth — Select Care: $17.42
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $23.97
  • Empire — Indemnity: $23.97
  • Empire — Medicare: $10.56
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL $143 $143 $20.10 – $1,912
Obstetric blood test panel: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $43
  • Aetna — Government Programs: $47.81
  • Beacon Health Strategies — Medicare: $47.81
  • Centerlight Healthcare — Centerlight Healthcare: $47.81
  • Centers Plan for Healthy Living — Medicare: $52.59
  • Centivo — Centivo: $59.76
  • Cigna — Managed Care Commercial: $86.86
  • Elderplan — Elderplan: $45.42
  • EmblemHealth — Select Care: $78.89
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $108.53
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $40 $40 $6.71 – $1,912
Cholesterol panel (lipid panel): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $19
  • Aetna — Government Programs: $13.39
  • Beacon Health Strategies — Medicare: $13.39
  • Centerlight Healthcare — Centerlight Healthcare: $13.39
  • Centers Plan for Healthy Living — Medicare: $14.73
  • Centivo — Centivo: $16.74
  • Cigna — Managed Care Commercial: $24.64
  • Elderplan — Elderplan: $12.72
  • EmblemHealth — Select Care: $22.09
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $30.40
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $40 $40 $11.38 – $1,912
Cholesterol panel (lipid panel): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $13.39
  • Beacon Health Strategies — Medicare: $13.39
  • Centerlight Healthcare — Centerlight Healthcare: $13.39
  • Centers Plan for Healthy Living — Medicare: $14.73
  • Centivo — Centivo: $16.74
  • Elderplan — Elderplan: $12.72
  • EmblemHealth — Select Care: $22.09
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $30.40
  • Empire — Indemnity: $30.40
  • Empire — Medicare: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $40 $40 $11.38 – $1,912
Cholesterol panel (lipid panel): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $13.39
  • Beacon Health Strategies — Medicare: $13.39
  • Centerlight Healthcare — Centerlight Healthcare: $13.39
  • Centers Plan for Healthy Living — Medicare: $14.73
  • Centivo — Centivo: $16.74
  • Elderplan — Elderplan: $12.72
  • EmblemHealth — Select Care: $22.09
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $30.40
  • Empire — Indemnity: $30.40
  • Empire — Medicare: $13.39
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL $26 $26 $7.38 – $1,912
Kidney function panel: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $12
  • Aetna — Government Programs: $8.68
  • Beacon Health Strategies — Medicare: $8.68
  • Centerlight Healthcare — Centerlight Healthcare: $8.68
  • Centers Plan for Healthy Living — Medicare: $9.55
  • Centivo — Centivo: $10.85
  • Cigna — Managed Care Commercial: $16.02
  • Elderplan — Elderplan: $8.25
  • EmblemHealth — Select Care: $14.32
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $19.70
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: KIDNEY FUNCTION BLOOD TEST PANEL $26 $26 $7.38 – $1,912
Kidney function panel: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $8.68
  • Beacon Health Strategies — Medicare: $8.68
  • Centerlight Healthcare — Centerlight Healthcare: $8.68
  • Centers Plan for Healthy Living — Medicare: $9.55
  • Centivo — Centivo: $10.85
  • Elderplan — Elderplan: $8.25
  • EmblemHealth — Select Care: $14.32
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $19.70
  • Empire — Indemnity: $19.70
  • Empire — Medicare: $8.68
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: KIDNEY FUNCTION BLOOD TEST PANEL $26 $26 $7.38 – $1,912
Kidney function panel: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $8.68
  • Beacon Health Strategies — Medicare: $8.68
  • Centerlight Healthcare — Centerlight Healthcare: $8.68
  • Centers Plan for Healthy Living — Medicare: $9.55
  • Centivo — Centivo: $10.85
  • Elderplan — Elderplan: $8.25
  • EmblemHealth — Select Care: $14.32
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $19.70
  • Empire — Indemnity: $19.70
  • Empire — Medicare: $8.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL $25 $25 $5 – $1,912
Liver function panel: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $11
  • Aetna — Government Programs: $8.17
  • Beacon Health Strategies — Medicare: $8.17
  • Centerlight Healthcare — Centerlight Healthcare: $8.17
  • Centers Plan for Healthy Living — Medicare: $8.99
  • Centivo — Centivo: $10.21
  • Cigna — Managed Care Commercial: $14.79
  • Elderplan — Elderplan: $7.76
  • EmblemHealth — Select Care: $13.48
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $18.55
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: LIVER FUNCTION BLOOD TEST PANEL $25 $25 $6.94 – $1,912
Liver function panel: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $8.17
  • Beacon Health Strategies — Medicare: $8.17
  • Centerlight Healthcare — Centerlight Healthcare: $8.17
  • Centers Plan for Healthy Living — Medicare: $8.99
  • Centivo — Centivo: $10.21
  • Elderplan — Elderplan: $7.76
  • EmblemHealth — Select Care: $13.48
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $18.55
  • Empire — Indemnity: $18.55
  • Empire — Medicare: $8.17
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: LIVER FUNCTION BLOOD TEST PANEL $25 $25 $6.94 – $1,912
Liver function panel: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $8.17
  • Beacon Health Strategies — Medicare: $8.17
  • Centerlight Healthcare — Centerlight Healthcare: $8.17
  • Centers Plan for Healthy Living — Medicare: $8.99
  • Centivo — Centivo: $10.21
  • Elderplan — Elderplan: $7.76
  • EmblemHealth — Select Care: $13.48
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $18.55
  • Empire — Indemnity: $18.55
  • Empire — Medicare: $8.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE $10 $10 $2 – $1,912
Urine test (automated, with microscope): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $5
  • Aetna — Government Programs: $3.17
  • Beacon Health Strategies — Medicare: $3.17
  • Centerlight Healthcare — Centerlight Healthcare: $3.17
  • Centers Plan for Healthy Living — Medicare: $3.49
  • Centivo — Centivo: $3.96
  • Cigna — Managed Care Commercial: $5.55
  • Elderplan — Elderplan: $3.01
  • EmblemHealth — Select Care: $5.23
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $7.20
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $17 $17 $2 – $1,912
Urine test (automated, with microscope): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $5
  • Aetna — Government Programs: $3.17
  • Beacon Health Strategies — Medicare: $3.17
  • Centerlight Healthcare — Centerlight Healthcare: $3.17
  • Centers Plan for Healthy Living — Medicare: $3.49
  • Centivo — Centivo: $3.96
  • Cigna — Managed Care Commercial: $5.55
  • Elderplan — Elderplan: $3.01
  • EmblemHealth — Select Care: $5.23
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $7.20
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $10 $10 $2.69 – $1,912
Urine test (automated, with microscope): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $3.17
  • Beacon Health Strategies — Medicare: $3.17
  • Centerlight Healthcare — Centerlight Healthcare: $3.17
  • Centers Plan for Healthy Living — Medicare: $3.49
  • Centivo — Centivo: $3.96
  • Elderplan — Elderplan: $3.01
  • EmblemHealth — Select Care: $5.23
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $7.20
  • Empire — Indemnity: $7.20
  • Empire — Medicare: $3.17
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE $10 $10 $1 – $1,912 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (manual, without microscope): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4
  • Aetna — Government Programs: $3.48
  • Beacon Health Strategies — Medicare: $3.48
  • Centerlight Healthcare — Centerlight Healthcare: $3.48
  • Centers Plan for Healthy Living — Medicare: $3.83
  • Centivo — Centivo: $4.35
  • Cigna — Managed Care Commercial: $6.16
  • Elderplan — Elderplan: $3.31
  • EmblemHealth — Select Care: $5.74
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $7.90
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST $7 $7 $1 – $1,912
Urine test (automated, without microscope): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4
  • Aetna — Government Programs: $2.25
  • Beacon Health Strategies — Medicare: $2.25
  • Centerlight Healthcare — Centerlight Healthcare: $2.25
  • Centers Plan for Healthy Living — Medicare: $2.48
  • Centivo — Centivo: $2.81
  • Cigna — Managed Care Commercial: $4.30
  • Elderplan — Elderplan: $2.14
  • EmblemHealth — Select Care: $3.71
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $5.11
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: AUTOMATED URINALYSIS TEST $7 $7 $1.91 – $1,912
Urine test (automated, without microscope): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $2.25
  • Beacon Health Strategies — Medicare: $2.25
  • Centerlight Healthcare — Centerlight Healthcare: $2.25
  • Centers Plan for Healthy Living — Medicare: $2.48
  • Centivo — Centivo: $2.81
  • Elderplan — Elderplan: $2.14
  • EmblemHealth — Select Care: $3.71
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $5.11
  • Empire — Indemnity: $5.11
  • Empire — Medicare: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: AUTOMATED URINALYSIS TEST $7 $7 $1.91 – $1,912
Urine test (automated, without microscope): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $2.25
  • Beacon Health Strategies — Medicare: $2.25
  • Centerlight Healthcare — Centerlight Healthcare: $2.25
  • Centers Plan for Healthy Living — Medicare: $2.48
  • Centivo — Centivo: $2.81
  • Elderplan — Elderplan: $2.14
  • EmblemHealth — Select Care: $3.71
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $5.11
  • Empire — Indemnity: $5.11
  • Empire — Medicare: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL $55 $55 $10.10 – $1,912
PSA (prostate specific antigen) blood test: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $26
  • Aetna — Government Programs: $18.39
  • Beacon Health Strategies — Medicare: $18.39
  • Centerlight Healthcare — Centerlight Healthcare: $18.39
  • Centers Plan for Healthy Living — Medicare: $20.23
  • Centivo — Centivo: $22.99
  • Cigna — Managed Care Commercial: $33.27
  • Elderplan — Elderplan: $17.47
  • EmblemHealth — Select Care: $30.34
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $41.75
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL $45 $45 $10.10 – $1,912
PSA (prostate specific antigen) blood test: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $26
  • Aetna — Government Programs: $18.39
  • Beacon Health Strategies — Medicare: $18.39
  • Centerlight Healthcare — Centerlight Healthcare: $18.39
  • Centers Plan for Healthy Living — Medicare: $20.23
  • Centivo — Centivo: $22.99
  • Cigna — Managed Care Commercial: $33.27
  • Elderplan — Elderplan: $17.47
  • EmblemHealth — Select Care: $30.34
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $41.75
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL $55 $55 $15.63 – $1,912
PSA (prostate specific antigen) blood test: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $18.39
  • Beacon Health Strategies — Medicare: $18.39
  • Centerlight Healthcare — Centerlight Healthcare: $18.39
  • Centers Plan for Healthy Living — Medicare: $20.23
  • Centivo — Centivo: $22.99
  • Elderplan — Elderplan: $17.47
  • EmblemHealth — Select Care: $30.34
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $41.75
  • Empire — Indemnity: $41.75
  • Empire — Medicare: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $50 $50 $10 – $1,912
Thyroid stimulating hormone (TSH) test: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $24
  • Aetna — Government Programs: $16.80
  • Beacon Health Strategies — Medicare: $16.80
  • Centerlight Healthcare — Centerlight Healthcare: $16.80
  • Centers Plan for Healthy Living — Medicare: $18.48
  • Centivo — Centivo: $21
  • Cigna — Managed Care Commercial: $30.81
  • Elderplan — Elderplan: $15.96
  • EmblemHealth — Select Care: $27.72
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $38.14
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $50 $50 $14.28 – $1,912
Thyroid stimulating hormone (TSH) test: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $16.80
  • Beacon Health Strategies — Medicare: $16.80
  • Centerlight Healthcare — Centerlight Healthcare: $16.80
  • Centers Plan for Healthy Living — Medicare: $18.48
  • Centivo — Centivo: $21
  • Elderplan — Elderplan: $15.96
  • EmblemHealth — Select Care: $27.72
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $38.14
  • Empire — Indemnity: $38.14
  • Empire — Medicare: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $50 $50 $14.28 – $1,912
Thyroid stimulating hormone (TSH) test: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $16.80
  • Beacon Health Strategies — Medicare: $16.80
  • Centerlight Healthcare — Centerlight Healthcare: $16.80
  • Centers Plan for Healthy Living — Medicare: $18.48
  • Centivo — Centivo: $21
  • Elderplan — Elderplan: $15.96
  • EmblemHealth — Select Care: $27.72
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $38.14
  • Empire — Indemnity: $38.14
  • Empire — Medicare: $16.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $23 $23 $3.52 – $1,912
Complete blood count (CBC) with differential: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $11
  • Aetna — Government Programs: $7.77
  • Beacon Health Strategies — Medicare: $7.77
  • Centerlight Healthcare — Centerlight Healthcare: $7.77
  • Centers Plan for Healthy Living — Medicare: $8.55
  • Centivo — Centivo: $9.71
  • Cigna — Managed Care Commercial: $14.18
  • Elderplan — Elderplan: $7.38
  • EmblemHealth — Select Care: $12.82
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $17.64
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $23 $23 $6.60 – $1,912
Complete blood count (CBC) with differential: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $7.77
  • Beacon Health Strategies — Medicare: $7.77
  • Centerlight Healthcare — Centerlight Healthcare: $7.77
  • Centers Plan for Healthy Living — Medicare: $8.55
  • Centivo — Centivo: $9.71
  • Elderplan — Elderplan: $7.38
  • EmblemHealth — Select Care: $12.82
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $17.64
  • Empire — Indemnity: $17.64
  • Empire — Medicare: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $23 $23 $6.60 – $1,912
Complete blood count (CBC) with differential: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $7.77
  • Beacon Health Strategies — Medicare: $7.77
  • Centerlight Healthcare — Centerlight Healthcare: $7.77
  • Centers Plan for Healthy Living — Medicare: $8.55
  • Centivo — Centivo: $9.71
  • Elderplan — Elderplan: $7.38
  • EmblemHealth — Select Care: $12.82
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $17.64
  • Empire — Indemnity: $17.64
  • Empire — Medicare: $7.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $19 $19 $3.52 – $1,912
Complete blood count (CBC), automated: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $9
  • Aetna — Government Programs: $6.47
  • Beacon Health Strategies — Medicare: $6.47
  • Centerlight Healthcare — Centerlight Healthcare: $6.47
  • Centers Plan for Healthy Living — Medicare: $7.12
  • Centivo — Centivo: $8.09
  • Cigna — Managed Care Commercial: $11.70
  • Elderplan — Elderplan: $6.15
  • EmblemHealth — Select Care: $10.68
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $14.69
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $19 $19 $5.50 – $1,912
Complete blood count (CBC), automated: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $6.47
  • Beacon Health Strategies — Medicare: $6.47
  • Centerlight Healthcare — Centerlight Healthcare: $6.47
  • Centers Plan for Healthy Living — Medicare: $7.12
  • Centivo — Centivo: $8.09
  • Elderplan — Elderplan: $6.15
  • EmblemHealth — Select Care: $10.68
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $14.69
  • Empire — Indemnity: $14.69
  • Empire — Medicare: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $19 $19 $5.50 – $1,912
Complete blood count (CBC), automated: 10 of 50 insurance plan rates
  • Aetna — Government Programs: $6.47
  • Beacon Health Strategies — Medicare: $6.47
  • Centerlight Healthcare — Centerlight Healthcare: $6.47
  • Centers Plan for Healthy Living — Medicare: $7.12
  • Centivo — Centivo: $8.09
  • Elderplan — Elderplan: $6.15
  • EmblemHealth — Select Care: $10.68
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $14.69
  • Empire — Indemnity: $14.69
  • Empire — Medicare: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME $13 $13 $2 – $1,912
Blood clotting time test (prothrombin time, PT): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $6
  • Aetna — Government Programs: $4.29
  • Beacon Health Strategies — Medicare: $4.29
  • Centerlight Healthcare — Centerlight Healthcare: $4.29
  • Centers Plan for Healthy Living — Medicare: $4.72
  • Centivo — Centivo: $5.36
  • Cigna — Managed Care Commercial: $8.01
  • Elderplan — Elderplan: $4.08
  • EmblemHealth — Select Care: $7.08
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $9.74
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $9 $9 $2 – $1,912
Blood clotting time test (prothrombin time, PT): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $6
  • Aetna — Government Programs: $4.29
  • Beacon Health Strategies — Medicare: $4.29
  • Centerlight Healthcare — Centerlight Healthcare: $4.29
  • Centers Plan for Healthy Living — Medicare: $4.72
  • Centivo — Centivo: $5.36
  • Cigna — Managed Care Commercial: $8.01
  • Elderplan — Elderplan: $4.08
  • EmblemHealth — Select Care: $7.08
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $9.74
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; CLOTTING TIME $13 $13 $3.65 – $1,912
Blood clotting time test (prothrombin time, PT): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $4.29
  • Beacon Health Strategies — Medicare: $4.29
  • Centerlight Healthcare — Centerlight Healthcare: $4.29
  • Centers Plan for Healthy Living — Medicare: $4.72
  • Centivo — Centivo: $5.36
  • Elderplan — Elderplan: $4.08
  • EmblemHealth — Select Care: $7.08
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $9.74
  • Empire — Indemnity: $9.74
  • Empire — Medicare: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $18 $18 $3.50 – $1,912
Blood clotting test (partial thromboplastin time, PTT): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $9
  • Aetna — Government Programs: $6.01
  • Beacon Health Strategies — Medicare: $6.01
  • Centerlight Healthcare — Centerlight Healthcare: $6.01
  • Centers Plan for Healthy Living — Medicare: $6.61
  • Centivo — Centivo: $7.51
  • Cigna — Managed Care Commercial: $11.08
  • Elderplan — Elderplan: $5.71
  • EmblemHealth — Select Care: $9.92
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $13.64
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL $13 $13 $3.50 – $1,912
Blood clotting test (partial thromboplastin time, PTT): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $9
  • Aetna — Government Programs: $6.01
  • Beacon Health Strategies — Medicare: $6.01
  • Centerlight Healthcare — Centerlight Healthcare: $6.01
  • Centers Plan for Healthy Living — Medicare: $6.61
  • Centivo — Centivo: $7.51
  • Cigna — Managed Care Commercial: $11.08
  • Elderplan — Elderplan: $5.71
  • EmblemHealth — Select Care: $9.92
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $13.64
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $18 $18 $5.11 – $1,912
Blood clotting test (partial thromboplastin time, PTT): 10 of 50 insurance plan rates
  • Aetna — Government Programs: $6.01
  • Beacon Health Strategies — Medicare: $6.01
  • Centerlight Healthcare — Centerlight Healthcare: $6.01
  • Centers Plan for Healthy Living — Medicare: $6.61
  • Centivo — Centivo: $7.51
  • Elderplan — Elderplan: $5.71
  • EmblemHealth — Select Care: $9.92
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $13.64
  • Empire — Indemnity: $13.64
  • Empire — Medicare: $6.01

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE $445 $445 $62.87 – $1,912
CT scan of the head or brain, without contrast: 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $241
  • Aetna — Commercial High Performance Network: $1,229
  • Aetna — Commercial Product: $1,229
  • Aetna — Commercial Whole Health: $1,168
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Centivo — Centivo: $129.86
  • Cigna — Managed Care Commercial: $1,756
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_TC_XU In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $445 $445 $79.99 – $1,912
CT scan of the head or brain, without contrast: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $241
  • Aetna — Commercial High Performance Network: $1,229
  • Aetna — Commercial Product: $1,229
  • Aetna — Commercial Whole Health: $1,168
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Centivo — Centivo: $129.86
  • Cigna — Managed Care Commercial: $1,756
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_TC In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $445 $445 $79.99 – $1,912
CT scan of the head or brain, without contrast: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $241
  • Aetna — Commercial High Performance Network: $1,229
  • Aetna — Commercial Product: $1,229
  • Aetna — Commercial Whole Health: $1,168
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Centivo — Centivo: $129.86
  • Cigna — Managed Care Commercial: $1,756
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE $1,557 $1,557 $202.32 – $2,456
MRI of the brain, before and after contrast: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $1,268
  • Aetna — Commercial High Performance Network: $1,673
  • Aetna — Commercial Product: $1,673
  • Aetna — Commercial Whole Health: $1,589
  • Aetna — Government Programs: $433.36
  • Beacon Health Strategies — Medicare: $433.36
  • Centerlight Healthcare — Centerlight Healthcare: $433.36
  • Centers Plan for Healthy Living — Medicare: $476.70
  • Centivo — Centivo: $433.36
  • Cigna — Managed Care Commercial: $2,456
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST $1,557 $1,557 $333.30 – $2,456
MRI of the brain, before and after contrast: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $1,268
  • Aetna — Commercial High Performance Network: $1,673
  • Aetna — Commercial Product: $1,673
  • Aetna — Commercial Whole Health: $1,589
  • Aetna — Government Programs: $433.36
  • Beacon Health Strategies — Medicare: $433.36
  • Centerlight Healthcare — Centerlight Healthcare: $433.36
  • Centers Plan for Healthy Living — Medicare: $476.70
  • Centivo — Centivo: $433.36
  • Cigna — Managed Care Commercial: $2,456
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC_XU In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST $1,557 $1,557 $333.30 – $2,456
MRI of the brain, before and after contrast: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $1,268
  • Aetna — Commercial High Performance Network: $1,673
  • Aetna — Commercial Product: $1,673
  • Aetna — Commercial Whole Health: $1,589
  • Aetna — Government Programs: $433.36
  • Beacon Health Strategies — Medicare: $433.36
  • Centerlight Healthcare — Centerlight Healthcare: $433.36
  • Centers Plan for Healthy Living — Medicare: $476.70
  • Centivo — Centivo: $433.36
  • Cigna — Managed Care Commercial: $2,456
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS $210 $210 $16.66 – $1,912
Chest X-ray, 2 views: 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $24
  • Aetna — Government Programs: $108.10
  • Beacon Health Strategies — Medicare: $108.10
  • Centerlight Healthcare — Centerlight Healthcare: $108.10
  • Centers Plan for Healthy Living — Medicare: $118.91
  • Elderplan — Elderplan: $110.26
  • EmblemHealth — Select Care: $178.37
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $245.39
  • Empire — Indemnity: $245.39
  • Empire — Medicare: $108.10
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC_XU In the file: X-RAY OF CHEST; 2 VIEWS $210 $210 $10 – $1,912
Chest X-ray, 2 views: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $24
  • Aetna — Commercial High Performance Network: $131.88
  • Aetna — Commercial Product: $131.88
  • Aetna — Commercial Whole Health: $125.40
  • Aetna — Government Programs: $108.10
  • Beacon Health Strategies — Medicare: $108.10
  • Centerlight Healthcare — Centerlight Healthcare: $108.10
  • Centers Plan for Healthy Living — Medicare: $118.91
  • Elderplan — Elderplan: $110.26
  • EmblemHealth — Select Care: $178.37
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: X-RAY OF CHEST; 2 VIEWS $210 $210 $10 – $1,912
Chest X-ray, 2 views: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $24
  • Aetna — Commercial High Performance Network: $131.88
  • Aetna — Commercial Product: $131.88
  • Aetna — Commercial Whole Health: $125.40
  • Aetna — Government Programs: $108.10
  • Beacon Health Strategies — Medicare: $108.10
  • Centerlight Healthcare — Centerlight Healthcare: $108.10
  • Centers Plan for Healthy Living — Medicare: $118.91
  • Elderplan — Elderplan: $110.26
  • EmblemHealth — Select Care: $178.37
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS $304 $304 $33.33 – $1,912
X-ray of the lower spine, at least 4 views: 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $47
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Elderplan — Elderplan: $132.46
  • EmblemHealth — Select Care: $214.27
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $294.78
  • Empire — Indemnity: $294.78
  • Empire — Medicare: $129.86
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN_TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS $304 $304 $20 – $1,912
X-ray of the lower spine, at least 4 views: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $47
  • Aetna — Commercial High Performance Network: $63.37
  • Aetna — Commercial Product: $63.37
  • Aetna — Commercial Whole Health: $60.25
  • Aetna — Government Programs: $51.94
  • Beacon Health Strategies — Medicare: $51.94
  • Centerlight Healthcare — Centerlight Healthcare: $51.94
  • Centers Plan for Healthy Living — Medicare: $57.13
  • Elderplan — Elderplan: $52.98
  • EmblemHealth — Select Care: $85.70
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS $304 $304 $20 – $1,912
X-ray of the lower spine, at least 4 views: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $47
  • Aetna — Commercial High Performance Network: $158.43
  • Aetna — Commercial Product: $158.43
  • Aetna — Commercial Whole Health: $150.64
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Elderplan — Elderplan: $132.46
  • EmblemHealth — Select Care: $214.27
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE $992 $992 $116.15 – $2,456
MRI of the lower back (lumbar spine), without contrast: 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $634
  • Aetna — Commercial High Performance Network: $1,673
  • Aetna — Commercial Product: $1,673
  • Aetna — Commercial Whole Health: $1,589
  • Aetna — Government Programs: $296.38
  • Beacon Health Strategies — Medicare: $296.38
  • Centerlight Healthcare — Centerlight Healthcare: $296.38
  • Centers Plan for Healthy Living — Medicare: $326.02
  • Centivo — Centivo: $296.38
  • Cigna — Managed Care Commercial: $2,456
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST $992 $992 $257.88 – $2,456
MRI of the lower back (lumbar spine), without contrast: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $634
  • Aetna — Commercial High Performance Network: $1,673
  • Aetna — Commercial Product: $1,673
  • Aetna — Commercial Whole Health: $1,589
  • Aetna — Government Programs: $296.38
  • Beacon Health Strategies — Medicare: $296.38
  • Centerlight Healthcare — Centerlight Healthcare: $296.38
  • Centers Plan for Healthy Living — Medicare: $326.02
  • Centivo — Centivo: $296.38
  • Cigna — Managed Care Commercial: $2,456
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST $992 $992 $257.88 – $2,456
MRI of the lower back (lumbar spine), without contrast: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $634
  • Aetna — Commercial High Performance Network: $1,673
  • Aetna — Commercial Product: $1,673
  • Aetna — Commercial Whole Health: $1,589
  • Aetna — Government Programs: $296.38
  • Beacon Health Strategies — Medicare: $296.38
  • Centerlight Healthcare — Centerlight Healthcare: $296.38
  • Centers Plan for Healthy Living — Medicare: $326.02
  • Centivo — Centivo: $296.38
  • Cigna — Managed Care Commercial: $2,456
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE $744 $744 $159.92 – $1,912
CT scan of the pelvis, with contrast: 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $349
  • Aetna — Commercial High Performance Network: $1,229
  • Aetna — Commercial Product: $1,229
  • Aetna — Commercial Whole Health: $1,168
  • Aetna — Government Programs: $217.88
  • Beacon Health Strategies — Medicare: $217.88
  • Centerlight Healthcare — Centerlight Healthcare: $217.88
  • Centers Plan for Healthy Living — Medicare: $239.67
  • Centivo — Centivo: $217.88
  • Cigna — Managed Care Commercial: $1,756
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT SCAN OF PELVIS WITH CONTRAST $744 $744 $113.32 – $1,912
CT scan of the pelvis, with contrast: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $349
  • Aetna — Commercial High Performance Network: $1,229
  • Aetna — Commercial Product: $1,229
  • Aetna — Commercial Whole Health: $1,168
  • Aetna — Government Programs: $217.88
  • Beacon Health Strategies — Medicare: $217.88
  • Centerlight Healthcare — Centerlight Healthcare: $217.88
  • Centers Plan for Healthy Living — Medicare: $239.67
  • Centivo — Centivo: $217.88
  • Cigna — Managed Care Commercial: $1,756
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE $992 $992 $132.04 – $2,456
MRI of a leg joint (such as the knee), without contrast: 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $571
  • Aetna — Commercial High Performance Network: $1,673
  • Aetna — Commercial Product: $1,673
  • Aetna — Commercial Whole Health: $1,589
  • Aetna — Government Programs: $296.38
  • Beacon Health Strategies — Medicare: $296.38
  • Centerlight Healthcare — Centerlight Healthcare: $296.38
  • Centers Plan for Healthy Living — Medicare: $326.02
  • Centivo — Centivo: $296.38
  • Cigna — Managed Care Commercial: $2,456
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_PO_TC In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST $1,133 $1,133 $291.14 – $2,456
MRI of a leg joint (such as the knee), without contrast: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $571
  • Aetna — Commercial High Performance Network: $1,673
  • Aetna — Commercial Product: $1,673
  • Aetna — Commercial Whole Health: $1,589
  • Aetna — Government Programs: $653.94
  • Beacon Health Strategies — Medicare: $653.94
  • Centerlight Healthcare — Centerlight Healthcare: $653.94
  • Centers Plan for Healthy Living — Medicare: $719.33
  • Centivo — Centivo: $653.94
  • Cigna — Managed Care Commercial: $2,456
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_TC In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST $1,133 $1,133 $291.14 – $2,456
MRI of a leg joint (such as the knee), without contrast: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $571
  • Aetna — Commercial High Performance Network: $1,673
  • Aetna — Commercial Product: $1,673
  • Aetna — Commercial Whole Health: $1,589
  • Aetna — Government Programs: $653.94
  • Beacon Health Strategies — Medicare: $653.94
  • Centerlight Healthcare — Centerlight Healthcare: $653.94
  • Centers Plan for Healthy Living — Medicare: $719.33
  • Centivo — Centivo: $653.94
  • Cigna — Managed Care Commercial: $2,456
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST $1,557 $1,557 $119.91 – $1,912
CT scan of the abdomen and pelvis, with contrast: 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $318
  • Aetna — Commercial High Performance Network: $1,229
  • Aetna — Commercial Product: $1,229
  • Aetna — Commercial Whole Health: $1,168
  • Aetna — Government Programs: $433.36
  • Beacon Health Strategies — Medicare: $433.36
  • Centerlight Healthcare — Centerlight Healthcare: $433.36
  • Centers Plan for Healthy Living — Medicare: $476.70
  • Centivo — Centivo: $433.36
  • Cigna — Managed Care Commercial: $1,756
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 76_TC In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $1,557 $1,557 $71.95 – $1,912
CT scan of the abdomen and pelvis, with contrast: 10 of 55 insurance plan rates
  • Aetna — Commercial High Performance Network: $1,229
  • Aetna — Commercial Product: $1,229
  • Aetna — Commercial Whole Health: $1,168
  • Aetna — Government Programs: $433.36
  • Beacon Health Strategies — Medicare: $433.36
  • Centerlight Healthcare — Centerlight Healthcare: $433.36
  • Centers Plan for Healthy Living — Medicare: $476.70
  • Centivo — Centivo: $433.36
  • Cigna — Managed Care Commercial: $1,756
  • Elderplan — Elderplan: $442.03
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $1,557 $1,557 $71.95 – $1,912
CT scan of the abdomen and pelvis, with contrast: 10 of 55 insurance plan rates
  • Aetna — Commercial High Performance Network: $1,229
  • Aetna — Commercial Product: $1,229
  • Aetna — Commercial Whole Health: $1,168
  • Aetna — Government Programs: $433.36
  • Beacon Health Strategies — Medicare: $433.36
  • Centerlight Healthcare — Centerlight Healthcare: $433.36
  • Centers Plan for Healthy Living — Medicare: $476.70
  • Centivo — Centivo: $433.36
  • Cigna — Managed Care Commercial: $1,756
  • Elderplan — Elderplan: $442.03
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE $254 $254 $66.66 – $1,912
Ultrasound of the abdomen, complete: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $101
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Elderplan — Elderplan: $132.46
  • EmblemHealth — Select Care: $214.27
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $294.78
  • Empire — Indemnity: $294.78
  • Empire — Medicare: $129.86
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $254 $254 $40 – $1,912
Ultrasound of the abdomen, complete: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $101
  • Aetna — Commercial High Performance Network: $158.43
  • Aetna — Commercial Product: $158.43
  • Aetna — Commercial Whole Health: $150.64
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Elderplan — Elderplan: $132.46
  • EmblemHealth — Select Care: $214.27
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $254 $254 $40 – $1,912
Ultrasound of the abdomen, complete: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $101
  • Aetna — Commercial High Performance Network: $158.43
  • Aetna — Commercial Product: $158.43
  • Aetna — Commercial Whole Health: $150.64
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Elderplan — Elderplan: $132.46
  • EmblemHealth — Select Care: $214.27
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >= 14 WKS SNGL FETUS $254 $254 $61.10 – $1,912
Pregnancy ultrasound (after the first trimester): 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $108
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Elderplan — Elderplan: $132.46
  • EmblemHealth — Select Care: $214.27
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $294.78
  • Empire — Indemnity: $294.78
  • Empire — Medicare: $129.86
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS $254 $254 $36.66 – $1,912
Pregnancy ultrasound (after the first trimester): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $108
  • Aetna — Commercial High Performance Network: $158.43
  • Aetna — Commercial Product: $158.43
  • Aetna — Commercial Whole Health: $150.64
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Elderplan — Elderplan: $132.46
  • EmblemHealth — Select Care: $214.27
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL US NON-OB $254 $254 $66.66 – $1,912
Transvaginal ultrasound: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $78
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Elderplan — Elderplan: $132.46
  • EmblemHealth — Select Care: $214.27
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $294.78
  • Empire — Indemnity: $294.78
  • Empire — Medicare: $129.86
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA $254 $254 $40 – $1,912
Transvaginal ultrasound: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $78
  • Aetna — Commercial High Performance Network: $158.43
  • Aetna — Commercial Product: $158.43
  • Aetna — Commercial Whole Health: $150.64
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Elderplan — Elderplan: $132.46
  • EmblemHealth — Select Care: $214.27
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA $254 $254 $40 – $1,912
Transvaginal ultrasound: 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $78
  • Aetna — Commercial High Performance Network: $158.43
  • Aetna — Commercial Product: $158.43
  • Aetna — Commercial Whole Health: $150.64
  • Aetna — Government Programs: $129.86
  • Beacon Health Strategies — Medicare: $129.86
  • Centerlight Healthcare — Centerlight Healthcare: $129.86
  • Centers Plan for Healthy Living — Medicare: $142.85
  • Elderplan — Elderplan: $132.46
  • EmblemHealth — Select Care: $214.27
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI $224 $224 $37.74 – $1,912
Diagnostic mammogram, one breast: 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $112
  • Aetna — Government Programs: $41.93
  • Beacon Health Strategies — Medicare: $41.93
  • Centerlight Healthcare — Centerlight Healthcare: $41.93
  • Centers Plan for Healthy Living — Medicare: $46.12
  • Elderplan — Elderplan: $42.77
  • EmblemHealth — Select Care: $69.18
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $95.18
  • Empire — Indemnity: $95.18
  • Empire — Medicare: $41.93
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_PO_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST $224 $224 $37.74 – $1,912
Diagnostic mammogram, one breast: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $112
  • Aetna — Commercial High Performance Network: $51.15
  • Aetna — Commercial Product: $51.15
  • Aetna — Commercial Whole Health: $48.64
  • Aetna — Government Programs: $41.93
  • Beacon Health Strategies — Medicare: $41.93
  • Centerlight Healthcare — Centerlight Healthcare: $41.93
  • Centers Plan for Healthy Living — Medicare: $46.12
  • Elderplan — Elderplan: $42.77
  • EmblemHealth — Select Care: $69.18
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST $224 $224 $37.74 – $1,912
Diagnostic mammogram, one breast: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $112
  • Aetna — Commercial High Performance Network: $51.15
  • Aetna — Commercial Product: $51.15
  • Aetna — Commercial Whole Health: $48.64
  • Aetna — Government Programs: $41.93
  • Beacon Health Strategies — Medicare: $41.93
  • Centerlight Healthcare — Centerlight Healthcare: $41.93
  • Centers Plan for Healthy Living — Medicare: $46.12
  • Elderplan — Elderplan: $42.77
  • EmblemHealth — Select Care: $69.18
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI $285 $285 $46.38 – $1,912
Diagnostic mammogram, both breasts: 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $143
  • Aetna — Government Programs: $51.53
  • Beacon Health Strategies — Medicare: $51.53
  • Centerlight Healthcare — Centerlight Healthcare: $51.53
  • Centers Plan for Healthy Living — Medicare: $56.68
  • Elderplan — Elderplan: $52.56
  • EmblemHealth — Select Care: $85.02
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $116.97
  • Empire — Indemnity: $116.97
  • Empire — Medicare: $51.53
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS $285 $285 $46.38 – $1,912
Diagnostic mammogram, both breasts: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $143
  • Aetna — Commercial High Performance Network: $62.87
  • Aetna — Commercial Product: $62.87
  • Aetna — Commercial Whole Health: $59.77
  • Aetna — Government Programs: $51.53
  • Beacon Health Strategies — Medicare: $51.53
  • Centerlight Healthcare — Centerlight Healthcare: $51.53
  • Centers Plan for Healthy Living — Medicare: $56.68
  • Elderplan — Elderplan: $52.56
  • EmblemHealth — Select Care: $85.02
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS $285 $285 $46.38 – $1,912
Diagnostic mammogram, both breasts: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $143
  • Aetna — Commercial High Performance Network: $62.87
  • Aetna — Commercial Product: $62.87
  • Aetna — Commercial Whole Health: $59.77
  • Aetna — Government Programs: $51.53
  • Beacon Health Strategies — Medicare: $51.53
  • Centerlight Healthcare — Centerlight Healthcare: $51.53
  • Centers Plan for Healthy Living — Medicare: $56.68
  • Elderplan — Elderplan: $52.56
  • EmblemHealth — Select Care: $85.02
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD $178 $178 $34.99 – $1,912
Screening mammogram, both breasts: 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $118
  • Aetna — Government Programs: $38.88
  • Beacon Health Strategies — Medicare: $38.88
  • Centerlight Healthcare — Centerlight Healthcare: $38.88
  • Centers Plan for Healthy Living — Medicare: $42.77
  • Elderplan — Elderplan: $39.66
  • EmblemHealth — Select Care: $64.15
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $88.26
  • Empire — Indemnity: $88.26
  • Empire — Medicare: $38.88
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52_LT_PO_TC In the file: SCREENING MAMMOGRAPHY $178 $178 $34.99 – $1,912
Screening mammogram, both breasts: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $118
  • Aetna — Commercial High Performance Network: $47.43
  • Aetna — Commercial Product: $47.43
  • Aetna — Commercial Whole Health: $45.10
  • Aetna — Government Programs: $38.88
  • Beacon Health Strategies — Medicare: $38.88
  • Centerlight Healthcare — Centerlight Healthcare: $38.88
  • Centers Plan for Healthy Living — Medicare: $42.77
  • Elderplan — Elderplan: $39.66
  • EmblemHealth — Select Care: $64.15
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN_TC In the file: SCREENING MAMMOGRAPHY $236 $236 $34.99 – $1,912
Screening mammogram, both breasts: 10 of 55 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $118
  • Aetna — Commercial High Performance Network: $47.43
  • Aetna — Commercial Product: $47.43
  • Aetna — Commercial Whole Health: $45.10
  • Aetna — Government Programs: $38.88
  • Beacon Health Strategies — Medicare: $38.88
  • Centerlight Healthcare — Centerlight Healthcare: $38.88
  • Centers Plan for Healthy Living — Medicare: $42.77
  • Elderplan — Elderplan: $39.66
  • EmblemHealth — Select Care: $64.15

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY $5,652 $5,652 $604.68 – $10,176
Left heart catheterization (diagnostic): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $8,607
  • Aetna — Commercial High Performance Network: $6,792
  • Aetna — Commercial Product: $6,792
  • Aetna — Commercial Whole Health: $6,453
  • Aetna — Government Programs: $4,027.02
  • Beacon Health Strategies — Medicare: $4,027.02
  • Centerlight Healthcare — Centerlight Healthcare: $4,027.02
  • Centers Plan for Healthy Living — Medicare: $5,033.77
  • Centivo — Centivo: $7,604.08
  • Cigna — Managed Care Commercial: $10,176
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INSERTION OF CATHETERS FOR RECORDING AND PACING OF RIGHT HEART CHAMBERS RHYTHM $12,954 $12,954 $307.91 – $20,636.46
Heart rhythm study (electrophysiology evaluation): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $381
  • Aetna — Government Programs: $9,688.48
  • Beacon Health Strategies — Medicare: $9,688.48
  • Centerlight Healthcare — Centerlight Healthcare: $9,688.48
  • Centers Plan for Healthy Living — Medicare: $12,110.60
  • Elderplan — Elderplan: $9,882.25
  • EmblemHealth — Select Care: $15,985.99
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $7,504
  • Empire — Indemnity: $7,504
  • Empire — Medicare: $9,688.48
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB $54,930 $54,930 $1,224 – $53,571.54
Heart rhythm study with ablation for atrial fibrillation: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $1,224
  • Aetna — Government Programs: $32,467.60
  • Beacon Health Strategies — Medicare: $32,467.60
  • Centerlight Healthcare — Centerlight Healthcare: $32,467.60
  • Centers Plan for Healthy Living — Medicare: $40,584.50
  • Cigna — Managed Care Commercial: $10,176
  • Elderplan — Elderplan: $33,116.95
  • EmblemHealth — Select Care: $53,571.54
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $7,504
  • Empire — Indemnity: $7,504
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) $1,814 $1,814 $245 – $2,775.80
Sleep study (overnight, in a sleep lab): 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $772
  • Aetna — Commercial High Performance Network: $2,552
  • Aetna — Commercial Product: $2,552
  • Aetna — Commercial Whole Health: $2,425
  • Aetna — Government Programs: $1,066.70
  • Beacon Health Strategies — Medicare: $1,066.70
  • Centerlight Healthcare — Centerlight Healthcare: $1,066.70
  • Centers Plan for Healthy Living — Medicare: $1,333.38
  • Elderplan — Elderplan: $1,088.03
  • EmblemHealth — Select Care: $1,760.06
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52_TC In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) $1,814 $1,814 $272 – $2,775.80
Sleep study (overnight, in a sleep lab): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $772
  • Aetna — Commercial High Performance Network: $2,552
  • Aetna — Commercial Product: $2,552
  • Aetna — Commercial Whole Health: $2,425
  • Aetna — Government Programs: $533.35
  • Beacon Health Strategies — Medicare: $533.35
  • Centerlight Healthcare — Centerlight Healthcare: $533.35
  • Centers Plan for Healthy Living — Medicare: $666.69
  • Elderplan — Elderplan: $544.02
  • EmblemHealth — Select Care: $880.03
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) $1,814 $1,814 $272 – $2,775.80
Sleep study (overnight, in a sleep lab): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $772
  • Aetna — Commercial High Performance Network: $2,552
  • Aetna — Commercial Product: $2,552
  • Aetna — Commercial Whole Health: $2,425
  • Aetna — Government Programs: $1,066.70
  • Beacon Health Strategies — Medicare: $1,066.70
  • Centerlight Healthcare — Centerlight Healthcare: $1,066.70
  • Centers Plan for Healthy Living — Medicare: $1,333.38
  • Elderplan — Elderplan: $1,088.03
  • EmblemHealth — Select Care: $1,760.06

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES $71 $71 $27 – $1,912
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $50
  • Aetna — Government Programs: $32.66
  • Beacon Health Strategies — Medicare: $32.66
  • Centerlight Healthcare — Centerlight Healthcare: $32.66
  • Centers Plan for Healthy Living — Medicare: $40.82
  • Cigna — Managed Care Commercial: $264
  • Elderplan — Elderplan: $33.31
  • EmblemHealth — Select Care: $53.89
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $74.14
  • Empire — Indemnity: $74.14
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES $71 $71 $27.76 – $1,912
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 53 insurance plan rates
  • Aetna — Government Programs: $32.66
  • Beacon Health Strategies — Medicare: $32.66
  • Centerlight Healthcare — Centerlight Healthcare: $32.66
  • Centers Plan for Healthy Living — Medicare: $40.82
  • Cigna — Managed Care Commercial: $264
  • Elderplan — Elderplan: $33.31
  • EmblemHealth — Select Care: $53.89
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $74.14
  • Empire — Indemnity: $74.14
  • Empire — Medicare: $32.66
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO_XU In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES $71 $71 $27.76 – $1,912
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 53 insurance plan rates
  • Aetna — Government Programs: $32.66
  • Beacon Health Strategies — Medicare: $32.66
  • Centerlight Healthcare — Centerlight Healthcare: $32.66
  • Centers Plan for Healthy Living — Medicare: $40.82
  • Cigna — Managed Care Commercial: $264
  • Elderplan — Elderplan: $33.31
  • EmblemHealth — Select Care: $53.89
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $74.14
  • Empire — Indemnity: $74.14
  • Empire — Medicare: $32.66
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN $200 $200 $35 – $1,912
Physical therapy evaluation (low complexity): 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $93
  • Aetna — Government Programs: $109.69
  • Beacon Health Strategies — Medicare: $109.69
  • Centerlight Healthcare — Centerlight Healthcare: $109.69
  • Centers Plan for Healthy Living — Medicare: $137.11
  • Cigna — Managed Care Commercial: $264
  • Elderplan — Elderplan: $111.88
  • EmblemHealth — Select Care: $180.99
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $249
  • Empire — Indemnity: $249
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES $200 $200 $93.24 – $1,912
Physical therapy evaluation (low complexity): 10 of 53 insurance plan rates
  • Aetna — Government Programs: $109.69
  • Beacon Health Strategies — Medicare: $109.69
  • Centerlight Healthcare — Centerlight Healthcare: $109.69
  • Centers Plan for Healthy Living — Medicare: $137.11
  • Cigna — Managed Care Commercial: $264
  • Elderplan — Elderplan: $111.88
  • EmblemHealth — Select Care: $180.99
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $249
  • Empire — Indemnity: $249
  • Empire — Medicare: $109.69
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN $275 $275 $35 – $1,912
Physical therapy evaluation (moderate complexity): 10 of 54 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $93
  • Aetna — Government Programs: $109.69
  • Beacon Health Strategies — Medicare: $109.69
  • Centerlight Healthcare — Centerlight Healthcare: $109.69
  • Centers Plan for Healthy Living — Medicare: $137.11
  • Cigna — Managed Care Commercial: $264
  • Elderplan — Elderplan: $111.88
  • EmblemHealth — Select Care: $180.99
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $249
  • Empire — Indemnity: $249
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES $275 $275 $93.24 – $1,912
Physical therapy evaluation (moderate complexity): 10 of 53 insurance plan rates
  • Aetna — Government Programs: $109.69
  • Beacon Health Strategies — Medicare: $109.69
  • Centerlight Healthcare — Centerlight Healthcare: $109.69
  • Centers Plan for Healthy Living — Medicare: $137.11
  • Cigna — Managed Care Commercial: $264
  • Elderplan — Elderplan: $111.88
  • EmblemHealth — Select Care: $180.99
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $249
  • Empire — Indemnity: $249
  • Empire — Medicare: $109.69
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN $350 $350 $35 – $1,912
Physical therapy evaluation (high complexity): 10 of 53 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $93
  • Aetna — Government Programs: $109.69
  • Beacon Health Strategies — Medicare: $109.69
  • Centerlight Healthcare — Centerlight Healthcare: $109.69
  • Centers Plan for Healthy Living — Medicare: $137.11
  • Cigna — Managed Care Commercial: $264
  • Elderplan — Elderplan: $111.88
  • EmblemHealth — Select Care: $180.99
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $249
  • Empire — Indemnity: $249
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES $350 $350 $93.24 – $1,912
Physical therapy evaluation (high complexity): 10 of 53 insurance plan rates
  • Aetna — Government Programs: $109.69
  • Beacon Health Strategies — Medicare: $109.69
  • Centerlight Healthcare — Centerlight Healthcare: $109.69
  • Centers Plan for Healthy Living — Medicare: $137.11
  • Cigna — Managed Care Commercial: $264
  • Elderplan — Elderplan: $111.88
  • EmblemHealth — Select Care: $180.99
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $249
  • Empire — Indemnity: $249
  • Empire — Medicare: $109.69
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_KX In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES $350 $350 $93.24 – $1,912
Physical therapy evaluation (high complexity): 10 of 53 insurance plan rates
  • Aetna — Government Programs: $109.69
  • Beacon Health Strategies — Medicare: $109.69
  • Centerlight Healthcare — Centerlight Healthcare: $109.69
  • Centers Plan for Healthy Living — Medicare: $137.11
  • Cigna — Managed Care Commercial: $264
  • Elderplan — Elderplan: $111.88
  • EmblemHealth — Select Care: $180.99
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $249
  • Empire — Indemnity: $249
  • Empire — Medicare: $109.69
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY; 30 MINUTES $324 $324 $55 – $1,912
Psychotherapy, 30 minutes: 10 of 49 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $71
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES $2,120 $2,120 $55 – $1,912
Psychotherapy, 30 minutes: 10 of 49 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $71
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: PSYCHOTHERAPY; 30 MINUTES $324 $324 $84 – $1,912
Psychotherapy, 30 minutes: 10 of 48 insurance plan rates
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
  • Empire — Indemnity: $182
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY; 45 MINUTES $276 $276 $100 – $1,912
Psychotherapy, 45 minutes: 10 of 49 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $100
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES $1,200 $1,200 $100 – $1,912
Psychotherapy, 45 minutes: 10 of 49 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $100
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95_AG_XU In the file: PSYCHOTHERAPY; 45 MINUTES $276 $276 $150 – $1,912
Psychotherapy, 45 minutes: 10 of 45 insurance plan rates
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
  • Empire — Indemnity: $182
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY; 1 HOUR $324 $324 $104 – $1,912
Psychotherapy, 60 minutes: 10 of 49 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $127
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES $276 $276 $104 – $1,912
Psychotherapy, 60 minutes: 10 of 49 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $127
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYTX W/O PT 50 MIN $238 $238 $75 – $1,912
Family psychotherapy, without the patient: 10 of 49 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $75
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY WITHOUT PATIENT; 50 MINUTES $276 $276 $75 – $1,912
Family psychotherapy, without the patient: 10 of 49 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $75
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 93 In the file: FAMILY PSYCHOTHERAPY WITHOUT PATIENT; 50 MINUTES $276 $276 $90 – $1,912
Family psychotherapy, without the patient: 10 of 45 insurance plan rates
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
  • Empire — Indemnity: $182
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYTX W/PT 50 MIN $475 $475 $30 – $1,912
Family psychotherapy, with the patient: 10 of 50 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $75
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY WITH PATIENT; 50 MINUTES $276 $276 $30 – $1,912
Family psychotherapy, with the patient: 10 of 50 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $75
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: FAMILY PSYCHOTHERAPY WITH PATIENT; 50 MINUTES $276 $276 $95 – $1,912
Family psychotherapy, with the patient: 10 of 46 insurance plan rates
  • Aetna — Government Programs: $220.47
  • Beacon Health Strategies — Medicare: $220.47
  • Centerlight Healthcare — Centerlight Healthcare: $220.47
  • Centers Plan for Healthy Living — Medicare: $275.59
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $224.88
  • EmblemHealth — Select Care: $363.78
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $182
  • Empire — Indemnity: $182
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: GROUP PSYCHOTHERAPY $155 $155 $25 – $1,912
Group psychotherapy: 10 of 49 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $35
  • Aetna — Government Programs: $126.19
  • Beacon Health Strategies — Medicare: $126.19
  • Centerlight Healthcare — Centerlight Healthcare: $126.19
  • Centers Plan for Healthy Living — Medicare: $157.74
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $128.71
  • EmblemHealth — Select Care: $208.21
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $156
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier XU In the file: GROUP PSYCHOTHERAPY $155 $155 $107.26 – $1,912
Group psychotherapy: 10 of 45 insurance plan rates
  • Aetna — Government Programs: $126.19
  • Beacon Health Strategies — Medicare: $126.19
  • Centerlight Healthcare — Centerlight Healthcare: $126.19
  • Centers Plan for Healthy Living — Medicare: $157.74
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $128.71
  • EmblemHealth — Select Care: $208.21
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $156
  • Empire — Indemnity: $156
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: GROUP PSYCHOTHERAPY $155 $155 $107.26 – $1,912
Group psychotherapy: 10 of 45 insurance plan rates
  • Aetna — Government Programs: $126.19
  • Beacon Health Strategies — Medicare: $126.19
  • Centerlight Healthcare — Centerlight Healthcare: $126.19
  • Centers Plan for Healthy Living — Medicare: $157.74
  • Centivo — Centivo: $456.24
  • Create Health Plan — Flex/NYC/Long Island: $371
  • Elderplan — Elderplan: $128.71
  • EmblemHealth — Select Care: $208.21
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $156
  • Empire — Indemnity: $156

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $3,009 $3,009 $578 – $8,024.97
Removal of breast growth (open surgery): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $578
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $4,863.62
  • Beacon Health Strategies — Medicare: $4,863.62
  • Centerlight Healthcare — Centerlight Healthcare: $4,863.62
  • Centers Plan for Healthy Living — Medicare: $6,079.52
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $3,183 $3,183 $1,912 – $8,024.97
Removal of breast growth (open surgery): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $4,863.62
  • Beacon Health Strategies — Medicare: $4,863.62
  • Centerlight Healthcare — Centerlight Healthcare: $4,863.62
  • Centers Plan for Healthy Living — Medicare: $6,079.52
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $3,067 $3,067 $1,912 – $8,024.97
Removal of breast growth (open surgery): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $4,863.62
  • Beacon Health Strategies — Medicare: $4,863.62
  • Centerlight Healthcare — Centerlight Healthcare: $4,863.62
  • Centers Plan for Healthy Living — Medicare: $6,079.52
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $4,917 $4,917 $1,912 – $26,313.85
Total hip replacement: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $17,237
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $15,947.79
  • Beacon Health Strategies — Medicare: $15,947.79
  • Centerlight Healthcare — Centerlight Healthcare: $15,947.79
  • Centers Plan for Healthy Living — Medicare: $19,934.74
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $4,084.50 $4,084.50 $1,912 – $26,313.85
Total hip replacement: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $17,237
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $15,947.79
  • Beacon Health Strategies — Medicare: $15,947.79
  • Centerlight Healthcare — Centerlight Healthcare: $15,947.79
  • Centers Plan for Healthy Living — Medicare: $19,934.74
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE $7,404 $7,404 $1,912 – $45,801
Total knee replacement: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $45,801
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $15,947.79
  • Beacon Health Strategies — Medicare: $15,947.79
  • Centerlight Healthcare — Centerlight Healthcare: $15,947.79
  • Centers Plan for Healthy Living — Medicare: $19,934.74
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE $7,899 $7,899 $1,912 – $45,801
Total knee replacement: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $45,801
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $15,947.79
  • Beacon Health Strategies — Medicare: $15,947.79
  • Centerlight Healthcare — Centerlight Healthcare: $15,947.79
  • Centers Plan for Healthy Living — Medicare: $19,934.74
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $3,598 $3,598 $1,912 – $6,706.23
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $4,064.38
  • Beacon Health Strategies — Medicare: $4,064.38
  • Centerlight Healthcare — Centerlight Healthcare: $4,064.38
  • Centers Plan for Healthy Living — Medicare: $5,080.48
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $3,367 $3,367 $1,912 – $6,706.23
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $4,064.38
  • Beacon Health Strategies — Medicare: $4,064.38
  • Centerlight Healthcare — Centerlight Healthcare: $4,064.38
  • Centers Plan for Healthy Living — Medicare: $5,080.48
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) $3,862 $3,862 $363 – $12,133.14
Removal of tonsils and adenoids (under age 12): 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $363
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $7,353.42
  • Beacon Health Strategies — Medicare: $7,353.42
  • Centerlight Healthcare — Centerlight Healthcare: $7,353.42
  • Centers Plan for Healthy Living — Medicare: $9,191.78
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,500 $1,500 $147 – $5,159
Upper GI endoscopy (diagnostic): 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $147
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,126.63
  • Beacon Health Strategies — Medicare: $1,126.63
  • Centerlight Healthcare — Centerlight Healthcare: $1,126.63
  • Centers Plan for Healthy Living — Medicare: $1,408.29
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,500 $1,500 $174 – $5,159
Upper GI endoscopy with biopsy: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $174
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,126.63
  • Beacon Health Strategies — Medicare: $1,126.63
  • Centerlight Healthcare — Centerlight Healthcare: $1,126.63
  • Centers Plan for Healthy Living — Medicare: $1,408.29
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XS In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,500 $1,500 $957.64 – $5,159
Upper GI endoscopy with biopsy: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,126.63
  • Beacon Health Strategies — Medicare: $1,126.63
  • Centerlight Healthcare — Centerlight Healthcare: $1,126.63
  • Centers Plan for Healthy Living — Medicare: $1,408.29
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,545.50 $1,545.50 $957.64 – $5,159
Upper GI endoscopy with biopsy: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,126.63
  • Beacon Health Strategies — Medicare: $1,126.63
  • Centerlight Healthcare — Centerlight Healthcare: $1,126.63
  • Centers Plan for Healthy Living — Medicare: $1,408.29
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $3,000 $3,000 $232 – $5,159
Colonoscopy (diagnostic): 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $232
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,155.16
  • Beacon Health Strategies — Medicare: $1,155.16
  • Centerlight Healthcare — Centerlight Healthcare: $1,155.16
  • Centers Plan for Healthy Living — Medicare: $1,443.95
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $3,000 $3,000 $981.89 – $5,159
Colonoscopy (diagnostic): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,155.16
  • Beacon Health Strategies — Medicare: $1,155.16
  • Centerlight Healthcare — Centerlight Healthcare: $1,155.16
  • Centers Plan for Healthy Living — Medicare: $1,443.95
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_PT In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $3,000 $3,000 $981.89 – $5,159
Colonoscopy (diagnostic): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,155.16
  • Beacon Health Strategies — Medicare: $1,155.16
  • Centerlight Healthcare — Centerlight Healthcare: $1,155.16
  • Centers Plan for Healthy Living — Medicare: $1,443.95
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $3,000 $3,000 $274 – $5,159
Colonoscopy with biopsy: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $274
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,486.43
  • Beacon Health Strategies — Medicare: $1,486.43
  • Centerlight Healthcare — Centerlight Healthcare: $1,486.43
  • Centers Plan for Healthy Living — Medicare: $1,858.04
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT_XS In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $1,500 $1,500 $1,263.47 – $5,159
Colonoscopy with biopsy: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,486.43
  • Beacon Health Strategies — Medicare: $1,486.43
  • Centerlight Healthcare — Centerlight Healthcare: $1,486.43
  • Centers Plan for Healthy Living — Medicare: $1,858.04
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $1,545.50 $1,545.50 $1,263.47 – $5,159
Colonoscopy with biopsy: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,486.43
  • Beacon Health Strategies — Medicare: $1,486.43
  • Centerlight Healthcare — Centerlight Healthcare: $1,486.43
  • Centers Plan for Healthy Living — Medicare: $1,858.04
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $3,000 $3,000 $325 – $5,159
Colonoscopy with removal of polyps (snare): 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $325
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,486.43
  • Beacon Health Strategies — Medicare: $1,486.43
  • Centerlight Healthcare — Centerlight Healthcare: $1,486.43
  • Centers Plan for Healthy Living — Medicare: $1,858.04
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $3,000 $3,000 $1,263.47 – $5,159
Colonoscopy with removal of polyps (snare): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,486.43
  • Beacon Health Strategies — Medicare: $1,486.43
  • Centerlight Healthcare — Centerlight Healthcare: $1,486.43
  • Centers Plan for Healthy Living — Medicare: $1,858.04
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $3,000 $3,000 $1,263.47 – $5,159
Colonoscopy with removal of polyps (snare): 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $1,486.43
  • Beacon Health Strategies — Medicare: $1,486.43
  • Centerlight Healthcare — Centerlight Healthcare: $1,486.43
  • Centers Plan for Healthy Living — Medicare: $1,858.04
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE $5,644 $5,644 $719 – $12,390.76
Gallbladder removal by laparoscope: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $719
  • Aetna — Commercial High Performance Network: $5,528
  • Aetna — Commercial Product: $5,528
  • Aetna — Commercial Whole Health: $5,250
  • Aetna — Government Programs: $7,509.55
  • Beacon Health Strategies — Medicare: $7,509.55
  • Centerlight Healthcare — Centerlight Healthcare: $7,509.55
  • Centers Plan for Healthy Living — Medicare: $9,386.94
  • Centivo — Centivo: $6,434.22
  • Cigna — Managed Care Commercial: $4,250
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $6,337 $6,337 $1,912 – $7,338.31
Groin (inguinal) hernia repair, age 5 or older: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $4,447.46
  • Beacon Health Strategies — Medicare: $4,447.46
  • Centerlight Healthcare — Centerlight Healthcare: $4,447.46
  • Centers Plan for Healthy Living — Medicare: $5,559.32
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $4,488 $4,488 $1,912 – $7,338.31
Groin (inguinal) hernia repair, age 5 or older: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $4,447.46
  • Beacon Health Strategies — Medicare: $4,447.46
  • Centerlight Healthcare — Centerlight Healthcare: $4,447.46
  • Centers Plan for Healthy Living — Medicare: $5,559.32
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE GLAND $2,110 $2,110 $99 – $5,159
Prostate biopsy: 10 of 25 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $99
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
  • Create Health Plan — Flex/NYC/Long Island: $3,399
  • Empire — HMO/PPO/POS/EPO/CDHP/NYS/NYC: $3,535
  • Empire — Indemnity: $3,535
  • Empire Blue Priority — Small Group/Pathway/Blue: $3,005
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE $7,231 $7,231 $200 – $9,127.78
Hysteroscopy with biopsy of the uterus lining: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $1,678.25
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $4,021.05
  • Beacon Health Strategies — Medicare: $4,021.05
  • Centerlight Healthcare — Centerlight Healthcare: $4,021.05
  • Centers Plan for Healthy Living — Medicare: $200
  • Centivo — Centivo: $456.24
  • Cigna — Managed Care Commercial: $289
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE $1,301.50 $1,301.50 $1,912 – $6,634.73
Hysteroscopy with biopsy of the uterus lining: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $2,914
  • Aetna — Commercial Product: $2,914
  • Aetna — Commercial Whole Health: $2,769
  • Aetna — Government Programs: $4,021.05
  • Beacon Health Strategies — Medicare: $4,021.05
  • Centerlight Healthcare — Centerlight Healthcare: $4,021.05
  • Centers Plan for Healthy Living — Medicare: $5,026.31
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC $1,639 $1,639 $89.03 – $4,679.44
Spinal injection, lower back (epidural), with imaging guidance: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $288
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $876.82
  • Beacon Health Strategies — Medicare: $876.82
  • Centerlight Healthcare — Centerlight Healthcare: $876.82
  • Centers Plan for Healthy Living — Medicare: $1,096.03
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE $1,342 $1,342 $89.03 – $5,159
Spinal injection, lower back (epidural), with imaging guidance: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $288
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $876.82
  • Beacon Health Strategies — Medicare: $876.82
  • Centerlight Healthcare — Centerlight Healthcare: $876.82
  • Centers Plan for Healthy Living — Medicare: $1,096.03
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1 $2,108 $2,108 $105 – $4,679.44
Nerve root injection, lower back, with imaging guidance: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $110
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $1,098.66
  • Beacon Health Strategies — Medicare: $1,098.66
  • Centerlight Healthcare — Centerlight Healthcare: $1,098.66
  • Centers Plan for Healthy Living — Medicare: $1,373.33
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $1,782.50 $1,782.50 $460 – $5,159
Carpal tunnel release: 10 of 52 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $460
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $2,425.62
  • Beacon Health Strategies — Medicare: $2,425.62
  • Centerlight Healthcare — Centerlight Healthcare: $2,425.62
  • Centers Plan for Healthy Living — Medicare: $3,032.02
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $2,110 $2,110 $1,912 – $5,159
Carpal tunnel release: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $2,425.62
  • Beacon Health Strategies — Medicare: $2,425.62
  • Centerlight Healthcare — Centerlight Healthcare: $2,425.62
  • Centers Plan for Healthy Living — Medicare: $3,032.03
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $1,577 $1,577 $1,912 – $5,159
Carpal tunnel release: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $2,425.62
  • Beacon Health Strategies — Medicare: $2,425.62
  • Centerlight Healthcare — Centerlight Healthcare: $2,425.62
  • Centers Plan for Healthy Living — Medicare: $3,032.02
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS $2,719 $2,719 $1,912 – $5,159
Cataract removal with lens implant: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $2,866.70
  • Beacon Health Strategies — Medicare: $2,866.70
  • Centerlight Healthcare — Centerlight Healthcare: $2,866.70
  • Centers Plan for Healthy Living — Medicare: $3,583.38
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS $2,632 $2,632 $1,912 – $5,159
Cataract removal with lens implant: 10 of 51 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $4,001
  • Aetna — Commercial High Performance Network: $3,996
  • Aetna — Commercial Product: $3,996
  • Aetna — Commercial Whole Health: $3,797
  • Aetna — Government Programs: $2,866.70
  • Beacon Health Strategies — Medicare: $2,866.70
  • Centerlight Healthcare — Centerlight Healthcare: $2,866.70
  • Centers Plan for Healthy Living — Medicare: $3,583.38
  • Centivo — Centivo: $4,679.44
  • Cigna — Managed Care Commercial: $4,250

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $500 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $228,808.28
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 46 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $157,631.42
  • Aetna — Commercial High Performance Network: $175,350.84
  • Aetna — Commercial Product: $175,350.84
  • Aetna — Commercial Whole Health: $166,577.99
  • Aetna — Government Programs: $128,843
  • Beacon Health Strategies — Medicare: $128,843
  • Centerlight Healthcare — Centerlight Healthcare: $128,843
  • Centers Plan for Healthy Living — Medicare: $144,304.16
  • Centivo — Centivo: $180,646.68
  • Cigna — Managed Care Commercial: $171,586.91
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT COMORBITY Not listed in the file Not listed in the file $500 – $44,701.43
Hip or knee replacement (major joint of the leg), without major complications: 10 of 45 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $30,795.87
  • Aetna — Government Programs: $27,898.30
  • Beacon Health Strategies — Medicare: $27,898.30
  • Centerlight Healthcare — Centerlight Healthcare: $27,898.30
  • Centers Plan for Healthy Living — Medicare: $31,246.10
  • Centivo — Centivo: $35,292.28
  • Cigna — Managed Care Commercial: $33,522.30
  • Create Health Plan — Flex/NYC/Long Island: $44,701.43
  • Elderplan — Elderplan: $27,898.30
  • EmblemHealth — Select Care: $27,070.12
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT COMPLICATION/COMORBITY Not listed in the file Not listed in the file $500 – $56,126.32
Neck (cervical) spinal fusion, without complications: 10 of 46 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $38,666.74
  • Aetna — Commercial High Performance Network: $43,013.29
  • Aetna — Commercial Product: $43,013.29
  • Aetna — Commercial Whole Health: $40,861.32
  • Aetna — Government Programs: $34,484.08
  • Beacon Health Strategies — Medicare: $34,484.08
  • Centerlight Healthcare — Centerlight Healthcare: $34,484.08
  • Centers Plan for Healthy Living — Medicare: $38,622.17
  • Centivo — Centivo: $44,312.35
  • Cigna — Managed Care Commercial: $42,090
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY WITHOUT COMPLICATION/COMORBITY Not listed in the file Not listed in the file $500 – $28,418.78
Uterus and ovary surgery (not for cancer), without complications: 10 of 46 insurance plan rates
  • 1999 National Benefit Fund — 1999 National Benefit Fund: $19,578.37
  • Aetna — Commercial High Performance Network: $21,779.18
  • Aetna — Commercial Product: $21,779.18
  • Aetna — Commercial Whole Health: $20,689.56
  • Aetna — Government Programs: $19,052.99
  • Beacon Health Strategies — Medicare: $19,052.99
  • Centerlight Healthcare — Centerlight Healthcare: $19,052.99
  • Centers Plan for Healthy Living — Medicare: $21,339.35
  • Centivo — Centivo: $22,436.94
  • Cigna — Managed Care Commercial: $21,311.69

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

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

Hospital information

Hospital typeAcute Care Hospital
Address89th Avenue and Van Wyck Expressway, Jamaica, NY 11418
CountyQueens County
StateNew York
Phone(718) 262‑6000
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating1 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number330014
Name in Medicare recordsJAMAICA HOSPITAL MEDICAL CENTER
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(718) 206‑6000[4][5]
Official websitejamaicahospital.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Clinical services - Jamaica Hospital Medical Center — jamaicahospital.org
  2. General info - Jamaica Hospital Medical Center — jamaicahospital.org
  3. Trauma Center — jamaicahospital.org
  4. Traumatic Brain Injury Services - Jamaica Hospital Medical Center — jamaicahospital.org
  5. Emergency Hospital NYC | Jamaica Hospital Medical Center | Queens Emergency Room Department — jamaicahospital.org
  6. Neurosurgery NYC | Neurosurgery Hospital | Jamaica Hospital — jamaicahospital.org
  7. Orthopedics - Jamaica Hospital Medical Center — jamaicahospital.org
  8. Cardiology Queens NY | Jamaica Hospital Medical Center — jamaicahospital.org
  9. Pediatric Heart Clinic | Experience Advanced Heart Disease Care — jamaicahospital.org
  10. Pediatric Surgery - Jamaica Hospital Medical Center — jamaicahospital.org
  11. Hospital Queens, New York | Jamaica Hospital Medical Center — jamaicahospital.org
  12. Chronic Care Management | Seek Help with a Chronic Condition Now — jamaicahospital.org
  13. Queens Comprehensive Stroke Center - Jamaica Hospital Medical Center — jamaicahospital.org